Transfusion in sub-Saharan Africa: does a Western model fit?
Identifieur interne : 001A01 ( Istex/Corpus ); précédent : 001A00; suivant : 001A02Transfusion in sub-Saharan Africa: does a Western model fit?
Auteurs : Stephen P. Field ; Jean-Pierre AllainSource :
- Journal of Clinical Pathology [ 0021-9746 ] ; 2007-10.
English descriptors
- KwdEn :
- African countries, African region, Anaemia, Blood donors, Blood safety, Blood services, Blood supply, Blood transfusion, Blood transfusion service, Centralised, Centralised blood service, Centralised blood services, Clin pathol, Family members, High risk, Hospital laboratory budgets, Kenyan hospital, Lara, Malarial anaemia, Maternal deaths, Pragmatic approach, Rapid tests, Safe blood, Southern african countries, Sustainability, Transfusion, Transfusion services, Voluntary blood donors, Voluntary donors, Welsh blood service, Western model, Whole blood, World health organization, blood transfusion, economic, models, sub-Saharan Africa.
- Teeft :
- African countries, African region, Anaemia, Blood donors, Blood safety, Blood services, Blood supply, Blood transfusion, Blood transfusion service, Centralised, Centralised blood service, Centralised blood services, Clin pathol, Family members, High risk, Hospital laboratory budgets, Kenyan hospital, Lara, Malarial anaemia, Maternal deaths, Pragmatic approach, Rapid tests, Safe blood, Southern african countries, Sustainability, Transfusion, Transfusion services, Voluntary blood donors, Voluntary donors, Welsh blood service, Western model, Whole blood, World health organization.
Abstract
This review examines the current state of transfusion services in sub-Saharan Africa and presents the argument for and against the Western model of a centralised blood service with 100% voluntary non-remunerated blood donors as advocated by the World Health Organization. The current practice of family replacement donors in hospital-based blood service is the most economical option, but in the face of high child and maternal mortality rates the blood supply has proved to be insufficient. With estimates of 5–10% of HIV transmission in Africa being the result of contaminated blood transfusions, there is a need to improve testing for transfusion transmissible diseases and the selection of blood donors. Of major concern, with respect to testing, is the quality of kits being used and the continuity of supply. The need to produce components is discussed in the context of the transfusion needs in sub-Saharan Africa. The running costs of establishing and maintaining centralised blood services need careful consideration as such projects need to be sustainable in the future. It is concluded that both options are viable while centralised programmes are being developed, and a pragmatic approach should be taken to ensure that the patients’ needs are met and that resources are suitably utilised to ensure sustainability.
Url:
DOI: 10.1136/jcp.2006.043505
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ISTEX:4F553020B00F8068AEFBBCCE8D582162BFE4BD35Le document en format XML
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Field</name><affiliation><mods:affiliation>Welsh Blood Service, Pontyclun, Wales, UK</mods:affiliation></affiliation></author><author><name sortKey="Allain, Jean Pierre" sort="Allain, Jean Pierre" uniqKey="Allain J" first="Jean-Pierre" last="Allain">Jean-Pierre Allain</name><affiliation><mods:affiliation>Department of Haematology, University of Cambridge, Cambridge, UK; jpa1000@cam.ac.uk</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:4F553020B00F8068AEFBBCCE8D582162BFE4BD35</idno><date when="2007" year="2007">2007</date><idno type="doi">10.1136/jcp.2006.043505</idno><idno type="url">https://api.istex.fr/document/4F553020B00F8068AEFBBCCE8D582162BFE4BD35/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001A01</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001A01</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Transfusion in sub-Saharan Africa: does a Western model fit?</title><author><name sortKey="Field, Stephen P" sort="Field, Stephen P" uniqKey="Field S" first="Stephen P" last="Field">Stephen P. 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The current practice of family replacement donors in hospital-based blood service is the most economical option, but in the face of high child and maternal mortality rates the blood supply has proved to be insufficient. With estimates of 5–10% of HIV transmission in Africa being the result of contaminated blood transfusions, there is a need to improve testing for transfusion transmissible diseases and the selection of blood donors. Of major concern, with respect to testing, is the quality of kits being used and the continuity of supply. The need to produce components is discussed in the context of the transfusion needs in sub-Saharan Africa. The running costs of establishing and maintaining centralised blood services need careful consideration as such projects need to be sustainable in the future. It is concluded that both options are viable while centralised programmes are being developed, and a pragmatic approach should be taken to ensure that the patients’ needs are met and that resources are suitably utilised to ensure sustainability.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>transfusion</json:string><json:string>centralised</json:string><json:string>sustainability</json:string><json:string>lara</json:string><json:string>anaemia</json:string><json:string>blood supply</json:string><json:string>african countries</json:string><json:string>maternal deaths</json:string><json:string>clin pathol</json:string><json:string>blood donors</json:string><json:string>pragmatic approach</json:string><json:string>transfusion services</json:string><json:string>southern african countries</json:string><json:string>kenyan hospital</json:string><json:string>safe blood</json:string><json:string>african region</json:string><json:string>western model</json:string><json:string>centralised blood service</json:string><json:string>centralised blood services</json:string><json:string>family members</json:string><json:string>high risk</json:string><json:string>blood services</json:string><json:string>voluntary blood donors</json:string><json:string>world health organization</json:string><json:string>malarial anaemia</json:string><json:string>blood safety</json:string><json:string>rapid tests</json:string><json:string>whole blood</json:string><json:string>voluntary donors</json:string><json:string>blood transfusion</json:string><json:string>hospital laboratory budgets</json:string><json:string>blood transfusion service</json:string><json:string>welsh blood service</json:string></teeft></keywords><author><json:item><name>Stephen P Field</name><affiliations><json:string>Welsh Blood Service, Pontyclun, Wales, UK</json:string></affiliations></json:item><json:item><name>Jean-Pierre Allain</name><affiliations><json:string>Department of Haematology, University of Cambridge, Cambridge, UK; jpa1000@cam.ac.uk</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Sexual transmitted infections (viral)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Haematology (incl blood transfusion)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Immunology (including allergy)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>HIV/AIDS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>blood transfusion</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>sub-Saharan Africa</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>models</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>economic</value></json:item></subject><language><json:string>eng</json:string></language><originalGenre><json:string>other</json:string></originalGenre><abstract>This review examines the current state of transfusion services in sub-Saharan Africa and presents the argument for and against the Western model of a centralised blood service with 100% voluntary non-remunerated blood donors as advocated by the World Health Organization. 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The current practice of family replacement donors in hospital-based blood service is the most economical option, but in the face of high child and maternal mortality rates the blood supply has proved to be insufficient. With estimates of 5–10% of HIV transmission in Africa being the result of contaminated blood transfusions, there is a need to improve testing for transfusion transmissible diseases and the selection of blood donors. Of major concern, with respect to testing, is the quality of kits being used and the continuity of supply. The need to produce components is discussed in the context of the transfusion needs in sub-Saharan Africa. The running costs of establishing and maintaining centralised blood services need careful consideration as such projects need to be sustainable in the future. It is concluded that both options are viable while centralised programmes are being developed, and a pragmatic approach should be taken to ensure that the patients’ needs are met and that resources are suitably utilised to ensure sustainability.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>KWD</head><item><term>blood transfusion</term></item><item><term>sub-Saharan Africa</term></item><item><term>models</term></item><item><term>economic</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Sexual transmitted infections (viral)</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Haematology (incl blood transfusion)</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Immunology (including allergy)</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>HIV/AIDS</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2007-04-05">Created</change><change when="2007-10">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/4F553020B00F8068AEFBBCCE8D582162BFE4BD35/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article xml:lang="en" article-type="other"><front><journal-meta><journal-id journal-id-type="hwp">jclinpath</journal-id><journal-id journal-id-type="nlm-ta">J Clin Pathol</journal-id><journal-title>Journal of Clinical Pathology</journal-title><abbrev-journal-title abbrev-type="publisher">J Clin Pathol</abbrev-journal-title><issn pub-type="ppub">0021-9746</issn><issn pub-type="epub">1472-4146</issn><publisher><publisher-name>BMJ Publishing Group Ltd and Association of Clinical Pathologists</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="other">CPT-60-10-1073</article-id><article-id pub-id-type="doi">10.1136/jcp.2006.043505</article-id><article-id pub-id-type="other">jclinpath;60/10/1073</article-id><article-id pub-id-type="other">jclinpath;jcp.2006.043505</article-id><article-id pub-id-type="pmid">17412874</article-id><article-id pub-id-type="other">1073</article-id><article-id pub-id-type="other">jcp.2006.043505</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Review</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Sexual transmitted infections (viral)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Haematology (incl blood transfusion)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Immunology (including allergy)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>HIV/AIDS</subject></subj-group></article-categories><title-group><article-title>Transfusion in sub-Saharan Africa: does a Western model fit?</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Field</surname><given-names>Stephen P</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Allain</surname><given-names>Jean-Pierre</given-names></name><xref rid="AFF2">2</xref></contrib><aff id="AFF1"><label>1</label>Welsh Blood Service, Pontyclun, Wales, UK </aff><aff id="AFF2"><label>2</label>Department of Haematology, University of Cambridge, Cambridge, UK; <ext-link xlink:href="jpa1000@cam.ac.uk" ext-link-type="email" xlink:type="simple">jpa1000@cam.ac.uk</ext-link></aff></contrib-group><author-notes><corresp>Dr Stephen Field, Consultant in Transfusion Medicine, Welsh Blood Service, Ely Valley Road, Talbot Green, Pontyclun CF72 9WB, UK; <ext-link xlink:href="stephen.field@wbs.wales.nhs.uk" ext-link-type="email" xlink:type="simple">stephen.field@wbs.wales.nhs.uk</ext-link></corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2007</year></pub-date><pub-date pub-type="epub-original"><day>30</day><month>3</month><year>2007</year></pub-date><pub-date pub-type="epub"><day>5</day><month>4</month><year>2007</year></pub-date><volume>60</volume><volume-id pub-id-type="other">60</volume-id><volume-id pub-id-type="other">60</volume-id><issue>10</issue><issue-id pub-id-type="other">jclinpath;60/10</issue-id><issue-id pub-id-type="other">10</issue-id><issue-id pub-id-type="other">60/10</issue-id><fpage>1073</fpage><history><date date-type="accepted"><day>18</day><month>3</month><year>2007</year></date></history><permissions><copyright-statement>2007 The BMJ Publishing Group and the Association of Clinical Pathologists</copyright-statement><copyright-year>2007</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jclinpath-60-1073.pdf"></self-uri><abstract xml:lang="en"><p>This review examines the current state of transfusion services in sub-Saharan Africa and presents the argument for and against the Western model of a centralised blood service with 100% voluntary non-remunerated blood donors as advocated by the World Health Organization. The current practice of family replacement donors in hospital-based blood service is the most economical option, but in the face of high child and maternal mortality rates the blood supply has proved to be insufficient. With estimates of 5–10% of HIV transmission in Africa being the result of contaminated blood transfusions, there is a need to improve testing for transfusion transmissible diseases and the selection of blood donors. Of major concern, with respect to testing, is the quality of kits being used and the continuity of supply. The need to produce components is discussed in the context of the transfusion needs in sub-Saharan Africa. The running costs of establishing and maintaining centralised blood services need careful consideration as such projects need to be sustainable in the future. It is concluded that both options are viable while centralised programmes are being developed, and a pragmatic approach should be taken to ensure that the patients’ needs are met and that resources are suitably utilised to ensure sustainability.</p></abstract><kwd-group kwd-group-type="KWD" xml:lang="en"><kwd>blood transfusion</kwd><kwd>sub-Saharan Africa</kwd><kwd>models</kwd><kwd>economic</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Transfusion in sub-Saharan Africa: does a Western model fit?</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Transfusion in sub-Saharan Africa: does a Western model fit?</title></titleInfo><name type="personal"><namePart type="given">Stephen P</namePart><namePart type="family">Field</namePart><affiliation>Welsh Blood Service, Pontyclun, Wales, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean-Pierre</namePart><namePart type="family">Allain</namePart><affiliation>Department of Haematology, University of Cambridge, Cambridge, UK; jpa1000@cam.ac.uk</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="other" displayLabel="other" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-7474895G-0">other</genre><originInfo><publisher>BMJ Publishing Group Ltd and Association of Clinical Pathologists</publisher><dateIssued encoding="w3cdtf">2007-10</dateIssued><dateCreated encoding="w3cdtf">2007-04-05</dateCreated><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract lang="en">This review examines the current state of transfusion services in sub-Saharan Africa and presents the argument for and against the Western model of a centralised blood service with 100% voluntary non-remunerated blood donors as advocated by the World Health Organization. The current practice of family replacement donors in hospital-based blood service is the most economical option, but in the face of high child and maternal mortality rates the blood supply has proved to be insufficient. With estimates of 5–10% of HIV transmission in Africa being the result of contaminated blood transfusions, there is a need to improve testing for transfusion transmissible diseases and the selection of blood donors. Of major concern, with respect to testing, is the quality of kits being used and the continuity of supply. The need to produce components is discussed in the context of the transfusion needs in sub-Saharan Africa. The running costs of establishing and maintaining centralised blood services need careful consideration as such projects need to be sustainable in the future. It is concluded that both options are viable while centralised programmes are being developed, and a pragmatic approach should be taken to ensure that the patients’ needs are met and that resources are suitably utilised to ensure sustainability.</abstract><note type="author-notes">Dr Stephen Field, Consultant in Transfusion Medicine, Welsh Blood Service, Ely Valley Road, Talbot Green, Pontyclun CF72 9WB, UK; stephen.field@wbs.wales.nhs.uk</note><subject lang="en"><genre>KWD</genre><topic>blood transfusion</topic><topic>sub-Saharan Africa</topic><topic>models</topic><topic>economic</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Clinical Pathology</title></titleInfo><titleInfo type="abbreviated"><title>J Clin Pathol</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>hwp-journal-coll</genre><topic>Sexual transmitted infections (viral)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Haematology (incl blood transfusion)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Immunology (including allergy)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>HIV/AIDS</topic></subject><identifier type="ISSN">0021-9746</identifier><identifier type="eISSN">1472-4146</identifier><identifier type="PublisherID-hwp">jclinpath</identifier><identifier type="PublisherID-nlm-ta">J Clin Pathol</identifier><part><date>2007</date><detail type="volume"><caption>vol.</caption><number>60</number></detail><detail type="issue"><caption>no.</caption><number>10</number></detail><extent unit="pages"><start>1073</start></extent></part></relatedItem><identifier type="istex">4F553020B00F8068AEFBBCCE8D582162BFE4BD35</identifier><identifier type="ark">ark:/67375/NVC-WG8HL8J8-7</identifier><identifier type="DOI">10.1136/jcp.2006.043505</identifier><identifier type="href">jclinpath-60-1073.pdf</identifier><identifier type="PMID">17412874</identifier><identifier type="local">CPT-60-10-1073</identifier><accessCondition type="use and reproduction" contentType="copyright">2007 The BMJ Publishing Group and the Association of Clinical Pathologists</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</recordContentSource><recordOrigin>2007 The BMJ Publishing Group and the Association of Clinical Pathologists</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/4F553020B00F8068AEFBBCCE8D582162BFE4BD35/metadata/json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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