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资源匮乏国家的输血服务管理

Management of blood transfusion services in low-resource countries.

作者信息

Patidar Gopal K, Thachil Jecko, Dhiman Yashaswi, Oreh Adaeze, Vrielink Hans, van den Berg Karin, Grubovic Rastvorceva Rada M, So-Osman Cynthia, Al-Riyami Arwa Z

机构信息

Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India.

Department of Haematology, Manchester Royal Infirmary, Manchester, UK.

出版信息

Vox Sang. 2022 Dec;117(12):1375-1383. doi: 10.1111/vox.13373. Epub 2022 Nov 8.

Abstract

BACKGROUND AND OBJECTIVES

Enabling universal access to safe blood components should be a key component of every country's national healthcare strategy. This study aimed to assess the current status of infrastructure and resources of blood transfusion services (BTS) in low- and middle-income countries.

MATERIALS AND METHODS

A cross-sectional survey was designed to gather information on blood donations, components, redistribution, testing resources and quality management systems (QMSs). The survey was distributed to the International Society of Blood Transfusion members between October 2021 and November 2021.

RESULTS

A total of 54 respondents from 20 countries responded to the survey. This included hospital-based BTS/blood centres (46%), national blood centres (11%)and national and regional blood services (11%). Voluntary non-remunerated, replacement and paid donors accounted for 94.2%, 84.6% and 21.1% of donations, respectively. Apheresis donation was available in 59.6% of institutions. National/regional criteria for redistribution of blood components were reported by 75.9% of respondents. Blood components incurred payment charges in 81.5% of respondents' institutions, and payments were borne by patients in 50% of them. Testing methods, such as manual (83%), semi-automated (68%) or fully automated (36.2%), were used either alone or in combination. QMSs were reported in 17 institutions, while accreditation and haemovigilance were reported in 12 and 8 countries, respectively.

CONCLUSION

QMS was implemented in most of the countries despite the common use of paid donations and the lack of advanced testing. Efforts to overcome persistent challenges and wider implementation of patient blood management programmes are required.

摘要

背景与目标

使所有人都能获得安全的血液成分应是每个国家国家医疗保健战略的关键组成部分。本研究旨在评估低收入和中等收入国家输血服务(BTS)的基础设施和资源现状。

材料与方法

设计了一项横断面调查,以收集有关献血、成分血、再分配、检测资源和质量管理体系(QMS)的信息。该调查于2021年10月至2021年11月分发给国际输血协会成员。

结果

来自20个国家的54名受访者回复了调查。其中包括医院输血服务部门/血库(46%)、国家血库(11%)以及国家和地区血液服务机构(11%)。自愿无偿献血者、替代献血者和有偿献血者分别占献血量的94.2%、84.6%和21.1%。59.6%的机构提供单采献血。75.9%的受访者报告了国家/地区血液成分再分配标准。81.5%的受访者所在机构的血液成分产生了支付费用,其中50%由患者承担。单独或组合使用手工检测(83%)、半自动检测(68%)或全自动检测(36.2%)等检测方法。17个机构报告了质量管理体系,12个国家和8个国家分别报告了认证和血液警戒情况。

结论

尽管普遍存在有偿献血且缺乏先进检测,但大多数国家仍实施了质量管理体系。需要努力克服持续存在的挑战,并更广泛地实施患者血液管理计划。

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