Bloodborne transmission of Hiv/Aids in Africa: Challenges and intervention strategies

Abstract

The causative agent of Acquired Immune Deficiency Syndrome (AIDS), is the human immuno-deficiency virus(HIV). Two types of HIV( types 1 and 2), have been linked with AIDS. HIV-2, has been described mainly in West Africa. HIV can be transmitted both in cellular and plasma components of blood. Bloodborne transmission, accounts for 3-5% of the mode of transmission worldwide.Figures for other modes of transmission are 5-10% for intravenous drug use, 5 to 10 % for the homosexual route , 70 to 75 % for the heterosexual route, while other routes account for 0 to 17%.The recipients of blood products are at the greatest risk of infection or probability of infection, if improperly screened blood is transfused. The essence of this manuscript is to highlight, the risk and preventive strategies for HIV transmission associated with blood transfusion. Relevant literature on the subject of this review article, have been obtained through journal articles and internet search engines. The main contributors to transfusion-related HIV transfusion in Africa, includes poorly structured donor screening programs, poor health infrastructure, with lack of properly equipped and supplied transfusion centers, cultural practices, such as scarification with unsterilised sharp instruments and the clinical condition of patients needing transfusion. In addition certain attributes in the blood donor, such as high free serum HIV, increase the risk of transmission. Studies have shown that the risk of transmission is less, when blood is stored, for a longer period. The latter has been attributed to the death of HIV-infected white blood cells. Intervention strategies advocated, for reduction in bloodborne transmission of HIV, include prevention of diseases such as malaria and injuries that require transfusion; discouraging the immediate transfusion of blood after collection; public health education based on cultural practices in Africa, especially with regards to circumcision and scarification; the use of alternative confirmatory algorithms, which utilize the use of two rapid assay kits such as Capillus and Genie, should be mandatory in health care facilities.

Keywords: BLOODBORNE, TRANSMISSION,HIV/AIDS,AFRICA