Transfusion medicine crucial in achieving MDG on health

The National Blood Transfusion Service Eastern Zone Centre, Laboratory Technician,  Sam Mduma, (2nd left), explains a point to participants of a symposium on Transmi ttable Transfusion  Infections and Immunohaematology in Blood Banks with Medexpo  during their visit at the centre in Ilala Mchikichini, Dar es Salaam last week.  Third (left) is the Centre's Laboratory  Department Head, Bahati Mfaki. 

ALOYCE NDELEIO

Dar es Salaam

Africa and the rest of the developing world, face several challenges that can be a threat to human existence particularly in the health care sector, therefore, national governments have a mandate to ensure improvement in the quality of life for the population and there is no better starting point than to have quality healthcare for everyone.

This was revealed recently during a symposium on Transmittable Transfussion Infections and Immunohaematology in Blood banks with Medexpo held in Dar es Salaam and organised by Bio-RAD Laboratories, one of the leading manufacturers of life science and clinical diagnostic products in the world.

The symposium, which provided a platform for key persons involved with blood transfusion centres in the region, discussed among others the status of TTI testing and blood group testing and challenges facing blood banks.

“Transfusion medicine is a key sector which, without a doubt, cannot be ignored in our quest to achieve the MDG set on health. As governments, we engage with our technical partners, the AID organizations from the developed nations, to implement solutions and offer such essential services as screening donor blood to ensure safe blood is available to those who need transfusion,said Dr. Magreth Mhando in her opening remarks to the symposium participants.

Dr. Mhando, who is the Director of Curative Services in the Ministry of Health and Social Welfare, point out, provision of safe blood to those who need transfusion, requires a unified approach by all stake holders to prevent transmittable transfusion infections, such as syphilis, hepatitis viruses and HIV and this is an essential objective in modern day laboratory medicine. The focus must be patient centered, outcome oriented and sustainable

She noted, that not only is the screening of TTI important, but it is of equal importance to ensure that the correct and compatible blood group is transfused to the patient also, adding, this therefore places the same importance to blood typing, cross matching, anti body identification and all other special immunohaematological tests required to ensure safe transfusion.”

Dr. Mhando revealed that true solutions that combine both optimized work flow and structured evidence-based transfusion solutions are essential in ensuring that service delivery levels are uplifted across the board in all health care facilities where transfusion is done for patients in need, from primary health care centers to referral centers such as the national blood transfusion laboratory.

On the other side of the coin, Dr. Mhando said that the government intends to extends its blood transfusion services to regions instead of the services being centred on the six selected zones.

This program will help in strengthening our services and preparations are on the way to make sure there is a conducive environment at least within five years.

Public-private partnership

The Health Ministry's Curative Director asserted that arriving at a recommendable and successful achievement in this juncture, combined forces should push the wheel together.

She added, in order to realize the desired results, of providing safe blood to all, in our resource constrained countries, we must embrace the public private partnership and work together to solidify the social contract that binds all of us.

“We must encourage private companies such as Bio-Rad Laboratories and their local partners, in the respective countries, such as Pyramid Pharma Ltd here in Tanzania, to engage and work closely with the government(s), through the Ministries of Health in collaboration with the supporting partners such as the American Association of Blood Banks (AABB), Centers for Disease Control and Prevention (CDC) to find practical solutions that would benefit our people.”

Through such partnership very important information and knowledge exchange can be gathered and realised among all stakeholders in the health delivery systems. And, they will also share experiences regarding various technologies used in different countries and challenges faced in the region.

This means both can seek and share their commons and coming up with steps to improve services delivered with regards to TTI and ImmunoHaematology testing in the blood banks.

National Blood Screening Program

The Tanzania National Blood Transfusion Service developed a policy, standards, strategy, system and infrastructure for the screening of all donated blood. All donated blood is screened for mandatory Transfusion Transmissible Infections prior to its release for clinical use.

National Blood Transfusion service Program manager Dr. Efesper Nkya revealed when presenting his paper at the symposium pointing that Transfusion Transmissible Infections screened by NBTS Tanzania includes HIV and Syphilis also RPR Syphilis rapid Test.However, he noted that the scientific diagnosis of antibodies in the blood that is Blood Group Serology there are two techniques used, Microtitre plate and Tube Technique in which both cell grouping and serum grouping are performed.

Dr. Nkya said discrepancy from the microtitre technique are confirmed by Tube Technique, Rhesus grouping performed parallel with ABO grouping.

So far, so good, blood is a very sensitive product and therefore, good manufacturing practices (GMP) if not adhered to may end up producing the product that does not meet pre-specified standards hence failing to meet customers expectations.

Among principles involved in ensuring GMP is use of machines that include various technologies in TTI testing and Blood Group Serology and their challenges and some of these are found in six NBTS centres of which each is equipped with a testing and component production Laboratory.