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The HIV/AIBS pandemic has
focused particular attention on the importance of preventing
transfusion-transmitted infection.
WHO estimates that between 5% and 10% of HIV infections worldwide
are transmitted through the transfusion of infected blood and blood
products, while many thousands more recipients of blood products are
infected with hepatitis B and C viruses, syphilis and other
infectious agents, such as Chagas disease and malaria.
In the past, strategies to promote blood safety tended to focus
primarily on screening donated blood for transfusion-transmissible
infections (TTIs). However, while systematic screening is essential,
it is insufficient in itself to ensure the safety of the blood
supply
Evidence from all regions of the world indicates that the absence of
a nationally-coordinated blood programme, a shortage of safe blood
donors and the unnecessary clinical use of transfusion are equally
important contributory factors to the transmission of infection by
transfusion,
The WHO strategy for blood safety emphasizes an integrated four-fold
approach. Effective quality assurance forms an essential part of
this approach |
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1 The establishment of a
coordinated blood transfusion service that can provide adequate and
timely supplies of safe blood for all patients in need.
2 The collection of blood
only from voluntary non-remunerated blood donors from low- risk
populations and the use of stringent donor selection procedures.
3 The screening of all donated blood for transfusion-transmissible
infections,
including thy, hepatitis viruses, syphilis and other infectious
agents, and blood grouping, compatibility testing and processing of
blood.
4 A reduction in
unnecessary transfusions through the appropriate clinical use of
blood, including the use of intravenous replacement fluids and other
simple
alternatives to transfusion, wherever possible.
Blood
transfusion service
A coordinated blood
transfusion service (BTS) is a prerequisite for an adequate supply
of safe blood. The national health authority may delegate
responsibility for the blood supply to a nonprofit, non-governmental
organization, but the BTS should he developed within the framework
of the country’s health care infrastructure.
The BTS should be established in accordance with an agreed national
blood policy and plan and within a legislative framework. It should
he responsible for establishing and maintaining a national quality
system, including the development of guidelines and standard
operating procedures, staff training, an information management
system and a system for monitoring and evaluation.
The BTS requires formal government commitment, support and
recognition as a separate, identifiable programme with a budgeting
and finance system that can ensure a sustainable blood programme
through cost recovery and/or annual budget allocation. The BTS
should be managed by an Executive
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