The contribution of unsafe blood transfusion to human immunodeficiency virus incidence in sub‐Saharan Africa: reexamination of the 5% to 10% convention

Morar, Malika M.; Pitman, John; McFarland, Willi; Bloch, Evan M.

doi:10.1111/trf.13816

Cited by 13 publications

(11 citation statements)

References 52 publications

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“…Despite uncertainty in the exact rates of transmission, blood transfusion is still considered to be a contributing mode of viral transmission in parts of Africa. Proportion of new HIV infections might ranges from 5 to 10% [ 5 ]. Similarly, 12.5% of patients at risk of post transfusion hepatitis [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence and trends of transfusion transmitted infections at Harar blood bank in Harari regional state, Eastern Ethiopia: eight years retrospective study

2018

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BackgroundThe 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.MethodsA 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.ResultA 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.ConclusionsThe 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.

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Section: Introductionmentioning

confidence: 99%

Seroprevalence and trends of transfusion transmitted infections at Harar blood bank in Harari regional state, Eastern Ethiopia: eight years retrospective study

2018

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“…Historically, a statistic of 5% to 10% of new cases was cited, a claim for which a 2016 review found no primary support. 41 Instead, the findings suggested that only 1% of new HIV infections are attributable to transfusion-a figure complicated by a lack of published HIV prevalence data in blood donors and deficient posttransfusion surveillance. 41 Additionally, the rates of preseroconversion "window period infections" are not widely available yet, likely because new infections are given near exclusive reliance on antibody-based screening.…”

Section: Biological Testing and Pathogen Reduction Of Blood Productsmentioning

confidence: 99%

“…In some cases, outdated or unsubstantiated statistics have been used to support policy decisions. 41 The absence of accurate data weakens any economic foundation for policy change while transfusion recipients remain at unquantified risk. Region-specific research is needed, as was highlighted at a workshop in 2017 at the National Heart Lung and Blood Institute.…”

Section: 962mentioning

confidence: 99%

Blood transfusion safety in sub‐Saharan Africa: A literature review of changes and challenges in the 21st century

Weimer

Tagny

Tapko³

et al. 2018

Transfusion

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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.

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“…Nevertheless, the residual risks have almost certainly decreased substantially in the past two decades. The authors of a recent publication reviewing the United Nations Programme on HIV and AIDS (UNAIDS) modes of transmission reports, representing 15 countries, conclude that between 0 and 1Á1% of new HIV infections per year (median 0Á2% or approximately 2 out of 1000 new infections per year) may be attributable to blood transfusions [27]. Once again, while this is much lower than an 1988 estimate (albeit an estimate that was never data-based) of 5-10% of all new HIV infections, it remains at a level that would be unacceptable in HIC [28].…”

Section: Hiv Hepatitis B (Hbv) and Hepatitis C (Hcv)mentioning

confidence: 99%

Towards a safe and sufficient blood supply in Sub‐Saharan Africa

Kyeyune‐Byabazaire

Hume

2018

ISBT Science Series

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Most countries in Sub‐Saharan Africa (SSA) are either low‐income or low‐middle income countries, that is countries whose gross national income per capita is $995 (USD) or less or $996–3895, respectively. Added to this, they have very few health care professionals specifically trained in transfusion medicine and are the countries whose populations have a high prevalence of transfusion‐transmissible agents (especially HIV, hepatitis B and malaria) and whose patients (women haemorrhaging at birth, men in motor vehicle or motorcycle accidents, children with malaria or sickle cell anaemia) are often in urgent need of blood transfusion. This combination of few resources, both financial and human, combined with many potential donors at risk of transmitting infection and patients with urgent transfusion requirements renders the provision of a safe and adequate blood supply in SSA extremely challenging. In this review, we will discuss the current literature addressing how these challenges are being met and present one example of a SSA national blood transfusion service, the Uganda Blood Transfusion Service.

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The contribution of unsafe blood transfusion to human immunodeficiency virus incidence in sub‐Saharan Africa: reexamination of the 5% to 10% convention

Cited by 13 publications

References 52 publications

Seroprevalence and trends of transfusion transmitted infections at Harar blood bank in Harari regional state, Eastern Ethiopia: eight years retrospective study

Seroprevalence and trends of transfusion transmitted infections at Harar blood bank in Harari regional state, Eastern Ethiopia: eight years retrospective study

Blood transfusion safety in sub‐Saharan Africa: A literature review of changes and challenges in the 21st century

Towards a safe and sufficient blood supply in Sub‐Saharan Africa

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