Survey of blood collection and transfusion practices among institutions in Africa

Author:

Jacobs Jeremy W.1ORCID,Stephens Laura D.2ORCID,Milner Danny A.34ORCID,Bloch Evan M.5ORCID,Goel Ruchika56ORCID,Tobian Aaron A. R.5ORCID,Shibemba Aaron Lunda7,Eichbaum Quentin89ORCID,

Affiliation:

1. Department of Laboratory Medicine Yale School of Medicine New Haven Connecticut USA

2. Department of Pathology University of California San Diego La Jolla California USA

3. American Society for Clinical Pathology Chicago Illinois USA

4. Harvard T. H. Chan School of Public Health Boston Massachusetts USA

5. Department of Pathology Johns Hopkins University School of Medicine Baltimore Maryland USA

6. Departments of Internal Medicine and Pediatrics Simmons Cancer Institute at SIU School of Medicine Springfield Illinois USA

7. Department of Pathology and Microbiology University Teaching Hospital Lusaka Zambia

8. Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville Tennessee USA

9. Vanderbilt University School of Medicine Nashville Tennessee USA

Abstract

AbstractIntroductionDramatic improvements in blood transfusion have occurred during the last two decades. Transfusion medicine services and practices in Africa remain underexplored.MethodsA survey of blood bank/transfusion medicine (BBTM) practices, available blood products, blood product source(s), pre‐transfusion testing, and blood donor infectious disease testing methodologies across Africa was performed using the American Society for Clinical Pathology (ASCP) listserv. Survey recipients included hospital‐based laboratories/blood banks, national transfusion medicine services, and free‐standing laboratories (collectively referred to as institutions).ResultsResponses from a total of 81 institutions across 22 countries were analyzed. All 81 institutions provide at least one type of blood product—whole blood, red blood cells (RBCs), platelets, plasma, and cryoprecipitate, with whole blood (90.1%, 73 of 81) and RBCs (79.0%, 64 of 81) most common, while cryoprecipitate is least common (12.4%, 10 of 81). Only five countries had a responding institution that provides all types of products. Among institutions that collect blood onsite, the most common sources of blood products are patients' family members (94.1%, 48 of 51) and pre‐screened on‐demand volunteer donors (82.4%, 42 of 51). The most commonly screened infectious agents are HIV and hepatitis B virus (both 81.5%), while 70.4% (57 of 81) test for hepatitis C virus (HCV) and Treponema pallidum.DiscussionThis study highlights significant variability and restrictions in blood product availability, pre‐transfusion testing, and blood donor infectious disease testing across Africa. Further studies are needed to ascertain barriers to improving blood donor availability, blood product safety, and infectious disease testing.

Publisher

Wiley

Subject

Hematology,Immunology,Immunology and Allergy

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