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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Reduced risk of transfusion-transmitted HIV in Kenya through centrally co-ordinated blood centres, stringent donor selection and effective p24 antigen-HIV antibody screening
Vox Sanguinis, Volume 99, No. 3, Year 2010
Notification
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Description
Background Following a 1994 study showing a high rate of transfusion-associated HIV, Kenya implemented WHO blood safety recommendations including: organizing the Kenya National Blood Transfusion Service (NBTS), stringent blood donor selection, and universal screening with fourth-generation p24 antigen and HIV antibody assays. Here, we estimate the risk of transfusion-associated HIV transmission in Kenya resulting from NBTS laboratory error and consider the potential safety benefit of instituting pooled nucleic acid testing (NAT) to reduce window period transmission. Methods From November to December 2008 in one NBTS regional centre, and from March to June 2009 in all six NBTS regional centres, every third unit of blood screened negative for HIV by the national algorithm was selected. Dried blood spots were prepared and sent to a reference laboratory for further testing, including NAT. Test results from the reference laboratory and NBTS were compared. Risk of transfusion-associated HIV transmission owing to laboratory error and the estimated yield of implementing NAT were calculated. Findings No cases of laboratory error were detected in 12 435 units tested. We estimate that during the study period, the percentage of units reactive for HIV by NAT but non-reactive by the national algorithm was 0·0% (95% exact binomial confidence interval, 0·00-0·024%). Interpretation By adopting WHO blood safety strategies for resource-limited settings, Kenya has substantially reduced the risk of transfusion-associated HIV infection. As the national testing and donor selection algorithm is effective, implementing NAT is unlikely to add a significant safety benefit. These findings should encourage other countries in the region to fully adopt the WHO strategies. © Vox Sanguinis © 2010 International Society of Blood Transfusion No claim to original US government works.
Authors & Co-Authors
Basavaraju, Sridhar V.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
United States, Atlanta
Centers for Disease Control and Prevention
Mwangi, Jane W.
United States, Atlanta
Centers for Disease Control and Prevention
Nyamongo, Jack A.
Kenya, Nairobi
Kenya National Blood Transfusion Service
Zeh, Clement E.
United States, Atlanta
Centers for Disease Control and Prevention
Kimani, Daniel
United States, Atlanta
Centers for Disease Control and Prevention
Shiraishi, Ray W.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Madoda, R.
Kenya, Nairobi
Kenya National Blood Transfusion Service
Okonji, Jully
Kenya, Nairobi
Kenya Medical Research Institute
Sugut, William
Kenya, Nairobi
Kenya National Blood Transfusion Service
Ongwae, S.
Kenya, Nairobi
Kenya National Blood Transfusion Service
Pitman, John P.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Marum, Lawrence H.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Statistics
Citations: 39
Authors: 12
Affiliations: 4
Identifiers
Doi:
10.1111/j.1423-0410.2010.01340.x
ISSN:
00429007
Research Areas
Infectious Diseases
Study Locations
Kenya