Priority needs and wisdom strategy for blood transfusion safety in developing low-resource countries

Area of Science:

• Transfusion Medicine
• Infectious Disease Epidemiology
• Public Health Policy

Background:

• Nucleic acid testing (NAT) for transfusion-transmissible infections is costly and challenging to implement in low-resource countries.
• Developing nations require effective transfusion programs prior to adopting expensive NAT technologies.
• Alternative safety measures are crucial for reducing transfusion-related risks in resource-limited settings.

Purpose of the Study:

• To evaluate alternative safety measures for reducing transfusion-transmissible infections in low-resource countries.
• To assess the feasibility and affordability of blood safety strategies beyond nucleic acid testing.
• To identify effective methods for enhancing blood safety in developing nations.

Main Methods:

• Individual nucleic acid testing (NAT) for HIV, HBV, and HCV was performed on 2,880 donations.
• Donations were analyzed from Fayoum University Hospital blood bank.
• Discriminatory-positive NAT results were compared between non-remunerated and family replacement donations.

Main Results:

• Significant differences in HBV NAT results were found between remunerated and non-remunerated donations (2 vs. 0).
• Significant differences in HCV NAT results were observed between remunerated and non-remunerated donations (4 vs. 1).
• No discriminatory-positive NAT HIV cases were detected; 7 of 8 positive cases were from first-time donations.

Conclusions:

• Prioritizing voluntary, non-remunerated repeat blood donors is essential for ensuring blood safety in low-resource countries.
• The high cost and complexity of NAT make it less feasible in resource-limited settings.
• Focusing on donor selection and retention offers a more affordable and effective approach to blood safety.