Sudan is a highly endemic area for hepatitis B virus (HBV),Hepatitis B virus (HBV) infection remains a major health problem causing considerable morbidity and mortality despite the availability of vaccine and antiviral treatments. The World Health Organization (WHO) estimates that more than onethird of the world population is or has been in contact with the virus, resulting in Ͼ350 million HBV chronic carriers worldwide, with Ͼ18% of them living in Africa. Sudan is classified among the African countries with high HBV endemicity. The reported prevalence of HBV chronic infection, characterized by the detectable level of HBV surface antigen (HBsAg), varied from region to region and ranged between 5 and 7% in the general population (1,13,28,31) and 26% in hospital outpatients (25). The prevalence of adults having been in contact with HBV and identified by the presence of anti-core antibodies (anti-HBc) was high, ranging between 47.5 and 67% (25,28).
Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.
In April 2017, a workshop sponsored by the National Heart, Lung, and Blood Institute, Division of Blood Diseases and Resources, and the Center for Translation Research and Implementation Science was held to discuss blood availability and transfusion safety in low- and middle-income countries (LMICs). The purpose of the workshop was to identify research opportunities for implementation science (IS) to improve the availability of safe blood and blood components and transfusion practices in LMICs. IS describes the late stages of the translational research spectrum and studies optimal and sustainable strategies to deliver proven-effective interventions. Regional working groups were formed to focus on opportunities and challenges in East Africa, Central/West Africa, Middle East and North Africa, Latin America and the Caribbean, Southeast Asia, Western Pacific Asia, Eastern Europe, and Central Asia. The need for an "adequate supply of safe blood" emerged as the major overriding theme. Among the regional working groups, common cross-cutting themes were evident. The majority of research questions, priorities, and strategies fell into the categories of blood availability, blood transfusion safety, appropriate use of blood, quality systems, health economics and budgeting, and training and education in IS. The workshop also brought into focus inadequate country-level data that can be used as the basis for IS initiatives. A mixed approach of needs assessment and targeted interventions with sufficient evidence base to move toward sustainment is an appropriate next step for blood availability and transfusion safety research in LMICs.
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