Abstract
SummaryBlood transfusion is one of the most commonly relied upon therapies in sub‐Saharan Africa. Existing safeguards recommended include systematic screening for transfusion‐transmitted infections and restricted voluntary nonremunerated blood donor selection. We report the transfusion‐transmitted infection screening and notification practice at a large urban blood transfusion centre in Dar‐es‐Salaam, Tanzania. Between October 2016 and March 2017 anonymized records of all donors registered at the blood transfusion unit were accessed to retrospectively note demographic information, donor status, first‐time status, transfusion‐transmitted infection result and notification. 6402 consecutive donors were screened for transfusion‐transmitted infections; the majority were family/replacement blood donors (88.0%) and male (83.8%). Overall transfusion‐transmitted infections prevalence was 8.4% (95% CI 7.8‐9.1), with hepatitis B being the most prevalent infection (4.1% (95% CI 3.6‐4.6)). Transfusion‐transmitted infections were more common in family/replacement blood donors (9.0% (95% CI 8.3‐9.8)) as compared to voluntary nonremunerated blood donor (4.1% (95% CI 2.8‐5.7)). A minority of infected‐donors were notified of a positive result (8.5% (95% CI 6.3‐11.2)). Although transfusion‐transmitted infections are more prevalent among family/replacement blood donors, overall risk of transfusion‐transmitted infections across all groups is considerable. In addition, existing efforts to notify donors of a positive transfusion‐transmitted infection are poor. Future policies must focus on improving linkage to care for newly diagnosed patients with transfusion‐transmitted infections.
Highlights
Blood transfusion forms part of the backbone of basic medical care in sub-Saharan Africa (SSA), in particular, its use is crucial in limiting mortality associated with malaria and obstetric blood loss.[1]
The statistically significant difference in the prevalence of overall transfusion-transmitted infections (TTI) observed between family/replacement blood donors (FRD) and voluntary nonremunerated blood donors (VNRD) remained for each category of infection, except for hepatitis C virus (HCV), after adjusting for age and sex: hepatitis B virus (HBV)
Donors with HIV infection were most likely to be informed of a positive result (13.1%), while patients with HBV were least likely to be informed (5.7%) (Table 3)
Summary
Blood transfusion forms part of the backbone of basic medical care in sub-Saharan Africa (SSA), in particular, its use is crucial in limiting mortality associated with malaria and obstetric blood loss.[1]. Despite the well-documented demand for blood transfusion, there is a chronic shortage of supply in SSA. In 2013, the WHO estimated that of the 112.5 million blood donations globally, only 5.6 (5%) were donated in SSA. This translates to less than 4 units per 1000 people in SSA, compared to more than 35 units per 1000 people in Europe, languishing behind the WHO minimum target of 10 units per 1000 people.[3]. In addition to challenges to supply, minimizing the risk of transfusion-transmitted infections (TTIs ie HIV, hepatitis B (HBV) and hepatitis C (HCV) viruses and syphilis) is imperative. It is reported that more than 50% of WHO Africa region countries are dependent on replacement donors (commonly relatives or financially incentivized donors), who are considered to be higher risk of TTIs.[1]
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