S J Heymann1, T F Brewer. 1. Center for Population and Development Studies, Harvard School of Public Health, Boston, MA.
Abstract
BACKGROUND: Transfusion-associated AIDS accounts for 10% of all cases of AIDS in Africa. The risk of HIV-1 contamination in transfusions continues to exist, even in countries where blood products are screened, because of limitations in test sensitivity, human error, and the window period. Furthermore, 30 African countries do not screen all of their blood products because of resource limitations. METHODS: This study used decision analysis to compare the survival outcomes of severely anemic patients who are transfused with those of patients who are not transfused. Sensitivity analyses were performed. RESULTS: When 5% of the blood supply is HIV-1 contaminated, every patient with a 6.6% or greater risk of dying from anemia should be transfused. Detailed results are provided for a wide range of HIV-1 contamination rates. CONCLUSIONS: This study provides a method for developing and evaluating locality-specific transfusion guidelines. This method can be applied to other regions, including the United States, and to other diseases transmitted by blood products.
BACKGROUND: Transfusion-associated AIDS accounts for 10% of all cases of AIDS in Africa. The risk of HIV-1 contamination in transfusions continues to exist, even in countries where blood products are screened, because of limitations in test sensitivity, human error, and the window period. Furthermore, 30 African countries do not screen all of their blood products because of resource limitations. METHODS: This study used decision analysis to compare the survival outcomes of severely anemicpatients who are transfused with those of patients who are not transfused. Sensitivity analyses were performed. RESULTS: When 5% of the blood supply is HIV-1 contaminated, every patient with a 6.6% or greater risk of dying from anemia should be transfused. Detailed results are provided for a wide range of HIV-1 contamination rates. CONCLUSIONS: This study provides a method for developing and evaluating locality-specific transfusion guidelines. This method can be applied to other regions, including the United States, and to other diseases transmitted by blood products.
Entities:
Keywords:
Acquired Immunodeficiency Syndrome--prevention and control; Africa; Behavior; Biology; Blood Supply; Decision Making; Developing Countries; Diseases; Economic Factors; Equipment And Supplies; Examinations And Diagnoses; Hematologic Tests; Hemic System; Hemoglobin Level; Hiv Infections--prevention and control; Laboratory Examinations And Diagnoses; Laboratory Procedures; Methodological Studies; Needs; Physiology; Recommendations; Risk Factors; Screening; Viral Diseases
Authors: Joshua N Bress; Todd Hulgan; Jennifer A Lyon; Cecilia P Johnston; Harold Lehmann; Timothy R Sterling Journal: Am J Med Date: 2007-05 Impact factor: 4.965