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  • Title: Increasing risk of transfusion-associated AIDS as the pandemic spreads: experience in Maiduguri, Nigeria.
    Author: Harry TO, Moses AE, Ola TO, Obi SO, Bajani MD.
    Journal: J Trop Med Hyg; 1993 Apr; 96(2):131-3. PubMed ID: 8459487.
    Abstract:
    Complacency and financial considerations have led many hospitals in developing countries with low HIV antibody prevalence to disregard the importance of pre-screening for HIV antibodies blood meant for transfusion. This report shows that during the year 1987 in which mandatory screening of donated blood was introduced at the University of Maiduguri Teaching Hospital, HIV antibody prevalence in donated blood units was 0%. However, four years later the prevalence had risen to 2.76%. This observation underlines the increasing risk to which transfusion recipients are exposed if given unscreened blood as HIV spreads with time. This spread can be rapid. Based on screening of all blood units donated to a Nigerian hospital using enzyme linked immunosorbent assay (ELISA) and Western blot, the prevalence of human immunodeficiency virus (HIV) rose from 0% in 1987 to 2.76% in 1991 (Western blot positives only). The prevalence in intervening years was .33% in 1988, .38% in 1989, and .94% in 1990. Western blot indeterminates rose from 0% in 1987 to 2.05% in 1991. The percentage of blood units which were ELISA positive but Western blot negative plus ELISA borderline rose from .90% in 1987 to 2.87% in 1991. Overall, the percentage of donated units that had to be discarded, because of a positive or borderline ELISA, rose from .90% in 1987 to 7.67% in 1991. Donors were male residents of Maiduguri, Nigeria, between the ages of 18 and 55. Positive units were from donors between the ages of 22 and 45 who did not belong to any high risk groups. All positives were for HIV-1 only. In view of these findings, screening of blood donations, although expensive, is recommended, even in areas such as Nigeria where the overall prevalence of HIV is low. Because of expense, pooling of sera for testing may be necessary and transfusions should be limited to imperative situations only. Also, fees can be charged for screening.
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