Hemovigilance in Countries with Scarce Resources –A WHO Perspective

Abstract

TATM 2003;5(1):277-284 • Safe blood • Scarce resources • Quality systems • Hemovigilance • HIV/AIDS In many parts of the world, people continue to die due to shortage of blood and blood products. The safety of blood transfusion therapy remains a continuing concern, particularly where resources are scarce.The different stages of economic and social development are reflected in the existing status of the countries health care systems and that of their national blood transfusion services. The lack of quality systems, standardization and traceability of collected blood along the blood transfusion chain are the major contributing factors to the undesired outcomes of transfusion and increased risk of transfusion-transmissible infections, namely HIV/AIDS and hepatitis. Hemovigilance as a concept and developed operational system, supports the continuous improvement of quality and safety of transfusion practices. Once the minimum safety requirements are in place, implementation of quality systems in the blood transfusion service throughout the entire blood transfusion chain has to be considered the first mandatory step for establishing hemovigilance systems. The challenge awaiting countries with scarce resources is the implementation of their own hemovigilance system in a sustainable way. The integrated approach for a safer blood supply developed by WHO is aimed at building capacities at a national level, through advocacy, infrastructure development, technical support, training and documentation, and it creates the necessary grounds for establishment of hemovigilance systems. By further increasing its commitment in this area, WHO fulfils its leadership role in preventing risk factors for major disease burden and in organizing equitable health services, in line with its strategic directions. Based on existing data and locally gained experience, joint programs and related expertise can be developed, strengthening inter-country, regional and global collaboration for a safer, adequate blood supply. ( Pa ge 27 7 ) Hemovigilance in Countries with Scarce Resources-A WHO Perspective NEELAM DHINGRA et al.

Estimate of the residual risk of transfusion‐transmitted human immunodeficiency virus infection in sub‐Saharan Africa: a multinational collaborative study

“…The latter may extend to viral variants not recognized by serologic tests in Africa due to divergent HIV‐1 subtypes; for example, Subtypes A1, D, and C are predominant in Eastern and Southern Africa, whereas recombinant forms such as CRF02‐AG and CDF06‐cpx represent the majority in Western Africa 25 . The risk of HIV transmission by transfusion may also stem from poor quality or poor performance of assays, 26 linked to lack of technical expertise or to unfavorable conditions in which the test kits are stored and the assays are performed as well as unforeseen equipment failure and deficient or absent quality assurance 27,28 …”

Blood Transfusion in Sub‐Saharan Africa

“…Considerable effort has been made in developing quality assurance and standard programs to improve the quality of available blood. 3 A few countries (e.g., Côte d'Ivoire, Benin, Malawi, Kenya) have invested significant resources in transfusion services (often with financial support and advisers from European or North American governments) and have committed to establishing centralized systems based on the blood bank model used in wealthy nations (Table 1). These centers typically collect over 10,000 units a year, use automated equipment and produce some components.…”

Red blood cell alloantibodies in paediatric transfusion in sub‐Saharan Africa: A new cohort and literature review

“…In daily medical practice, transfusion support requires high standards for infectious and immunologic safety which are allowed in HICs. However, in LMICs where resides around 80% of the world's population, only 20% of the worldwide supply of safe and screened blood is available according to WHO [ 4 , 10 , 15 , 16 , 17 , 18 , 19 , 20 ]. Despite the improvements on transfusion safety over a few decades in LMICs in SSA, these countries continue to struggle with inadequate resources and infrastructure for a safer blood supply [ 10 , 15 , 17 , 20 ].…”