Mahfooz ur Rahman, Gul Naz Akhtar, Yasmin Lodhi.
Transfusion transmitted HIV and HBV infections in Punjab, Pakistan.
Pak J Med Sci Jan ;18(1):18-25.

Objective: To assess the prevalence and risk of transfusion transmitted HIV and HBV infections in Punjab Design: The retrospective sero epidemiological data of the Institute of Haematology and Blood Transfusion Service, Punjab from 1996-2000 was analysed with regard to: a) Number of donors bled, b) Percentage of screening coverage, c) Percentage prevalence of HIV & HBV, d) Probability of receiving an infective unit P(R), probability of transmitting infection P(I) & spreading index evaluation and e) Cost assessment. Setting: The data was obtained regularly from 71 field units established in the government hospitals throughout the Province of Punjab from 1996- 2000. Subjects: A total of 1176284 directed first time or replacement blood donors as well as voluntary non-remunerated blood donors who donated blood at these blood banks or at mobile sessions have been included in this study. Main outcome measures: Assessment of prevalence of HIV and HBV in blood donors and risk estimation. Results: The screening coverage on the average has been 77.42% for HIV and 86.84% for HBV. The prevalence of HIV is 0.001% and of HBV is 2.259%. The probability of receiving an infective unit P(R) per 10000 donations is 0.023 for HIV and 29.72 for HBV. The probability of transmitting infection P(I) per 10000 donations is 0.021 for HIV and 26.75 for HBV The spreading index for both viral infections combined is 26.75 per 10000 donations. The cost of collecting and screening a single unit is Rs.350, while the cost of preventing the transfusion of a single infective unit is Rs.17836. Conclusions: Efforts should be made to extend 100% screening coverage, with development of altruistic voluntary non-remunerated blood donor registries, donor deferral registries and donor counseling service. There is a need to move away from hospital based blood donation system to a community-based system which would mean moving to a central and regional service concept in blood transfusion. An independent external QA programme or monitoring system is needed. The target should be to decrease prevalence to a minimum to ensure blood safety.

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