Fourteen-year experience of a tertiary hospital transfusion committee in West Africa
Ohene Opare-Sem
Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorGeorge Bedu-Addo
Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorPatrick Karikari
Department of Oral Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorPeter Boateng
Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorFrancis Sarkodie
Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorRabiniatu Rahman
Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorKwame Asenso-Mensah
Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorBaffour Awuah
Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorAlex Osei Akoto
Department of Paediatrics, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorS.A. Abdul Munin
Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorFred Mensah-Acheampong
Policy, Planning, Monitoring and Evaluation Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorJean-Pierre Allain
Department of Haematology, University of Cambridge, Cambridge, UK
Search for more papers by this authorCorresponding Author
Shirley Owusu-Ofori
Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Address reprint requests to: Shirley Owusu-Ofori, Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana; e-mail: [email protected].Search for more papers by this authorOhene Opare-Sem
Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorGeorge Bedu-Addo
Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorPatrick Karikari
Department of Oral Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorPeter Boateng
Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorFrancis Sarkodie
Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorRabiniatu Rahman
Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorKwame Asenso-Mensah
Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorBaffour Awuah
Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorAlex Osei Akoto
Department of Paediatrics, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorS.A. Abdul Munin
Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorFred Mensah-Acheampong
Policy, Planning, Monitoring and Evaluation Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Search for more papers by this authorJean-Pierre Allain
Department of Haematology, University of Cambridge, Cambridge, UK
Search for more papers by this authorCorresponding Author
Shirley Owusu-Ofori
Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana, UK
Address reprint requests to: Shirley Owusu-Ofori, Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana; e-mail: [email protected].Search for more papers by this authorAbstract
Background
Hospital transfusion committees (HTCs) have been established in the United States to link producers and users as well as to ensure appropriate use of blood. The HTC has been little reported in sub-Saharan Africa (SSA), although it has been established in some hospitals.
Study Design and Methods
The minutes of three to four HTC meetings per year in a tertiary hospital hosting its own blood service have been reviewed to examine the HTC role over a period of 14 years. Minutes were broken down into themes and indexes, and incomplete data were reinforced by other information sources. Specific data on progress over time were reviewed.
Results
The HTC systematically scrutinized the blood supply, blood safety, donor care, clinical use of blood products, and costs. It operated more as a blood transfusion service supervisory board than the limited function allocated to western HTCs. Clinicians and hospital administration were directly involved in decision making and directing investigations to support potential changes and advances in the role and function of the blood transfusion service. The close relation with a UK major blood center and university laboratory provided the impetus and support for research and investigations preliminary to decision making. Data collected and analyzed were reported in the international literature and contributed to disseminate progress made.
Conclusions
The HTC in a major SSA tertiary hospital inclusive of all sections of hospital organization was critically instrumental in decision making, funding, and implementing measures improving the amount and quality of blood products on the basis of evidence collected despite lack of resources. Steps are taken to ensure sustainability of the HTC.
References
- 1 Grindon AJ, Tomasulo PS, Bergin JJ, et al. The hospital transfusion committee. Guidelines for improving practice. JAMA 1985; 253: 540-543.
- 2 Haynes SL, Torella F. The role of hospital transfusion committee in blood product conservation. Transfus Med Rev 2004; 18: 93-104.
- 3 Popovsky MA. The transfusion medicine consultant and hospital transfusion committee. Vox Sang 1998; 74(Suppl 2): 391-393.
- 4 James RM, Brown S, Parapia LA, et al. The impact of a 10-year audit cycle on blood usage in a district general hospital. Transfus Med 2001; 11: 371-375.
- 5 Torella F, Haynes SL, Bennett J, et al. Can hospital transfusion committee change transfusion practice? J R Soc Med 2002; 95: 450-452.
- 6 Jackson GN, Snowden CA, Indrikovs AJ. A prospective audit program to determine blood component transfusion appropriateness at a large university hospital: a 5-year experience. Transfus Med Rev 2008; 22: 154-161.
- 7 Shulman IA, Saxena S. The transfusion services committee—responsibilities and response to adverse transfusion events. Hematology Am Soc Hematol Educ Program 2005: 483-490.
- 8 Lund TC, Hume H, Allain JP, et al. The blood supply in Sub-Saharan Africa: needs, challenges, and solutions. Transfus Apher Sci 2013; 49: 416-421.
- 9 Owusu-Ofori S, Temple J, Sarkodie F, et al. Pre-donation screening of blood donors with rapid tests: implementation and efficacy of a novel approach to blood safety in resource-poor settings. Transfusion 2005; 45: 133-140.
- 10 Allain JP, Opare-Sem O, Sarkodie F, et al. Deferred donor care in a regional hospital blood center in Ghana. Transfusion 2009; 49: 669-675.
- 11 Allain JP, Smit-Sibinga CT. Stigmatizing family donors impairs blood availability in developing countries. J Blood Transfus 2014; in press.
- 12 Allain JP, Sarkodie F, Asenso-Mensah K, et al. Relative safety of first-time volunteer and replacement donors in West Africa. Transfusion 2010; 50: 340-343.
- 13 Allain JP, Sarkodie F, Boateng P, et al. A pool of repeat blood donors can be generated with little expense to the blood center in Sub-Saharan Africa. Transfusion 2008; 48: 735-741.
- 14 Owusu-Ofori S, Asenso-Mensah K, Boateng P, et al. Fostering repeat donations in Ghana. Biologicals 2010; 38: 47-52.
- 15 Sarkodie F, Adarkwa M, Adu-Sarkodie Y, et al. Screening for viral markers in volunteer and replacement blood donors in West Africa. Vox Sang 2001; 80: 142-147.
- 16 Allain JP, Candotti D, Soldan K, et al. The risk of hepatitis B virus infection by transfusion in Kumasi, Ghana. Blood 2003; 101: 2419-2425.
- 17 Candotti D, Temple J, Sarkodie F, et al. Frequent recovery and broad genotype 2 diversity characterize hepatitis C virus infection in Ghana, West Africa. J Virol 2003; 77: 7914-7923.
- 18 Candotti D, Sarkodie F, Allain JP. Residual risk of HIV and HCV transmission by transfusion in Ghana. Br J Haematol 2001; 113: 37-39.
- 19 Allain JP. Moving on from voluntary non-remunerated donors: who is the best donor? Br J Haematol 2011; 154: 763-769.
- 20 Loua A, Nze Nkoure G. Relative safety of first-time volunteer and replacement donors in Guinea. Transfusion 2010; 50: 1851-1852.
- 21 Mbanya DN, Feunou F, Tayou TC. Volunteer or family/replacement donations: are the tides changing? Transfusion 2010; 50: 1849-1850.
- 22 Diarra A, Kouriba B, Baby M, et al. HIV, HCV, HBV and syphilis rate of positive donations among blood donations in Mali: lower rates among volunteer blood donors. Transfus Clin Biol 2009; 16: 444-447.
- 23 Asenso-Mensah K, Achina G, Appiah R, et al. Can family or replacement blood donors become regular volunteer donors? Transfusion 2014; 54: 797-804.
- 24 Li C, Danso K, Addo-Yobo E, et al. GB virus C genotype 1 is rarely transmitted vertically but acquired during infancy in West Africa. AIDS 2006; 20: 1458-1459.
- 25 Parsyan A, Kerr S, Owusu-Ofori S, et al. Reactivity of genotype-specific recombinant proteins of human erythrovirus B19 with plasmas from genotype 1 or 3 endemic areas. J Clin Microbiol 2006; 44: 1367-1375.
- 26 Wang W, Sarkodie F, Danso K, et al. Seroprevalence of west Nile virus in Ghana. Viral Immunol 2009; 22: 17-27.
- 27 Gobbini F, Owusu-Ofori S, Marcelin AG, et al. Human herpesvirus 8 transfusion transmission in Ghana, an endemic region of West Africa. Transfusion 2012; 52: 2294-2299.
- 28 Owusu-Ofori AK, Parry CM, Bates I. Transfusion-transmitted syphilis in teaching hospital, Ghana. Emerg Infect Dis 2011; 17: 2080-2082.
- 29 Freimanis G, Sedegah M, Owusu-Ofori S, et al. Investigating the prevalence of transfusion transmission of Plasmodium within a hyperendemic blood donation system. Transfusion 2013; 53: 1429-1441.
- 30 El Chaar M, Atwal S, Freimanis GL, et al. Inactivation of Plasmodium falciparum in whole blood by riboflavin plus irradiation. Transfusion 2013; 53: 3174-3183.
- 31 Owusu-Ofori S, Owusu-Ofori A, Freimanis GL, et al. Riboflavin and UV illumination treatment of whole blood units (WBU) in a Ghanaian blood center [abstract]. Transfusion 2013; 53 Suppl 2: 202A.
- 32 Candotti D, Temple J, Owusu-Ofori S, et al. Multiplex real-time quantitative RT-PCR assay for hepatitis B virus, hepatitis C virus and human immunodeficiency virus type 1. J Virol Methods 2004; 118: 39-47.
- 33 Candotti D, Opare-Sem O, Rezvan H, et al. Molecular and serological characterization of hepatitis B virus in deferred Ghanaian blood donors with and without elevated alanine amino transferase. J Viral Hepat 2006; 13: 715-724.
- 34 Ala F, Allain JP, Bates I, et al. External financial aid to blood transfusion services in sub-Saharan Africa: a need for reflection. Plos Med 2012; 9: e1001309.
- 35 Candotti D, Richetin A, Cant B, et al. Evaluation of a transcription-mediated amplification-based HCV and HIV-1 RNA duplex assay for screening individual blood donations: a comparison with a minipool testing system. Transfusion 2003; 43: 215-225.
- 36 Parsyan A, Addo-Yobo E, Owusu-Ofori S, et al. Effects of transfusion on human erythrovirus B19 susceptible or infected pediatric recipients in a genotype 3 endemic area. Transfusion 2006; 46: 1593-1600.
- 37 Zahn A, Li C, Danso K, et al. Molecular characterization of occult hepatitis B virus in genotype E-infected subjects. J Gen Virol 2008; 89: 409-418.
- 38 Lefrère JJ, Allain JP, Prati D, et al. Blood and Organ Transmissible Infectious Agents (BOTIA) group. West Nile virus and blood donors. Lancet 2003; 361: 2083-2084.
- 39 Osei EN, Odoi AT, Owusu-Ofori S, et al. Appropriateness of blood product transfusion in the Obstetrics and Gynaecology (O&G) department of a tertiary hospital in West Africa. Transfus Med 2013; 23: 160-166.
- 40 Opare-Sem O, Owusu-Ofori S, Allain JP. A novel approach to blood safety: pre-donation screening of blood donors for viral markers. Afr Sang 2002; 5: 12-16.
- 41 Kubio C, Tierney G, Quaye T, et al. Blood transfusion practice in a rural hospital in Northern Ghana, Damongo, West Gonja District. Transfusion 2012; 52: 2161-2166.
- 42 Okafor LA, Orhue A, Sahu BB. Blood transfusion in obstetrics and gynaecology: pattern, problems and prospects. East Afr Med J 1986; 63: 63-66.
- 43 Bates I, Chapotera GK, McKew S, et al. Maternal mortality in sub-Saharan Africa: the contribution of ineffective blood transfusion services. BJOG 2008; 115: 1331-1339.
- 44 Natukunda B, Schonewille H, Smit Sibinga CT. Assessment of the clinical transfusion practice at a regional referral hospital in Uganda. Transfus Med 2010; 20: 134-139.
- 45 Tapko JB, Toure B, Sambo LG. Status of blood safety in the WHO African region. Report of the 2010 survey. Brazzaville, Democratic Republic of the Congo: WHO Regional Office for Africa; 2014.
- 46 Zervou EK, Ziciadis K, Karabini F, et al. Vasovagal reactions in blood donors during or immediately after blood donation. Transfus Med 2005; 15: 389-394.
- 47 Tondon R, Pandey P, Chaudhary R. Vasovagal reactions in “at risk” donors: a univariate analysis of effect of age and weight on the grade of donor reactions. Transfus Apher Sci 2008; 39: 95-99.
- 48 Garozzo G, Crocco I, Giussani B, et al. Adverse reactions to blood donations: the READ project. Blood Transfus 2010; 8: 49-62.
- 49 Newman B. Arm complications after manual whole blood donation and their impact. Transfus Med Rev 2013; 27: 44-49.
- 50 Goldman M, Osmond L, Yi QL, et al. Frequency and risk factors for donor reactions in an anonymous blood donor survey. Transfusion 2013; 53: 1979-1984.
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