Estimated risk of HIV transmission by blood transfusion in Kenya

Background During the past decade, developing countries have received limit ed support for blood safety programmes. The Kenya Ministry of Health did a collaborative multicentre assessment to establish the risk of HIV transmiss ion by transfusion in Kenya, to promote awareness of blood safety issues in this country with a mature HIV epidemic, and to identify methods to reduce the risk of HIV transmission by blood transfusion in Kenya. Methods For 12 weeks, from April to July 1994, we collected information and blood samples from all blood donors, and pretransfusion samples were colle cted from all recipients in six government hospitals in Kenya. Blood donati ons were collected and screened for HIV according to standard practice in t he hospital laboratories. Test results at a reference laboratory were compa red with those of the hospital laboratories and risk of transfusion-associa ted HIV transmission was calculated. Findings The prevalence of HIV among blood donors was 6.4% (120 of 1877) an d varied by hospital (range 2-20%). HIV test results were available for 129 0 donor-recipient pairs. Of these, 26 HIV-positive donations were given to HIV-negative patients. We estimate that 2.0% of transfusions transmitted HI V. Problems in the hospitals that contributed to transfusion risk included inconsistent refrigeration, data entry errors, equipment failure, and lack of a quality-assurance programme. Interpretation A high proportion of blood transfusions transmitted HIV in t his high-prevalence area of Africa, primarily because of erroneous laborato ry practices. On the basis of these results, the Kenya Ministry of Health i ntroduced a number of practical and inexpensive interventions to improve na tional blood safety.