Blood Transfusion Service and Hospital Blood Rotation: The Implications on Transfusion Safety in Nigeria

Blood donation is not readily an altruistic sacrifice in sub-Saharan Africa where microbial infections, maternal haemorrhages, malaria and other tropical diseases that frequently require blood transfusion are daily diagnoses. Blood transfusion safety is hindered by the combined prevailing high rate of Transfusion-Transmissible Infections (TTIs) and poor screening techniques. This study determined the rate of Enzyme-Linked Immuno-Sorbent Assay (ELISA) positive reactions to transfusion-transmissible infections in rapid diagnostic test negative family replacement blood units, compared to the first time voluntarily donated blood. We studied records of blood units collected in a tertiary hospital from donors who scaled pre-donation Rapid diagnostic test (RDT) screening for the human immunodeficiency virus, hepatitis B and hepatitis C viruses and syphilis and rescreened by ELISA techniques at the National Blood Transfusion Service Centre in Jos, along with units from first-time voluntary blood donors. A total of 19562 blood units; 5945 (30.39%) rapid diagnostic tests negative from a linkage hospital and 13617 (69.61%) from first time voluntary donors were screened by ELISA methods for HIV, HBV, HCV, and syphilis. The overall TTIs detected by ELISA was 16.08%, significantly lower among pre-donation rapid screened family replacement blood donors [495(8.32%)] compared to 2651 (19.47%) among first-time voluntary donors; P=0.0001. Fifty-seven (0.96%) HIV, 166 (2.79%) HBV, 137 (2.31%) HCV and 137 (2.31%) syphilis were still detected respectively by ELISA in the pre-screened negative family replacement blood units. The outcome of ELISA screenings of blood collected from first-time volunteer donors were; 143 (1.05%) HIV, 1,486 (10.91%) HBV, 683 (5.02%) HCV, and 339 (2.49%) syphilis. Blood for transfusion should be screened negative at least with ELISA.