Evaluation of blood banking practices during the HIV/AIDS era in Nigeria

Less than one percent of the entire population of Nigeria knows their HIV status. The observation is problematic because the target population is composed of youths between the ages of 15 and 25 who because of the high HIV prevalence or the lack of knowledge about their HIV status are among the most vulnerable in contracting the disease.;As of the year 2003, Nigeria had the third highest numbers of people living with HIV. It trails South Africa and India in that statistic. Estimates using the 2001 HIV seroprevalence sentinel survey of women attending antenatal clinics indicate that more than 3.8 million Nigerians were living with the virus in 2002 while 310,000 people died of AIDS in 2003. It is projected that by 2010, Nigeria will have 10 to 15 million people living with HIV/AIDS which will be at par with China which has a population that is more than eight times that of Nigeria.;The special importance of blood and blood products transfusion in the transmission of HIV was recognized in both Africa and the developed world in the early years of AIDS because they transmit viral infection far more effectively and efficiently than any other means. Blood transfusion service is an area where the Nigerian government efforts have yielded little or no results. Many lives are lost every day in emergencies due to non-availability of transfusable blood. Patients continue to suffer because of the absence of organized Emergency Transfusion Service.;To assess the practices of blood collection and blood transfusion facilities in a specific location in Abia State Nigeria, three full service institutions were surveyed using an expanded version of the WHO integrated strategy for blood transfusion safety questionnaire. Two of the three full service hospitals are located in Abia State while the third institution, which was adopted as a benchmark institution, was located in Lagos, the commercial capital and former capital of Nigeria. All three facilities are tertiary institutions that also serve as teaching hospitals. The sampling method was purposive.;Of the 36 respondents that participated in the exercise, only 28% was a medical director who is a licensed physician with blood banking training the facility administrator, while 75% identified the blood donor officer as a blood bank specialist. Fifty eight percent do not recruit paid donors. Ninety two percent test 100% of all donor blood for HIV, while 81% utilize two testing methods for HIV. About 86% provide proper storage and monitoring. Ninety four percent do not have reliable electricity and 86 use backup generators. One hundred percent of the facilities were government owned, 47% federal and 53% state. Only 22% indicated that the national policy on transfusion provided for the use of blood alternatives, and 94% indicated that the blood policy had emphasized both HIV prevention and HIV reduction.;From all indications, there are still considerable variations in the practices of these blood transfusion centers. One common thread among all the facilities is the absence of necessary infrastructure without which compliance with the WHO guidelines remains impossible.;The only way to unify and improve the standard of performance in the region and in the country is through proper regulations and adequate enforcement of existing regulations. Greater effort should be invested to meet the infrastructural need of the region and the rest of the country to help achieve the standard of performance mandated by the WHO. It is impossible to collect, store and transfuse blood without adequate and reliable electricity or power supply.