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DONOR INFECTIOUS DISEASE TESTING
Blood supply safety in Afghanistan: a national assessment of high-volume facilities
Article first published online: 7 DEC 2012
© 2012 American Association of Blood Banks
Volume 53, Issue 9, pages 2061–2068, September 2013
How to Cite
Mansoor, G. F., Rahmani, A. M., Kakar, M. A., Hashimy, P., Abrahimi, P., Scott, P. T., Peel, S. A., Rentas, F. J. and Todd, C. S. (2013), Blood supply safety in Afghanistan: a national assessment of high-volume facilities. Transfusion, 53: 2061–2068. doi: 10.1111/trf.12005
Funded by the Military Infectious Disease Research Program and Armed Services Blood Program.
- Issue published online: 9 SEP 2013
- Article first published online: 7 DEC 2012
- Manuscript Accepted: 12 OCT 2012
- Manuscript Revised: 9 OCT 2012
- Manuscript Received: 9 JUL 2012
- Military Infectious Disease Research Program
- Armed Services Blood Program
Little information is available regarding blood supply safety in Afghanistan. The purpose of this study was to assess blood safety through serologic and observational measures in Afghanistan.
Study Design and Methods
This cross-sectional assessment included the 40 highest-volume facilities collecting and transfusing blood nationally identified in a previous survey. At each facility, study representatives completed a standardized instrument assessing staff performance of transfusion-related activities and performed rapid testing for human immunodeficiency virus, syphilis, and hepatitis B and C with rapid diagnostic tests on clinically discarded specimens. Reactive samples received confirmatory testing. Descriptive statistics were generated, with differences analyzed using chi-square or Fisher's exact tests.
Between November 2010 and May 2011, a total of 332 blood donor collection procedures were observed. Only 52.4% of observed encounters correctly screened and deferred donors by international criteria. Public and private facilities demonstrated glove use, proper sharps disposal, and patient counseling and relayed screening test results in less than 75% of observed events, significantly less likely than military facilities (p < 0.01). Of 1612 specimens assessed, confirmed cases of hepatitis B (n = 6), hepatitis C (n = 1), and syphilis (n = 3) were detected among units already prescreened and accepted for transfusion.
Lapses in proper donor screening contributed to the presence of confirmed-positive units available for transfusion, as detected in this study. Steps must be taken to ensure standardization of testing kits requirements, documentation, and mandatory training and continuing education for blood bank staff with regard to counseling, drawing, processing, and transfusion of blood products.