RFI: Sustainability of Blood Safety Programme (3)
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Dear Dr. Ndugulile,
Pleased to hear on the matter echoed.
I have the following lines to share with you on the national
blood transfusion initiatives. Will focus much on two issues:
sustainability and safety.
In this era of HIV/AIDS blood transfusion is a case-sensitive
undertaking action though the service is inevitably needed too.
With the little insights I have on how the current national sys-
tem on blood transfusion operates I would advice to have a link
with VCT and cohorts studies ongoing. This country is big enough
to centralize such an important service, which is often needed
under emergency events.
I had an opportunity to visit two big HIV cohorts in the coun-
try, namely Kisesa and Mbeya. These cohorts together with the
ongoing VCT services countrywide could be an immediate resource-
ful hub to link with. Apparently, only HIV-negative individuals
qualifies for this purpose.
While you are still looking forward to have more thoughts on the
matter I suggest you start venture and conceptualize on the pos-
sibility of liaising with the ongoing VCT services. Linking with
renown cohorts in the country also would facilitate and make the
programme stable (less investment compared to separate new set-
up initiatives). This means you need to create a network (decen-
tralize) nested on the related ongoing activities. This option
will reduce possibility of facing many barriers, which are known
to be associated with HIV/AIDS. Obviously, many people country-
wide are now confident with VCT services blended with ART avail-
ability. In summary through VCT and HIV-negative cohorts you
will have the right group of people to start with for donating
blood and contribute to this important, needed and exciting na-
tional move - "national blood transfusion services".
On safety issue
Indeed, I strongly agree with you that doubts on safety of blood
and its product is unbearable excuse, especially when comes to
testing blood from patient in AHI (Acute HIV Infection) phase.
Unfortunately, there is no absolute 100% sensitive and specific
test assays but the current rapid diagnostic tests on use have
many shortfalls when AHI is taken onboard. DNA-based assay is an
alternative for this. The challenges are expensiveness and
highly trained personnel is required. However, this shouldn't
permit health workers giving HIV-infected blood to naive indi-
viduals (think of ethics). I understand that the economic power
in our country in undertaking this option would be difficult to
quench all health levels countrywide but novel ideas needs to be
thought of.
I encourage this national move to be in place ASAP.
Thanks,
Jullu S. Boniphace (BVM, MVM)
Research Scientist
Ifakara Health Research & Development Center (IHRDC)
Box 53, Ifakara, Morogoro, Tanzania (EA)
Tel: +255-23-262-5164
Fax: +255-23-262-5312
Mobile: +255-744-090897
mailto:bjullu@ifakara.mimcom.net
or mailto:jullub@yahoo.com