The Issue of Screening for Transfusion-Transmitted Infections in Sub-Saharan Africa Presents Several Challenges: A Review

Abstract

Blood transfusion is a vital medical procedure with the potential to save lives; however, it can have serious consequences if not carried out under rigorous principles. Sub-Saharan Africa (SSA) faces considerable challenges in ensuring the security of the transfusion process, particularly in the context of transfusion-transmissible infections (TTIs). These difficulties are principally associated with the elevated prevalence of TTI in the region, including viral (e.g., hepatitis B, HIV and hepatitis C), bacterial (e.g., syphilis), and parasitic (e.g., malaria) diseases, among others. Also, the family replacement donation system, economic and technological limitations and an insufficient donor pool constitute substantial obstacles. Various solutions are currently being recommended, implemented, or applied on a variable scale, depending on the specific country and subregion, to address the challenges above. For instance, it would be judicious to implement measures to prevent infections, such as rigorous donor selection, quality testing for the primary TTI, and pathogen inactivation. This would necessitate deploying innovative and adapted communication strategies to establish a sufficient pool of regular, unpaid voluntary donors and high-quality screening. Therefore, robust and coherent national or regional blood transfusion policies should support the previously outlined measures. These policies should include rigorous quality control and haemovigilance systems and reflect local epidemiological and economic realities.

Keywords: Africa; TTI; blood transfusion; challenges; screening.