Are there simple measures to reduce the risk of HIV infection through blood transfusion in a Zambian district hospital?

Abstract

Summary objective To quantify the potential impact of simple measures to reduce the risk of iatrogenic HIV infection through blood transfusion in a Zambian district hospital. methods Three studies were conducted at St. Francis' Hospital, Katete, Zambia: (1) From 1991 to 1995 HIV seroprevalence among all listed blood donors and the impact of proper subgroup selection were studied retrospectively; (2) the sensitivity of locally used rapid antibody assays (HIV‐spot/Wellcozyme HIV 1 & 2) for the detection of HIV in donor blood and the influence of the expiration date of the tests on this sensitivity were determined prospectively from June 1993 until March 1994 by screening all consecutive surgical patients and blood donors; (3) the number of unnecessary blood transfusions was determined retrospectively from January 1995 through January 1996 and prospectively from February 1996 through March 1996, and possibilities to reduce the total number of blood transfusions were considered. results (1) Excluding prisoners, who have an HIV seroprevalence of 19–25%, from the donor population significantly reduces the overall HIV seroprevalence from 13–16% to 8–9% (P < 0.01). (2) Under local circumstances the sensitivity of the used rapid antibody assays was 6.8–17.9% lower than claimed by the manufacturer. Usage of non‐expired tests increased the sensitivity significantly from 88.2% to 91.7% (P < 0.05). (3) None of the 294 studied blood transfusions can be classified as inappropriate according to international standards. conclusions Simple measures such as proper subgroup selection among blood donors and correct use of non‐expired tests may decrease the risk of iatrogenic HIV transmission. Stricter indications for blood transfusions will not substantially reduce the number of transfusions.

Donor Blood Procurement and Utilisation at the University of Benin Teaching Hospital, Benin City

“…Simple measures such as sub-group selection of donor, stricter indication for blood transfusion and correct use of non-expired tests have been speculated to decrease the risk of iatrogenic HIV transmission. 11 Extending these simple measures to our centre may be difficult for some reasons. Commercial blood donors, the major source of donor blood in our environment, may refuse pre-donation screening.…”

Health economics of blood transfusion safety – focus on sub-Saharan Africa

“…The contribution of human error to the risk of pathogen transmission is reported to be very low in high-HDI countries [53]. In low-HDI countries, however, what little data there are, indicate that human error can contribute up to 20% of the HIV transmission risk [54,55]. An overview of interventions improving transfusion safety in a selection of African countries revealed that interventions reducing human error in screening and processing of blood donations were cost-effective [49].…”

Letters to the Editors

“…Sirs , In the paper by Van Hoogstraten et al . (2000) a serious error occurred in the Methods section, which has direct implications for the conclusions that the authors draw.…”