NBTS untested blood issue…
Report was presenting global perspective -Dr Ramsammy
Kaieteur News
December 1, 2006

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Minister of Health Dr Leslie Ramsammy has said a report claiming that the National Blood Transfusion Service (NBTS) provides untested blood to patients was taken out of context.

According to Dr Ramsammy, the report was presenting a more global perspective on the issue of suspected unsafe blood in respect to what happens in other parts of the world.

The report, titled the `National Strategic Plan for Blood Safety 2006-2010, under the subhead `Weakness' stated the following: “The NBTS lacks the support of a National Blood Police and the relevant legislation within which to operate.

“The current blood supply is not sufficient to meet the demand. Inefficiencies in the system led to only 67 percent of blood being garnered from prospective donors in 2004. This may well be the result of an almost total dependency on family replacement rather than volunteer blood donors. Furthermore, pre-transfusion testing in all the hospital transfusion services is not complete, leading to an occasional blood transfusion being administered prior to completion of testing for transfusion for transmissible infections. This potentially catastrophic situation results from organisational problems.

“The lack of clinical guidelines for the appropriate use of blood and blood products is of great concern. The lack of knowledge of the minimum requirements of the blood cold chain, particularly during transportation, holding on the ward and infusion, also contributes to weakness in the system. There needs to be greater temperature control of the refrigerators with the appropriate knowledge of the reasons and frequency for checking and control of temperature of the blood during the transfusion to patients.”

The report added: “Transfusion related record keeping in the clinical setting is almost non-existent and there is no information available of the purposes for which blood and its products are actually being used. There is also no information on adverse reactions, blood provided but not used and how much is returned.

“Some senior staff at the NBTS have additional responsibilities outside the scope of the blood programme. For example, the chief technologist is an employee of FXB and provides only part time service to the Blood Bank. Some staff time is also taken up with providing non-blood banking services such as clinical infectious disease testing, routine testing services for the Ante National Clinics in Region Four and HIV testing for VCT and PMTCT sites and the GUM Clinic.”

These weaknesses were highlighted under the section `Analysis of the Current Situation of the Blood Transfusion Service'. There was no reference in that part of the report about blood transfusion services in any other part of the world.

The National Strategy Plan for Blood Safety which outlines a five-year plan for improving blood safety practices noted that the potentially catastrophic situation results from organisational issues.

Ramsammy assured Wednesday that every unit of blood collected is screened for various diseases. However, the screening is not foolproof because of that window period,” Dr Ramsammy.

The window period is when a person is tested negative for HIV even though they are positive.

This is why there is need for follow-up testing, the Minister said.

He explained that because hospitals rely on family members to donate blood, they in turn revert to strangers who are paid for their blood.

Dr Ramsammy said these strangers are not likely to reveal their status and it may not show up in the blood if the person recently contracted the virus.

However, the Ministry is moving to have 100 percent of blood donated voluntarily by the end of 2007.

The Minister said Guyana now has a 30 percent voluntary blood donation service.

Director of NBTS, Dr Clement McEwan had refuted the article which stated that not all the blood given to patients is tested for disease.

He said the Blood Bank is tasked with supplying all hospitals with blood and at no point has it allowed untested blood to be transfused.

The NBTS had also mentioned that the report was not necessarily making specific reference to the Blood Bank.

But checks revealed that only one private hospital has a small Blood Bank facility. That hospital turns to the NBTS for blood when its supplies run low.

Other private hospitals do not store blood and are dependent on the NBTS for supplies.

Dr McEwan declared that the Kaieteur News article was misleading and frightening since it conveys a message that unsafe blood is stored at the NBTS, intended for transfusion.