Achieving self-sufficiency of red blood cells based on universal voluntary blood donation in Latin America. The case of Nicaragua.

In 2007, the blood collection rate in Nicaragua was 106.6 units per 10,000 inhabitants. Voluntary donation was 39%. The health authorities decided to pursue self sufficiency of blood by eliminating replacement donation and consolidating blood processing in two centers. Replacement donation was terminated in 2009, voluntary donation reached 100% in 2010, and the blood collection rate increased to 125.9 in 2011. The rate of red blood cell transfusion improved from 96.0 to 119.1 units per 10,000 during the 4-year period. The political will of the government, pertinent technical leadership, and a country-wide approach were essential for attaining those goals.

Preventing transfusion-transmitted HIV infection in Latin America and the Caribbean: issues associated with blood donor interviews and sex between men.

BACKGROUND: Blood-borne transmission is the most efficient route for acquiring HIV infection, particularly through transfusion. Availability of noninfectious blood units for hemotherapy is a necessary condition for efficient functioning of health services. They have the obligation to ensure that the blood supply is safe, which includes interviewing potential donors to ascertain whether they might be at risk of being HIV infected. The interview procedures demand that blood services staff inquire potential blood donors about sexual practices associated to HIV transmission. Assumptions and misconceptions may unnecessary exclude adequate donors. METHODS: Review of published and unpublished country reports in Latin America regarding blood safety and deferral criteria related to same sexual behavior among males. RESULTS: An analysis of criteria for deferral of potential blood donors shows inconsistencies that may impact the necessary safe blood supply. CONCLUSIONS: The blood donor deferral criteria should be revised according to relevant epidemiological evidence and social legitimacy. Personnel in blood banks and hemotherapy services should be educated to conduct appropriate interviews for accepting or deferring potential donors. Potential donors and the public should be knowledgeable for them to understand the reasons why some individuals may be deferred. Health authorities should work to reduce the stigma associated with HIV, prioritize building strong and meaningful partnerships with civil society, and engage diverse sectors in the national AIDS response.

Suministro de Sangre para Transfusiones en los Países del Caribe y Latinoamérica en 2006 y 2007

[Introducción] El 46º Consejo Directivo de la Organización Panamericana de la Salud (OPS), reunido en Washington, D. C. en septiembre de 2005, aprobó el PLAN REGIONAL DE ACCIÓN PARA LA SEGURIDAD TRANSFUSIONAL 2006-2010, resolvió instar a los Estados Miembros a que lo adoptasen oficialmente y solicitó a la Directora de la OPS que vigile el desarrollo de los programas nacionales de sangre y que informe periódicamente a los Cuerpos Directivos sobre el progreso de la implementación de dicho Plan.1,2 El Plan Regional tiene como finalidad contribuir a reducir la mortalidad y mejorar el cuidado de los pacientes en América Latina y el Caribe, con la provisión oportuna de sangre segura para transfusión para todos aquellos que la necesiten.1 Los indicadores de progreso del plan son los siguientes: • El 100% de los países tendrá un estimado nacional de las necesidades de sangre y componentes sanguíneos, de acuerdo a zonas geográficas y épocas del año. • El 95% de las unidades de sangre recogidas se fraccionarán en componentes. • El 100% de los países habrá implantado un plan de garantía de la calidad que incluya a todos los servicios de sangre. • Al menos 50% de las unidades de sangre recogidas en cada país provendrá de donantes voluntarios, altruistas y no remunerados. • El 100% de los países habrá establecido un programa de hemovigilancia para evaluar el impacto de transfusiones en la salud de los pacientes, de acuerdo a la organización y estructura del sistema nacional de sangre. • El 100% de los países habrá revisado su marco legal y normativo. • El 100% de los países tendrá comités de transfusión operando. • El 100% de los países habrá implantado guías nacionales para el uso clínico de la sangre en todos los servicios de transfusión. • El 100% de los países latinoamericanos habrá implantado sistemas regionales de obtención y procesamiento de sangre para satisfacer las necesidades de los pacientes de zonas geográficamente diferenciadas. Estos indicadores se suman a las metas regionales incluidas en las Orientaciones Estratégicas y Programáticas para la OPS 1999-2002, aprobadas por la 25ª Conferencia Sanitaria Panamericana de alcanzar la universalidad del tamizaje de las unidades de sangre y de la participación de los bancos de sangre en programas de calidad,3 metas que aún no han sido alcanzadas.

Availability, safety and quality of blood for transfusion in the Americas.

OBJECTIVES: This article has two objectives: (1) to present for countries and territories of the Region of the Americas data on the number of blood donations, proportion of voluntary blood donors versus remunerated blood donors, coverage of screening for infectious agents, and separation of donated blood into its components and (2) to explore the relationships of those characteristics with economic and organisational factors in the countries and territories. METHODS: We carried out comparative analyses using population and health information gathered annually by the Pan American Health Organization (PAHO) from national health officials from the countries in the Americas, as well as economic information (gross national product (GNP) per capita) obtained from publications of the World Bank. RESULTS: There is a direct correlation between the availability of blood for transfusion and GNP per capita. Seven countries with a GNP per capita above US dollar 10,000 per year account for 38% of the Regional population but 68% of the Regional blood donations. Voluntary blood donation is more common in the countries with better blood availability. There is no association between GNP per capita and coverage of screening for infectious agents. Nevertheless, of the six countries with a GNP per capita below US dollar 1,000, only one of the six screens all units for human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B surface antigen (HBsAg). Countries with a higher proportion of voluntary blood donors tend to have lower prevalence rates of infectious markers. Separation of blood into its components is also more common in countries with higher blood donation rates. CONCLUSIONS: The availability, safety and quality of blood for transfusion in the Americas needs to be improved. As part of that effort, national policies and strategies must be put into place so that the resources already allocated for blood services are better utilised.

[A study of sociocultural factors related to voluntary blood donation in the Americas]. / Estudio de factores socioculturales relacionados con la donación voluntaria de sangre en las Américas.

OBJECTIVE: To obtain baseline data for countries of the Americas on knowledge, attitudes, and practices related to voluntary blood donation as well as on the current level and quality of services that blood banks provide to donors. METHODS: The study was conducted in 15 countries in the Americas: Argentina, Bolivia, Colombia, Costa Rica, Cuba, the Dominican Republic, Ecuador, El Salvador, Guatemala, Jamaica, Nicaragua, Panama, Paraguay, Peru, and Venezuela. Technical cooperation for the study came from the Pan American Health Organization. A qualitative formative methodology was applied, utilizing interviews with donors, health workers, and members of the general public; direct observation; focus groups; knowledge tests; and a review of documents. RESULTS: Information was generated on people's knowledge of donation; their beliefs, perceptions, attitudes, and motivations; and their barriers to donating. Knowledge was also gained as to the best means for disseminating messages supporting voluntary donation. CONCLUSIONS: This information will serve as a foundation for designing a strategy in the countries of the Americas that is aimed at establishing and building the loyalty of voluntary blood donors. This strategy can support the implementation of changes needed in the care of donors, and it can also help in motivating donors to regularly return to donate blood.

Availability, safety, and quality of blood for transfusion in the Americas.

OBJECTIVES: This article has two objectives: (1) to present for countries and territories of the Region of the Americas data on the number of blood donations, proportion of voluntary blood donors versus remunerated blood donors, coverage of screening for infectious agents, and separation of donated blood into its components and (2) to explore the relationships of those characteristics with economic and organizational factors in the countries and territories. METHODS: We carried out comparative analyses using population and health information gathered annually by the Pan American Health Organization (PAHO) from national health officials from the countries in the Americas, as well as economic information (gross national product (GNP) per capita) obtained from publications of the World Bank. RESULTS: There is a direct correlation between the availability of blood for transfusion and GNP per capita. Seven countries with a GNP per capita above US$ 10 000 per year account for 38% of the Regional population but 68% of the Regional blood donations. Voluntary blood donation is more common in the countries with better blood availability. There is no association between GNP per capita and coverage of screening for infectious agents. Nevertheless, of the six countries with a GNP per capita below US$ 1 000, only one of the six screens all units for human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B surface antigen (HBsAg). Countries with a higher proportion of voluntary blood donors tend to have lower prevalence rates of infectious markers. Separation of blood into its components is also more common in countries with higher blood donation rates. CONCLUSIONS: The availability, safety, and quality of blood for transfusion in the Americas needs to be improved. As part of that effort, national policies and strategies must be put into place so that the resources already allocated for blood services are better utilized.

Estudio de factores socioculturales relacionados con la donacion voluntaria de sangre en las Americas / A study of sociocultural factors related to voluntary blood donation in the Americas

Objective. To obtain baseline data for countries of the Americas on knowledge, attitudes, and practices related to voluntary blood donation as well as on the current level and quality of services that blood banks provide to donors. Methods. The study was conducted in 15 countries in the Americas: Argentina, Bolivia, Colombia, Costa Rica, Cuba, the Dominican Republic, Ecuador, El Salvador, Guatemala, Jamaica, Nicaragua, Panama, Paraguy, Peru, and Venezuela. Technical cooperation for the study came from the Pan American Health Organization. A qualitative formative methodology was applied, utilizing interviews with donors, health workers, and members of the general public; direct observation; focus groups; knowledge tests; and a review of documents. Results. Information was generated on people's knowledge of donation; their beliefs, perceptions, attitudes, and motivations; and their barriers to donating. Knowledge was also gained as to the best means for disseminating messages supporting voluntary donation. Conclusions. This information will serve as a foundation for designing a strategy in the countries of the Americas that is aimed at establishing and building the loyalty of voluntary blood donors. This strategy can support the implementation of changes needed in the care of donors, and it can also help in motivating donors to regularly return to donate blood (AU)

Availability, safety, and quality of blood for transfusion in the Americas

Objectives. This article has two objectives: (1) to present for countries and territories of the Region of the Americas data on the number of blood donations, proportion of voluntary blood donors versus remunerated blood donors, coverage of screening for infectious agents, and separation of donated blood into its components and (2) to explore the relationships of those characteristics with economic and organizational factors in the countries and territories. Methods. We carried out comparative analyses using population and health information gathered annually by the Pan American Health Organization (PAHO) from national health officials from the countries in the Americas, as well as economic information (gross national product (GNP) per capita) obtained from publications of the World Bank. Results. There is a direct correlation between the availability of blood for transfusion and GNP per capita. Seven countries with a GNP per capita above US$ 10 000 per year account for 38 percent of the Regional population but 68 percent of the Regional blood donations. Voluntary blood donation is more common in the countries with better blood availability. There is no association between GNP per capita and coverage of screening for infectious agents. Nevertheless, of the six countries with a GNP per capita below US$ 1 000, only one of the six screens all units for human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B surface antigen (HBsAg). Countries with a higher proportion of voluntary blood donors tend to have lower prevalence rates of infectious markers. Separation of blood into its components is also more common in countries with higher blood donation rates. Conclusions. The availability, safety, and quality of blood for transfusion in the Americas needs to be improved. As part of that effort, national policies and strategies must be put into place so that the resources already allocated for blood services are better utilized (AU)