Characteristics of blood donors and donated blood in sub-Saharan Francophone Africa.
ABSTRACT The importance of blood safety in public health was recognized long ago, and data are essential to plan strategies to improve the status. This study aims to obtain data on blood donor and blood donation characteristics that would complement blood safety data from national and international organizations.
A questionnaire was sent to seven Francophone countries (Burkina Faso, Cameroon, Congo, Ivory Coast, Mali, Niger, and Rwanda) and was structured to obtain objective data on blood donors and donated blood and in administrative and technical organization.
The results reflect a poor level of organization of blood transfusion centers in large regions of the African continent, insufficient supply of blood products, high prevalence of transfusion-transmitted infections, limited financial resources, a lack of well-trained personnel, and cultural obstacles. Six countries had less than 50% of their personnel trained in transfusion medicine. Only one country had the entire standard operating procedure written. Female donors represented less than 30% of the donors and the range of percentage of hepatitis B found in donors was 2.76% to 18.96%.
The inclusion of these regions in future blood safety surveys and in the development of national blood transfusion programs is essential and will undoubtedly require the assistance of international organizations.
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ABSTRACT: Infectious risk associated with blood transfusion remains a major public health challenge in Africa, where prevalence rates of the major transfusion transmissible infections [i.e. Hepatitis B, Hepatitis C, HIV and Syphilis] are amongst the highest in the world. Resource-limited blood services often operate with minimal pre-donation screening safeguards, prompting exclusive reliance on laboratory testing to mitigate infectious risk. Transfusion screening with rapid diagnostic tests (RDTs) has been adopted in areas that lack the capacity to support the routine use of more sophisticated technologies. However, uncertainty surrounding the performance of some RDTs in the field has spurred debate regarding their application to blood donation screening. Our review of the literature identified 17 studies that evaluated RDTs for the infectious screening of blood donors in Africa. The review highlights the variable performance of available RDTs and the importance of their use in a quality assured manner. Deficiencies in performance observed with some RDTs underscore the need to validate test kits prior to use under field conditions with locally acquired samples. Suboptimal sensitivities of some available tests, specifically HBV rapid assays, question their suitability in single-test algorithms, particularly in high prevalence regions. Although RDTs have limitations, many of which can be addressed through improved training and quality systems, they are frequently the only viable option for infectious screening in resource poor African countries. Therefore, additional studies and specific guidelines regarding the use of RDTs in the context of blood safety are needed.Transfusion Medicine Reviews 09/2014; 29(1). DOI:10.1016/j.tmrv.2014.09.003 · 4.54 Impact Factor
- Journal of the American Medical Directors Association 03/2011; 12(3). DOI:10.1016/j.jamda.2010.12.057 · 4.78 Impact Factor
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ABSTRACT: Unsafe reuse of injection equipment in hospitals is an on-going threat to patient safety in many parts of Africa. The extent of this problem is difficult to measure. Standard WHO injection safety assessment protocols used in the 2003 national injection safety assessment in Cameroon are problematic because health workers often behave differently under the observation of visitors. The main objective of this study is to assess the extent of unsafe injection equipment reuse and potential for blood-borne virus transmission in Cameroon. This can be done by probing for misconceptions about injection safety that explain reuse without sterilization. These misconceptions concern useless precautions against cross-contamination, i.e. "indirect reuse" of injection equipment. To investigate whether a shortage of supply explains unsafe reuse, we compared our survey data against records of purchases. All health workers at public hospitals in two health districts in the Northwest Province of Cameroon were interviewed about their own injection practices. Injection equipment supply purchase records documented for January to December 2009 were compared with self-reported rates of syringe reuse. The number of HIV, HBV and HCV infections that result from unsafe medical injections in these health districts is estimated from the frequency of unsafe reuse, the number of injections performed, the probability that reused injection equipment had just been used on an infected patient, the size of the susceptible population, and the transmission efficiency of each virus in an injection. Injection equipment reuse occurs commonly in the Northwest Province of Cameroon, practiced by 44% of health workers at public hospitals. Self-reported rates of syringe reuse only partly explained by records on injection equipment supplied to these hospitals, showing a shortage of syringes where syringes are reused. Injection safety interventions could prevent an estimated 14-336 HIV infections, 248-661 HBV infections and 7-114 HCV infections each year in these health districts. Injection safety assessments that probe for indirect reuse may be more effective than observational assessments. The autodisable syringe may be an appropriate solution to injection safety problems in some hospitals in Cameroon. Advocacy for injection safety interventions should be a public health priority.Harm Reduction Journal 02/2011; 8(1):4. DOI:10.1186/1477-7517-8-4 · 1.26 Impact Factor