Trends and Gaps in National Blood Transfusion Services - 14 Sub-Saharan African Countries, 2014-2016

Abstract

Ensuring availability of safe blood products through recruitment of voluntary, nonremunerated, blood donors (VNRDs) and prevention of transfusion-transmissible infections (TTIs), including human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis, is important for public health (1,2). During 2004-2016, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) provided approximately $468 million in financial support and technical assistance* to 14 sub-Saharan African countries^† with high HIV prevalence to strengthen national blood transfusion services (NBTSs)^§ and improve blood safety and availability. CDC analyzed these countries' 2014-2016 blood safety surveillance data to update previous reports (1,2) and summarize achievements and programmatic gaps as some NBTSs begin to transition funding and technical support from PEPFAR to local ministries of health (MOHs) (2,3). Despite a 60% increase in blood supply since 2004 and steady declines in HIV prevalence (to <1% among blood donors in seven of the 14 countries), HIV prevalence among blood donors still remains higher than that recommended by the World Health Organization (WHO) (4). PEPFAR support has contributed to significant reductions in HIV prevalence among blood donors in the majority of PEPFAR-supported countries, and linking donors who screen HIV-positive to confirmatory testing and indicated treatment, as well as further reducing TTIs, remains a public health priority (5).

FIGURE

Total number of blood units collected for all deferrals, deferrals at high risk,^, human immunodeficiency virus (HIV)–positive donors, and HIV-positive donors notified of their HIV status, by year — nine U.S. President’s Emergency Plan for AIDS Relief–supported countries, 2014–2016 Abbreviation: AIDS = acquired immunodeficiency syndrome. * Total number of blood units collected: 1,583,617 in 2014; 1,590,104 in 2015; and 1,771,798 in 2016. ^† Deferrals are defined as donors who do not meet donor selection criteria after administration of a risk assessment questionnaire. ^§ Deferrals at high risk, classified based on seven categories of behavior; data for number of deferrals at high risk from Global Database for Blood Safety. ^¶ Percentage of deferrals at high risk from total blood units collected: 2014, 14%; 2015, 7%; and 2016, data not available. ** Ethiopia, Kenya, Nigeria, Rwanda, South Africa, Swaziland, Tanzania, Uganda, and Zambia. ^†† Number of deferrals at high risk for 2016 was not available.