Reducing the Proportion of Blood Discards at Fort Portal Regional - - PowerPoint PPT Presentation

November 22, 2013 1

Reducing the Proportion of Blood Discards at Fort Portal Regional Blood Bank

Ambrose Mugume Moses Mukembo Fellows Mentors: 1.Dr. Kayita Godfrey (Academic) 2.Dr. Ngobi James (Institutional) Dissemination workshop-Speke Resort Munyonyo

November 22, 2013 2

Introduction

• Uganda Blood Transfusion Service (UBTS) -

Ministry of health

• It has 7 regional blood banks including Fort

Portal

• UBTS collects, tests and distributes safe blood in

Uganda

• Donated blood at UBTS is screened at the

laboratory

• Blood discards are mainly due to transfusion

transmissible infections

November 22, 2013 3

Problem

• 676(9.8%) of 6,924 units

collected were discarded between October 2012 and March 2013

– 40% - hepatitis B – 35% - HIV – 12% - Inadequate volume – 5% - hepatitis C – 8% - others

• 5% is acceptable discard

rate by UBTS

Blood ready for discard

November 22, 2013 4

Problem cont’d

• Approximate cost of a unit of blood= USH70,000

(USD28)

• At least USH18,900,000 (USD 7,560) was lost

due to hepatitis B blood discards in the period

• Loss of a precious resource by the blood donor

November 22, 2013 5

Project objectives

General objective

• Reduce the proportion of blood discards due to

hepatitis B at Fort Portal regional blood bank Specific objectives

• To reduce hepatitis B discards from 40% to 15%

by Oct 2013

• Strengthen the blood donor selection process
• To reduce costs due to high blood discards

November 22, 2013 6

Project implementation

• Introduced pre donation screening for

hepatitis B

• Trained 11 staff on hepatitis B rapid testing
• Standard operating procedures for on site

screening developed

• Referral form introduced in the field
• Work flow charts were put in place

November 22, 2013 7

Out comes

Percentage baseline discards

35 40 5 4 12 4 HIV Hepatitis B Hepatitis C Syphilis Inadequates Expired

Percentage current discards 27 23 32.5 9 7.8 HIV Hepatitis B Hepatitis C Syphilis Inadequates

Before After

November 22, 2013 8

Key project Outcomes

• Hepatitis B discards reduced from 40% to 23%
• 81 of 2,419 blood donors tested were deferred

for hepatitis B

• Observed unintended reduction in discards due

to HIV, expiry and inadequate blood volume

• Net saving of USH3,670,000 (USD1,468) made

in 4 months

November 22, 2013 9

Lessons learnt

• The intervention can be applied in communities

with a high viral prevalence

• Positive association between Hepatitis B and

HIV

• Instant hepatitis B checks makes pre and post

donation counseling easier

November 22, 2013 10

Challenges and counter measures

No Challenge Counter measure 1 Referral of hepatitis B positive donors Introduction of a referral form. 2 Follow up difficulties of referred blood donors Captured telephone numbers 3 Limited time in schools Teacher education to give more time 4 Confidentiality issues Strengthened pre donation education 5 Long queuing of blood donors at hepatitis B screening point Need extra man power/ trained volunteers

November 22, 2013 11

Recommendations

• Scale up pre donation screening
• Reduce blood discards due to Hepatitis C
• Introduce free/routine hepatitis B

vaccination to blood donors

• Target populations most affected by

Hepatitis B virus

• UBTS review of Standard operating

procedures

November 22, 2013 12

Conclusion

• Pre donation screening for Hepatitis B

reduced blood discards by 42.5% in 4 months

• Strengthened the blood donor selection

process and also had unintended benefits

• Reduced costs by USH3,670,000

(USD1,468) at Fort Portal regional blood bank

November 22, 2013 13

Acknowledgements

• Management of Uganda Blood Transfusion

Service

• Fort Portal regional blood bank staff
• MakSPH-CDC Fellowship staff – Mr Matovu,

Ms Stella and Ms Faridah

• Academic mentors – Dr Kayita Godfrey
• Mr Enock Kizito
• Institutional mentor – Dr Ngobi James
• CQI Fellows of 2013 cohort