Département d'Études des Agents Transmissibles par le Sang, Institut National de la Transfusion Sanguine, Centre National de Référence Risques Infectieux Transfusionnels, 75015 Paris, France.
Department of Hematology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, BP: 1364, Yaoundé, Cameroon.
Transfus Clin Biol. 2021 May;28(2):163-170. doi: 10.1016/j.tracli.2021.01.007. Epub 2021 Jan 27.
In Sub-Saharan Africa, high clinical demand for transfusion faces endemic bloodborne infections and limited resources. Blood screening for transfusion-transmitted bloodborne pathogens is the cornerstone of blood safety. Although there have been substantial improvements over the years, challenges in transfusion-transmitted infection screening that have been identified repeatedly long ago still need to be addressed. Affordability and sustainability of state-of-the-art quality assessed serological and molecular assays, and associated confirmation strategies remain of real concern. In addition, limited resources and infrastructures hamper the development of adequate facilities, quality management, and staff qualification, and exacerbate shortage of reagents and equipment maintenance. It is also important to maintain effort in constituting pools of repeat voluntary non-remunerated donors. Alternative strategies for blood screening that take into account local circumstances might be desirable but they should rely on appropriate field evaluation and careful economic assessment rather than dogma established from high-resource settings.
在撒哈拉以南非洲地区，临床对输血的高度需求面临着地方性血源感染和有限资源的双重挑战。用于输血传播病原体检测的血液筛查是血液安全的基石。尽管近年来已经取得了实质性的进展，但很久以前就已经确定的输血传播感染筛查方面的挑战仍有待解决。负担得起和可持续地使用经过质量评估的先进血清学和分子检测方法，以及相关的确认策略仍然是真正令人关注的问题。此外，有限的资源和基础设施阻碍了适当设施、质量管理和员工资质的发展，加剧了试剂和设备维护的短缺。此外，努力组建重复的、自愿的、非报酬性的献血者库也很重要。考虑到当地情况的血液筛查替代策略可能是可取的，但它们应该依赖于适当的现场评估和仔细的经济评估，而不是从高资源环境中建立起来的教条。
