Retesting of blood samples finds risk of spreading HIV, hepatitis B, hepatitis C, and syphilis through transfusions and medical malpractice

The health systems in Central Asian countries have an urgent need to improve their screening efforts in order to prevent the use of infected blood in transfusions and the accidental transmission of communicable diseases to unsuspecting patients. After rescreening samples from 7500 donors, the results showed a clear and present danger that blood contaminated with HIV, hepatitis B, hepatitis C and syphilis may be entering into the countries' blood supply.

The findings are reported in "Blood Services in Central Asian Health Systems: A Clear and Present Danger of Spreading HIV/AIDS and Other Infectious Diseases," a new World Bank report, prepared in collaboration with US CDC and WHO-EURO, that sheds light on a previously neglected subject and provides insight into where screening and medical practices need to be improved.

"The current screening of donated blood in Central Asia may be providing a false sense of security, while on the contrary, the risk of receiving infected blood by transfusion is real," said Patricio V. Marquez, Lead Health Specialist for ECA and lead author of the report. "More ominous is the fact that some health facilities in Central Asia do not test blood donations at all. This means that the transmission risks indicated in this study may be conservative estimates, as there is other blood being used that doesn't ever enter a screening system."

Blood centers that used re-usable vials have started using disposable bags; they are also using more-reliable test-kits.

The re-testing found prevalence of communicable diseases in the blood samples to be 0.20 percent for HIV, 2.7 percent for hepatitis B, 3.0 percent for hepatitis C, and 3.6 percent for syphilis.

The report's findings underscore the need to strengthen screening of blood donors on the occasion of each donation and other prevention and control measures to guarantee the safety of the blood supply in the health systems of Central Asia countries, and reduce the risk of involuntary infection to the unsuspecting population.

The report discusses inter-related parts of blood transfusions systems, and presents an overview of the parts that need to be strengthened in Central Asia. It finds that parts of the system are in serious need of organizational restructuring, new investment and increased budgetary support for operation and maintenance. The report sets them out such that each can be addressed in turn – and some simultaneously.

It is expected that this report will contribute to advance health system reforms in Central Asia and beyond.

The report also discusses the health threat posed by alarmingly low levels of blood supplies, fostered by a culture that places little value on donating blood, public fear of being infected by giving blood, and the near absence of donor promotion campaigns.

In an effort to solve some of the challenges contributing to the problem, the report recommends that efforts to address the systemic deficiency of blood transfusion services in Central Asia should be part of broader health system strengthening programs and regional activities that need to be supported by national governments and the international community.