HIV and blood transfusion in sub-Saharan Africa

Abstract

Blood transfusion services were poorly developed until the mid 1980s in most of sub-Saharan Africa, and were unable to provide adequate supplies of blood with acceptable safety. The pandemic of HIV was recognized seroepidemiologically from 1985 onwards. Blood transfusion was contributing from 10 to 15% to transmission in Africa. Groups at highest risk are children with malaria and anaemia, women with pregnancy-related haemorrhage or anaemia, victims of trauma and subjects with sickle-cell disease. Haemophiliacs are not a major risk group in comparison. Blood transfusion services have undoubtedly benefitted from the international, national and regional responses to the AIDS epidemic. Organizational structures have been established. There have been concerted moves to recruit voluntary unremunerated blood donors, selected from population groups with low seroprevalence. Serological screening for HIV, hepatitis viruses and syphilis has been introduced or strengthened. Standards for blood group serology, blood storage and handling have been improved. Guidelines for the appropriate use of blood have been formulated and adopted. There have been many training and retraining programmes. Much remains to be completed, however, using national and international resources, before the blood supply reaches acceptable standards of safety and is adequate in remote as well as in central areas of Africa.

PIP: Blood transfusion services for civilian populations were poorly established until the mid-1980s in most of sub-Saharan Africa and were unable to provide sufficient supplies of blood with acceptable safety. From 1985 onwards the HIV pandemic was recognized seroepidemiologically. About 10-15% of HIV transmission has been related to blood transfusion. The high-risk groups are children suffering from malaria and anemia, women with pregnancy-related hemorrhage or anemia, victims of trauma, and persons with sickle cell disease. However, hemophiliacs are not a major risk group in comparison. As a result of the HIV/AIDS pandemic, national and international attention has at last been focused on the inadequacies of blood transfusion services. Organizational structures have been developed. There have been concerted efforts to recruit voluntary unremunerated blood donors, chosen from population groups with low seroprevalence. Serological screening for HIV, hepatitis viruses, and syphilis has been introduced or strengthened. Standards for blood group serology, blood storage, and handling have been improved and guidelines for the proper use of blood have been developed and adopted. In addition, there have been many training and retraining programs. Much has yet to be completed, however, using national and international resources, before the blood supply achieves acceptable standards of safety and is adequate in both remote and central areas of Africa.