Safe blood supply and other HIV testing priorities in resource-limited settings.
Int Conf AIDS 1996 Jul 7-12; 11:215 (abstract no. Th.A.264) Zekeng L; Cameroonian AIDS Control Programme, Yaounde, Cameroon.
When little money is available for testing, screening blood for HIV and HBV prior to transfusion is absolutely a priority, in developed countries, implementation of several strategies for the blood banking systems have effectively limited the spread of bloodborne HIV transmission. In resource-limited settings (especially sub-Saharan Africa), bloodborne transmission has become a significant risk factor for HIV infection. In some countries (Uganda, Zimbabwe, Cote d'Ivoire, etc.) the beginning of the organization of blood transfusion services (BTSs) has made a substantial contribution to reducing the spread of HIV infection through infected blood. In many other countries (Cameroon, Nigeria, Angola, etc.) where BTSs are not organized at all, it is impossible to assure safety of blood supply when: *blood screening lacks policies, well defined priorities and co-ordination; *laboratory testing is performed by poorly trained/not motivated personnel dealing with lack of/irregular reagents supplies and the absence of quality assurance programme (QA). The rapid/simple assays commonly used could have a limited sensitivity in detecting variants such as HIV-1 group 0; *only few HIV-positive donors are informed and excluded from further donations. With better organized BTSs, better results could be achieved. Safety of blood supply will be assured with: *an effective donor education and selection programme aiming at recruiting volunteer repeating and non-remunerated donors; *because QA is essential, screening should be performed in few sites by well trained and motivated personnel using Elisa technique. These screening sites could also screen for other purposes (voluntary testing, diagnosis, surveillance) if reagents are made available; *an early treatment and prevention of diseases and injuries that require transfusions; *the promotion of the appropriate use of blood and blood products; *the establishment of a cost recovery policy to sustain BTSs. Whenever possible and according to local conditions, autologous transfusion as well as screening for other pathogens (HCV, HTLV) should be encouraged.
Keywords: AEGIS, Blood Banks, Mass Screening, Blood Donors, Blood Transfusion, HIV Infections, HIV-1, Health Resources, Risk Factors, Laboratory Techniques and Procedures, Risk Management, Blood-Borne Pathogens, Hepacivirus, Hepatitis B Virus, Cote d'Ivoire, Africa South of the Sahara, Zimbabwe, Nigeria, Angola, Cameroon, Uganda, blood, diagnosis, blood supply, economics, ICA11
