1
|
Bloch EM. Blood Banking Capacity in Low-and Middle-Income Countries: Covid-19 Convalescent Plasma in Context. Curr Top Microbiol Immunol 2024. [PMID: 38772969 DOI: 10.1007/82_2024_266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024]
Abstract
Blood transfusion capacity in low- and middle-income countries (LMICs), encompassing both the safety and adequacy of the blood supply, is limited. The challenges facing blood banks in LMICs include regulatory oversight, blood donor selection, collection procedures, laboratory testing, and post-transfusion surveillance. A high proportion of LMICs are unable to fully meet clinical demands for blood products, and many do not meet even the minimum threshold of collection (10 units per 1000 population). Suboptimal clinical transfusion practices, in large part due to a lack of training in transfusion medicine, contribute to blood wastage. During the COVID-19 pandemic, high- and LMICs alike experienced blood shortages, in large part due to quarantine and containment measures that impeded donor mobility. COVID-19 convalescent plasma (CCP) was particularly appealing for the treatment of patients with COVID-19 in LMICs, as it is a relatively inexpensive intervention and makes use of the existing blood collection infrastructure. Nonetheless, the challenges of using CCP in LMICs need to be contextualized among broad concerns surrounding blood safety and availability. Specifically, reliance on first time, family replacement and paid donors, coupled with deficient infectious disease testing and quality oversight, increase the risk of transfusion transmitted infections from CCP in LMICs. Furthermore, many LMICs are unable to meet general transfusion needs; therefore, CCP collection also risked exacerbation of pervasive blood shortages.
Collapse
Affiliation(s)
- Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Transfusion Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Pathology, Johns Hopkins Bloomberg School of Public Health (Joint Appt. International Health), 600 N. Wolfe Street/Carnegie 446 D1, Baltimore, MD, 21287, USA.
| |
Collapse
|
2
|
Masenga SK, Mweene BC, Luwaya E, Muchaili L, Chona M, Kirabo A. HIV-Host Cell Interactions. Cells 2023; 12:1351. [PMID: 37408185 DOI: 10.3390/cells12101351] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 07/07/2023] Open
Abstract
The development of antiretroviral drugs (ARVs) was a great milestone in the management of HIV infection. ARVs suppress viral activity in the host cell, thus minimizing injury to the cells and prolonging life. However, an effective treatment has remained elusive for four decades due to the successful immune evasion mechanisms of the virus. A thorough understanding of the molecular interaction of HIV with the host cell is essential in the development of both preventive and curative therapies for HIV infection. This review highlights several inherent mechanisms of HIV that promote its survival and propagation, such as the targeting of CD4+ lymphocytes, the downregulation of MHC class I and II, antigenic variation and an envelope complex that minimizes antibody access, and how they collaboratively render the immune system unable to mount an effective response.
Collapse
Affiliation(s)
- Sepiso K Masenga
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia
- Vanderbilt University Medical Center, Department of Medicine, Division of Clinical Pharmacology, Room 536 Robinson Research Building, Nashville, TN 37232-6602, USA
| | - Bislom C Mweene
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia
| | - Emmanuel Luwaya
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia
| | - Lweendo Muchaili
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia
| | - Makondo Chona
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia
| | - Annet Kirabo
- Vanderbilt University Medical Center, Department of Medicine, Division of Clinical Pharmacology, Room 536 Robinson Research Building, Nashville, TN 37232-6602, USA
| |
Collapse
|
3
|
Mangala C, Fokam J, Maulot-Bangola D, Rebienot-Pellegrin O, Nkoa T. Genetic diversity of the human immunodeficiency virus of type 1 in Gabonese transfusional settings. BMC Infect Dis 2023; 23:191. [PMID: 36997860 PMCID: PMC10061732 DOI: 10.1186/s12879-023-08154-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 03/13/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND The high endemicity of transfusion-transmissible infections (TTIs) in sub-Saharan Africa is a real public health problem. To reduce the risk of HIV transmission through blood donation, the NBTC of Gabon has launched in recent years a reorganization of its blood transfusion system. This study aims to characterize the molecular strains of HIV-1 circulating in donors and to estimate the risk of viral transmission. MATERIALS AND METHODS A cross-sectional study was carried out during the period from August 2020 to August 2021 among 381 donors who had agreed to donate blood at the National Blood Transfusion Center (NBTC). Viral load was determined by Abbott Real-Time (Abbott m2000®, Abbott) and sequencing by the Sanger method (ABI 3500 Hitachi®). The phylogenetic tree was constructed by MEGA X software. Data were checked, entered, and analyzed using SPSS version 21.0 software, with p ≤ 0.05 considered statistically significant. RESULTS A total of 381 donors were enrolled in the study. Among the 359 seronegative donors, five (5) seronegative donors were detected positive for HIV-1 using Real-Time PCR. The residual risk was 648 per 1,000,000 donations. The prevalence of residual infection was 1.4% [0,01; 0,03]. Sixteen (16) samples were sequenced. The strains obtained were CRF02_AG (50%), subtype A1 (18.8%), subtype G (12.5%), CRF45_cpx (12.5%) and subtype F2 (6.2%). Six sequences clustered with A1, G, CRF02_AG, and CRF45_cpx subtypes. CONCLUSION The residual risk of HIV-1 transmission by blood transfusion remains a concern in the Gabonese transfusional settings. A policy based on improving the current screening strategy would involve the implementation of the nucleic acid test (NAT) in order to optimize the safety of the donation by detecting the HIV-1 subtypes in circulation in the donors.
Collapse
Affiliation(s)
- Christian Mangala
- Catholic University of Central Africa (CUCA), Yaoundé, Cameroon.
- National Public Health Laboratory (NPHL), Libreville, Gabon.
| | - Joseph Fokam
- Chantal Biya International Reference Center (CBIRC)), Yaoundé, Cameroon
| | - Denis Maulot-Bangola
- Catholic University of Central Africa (CUCA), Yaoundé, Cameroon
- National Public Health Laboratory (NPHL), Libreville, Gabon
| | | | - Thérèse Nkoa
- Catholic University of Central Africa (CUCA), Yaoundé, Cameroon
| |
Collapse
|
4
|
Aliyo A, Ashenafi G, Adem S. Evaluation of Transfusion Transmissible Infections Prevalence and
Trend Among Blood Donors Attended at Bule Hora Blood Bank, West Guji, South
Ethiopia. Health Serv Res Manag Epidemiol 2022; 9:23333928221136717. [PMID: 36337767 PMCID: PMC9634199 DOI: 10.1177/23333928221136717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Transfusion transmissible infections (TTIs) are among the greatest threats to
blood safety for recipients and the economy of the developed and developing
countries. Therefore, the study of the prevalence and trends of TTIs is
important to assess for its prevention and control strategies. Objectives This study aimed to evaluate the prevalence and trend of transfusion
transmissible infections among blood donors at the Bule Hora Blood Bank,
West Guji, Ethiopia, from 2019 to 2021. Method A retrospective study was conducted on all blood donors at the Bule Hora
Blood Bank from 2019-2021. The data of 4193 blood donors were collected from
the databank (logbook) of the blood bank using a checklist. Data were
analyzed by using SPSS software, and the chi-square test was used to assess
the association between independent variables and transfusion transmission
infection. Different types of graphs, charts and tables were used to present
the data. P values less than .05 were considered statistically
significant. Result The overall transfusion transmissible infection among blood donors was 4.6%
(192). Out of the tested blood donors, 86 (2.1%) were found to be
seropositive for hepatitis B virus. The trend analysis showed that the
positivity rates of the screened tests were 28 (4.72%) in 2019, decreased to
77 (4.26%) in 2020 and increased to 87 (4.86%) in 2021. The sex of blood
donors was significantly associated with TTIs (P
value = .021), and the positivity rates were significantly higher among male
than female blood donors. The study results showed that overall
seropositivity rates increased along the age groups of the donors. Conclusion The study reported a moderate prevalence of transfusion transmissible
infections among blood donors visiting the Bule hora blood bank. Health
education about the transmission, prevention and create awareness of TTIs
should be strengthened by the government and non-government
organization.
Collapse
Affiliation(s)
- Alqeer Aliyo
- Medical Laboratory Science Department, Institute of Health,
Bule Hora
University, Bule Hora, Ethiopia,Alqeer Aliyo, Medical Laboratory Science
Department, Institute of Health, Bule Hora University, Bule Hora, Ethiopia.
| | - Girma Ashenafi
- Medical Laboratory Science Department, Institute of Health,
Bule Hora
University, Bule Hora, Ethiopia
| | - Seid Adem
- Medical Laboratory Science Department, Institute of Health,
Bule Hora
University, Bule Hora, Ethiopia
| |
Collapse
|
5
|
Candotti D, Tagny-Tayou C, Laperche S. Challenges in transfusion-transmitted infection screening in Sub-Saharan Africa. Transfus Clin Biol 2021; 28:163-170. [PMID: 33515730 DOI: 10.1016/j.tracli.2021.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In Sub-Saharan Africa, high clinical demand for transfusion faces endemic bloodborne infections and limited resources. Blood screening for transfusion-transmitted bloodborne pathogens is the cornerstone of blood safety. Although there have been substantial improvements over the years, challenges in transfusion-transmitted infection screening that have been identified repeatedly long ago still need to be addressed. Affordability and sustainability of state-of-the-art quality assessed serological and molecular assays, and associated confirmation strategies remain of real concern. In addition, limited resources and infrastructures hamper the development of adequate facilities, quality management, and staff qualification, and exacerbate shortage of reagents and equipment maintenance. It is also important to maintain effort in constituting pools of repeat voluntary non-remunerated donors. Alternative strategies for blood screening that take into account local circumstances might be desirable but they should rely on appropriate field evaluation and careful economic assessment rather than dogma established from high-resource settings.
Collapse
Affiliation(s)
- D Candotti
- Département d'Études des Agents Transmissibles par le Sang, Institut National de la Transfusion Sanguine, Centre National de Référence Risques Infectieux Transfusionnels, 75015 Paris, France.
| | - C Tagny-Tayou
- Department of Hematology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, BP: 1364, Yaoundé, Cameroon
| | - S Laperche
- Département d'Études des Agents Transmissibles par le Sang, Institut National de la Transfusion Sanguine, Centre National de Référence Risques Infectieux Transfusionnels, 75015 Paris, France
| |
Collapse
|
6
|
Kebede E, Getnet G, Enyew G, Gebretsadik D. Transfusion Transmissible Infections Among Voluntary Blood Donors at Dessie Blood Bank, Northeast Ethiopia: Cross-Sectional Study. Infect Drug Resist 2020; 13:4569-4576. [PMID: 33376363 PMCID: PMC7762780 DOI: 10.2147/idr.s287224] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 11/26/2020] [Indexed: 01/19/2023] Open
Abstract
Background The prevalence of transfusion transmitted infections (TTIs) among blood donors varies across different geographical populations. Establishing the sero-prevalence of the disease among blood donors is important to informing the direction of preventive and control strategies. Objective The aim of this study was to determine the sero-prevalence of transfusion transmitted infections among voluntarily blood donors at Dessie Blood Bank, North East Ethiopia. Methods and Materials A cross-sectional study was conducted from November 10 to December 12, 2018. A total of 384 blood donors were conveniently included in this study. Socio-demographic data and other factors were collected using a pre-tested structured questionnaire. Five milliliters of venous blood was collected using a sterile test tube from each blood donor and the blood was allowed to clot; then, serum was separated by centrifugation for laboratory investigation. Serum samples from blood donors were tested by enzyme-linked immunosorbent assays (ELISA) for the presence of hepatits B surface antigen (HBsAg), and antibodies to human immunodeficiency virus (HIV-1/2), hepatits C virus (HCV), and Treponema pallidum. Logistic regression was used to explore risk factors associated with each transfusion transmissible infection. Results From a total of 384 blood donors, 24 (6.25%) of them had serological evidence for at least one infection. The overall sero-prevalence rates of HBV, HCV, HIV, and syphilis among blood donors were 4.2%, 0%, 0.26%, and 1.82%, respectively. Educational status was significantly associated with HBV infection. Multiple sexual behaviors had statistically significant association with syphilis. Conclusion In conclusion, 6.25% of blood donors still harbor transfusion transmissible infections despite recent blood donation safety improvements with the greater majority (4.2%) of cases caused by HBV infection.
Collapse
Affiliation(s)
- Edosa Kebede
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Gashaw Getnet
- Department of Medical Laboratory Science, Family Guidance Association of Ethiopia, Dessie Branch, Dessie, Ethiopia
| | - Getie Enyew
- Department of Medical Laboratory Science, Dr. Mehretie Children's Speciality Clinic, Gondar, Ethiopia
| | - Daniel Gebretsadik
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| |
Collapse
|
7
|
Kanagasabai U, Singh A, Shiraishi RW, Ly V, Hy C, Sanith S, Srun S, Sansam S, SopHeap ST, Liu Y, Jones G, Ijeoma UC, Bock N, Benech I, Selenic D, Drammah B, Gadde R, Mili FD. Improving injection safety practices of Cambodian healthcare workers through training. PLoS One 2020; 15:e0241176. [PMID: 33126238 PMCID: PMC7599083 DOI: 10.1371/journal.pone.0241176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/12/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND This study evaluated the impact of a safe injection safety training on healthcare worker (HCW) practice and knowledge following an HIV outbreak in Roka commune, Cambodia. METHODS Surveys were conducted at baseline (September 2016) and seven months after a training intervention (March 2018) using the World Health Organization standardized injection practices assessment tool. HCWs were sampled at 15 purposively government health facilities in two provinces. HCWs were observed during injection practices and interviewed by trained experts from Becton-Dickinson and the Ministry of Health Cambodia. The Rao-Scott chi square test was used test for differences between baseline and follow-up. RESULTS We completed 115 observations of practice at baseline and 206 at post-training follow-up. The proportion of patients whose identification was confirmed by HCWs prior to procedure being performed increased from 40.4% to 98% (p <0.0001). The proportion of HCWs who practiced correct hand hygiene increased from 22.0% to 80.6% (p = 0.056) [therapeutic observations] and 17.2% to 63.4% (p = 0.0012) [diagnostic observations]. Immediate disposal of sharps by HCWs decreased from 96.5% to 92.5% (p = 0.0030). CONCLUSIONS We found significant improvements in the practice of patient identity confirmation and hand hygiene but not in the immediate disposal of sharps in the post-training intervention. However, findings are not representative of all HCWs in the country. Further pre-service and in-service training and monitoring are necessary to ensure sustained behavior change.
Collapse
Affiliation(s)
| | - Adarshpal Singh
- Becton, Dickinson and Company, Franklifn Lakes, NJ, United States of America
| | - Ray W. Shiraishi
- Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, United States of America
| | - Vanthy Ly
- U.S. Centers for Disease Control and Prevention, Cambodia
| | - Chhaily Hy
- U.S. Centers for Disease Control and Prevention, Cambodia
| | - Sou Sanith
- Ministry of Health, Phnom Pehn, Cambodia
| | - Sok Srun
- Ministry of Health, Phnom Pehn, Cambodia
| | - Sim Sansam
- Ministry of Health, Phnom Pehn, Cambodia
| | | | - Yuliang Liu
- Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, United States of America
| | - Gerald Jones
- Division of Health Informatics and Surveillance, Epidemiology and Laboratory Services, CDC, Atlanta, GA, United States of America
| | - Ugonna C. Ijeoma
- Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, United States of America
| | - Naomi Bock
- Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, United States of America
| | - Irene Benech
- Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, United States of America
| | - Dejana Selenic
- Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, United States of America
| | - Bakary Drammah
- Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, United States of America
| | - Renuka Gadde
- Becton, Dickinson and Company, Franklifn Lakes, NJ, United States of America
| | - Fatima D. Mili
- Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, United States of America
| |
Collapse
|
8
|
Abdella S, Moshago Berheto T, Tolera G, Belete W, Deressa T, Feleke A, H/silassie A, Gezahegn N, Tadesse D, Tefera M, Dillnessa E, Kinfu A, Abate E, Kifle T. Sero-prevalence of transfusion transmittable infections: HIV, Hepatitis B, C and Treponema pallidum and associated factors among blood donors in Ethiopia: A retrospective study. PLoS One 2020; 15:e0241086. [PMID: 33119668 PMCID: PMC7595291 DOI: 10.1371/journal.pone.0241086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/08/2020] [Indexed: 12/15/2022] Open
Abstract
Background Blood transfusion is a therapeutic procedure that has proven to be effective in saving millions of lives. However, its safety is still a crucial issue that needs due attention. Unsafe blood transfusion is one of the sources of transmission for infectious agents. Therefore, the objective of this study was to assess the sero-prevalence of Transfusion Transmittable Infections (TTIs) such as Human immunodeficiency virus (HIV), Hepatitis B Virus (HBV), Hepatitis C virus (HCV), Treponema pallidum, and associated factors among blood donors in Ethiopia. Methods A retrospective cross-sectional study design was used to measure the prevalence of transfusion transmittable infections using data collected from 2014 to 2019 in fourteen blood bank facilities in Ethiopia. Screening of HIV, HBV and HCV was done by using the Enzyme-Linked Immunosorbent Assay (ELISA). Presence of Treponema pallidum infection was assessed using rapid plasma reagin (RPR). Records of blood donors were collected using a checklist from Central Blood Bank Laboratory (BBL) electronic database and reviewed. Data was entered, cleaned and analyzed using SPSS version 23. Logistic regression was fitted to identify factors associated with cumulative TTIs positivity, and for each of the transfusion transmittable infection. P value < 0.05 was considered statistically significant. Result A total of 554,954 blood donors in the fourteen blood bank facilities from 2014–2019 was included in the study. The overall sero-prevalence of HBV, Treponema pallidum, HIV and HCV, was 2.4%, 0.9%, 0.4% and 0.4% respectively. The prevalence of TTIs was comparatively higher in 2014, 5.70% and lowest in 2019, 3.40%. The odds of screening HBV in blood donors in age group of 35–39 and 40–44 were 1.2 [1.1, 1.3] and 1.3 [1.1, 1.5] respectively. The odds of screening HCV in blood donors in the age group of 25–34, 35–44 and 45–54 were 1.3 [1.1, 1.5], 1.3 [1.1, 1.7] and 1.7 [1.2, 2.2] respectively. The likelihood of having at least one infection among blood donors was 1.2 [1.1, 1.3] times in male blood donors compared to female. The odds of getting at least one TTI and Treponema pallidum in unemployed blood donors were 2.4 [2.0, 2.8] and 8.1 [6.1, 10.7] respectively. The probability of getting those who have at least one TTIs, HBV and Treponema pallidum were higher in blood donors those who live in Semi Urban and Rural parts of the country than those who live in Urban areas. The odds of having at least one TTI, HBV and HCV in blood donors with mobile mode of blood donation were 1.4 [1.3, 1.6], 1.6 [1.4, 1.8], and 1.6 [1.1, 2.2]. Conclusion The current magnitudes of TTIs are lower when compared to other previous studies conducted in Ethiopia. Older age, male, occupation, donations from mobile sites, residents of semi urban and rural settings were found to be strongly associated with sero-positivity of TTIs. Hence, strict donor screening and testing particularly taking the above factors into consideration is strongly recommended.
Collapse
Affiliation(s)
- Saro Abdella
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | | | - Altaye Feleke
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Demewoz Tadesse
- Ethiopian National Blood Bank Service, Addis Ababa, Ethiopia
| | - Mengistu Tefera
- Ethiopian National Blood Bank Service, Addis Ababa, Ethiopia
| | | | - Abiy Kinfu
- Ethiopian National Blood Bank Service, Addis Ababa, Ethiopia
| | - Ebba Abate
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | |
Collapse
|
9
|
Weimer A, Tagny CT, Tapko JB, Gouws C, Tobian AAR, Ness PM, Bloch EM. Blood transfusion safety in sub-Saharan Africa: A literature review of changes and challenges in the 21st century. Transfusion 2018; 59:412-427. [PMID: 30615810 DOI: 10.1111/trf.14949] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/20/2018] [Accepted: 08/20/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Access to a safe, adequate blood supply has proven challenging in sub-Saharan Africa, where systemic deficiencies spanning policy, collections, testing, and posttransfusion surveillance have long been recognized. Progress in transfusion safety in the early 2000s was in large part due to intervention by the World Health Organization and other foreign governmental bodies, coupled with an influx of external funding. STUDY DESIGN AND METHODS A review of the literature was conducted to identify articles pertaining to blood safety in sub-Saharan Africa from January 2009 to March 2018. The search was directed toward addressing the major elements of the blood safety chain, in the countries comprising the World Health Organization African region. Of 1380 articles, 531 met inclusion criteria and 136 articles were reviewed. RESULTS External support has been associated with increased recruitment of voluntary donors and expanded testing for the major transfusion-transmitted infections (TTIs). However, the rates of TTIs among donors remain high. Regional education and training initiatives have been implemented, and a tiered accreditation process has been adopted. However, a general decline in funding for transfusion safety (2009 onwards) has strained the ability to maintain or improve transfusion-related services. Critical areas of need include data collection and dissemination, epidemiological surveillance for TTIs, donor recruitment, quality assurance and oversight (notably laboratory testing), and hemovigilance. CONCLUSION Diminishing external support has been challenging for regional transfusion services. Critical areas of deficiency in regional blood transfusion safety remain. Nonetheless, substantive gains in education, training, and accreditation suggest durable gains in regional capacity.
Collapse
Affiliation(s)
- A Weimer
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
| | - C T Tagny
- Hematology and Blood Transfusion service, University Teaching Hospital, Yaoundé, Cameroon
| | - J B Tapko
- African Society of Blood Transfusion, Yaoundé, Cameroon
| | - C Gouws
- Blood Transfusion Service of Namibia, Windhoek, Namibia
| | - A A R Tobian
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
| | - P M Ness
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
| | - E M Bloch
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
| |
Collapse
|
10
|
Teklemariam Z, Mitiku H, Weldegebreal F. Seroprevalence and trends of transfusion transmitted infections at Harar blood bank in Harari regional state, Eastern Ethiopia: eight years retrospective study. BMC HEMATOLOGY 2018; 18:24. [PMID: 30237893 PMCID: PMC6139147 DOI: 10.1186/s12878-018-0115-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 08/15/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND The use of unscreened blood exposes the patient to many transfusion transmitted infections including Hepatitis B Virus (HBV), Hepatitis C virus (HCV), Human Immunodeficiency Virus (HIV), and syphilis, among others. Thus, blood transfusion demands for meticulous pre-transfusion testing and screening. Trends of transfusion transmitted infections are important to take appropriate measures on blood bank services. Therefore the aim of this study was to assess seroprevalence and trends of transfusion transmitted infections at Harar blood bank in Harari regional state, Eastern Ethiopia from 2008 to 2015. METHODS A retrospective cross-sectional study was employed to review blood donors' history and laboratory tests records from November 16-December 31, 2017. All records of blood donors having vividly documented history and laboratory tests were reviewed by data collectors. All data were entered into EPI data version 3.1. It was exported and analyzed with Statistical Package for the Social Sciences version 16 soft ware. RESULT A total of 11, 382 blood donors' history and laboratory tests records were reviewed. Majority of them were males (82.6%), 57.6 % were in the age group of 17 to 25 years and 99.9% donors donated blood for the first time. The overall seroprevalence of transfusion transmitted infections (HBV, HIV, HCV and syphilis combined) was found to be 6.6%. The prevalence of HBV, HIV, HCV and syphilis were found to be 4.4%, 0.6%, 0.8% and 1.1%, respectively. The trend in prevalence of syphilis and HCV was statistical significant by year (p< 0.05). Those donors in the age group of 26-35 years (AOR: 2.1; 95% CI: 1.2,3.6), 36-45 years (AOR: 4.1; 95% CI: 2.4,7.1) and greater than 46 years (AOR:4.6; 95% CI: 2.3,9.1) were more likely to be infected with syphilis compared to the age group of 17-25 years. Male were more likely to be infected with HBV (AOR: 1.9; 95% CI: 1.4, 2.5) than females. CONCLUSIONS The magnitude of transfusion transmitted infections was lower than the previous studies conducted in Ethiopia. However, the decline in trends of transfusion transmitted infections has not been significant for some pathogens. Therefore, strict adherence with the criteria of preliminary blood donor selection should be implemented to reduce the amount of blood being withdrawn from transfusion after collection and screening.
Collapse
Affiliation(s)
- Zelalem Teklemariam
- College of Health and Medical Sciences, Department of Medical Laboratory Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| | - Habtamu Mitiku
- College of Health and Medical Sciences, Department of Medical Laboratory Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| | - Fitsum Weldegebreal
- College of Health and Medical Sciences, Department of Medical Laboratory Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| |
Collapse
|
11
|
Lee SS, Cheung EKH, Leung JNS, Lee CK. Non-compliance to infectious disease deferral criteria among Hong Kong's blood donors. Vox Sang 2017; 112:425-433. [PMID: 28401619 DOI: 10.1111/vox.12520] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/20/2017] [Accepted: 03/07/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Donor screening alone cannot eliminate the risk of transfusion-transmitted HIV infection. Donor deferral according to established criteria is a supplemental strategy, which has focused largely on men who have sex with men (MSM). A study was conducted to determine the compliance of non-MSM donors with such criteria and examine its implications on blood safety. MATERIALS AND METHODS Chinese donors who have just donated blood at blood donor centres in Hong Kong were recruited. Based on the contents of the routinely administered predonation Health Screening Questionnaires, participants were requested to complete a survey to assess their practice of deferrable risk behaviours and lifestyle encounters, using tablet computers. RESULTS Over an 8-week period in mid-2016, 1614 donors (male-to-female ratio 1·23) had enrolled in the survey, accounting for 40% of donors giving blood on the survey days. The proportion of respondents who gave blood despite having deferrable HIV risk was 5%: MSM 1·2% (of the male donors); non-MSM risk behaviours 2·6%; risky lifestyle encounters 2·1%. If inconsistent declaration and suspected risk behaviours were included, the total non-compliance rate became 10·8%. Male donors had a higher prevalence of deferrable behavioural risk, even after excluding MSM. Unawareness and non-acceptability were main reasons for non-compliance. CONCLUSION The non-compliance rate of donors to deferral was high, although the ultimate infection risk might be small in the presence of universal screening. Simplification of questionnaires, focus on time-limited deferral and a reduction of deferral items may improve the deferral mechanism without compromising blood safety.
Collapse
Affiliation(s)
- S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - E K H Cheung
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J N S Leung
- Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong
| |
Collapse
|