Author(s): Wake DJ, Cutting WA
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Abstract The acute medical services could not exist without blood transfusions--life-savers in many situations. But transfusions can also be a quick and easy route for the transmission of infectious agents such as HIV, HBV, HCV and malaria. Infection through blood supply is a major issue in all countries but particularly in those with economic constraints which limit safety. This study was carried out in India (March-May 1997) and involved centres in Delhi, Calcutta and Vellore. It examined many aspects of blood transfusion including donor screening, use of professional donors, blood testing and criteria for blood use. The many problems in Indian blood transfusion services are mirrored in other countries. Here we examine the problems, priorities and practicalities of blood transfusion particularly in developing countries. PIP: HIV and hepatitis transmission through blood transfusion is a major concern in developing countries where economic constraints limit blood supply safety. Blood transfusion may account for up to 15\% of HIV transmission in developing countries. Only 66\% of developing and 46\% of the least developed countries screen blood for HIV since such testing can double the basic cost of a unit of blood. Blood banks in the private sector tend to be driven by commercial interests, and both public and private programs rely on high-risk professional donors given a shortage of voluntary donors. The following measures are recommended to improve blood transfusion services in India and other developing countries: 1) thorough donor screening to eliminate high-risk donors; 2) the availability of cheaper, more sensitive HIV tests; 3) assumption of responsibility for blood safety by physicians giving the transfusions; 4) adaptation of guidelines for blood administration to local needs; 5) avoidance of unnecessary transfusions; 6) more widespread use of autologous transfusions and intra- and postoperative blood salvage; 7) cost-benefit analyses of blood safety procedures; 8) monitoring of implementation of blood safety legislation; 9) use of an independent authority for blood bank licensing and monitoring; and 10) promotion of voluntary donation as a public responsibility.
This article was published in Trop Doct
and referenced in Journal of Bioequivalence & Bioavailability