ABSTRACT
INTRODUCTION: The World Health Organization (WHO) recommends the creation of national blood transfusion services. Burkina Faso has a CNTS (Centre National de Transfusion Sanguine-National Blood Transfusion Center) but it currently covers only 53% of the national blood supply versus 47% produced by independent hospital blood banks. STUDY DESIGN: To evaluate blood collection, testing, preparation, and prescription practices in the regions of Burkina Faso that are not covered by the CNTS, a cross-sectional survey was conducted. METHODS: Data were collected by trained professionals from May to June 2009 at 42 autonomous blood centers not covered by the CNTS. RESULTS: Blood collection was supervised in all sites by laboratory technicians without specific training. There was no marketing of community blood donation nor mobile collection. Donation was restricted to replacement (family) donors in 21.4% of sites. Predonation screening of donors was performed in 63.4% of sites, but some did not use written questionnaires. Testing for HIV, hepatitis B virus, and syphilis was universal, although some sites did not screen for hepatitis C virus. In 83.3% of the sites, blood typing was performed without reverse ABO typing. In 97.6% of the sites, nurses acted alone or in conjunction with a physician to order blood transfusions. CONCLUSION: Shortcomings in non-CNTS blood centers argue for the development of a truly national CNTS. Such a national center should coordinate and supervise all blood transfusion activities, and is the essential first step for improving and institutionalizing blood transfusion safety and efficacy in a developing country.
Subject(s)
Blood Banks/organization & administration , Blood Banks/standards , Infection Control/standards , Quality Assurance, Health Care/methods , Quality Assurance, Health Care/standards , Blood Banks/statistics & numerical data , Blood Specimen Collection/standards , Blood Specimen Collection/statistics & numerical data , Burkina Faso/epidemiology , Cross-Sectional Studies , Developing Countries , Geography , HIV Infections/epidemiology , HIV Infections/prevention & control , Hepatitis/epidemiology , Hepatitis/prevention & control , Humans , Infection Control/organization & administration , Medical Laboratory Personnel/standards , Medical Laboratory Personnel/statistics & numerical data , Medical Records/standards , Quality Assurance, Health Care/organization & administration , Quality Control , Syphilis/epidemiology , Syphilis/prevention & controlABSTRACT
Most African countries do not initiate hepatitis B vaccination at birth. We conducted a non-randomized controlled trial comparing hepatitis B vaccination given at age 0, 6, and 14 weeks versus the current Côte d'Ivoire schedule of 6, 10, and 14 weeks. Pregnant women were enrolled at four health centers in Abidjan. At age 9 months, 0.5% of infants in both the birth and 6-week cohorts were positive for HBsAg and all were born to HBeAg-positive women. Among infants of HBeAg-positive mothers, 9 of 24 (37.5%) in the birth cohort and 10 of 17 (58.8%) in the 6-week cohort were HBsAg positive (adjusted OR, 2.7; 95% CI: 0.7-11.0). While both vaccine schedules prevented most cases of infant HBV transmission, both also had high failure rates among infants of HBeAg-positive mothers. African infants may benefit from a birth dose but additional studies are needed to verify this hypothesis.
