Availability and suitability of rapid diagnostic kits for screening donated blood in Afghanistan

As health infrastructure is being rebuilt in Afghanistan, military, public, and private facilities offer donor blood collection/ transfusion services. This study aims to measure availability and type of blood screening test kits in the military, public and private facilities in Afghanistan. This national cross-sectional assessment targeted all facilities providing donor blood collection/transfusion services across all sectors. Descriptive statistics were generated with screening test availability compared by setting [urban vs. rural], province/region, and facility type [private vs public] using Chi-square test. A total of 243 facilities were assessed, with all 34 provinces represented with urban settings containing 63% of the facilities. Screening rapid tests were widely present for most pathogens, including HIV [87.7% of facilities], hepatitis B surface antigen [HB[s]Ag] [93.8%], hepatitis [HCV] antibody [90.5%], and syphilis [70.0%]. Private facilities were less likely to have syphilis tests available [51.4% vs. 84.1% [public], p<0.01]. Nineteen percent of facilities use the WHO evaluated test kit for HIV, 2.1% for HB[s]Ag, and none for HCV Ab. Of sites with available test kits, 7.5% of HIV, 0.9% of HB[s]Ag, 2.3% of HCV, and 6.5% of syphilis tests were expired at time of assessment. For expired tests, private facilities were more likely to have expired HIV and syphilis tests [p=0.07 and p=0.02, respectively] than other facility types. Blood collection/transfusion is a multisectoral service in Afghanistan, with substantial differences in test availability and type between sectors. Mechanisms are needed that ensure availability of quality test kits at all levels where blood collection/transfusion is performed. Test kits that have been evaluated by the WHO should be used for blood screening in all facility types

Surveying respiratory infections among Iranian Hajj pilgrims

The annual Hajj pilgrimage to Mecca brings over two million people together in a small confined area. Respiratory involvement is the most common disease during this ceremony, and up to now no unique cause has been identified. The present study was conducted to determine the incidence and types of respiratory diseases and their associated etiologic agents. During this prospective study, seroconversion was assessed for bacteria, viruses and fungi on 170 Iranian pilgrims prior to departure and 2 weeks after convalescence and returning from the Hajj pilgrimage. Meanwhile, sputum specimens of 252 patients were cultured. The following viruses were detected: influenza type A and B [21.5%], adenovirus [36.2%], and RSV [1.9%]. Among bacteria isolates, beta-haemolytic Streptococcous [9.7%], Haemophilus species [9.1%], Gram negative bacilli [20.6%], Legionella pneumophila [6.3%], Mycoplasma pneumonia [0.8%], and Chlamydia [32%] were more common, however, no fungal seroconversion was noted. We suggest administration of Fluvaccin for high risk groups, adenoviral vaccine for volunteer pilgrims, erythromycin or azithromycine for empiric bacterial therapy, and Oseltamivir or Zanamivir for prophylaxis or treatment of influenza like illness