Get access

Blood supply safety in Afghanistan: a national assessment of high-volume facilities

Authors

  • G. Farooq Mansoor,

    1. Health Protection and Research Organisation, Afghan National Blood Safety and Transfusions Services, Ministry of Public Health, Islamic Republic of Afghanistan
    2. School of Medicine, Yale University, New Haven, Connecticut
    3. United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
    4. Armed Services Blood Program Office, United States Department of Defense, Washington, DC
    5. Department of Obstetrics & Gynecology, Columbia University, New York, New York
    Search for more papers by this author
  • Ahmad Masoud Rahmani,

    1. Health Protection and Research Organisation, Afghan National Blood Safety and Transfusions Services, Ministry of Public Health, Islamic Republic of Afghanistan
    2. School of Medicine, Yale University, New Haven, Connecticut
    3. United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
    4. Armed Services Blood Program Office, United States Department of Defense, Washington, DC
    5. Department of Obstetrics & Gynecology, Columbia University, New York, New York
    Search for more papers by this author
  • M. Aziz Kakar,

    1. Health Protection and Research Organisation, Afghan National Blood Safety and Transfusions Services, Ministry of Public Health, Islamic Republic of Afghanistan
    2. School of Medicine, Yale University, New Haven, Connecticut
    3. United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
    4. Armed Services Blood Program Office, United States Department of Defense, Washington, DC
    5. Department of Obstetrics & Gynecology, Columbia University, New York, New York
    Search for more papers by this author
  • Pashtoon Hashimy,

    1. Health Protection and Research Organisation, Afghan National Blood Safety and Transfusions Services, Ministry of Public Health, Islamic Republic of Afghanistan
    2. School of Medicine, Yale University, New Haven, Connecticut
    3. United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
    4. Armed Services Blood Program Office, United States Department of Defense, Washington, DC
    5. Department of Obstetrics & Gynecology, Columbia University, New York, New York
    Search for more papers by this author
  • Parwiz Abrahimi,

    1. Health Protection and Research Organisation, Afghan National Blood Safety and Transfusions Services, Ministry of Public Health, Islamic Republic of Afghanistan
    2. School of Medicine, Yale University, New Haven, Connecticut
    3. United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
    4. Armed Services Blood Program Office, United States Department of Defense, Washington, DC
    5. Department of Obstetrics & Gynecology, Columbia University, New York, New York
    Search for more papers by this author
  • Paul T. Scott,

    1. Health Protection and Research Organisation, Afghan National Blood Safety and Transfusions Services, Ministry of Public Health, Islamic Republic of Afghanistan
    2. School of Medicine, Yale University, New Haven, Connecticut
    3. United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
    4. Armed Services Blood Program Office, United States Department of Defense, Washington, DC
    5. Department of Obstetrics & Gynecology, Columbia University, New York, New York
    Search for more papers by this author
  • Sheila A. Peel,

    1. Health Protection and Research Organisation, Afghan National Blood Safety and Transfusions Services, Ministry of Public Health, Islamic Republic of Afghanistan
    2. School of Medicine, Yale University, New Haven, Connecticut
    3. United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
    4. Armed Services Blood Program Office, United States Department of Defense, Washington, DC
    5. Department of Obstetrics & Gynecology, Columbia University, New York, New York
    Search for more papers by this author
  • Francisco J. Rentas,

    1. Health Protection and Research Organisation, Afghan National Blood Safety and Transfusions Services, Ministry of Public Health, Islamic Republic of Afghanistan
    2. School of Medicine, Yale University, New Haven, Connecticut
    3. United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
    4. Armed Services Blood Program Office, United States Department of Defense, Washington, DC
    5. Department of Obstetrics & Gynecology, Columbia University, New York, New York
    Search for more papers by this author
  • Catherine S. Todd

    Corresponding author
    1. School of Medicine, Yale University, New Haven, Connecticut
    2. United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
    3. Armed Services Blood Program Office, United States Department of Defense, Washington, DC
    4. Department of Obstetrics & Gynecology, Columbia University, New York, New York
    • Health Protection and Research Organisation, Afghan National Blood Safety and Transfusions Services, Ministry of Public Health, Islamic Republic of Afghanistan
    Search for more papers by this author

  • Disclaimer: Material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its presentation and/or publication. The opinions or assertions contained herein are the private views of the author, and are not to be construed as official or as reflecting true views of the Department of the Army or the Department of Defense.
  • Funded by the Military Infectious Disease Research Program and Armed Services Blood Program.

Address correspondence to: Catherine S. Todd, MD, MPH, Department of Obstetrics & Gynecology, Columbia University, PH 16-69, 622 West 168th Street, New York, NY 10032; e-mail:cst2121@columbia.edu.

Abstract

Background

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.

Results

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.

Conclusion

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.

Ancillary