Prevention of blood-borne HIV transmission using a decentralized approach in Shaba, Zaire.

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

Prevention of blood-borne HIV transmission using a decentralized approach in Shaba, Zaire.

AIDS. 1992 Nov;6(11):1353-8. Unique Identifier : AIDSLINE MED/93112311
Laleman G; Magazani K; Perriens JH; Badibanga N; Kapila N; Konde M; Selemani U; Piot P; Centre Regional de Lutte Contre le SIDA, Lubumbashi, Zaire.

Abstract: OBJECTIVE: To prevent blood transfusion-acquired HIV infection with a decentralized approach to HIV screening of blood donors, using an instrument-free rapid test. SETTING: Shaba province, Zaire (496,877 km2). METHODS: The programme consisted of training health-care workers, distribution of a rapid HIV-antibody test (DuPont's HIVCHEK) for screening of all blood donations, and quality control of testing by a regional reference centre. RESULTS: Over a 2-year period, 11,940 rapid tests were distributed to 37 hospitals, covering 75% of all hospital beds outside the copper mine's health system in Shaba. Eighty-five per cent of the tests were used to screen blood donors (5.4% positive test rate) and 13% to test patients (39.7% positive test rate). At least 265 cases of HIV-positive blood donation were prevented, at an estimated cost of 137-279 ECU per case. Only 26% of initially positive specimens reached the central laboratory for supplemental testing, and sterile transfusion equipment and blood-grouping reagents were frequently unavailable. The lack of transport and communications and a deteriorating health system were major constraints. CONCLUSIONS: District hospitals in Africa are often long distances from major cities, difficult to reach for most of the year, and perform a small number of transfusions. In this context a classical centralized regional blood bank may not be a feasible option to ensure safe blood transfusions. However, safe blood transfusion can be achieved with a decentralized approach using a rapid test, provided that minimum standards of health-care services are available.

Keywords: *Blood Banks/ECONOMICS/STANDARDS Blood Donors Blood Transfusion/*ADVERSE EFFECTS Evaluation Studies Human HIV Antibodies/BLOOD HIV Infections/DIAGNOSIS/*PREVENTION & CONTROL/*TRANSMISSION HIV-1/IMMUNOLOGY HIV-2/IMMUNOLOGY Mass Screening/*ORGANIZATION & ADMIN Quality Control *Regional Medical Programs/ECONOMICS/STANDARDS Support, Non-U.S. Gov't Zaire JOURNAL ARTICLE
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