Pre-donation screening of blood for transfusion transmissible infections: The gains and the pains - experience at a resource limited blood bank

Abstract

SUMMARYObjective: To determine whether or not pre-donation testing of blood donors affords substantial cost savings without compromise to blood transfusion safety. Predonation testing of blood donors for Transfusion Transmissible Infections (TTIs) is done in most developing countries because substantial cost savings are made from resources, materials and man-hours which would have been spent to procure infected blood units. Simple rapid test kits used in pre-donation testing is not as sensitive as the Enzyme Linked Immuno-sorbent Assay (ELISA) method used in post-donation screening in a quality assured manner. Design: It is a retrospective study where records of pre-and post-donation tests done in donor clinic of University of Ilorin Teaching Hospital, between January and December 2010 were retrieved. All processes and inputs were evaluated and costs calculated for predonation testing by simple rapid techniques and post donation screening by ELISA. Results: 5000 prospective donors were tested in the study period. The cost of single rapid Pre-donation testing was less than that of single ELISA Postdonation screen. The cost of double rapid Pre-donation and Post donation ELISA screen exceeded the cost of single post donation ELISA screen. Substantial cost savings were made when single rapid Pre-donation testing is relied on. More blood units were found reactive for the TTIs with the more expensive Postdonation ELISA. Conclusion: Pre-donation testing of blood donors was not cost effective. Although, there is an apparent savings if pre-donation testing is not followed by postdonation ELISA testing, it is done at a compromise to blood transfusion safety.

A Seven Year Review of the Seroprevalence of Transfusion Transmitted Infections in a Hospital Based Blood Bank in Ibadan, Nigeria

“…The blood donor HIV rate of 1.3% in 2010 was also less than 4.1% of the general population [25]. These rates are within the estimated values ranging between 1.0 % and 6 % reported from other regions of the country for blood donors [4,5,[9][10]. Marked differences in the prevalence among regions in Nigeria is due to cultural differences, varying level of education, religion, differing socio-economic structure.…”

“…A prevalence of 0.8 to 6.0% has been reported among blood donors in Nigeria [4,5,8,9]. A prevalence of 4.4% was reported from a neighbouring country, Ghana and 1.8% for Libya and 0.11% for California, USA [20,35,36].…”

“…The similar total TTI rate but different predonation and post donation test results obtained in 2010 and 2014 underscores the importance of test methods in determining infection rates. Higher prevalence rate was obtained in a study from Ilorin, Nigeria using the predonation tests [9]. The sensitivity of rapid screening test has been reported to be suboptimal therefore the need for second ELISA screening for all donated blood units to improve blood safety [15][16].…”

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

“…31,32 Cited costs of HIV, hepatitis B surface antigen, and HCV enzyme-linked immunosorbent assay are $5.7 $3.6, and $3.6/unit respectively; in contrast, corresponding RDTs cost $0.62, $0.50, and $0.40/unit. 33 The cited costs do not factor in the purchasing power parity; that is, $5.7 in Nigeria is the equivalent of $97.38 in the United States. 34 Namibia introduced NAT in 2004, contracting the South African Nation Blood Service for a fee.…”

Correlation of razor hygiene with HIV disease transmission risk in barber shop

“…For example, transmission through blood transfusion despite the high odds, but in fact such cases are very rare, because of transmission through blood transfusion can be controlled through the process of screening blood donors beforehand calor (John, 2011). If found blood containing the HIV virus during the screening process, then the blood will not be used for blood transfusions (Chaurasia et al, 2014;Shitu et al, 2014). Instead, transmission through the razor is still a serious concern for everyone.…”