The Francophone Africa Blood Transfusion Research Network: a five‐year report (2007–2012)

Abstract

Peer reviewed eScholarship.org Powered by the California Digital Library University of CaliforniaThis article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. RésuméLes travaux de recherches sur la sécurité transfusionnelle en Afrique sub-saharienne sont peu nombreux, souvent limités à des initiatives locales avec des conclusions difficilement représentatives de cette région. Le Groupe de recherches transfusionnelles en Afrique sub-saharienne francophone a été créé en mai 2007 avec pour objectif de développer des stratégies globales d'amélioration de la sécurité transfusionnelle mais adaptables à la situation de chaque pays. Les activités du Groupe à ce jour ont porté essentiellement sur l'obtention de données épidémiologiques et de laboratoire sur la transfusion sanguine et à proposer des stratégies de sécurité transfusionnelle dans le domaine des infections transmissibles par la transfusion. Pour mener à bien ces activités de recherche, le Groupe travaille en étroite collaboration avec les Centres nationaux de transfusion sanguine (CNTS), les Centres régionaux de transfusion sanguine (CRTS), les banques de sang hospitalières (BSH) et les postes de collecte de sang. Pour les 5 premières années, quatre priorités de recherche ont été identifiées : (i) des études descriptives sur les caractéristiques des donneurs de sang et des centres de transfusion ; (ii) une estimation du risque résiduel post-transfusionnel des principales infections virales transmissibles par la transfusion ; (iii) une analyse des stratégies de sélection médicale des donneurs de sang ; et ( AbstractThere has been little blood safety research in sub-Saharan Africa, often consisting of local efforts whose findings had limited impact The "Francophone Africa Transfusion Research Network" was created in May 2007 with the objective of developing common evidence-based blood safety policies that may be adapted to each country's situation. The Group's activities to date have focused mainly on obtaining epidemiological and laboratory data on blood transfusion and on suggesting blood safety strategies, particularly in the field of TTIs. To carry out such research activities, the group works closely with the National Blood Transfusion Services (NBTS), the Regional Blood Transfusion Services (RBTS), the hospital blood banks (HBB) and collection stations. For the first 5 years, four research priorities were identified: (i) descriptive studies of the characteristics of francophone African blood donors and blood centers; (ii) estimation of the residual risk of transfusion-transmitted major viral infections; * Auteur correspondant. Author's personal copy 38 C.T. Tagny et al. / Transfusion Clinique et Biologique 21 (2014) 3...

Whole blood pathogen reduction technology and blood safety in sub-Saharan Africa: A systematic review with regional discussion

“…2 The WHO has estimated that in low-income countries the prevalence of infectious diseases such as HIV is 425 times greater than in high-income countries. 3,4,5 Testing methodologies also vary significantly between these regions. In high-income countries, almost all blood samples are tested with the highly-sensitive nucleic acid testing (NAT), 3,4,5 whereas low- and middle-income countries still rely on various serological methods and rapid tests, which are less sensitive and thus have a greater window period than NAT screening.…”

“…Moreover, most laboratories in low-income countries do not perform tests in a quality-assured manner. 3,4,5 Indeed, this has necessitated accreditation and mentoring initiatives, such as the establishment of the African Society for Laboratory Medicine in 2011. Thus, patients in low- and middle-income countries are at higher risk for transmission of infection through blood transfusion than patients in high-income countries.…”

“…Thus, patients in low- and middle-income countries are at higher risk for transmission of infection through blood transfusion than patients in high-income countries. 3,4,5 Whilst improvements have been made in the past, a high residual risk of transfusion-transmitted infections (TTIs) remains because of viruses, bacteria, protozoa and residual contaminating leukocytes, despite decades of blood safety programmes. 3,4,5,6,7,8 …”

“…2,3,4,9,10 Also important to note is that, of the estimated one million annual deaths resulting from malaria globally, 90% occur in sub-Saharan Africa. 7,9 This suggests a high carrier rate of malarial parasite in this region and hence in the pool of potential blood donors.…”

“…9 In high-income countries, donor screening and deferral procedures, as well as serologic testing and NAT, have helped to make blood a safer product, drastically reducing the risk of classical TTI agents such as HIV and hepatitis viruses. 3,4 However, whilst highly-sensitive techniques such NAT are available in high-income countries, screening and testing in low- and middle-income countries where the risk is highest, are limited to a combination of donor screening and/or deferral and serological procedures. High residual risks have been reported in African blood banks where NAT is not performed.…”