A new strategy to improve the cost‐effectiveness of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis testing of blood donations in sub‐Saharan Africa: a pilot study in Burkina Faso

Kania, Dramane; Sangaré, Lassana; Sakandé, Jean; Koanda, Abdoulaye; Nébié, Yacouba; Zerbo, Oumarou; Combasséré, A W; Guissou, Innocent Pierre; Raffi, François

doi:10.1111/j.1537-2995.2009.02276.x

Cited by 20 publications

(18 citation statements)

References 19 publications

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“…In the blood bank of Tete, only the cost of the rapid HCV screening tests represents an additional amount of at least 7,000 USD annually, for a few prevented infections. Although innovative testing strategies could be explored in Tete [27], it is likely that HCV screening could become really cost-effective only if the prices of available rapid tests were drastically reduced.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of transfusion-transmissible infections and evaluation of the pre-donation screening performance at the Provincial Hospital of Tete, Mozambique

et al. 2011

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BackgroundThe World Health Organization recommends universal and quality-controlled screening of blood donations for the major transfusion-transmissible infections (TTIs): human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis. The study objectives were to determine the seroprevalence of these TTIs among blood donors at the Provincial Hospital of Tete, Mozambique, and to assess the local pre-donation screening performance.MethodsAll consenting voluntary and replacement candidate blood donors were consecutively included from February to May 2009. Sera of all candidates, independent of deferral by questionnaire, were submitted to screening with quality-assured rapid or simple assays for HIV, HBV surface antigen (HBsAg), HCV and syphilis. Assays locally used by the blood bank for HBV and syphilis screening were run in parallel to quality-assured external assays supplied during the study, and all discordant samples were submitted to confirmation testing in reference laboratories in Mozambique and Belgium.ResultsOf 750 consenting candidates (50.5% of voluntary donors), 71 (9.5%) were deferred by the questionnaire, including 38 specifically because of risk behavior for TTI. Of the 679 non-deferred candidates, 127 (18.7%) had serological confirmation of at least one TTI, with a lower prevalence in voluntary than in replacement donors (15.2% versus 22.4%, p = 0.016). Seroprevalence of HIV, HBsAg and syphilis infections was 8.5%, 10.6 % and 1.2%. No confirmed HCV infection was found. Seroprevalence of TTIs was similar in the 38 candidates deferred for TTI risk as in the non-deferred group, except for HBsAg (26.3 % versus 10.6 %; p = 0.005). The local assays used for HBV and syphilis had sensitivities of 98.4% and 100% and specificities of 80.4% and 98.8% respectively. This resulted in the rejection of 110 of the 679 blood donations (16.2%) because of false positive results.ConclusionsThe seroprevalence of TTIs after questionnaire screening is high in Tete, Mozambique, but HCV infection does not appear as a major issue. The questionnaire did not exclude effectively HIV-infected donor candidates, while the locally used assays led to unnecessary rejection of many safe donations. A contextualized questionnaire and consistent use of quality-assured assays would considerably improve the current screening procedure for blood donation.

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Section: Discussionmentioning

confidence: 99%

Seroprevalence of transfusion-transmissible infections and evaluation of the pre-donation screening performance at the Provincial Hospital of Tete, Mozambique

et al. 2011

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“…Prevalence was higher among first-time and female donors 68. A study to estimate the prevalence of transfusion-transmissible HIV infection in 2 groups of blood donors at Douala city over the period 1995 to 2004 indicated that the prevalence of HIV ranged from 2.2% to 8.12% at the Douala University and 7.89% at the blood bank of Laquintinie Hospital 69. Remunerated and family replacement donors are at more risk of being HIV positive 70.…”

Section: Challenge Of Transfusion-transmissible Infectionsmentioning

confidence: 99%

“…A cross-sectional study undertaken to determine the seroprevalence of HBsAg among 1410 apparently healthy prospective blood donors in Nigeria observed an overall seroprevalence of 18.6% 73. A study to estimate the prevalence of transfusion-transmissible HBV in 2 groups of blood donors at Douala city over the period 1995 to 2004 indicated that the seroprevalence for HBV ranged from 6.10% to 16% for donors at Douala University, while at the blood bank of Laquintinie Hospital the prevalence was 6.91% 69. Between January and August 1999, a total of 7277 blood donors at various health centers in Kinshasa, Democratic Republic of the Congo were screened for HBsAg using the ELISA technique.…”

Section: Challenge Of Transfusion-transmissible Infectionsmentioning

confidence: 99%

The challenges of meeting the blood transfusion requirements in Sub-Saharan Africa: the need for the development of alternatives to allogenic blood

Erhabor

Charles²

2011

JBM

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As a resource, allogenic blood has never been more in demand than it is today. Escalating elective surgery, shortages arising from a fall in supply, a lack of national blood transfusion services, policies, appropriate infrastructure, trained personnel, and financial resources to support the running of a voluntary nonremunerated donor transfusion service, and old and emerging threats of transfusion-transmitted infection, have all conspired to ensure that allogenic blood remains very much a vital but limited asset to healthcare delivery particularly in Sub-Saharan Africa. This is further aggravated by the predominance of family replacement and commercially remunerated blood donors, rather than regular benevolent, nonremunerated donors who give blood out of altruism. The demand for blood transfusion is high in Sub-Saharan Africa because of the high prevalence of anemia especially due to malaria and pregnancy-related complications. All stakeholders in blood transfusion have a significant challenge to apply the best available evidenced-based medical practices to the world-class management of this precious product in a bid to using blood more appropriately. Physicians in Sub-Saharan Africa must always keep in mind that the first and foremost strategy to avoid transfusion of allogenic blood is their thorough understanding of the pathophysiologic mechanisms involved in anemia and coagulopathy, and their thoughtful adherence to the evidenced-based good practices used in the developed world in a bid to potentially reduce the likelihood of allogenic blood transfusion in many patient groups. There is an urgent need to develop innovative ways to recruit and retain voluntary low-risk blood donors. Concerns about adverse effects of allogenic blood transfusion should prompt a review of transfusion practices and justify the need to search for transfusion alternatives to decrease or avoid the use of allogenic blood. These strategies should include the correction of anemia using pharmacological measures (use of antifibrinolytics to prevent bleeding and the use of erythropoietin and oral and intravenous iron to treat anemia) use of nonpharmacologic measures (preoperative autologous blood transfusion, perioperative red blood cell salvage and normothermia to reduce blood loss in surgical patients). All these strategies will help optimize the use of the limited blood stocks.

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“…In Burkina Faso, few published data are available on the prevalence of syphilis in the population. Previous studies have reported a regional variation in the prevalence of syphilis among pregnant women [4, 5] and blood donors[6, 7]; however, most of these studies had several limitations. In fact, they involved a small sample size and the sociodemographic factors associated with the risk of syphilis infection were not systematically studied.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Syphilis in regional blood transfusion centres in Burkina Faso, West Africa

Bisseyé¹,

Sanou²,

Nagalo³

et al. 2013

Pan Afr Med J

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IntroductionSyphilis remains a major public health problem in sub-Saharan Africa, including Burkina Faso. However, few published data are available on the prevalence of syphilis in the general population. This study had two main objectives: to determine the seroprevalence of syphilis in a cohort of 37,210 first time blood donors and to study socio-demographic factors associated with the risk of infection by Treponema pallidum.MethodsAntibodies to Treponema pallidum were screened for, by using Reagin Rapid Test (RPR) and their presence was confirmed by treponema pallidum haemagglutination test (TPHA).ResultsThe overall seroprevalence of syphilis was 1.5% among first time blood donors and was significantly different between centers (p <0.001). The infection was significantly higher in men than women among blood donors in Ouagadougou and Fada N′gourma (P = 0.001 and P = 0.034). The overall seroprevalence of syphilis among blood donors was not associated with either age group or HIV status. In contrast, a significantly high seroprevalence of syphilis was observed in blood donors with HBsAg (P = 0.014) and anti-HCV (P = 0.007) positive.ConclusionOur report shows a low seroprevalence of syphilis in the representative sample of the population of Burkina Faso. The seroprevalence of syphilis remains unequally distributed between urban and rural areas and was not associated with HIV infection.

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A new strategy to improve the cost‐effectiveness of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis testing of blood donations in sub‐Saharan Africa: a pilot study in Burkina Faso

Abstract: In resource-limited settings, the implementation of a sequential strategy appears as a pragmatic solution to promote safe blood supply and ensure sustainability of the system.

Cited by 20 publications

References 19 publications

Seroprevalence of transfusion-transmissible infections and evaluation of the pre-donation screening performance at the Provincial Hospital of Tete, Mozambique

Seroprevalence of transfusion-transmissible infections and evaluation of the pre-donation screening performance at the Provincial Hospital of Tete, Mozambique

The challenges of meeting the blood transfusion requirements in Sub-Saharan Africa: the need for the development of alternatives to allogenic blood

Epidemiology of Syphilis in regional blood transfusion centres in Burkina Faso, West Africa

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