Kenyan Hospitals Neglected HIV Blood Risks: Study

By Charnicia E. Huggins

NEW YORK (Reuters Health) - Although simple inexpensive methods of blood screening had been developed more than a decade earlier, a new report finds that by the mid-1990s Kenyans continued to contract HIV (news - web sites) through blood transfusions.

The country subsequently tightened controls on its blood supply, and researchers say Kenya's experience should serve as an example to other poor African nations.

``In a nutshell, blood safety equals HIV prevention,'' study author Dr. Robert Janssen of the Centers for Disease Control and Prevention (news - web sites) (CDC) in Atlanta, Georgia, told Reuters Health. Janssen and his colleagues published their report in the August 25th issue of The Lancet.

They conducted their study from April to July 1994, when blood transfusions--mainly linked to malaria--were at their peak, according to the report. Most blood transfusions were requested for children aged 10 and younger, with nearly 40% for toddlers under the age of 2 years.

Blood was collected primarily from volunteer donors at secondary schools, but also from hospital blood banks, usually from donors recruited by the patient's family.

Samples collected from hospital blood banks were almost six times more likely to test positive for HIV than were those collected in secondary schools, the report indicates.

Overall, 31 (2%) of 1,482 blood donations used for transfusions were later identified as HIV positive. Of these, one donation was known to be positive based on hospital test results and 14 were reported to have tested negative. Thirteen donations were not screened and three were screened but had missing results.

Further, upon investigating 1,290 blood donor-recipient pairs for whom HIV test results were available, the researchers found that in 26 cases, HIV-positive blood was donated to HIV-negative individuals.

Factors that may have contributed to this HIV transmission included inadequate refrigeration due to a three or more day lack of electricity, lack of quality-assurance programs, and human errors in record keeping and transcription. Also, due to space constraints, HIV-positive and HIV-negative blood was often stored on the same refrigerator shelves, without clear labels.

After these findings were revealed, however, the Kenyan government took steps to prevent future errors and cases of HIV resulting from blood transfusions, according to Janssen.

The Kenyan Ministry of Health developed a national program to improve laboratory practices and hospital blood screening methods, and also secured international aid funding to implement training programs, improve volunteer blood donor recruitment and develop a standardized quality assurance program, the authors report.

Janssen and colleagues conclude that their study ``may serve as an example other countries could use to assess the safety of their blood supply and to identify procedures to improve blood safety.''

SOURCE: The Lancet 2001;358:657-660.