Laleman G, Magazani K, Perriëns J H, Badibanga N, Kapila N, Konde M, Selemani U, Piot P
Centre Régional de Lutte Contre le SIDA, Lubumbashi, Zaire.
AIDS. 1992 Nov;6(11):1353-8. doi: 10.1097/00002030-199211000-00019.
To prevent blood transfusion-acquired HIV infection with a decentralized approach to HIV screening of blood donors, using an instrument-free rapid test.
Shaba province, Zaire (496,877 km2).
The programme consisted of training health-care workers, distribution of a rapid HIV-antibody test (DuPont's HIVCHEK) for screening of all blood donations, and quality control of testing by a regional reference centre.
Over a 2-year period, 11,940 rapid tests were distributed to 37 hospitals, covering 75% of all hospital beds outside the copper mine's health system in Shaba. Eighty-five per cent of the tests were used to screen blood donors (5.4% positive test rate) and 13% to test patients (39.7% positive test rate). At least 265 cases of HIV-positive blood donation were prevented, at an estimated cost of 137-279 ECU per case. Only 26% of initially positive specimens reached the central laboratory for supplemental testing, and sterile transfusion equipment and blood-grouping reagents were frequently unavailable. The lack of transport and communications and a deteriorating health system were major constraints.
District hospitals in Africa are often long distances from major cities, difficult to reach for most of the year, and perform a small number of transfusions. In this context a classical centralized regional blood bank may not be a feasible option to ensure safe blood transfusions. However, safe blood transfusion can be achieved with a decentralized approach using a rapid test, provided that minimum standards of health-care services are available.
采用分散式方法对献血者进行艾滋病毒筛查，使用无需仪器的快速检测，以预防输血获得性艾滋病毒感染。
扎伊尔沙巴省（496,877平方公里）。
该项目包括培训医护人员、分发用于筛查所有献血的快速艾滋病毒抗体检测试剂（杜邦HIVCHEK），以及由区域参考中心进行检测的质量控制。
在两年时间里，向37家医院分发了11940份快速检测试剂，覆盖了沙巴铜矿卫生系统以外所有医院床位的75%。85%的检测试剂用于筛查献血者（阳性检测率为5.4%），13%用于检测患者（阳性检测率为39.7%）。至少预防了265例艾滋病毒阳性献血，估计每例成本为137 - 279欧洲货币单位。最初呈阳性的标本中只有26%送达中央实验室进行补充检测，而且无菌输血设备和血型试剂经常短缺。缺乏交通和通讯以及卫生系统不断恶化是主要制约因素。
非洲的地区医院通常距离大城市很远，一年中大部分时间难以到达，且输血次数较少。在这种情况下，传统的集中式区域血库可能不是确保安全输血的可行选择。然而，只要有最低标准的医疗服务，采用分散式方法使用快速检测就能实现安全输血。
