[Blood transfusions in Africa during the AIDS epidemic. Condition of localities and perspectives in the Ivory Coast].

HIV is transmitted essentially by the heterosexual route in Africa. As part of an international mobilization against the Aids epidemic, information, education and communication strategies should continue to reduce the frequency of the infection. In this paper, we underline the high risk of HIV infection from blood transfusion in Africa. Although few epidemiological data are available, we feel that this problem should be made a priority, and that blood transfusion in Africa can be made reasonably safe by rational use of limited resources. We first report how the Ivory Coast health ministry, with funding from the European Community, has organized blood transfusion services in the main urban areas. Despite routine screening tests, the risk of HIV transmission through blood products remains high because of the large number of infected donors who are antibody-negative. The accent must thus be placed on alternatives to blood transfusions, while the use of transfusions must be minimized, especially in pediatric and general medical wards. As malaria, undernutrition and obstetric surgery are leading causes of anemia, health programs should be aimed at controlling these factors with the ultimate goal of limiting the spread of HIV.