24c63a547a7b.jpgFollowing heavy criticism in 2005 for marginalising black donors, the South African National Blood Service (SANBS) had to regain the public’€™s confidence and it revised its risk management system. What followed was the introduction of what is called the Nucleic Acid Testing or NAT system, a very sensitive tool in detecting infections.      

‘€œWe started our routine testing in early October 2005. We have now tested over 3.6 million donations over the five year period. We did NAT testing in all the bloods. The significant improvement in blood safety you see with the number of transmissions we prevented is high’€, says Ravi Reddy, the SANBS’€™s Chief Operations Officer.

Reddy stresses that over the years they have learned that it is critical to eliminate contaminated blood.

‘€œThe prevalence in our first time donors was from 4% to 7%. This is really in our blood donor population. By 1996, 1997 and 1998 up to 7% of the females were positive. That means despite all the donor exclusion questionnaires, 7 out of 100 females that donated to at the time, actually tested HIV-positive. Something had to be done’€.

He adds that black donors were classified as a high risk category, thus their blood was rejected outright. Ironically, though, the blood service now wants to increase the pool of black donors.

‘€œThey are the future sustainability of SANBS. We were having an ageing white donor base. Up to 2007 we had got to less than 5% of our donors being black. By 2008, we increased to 11.5%, collecting 65  000 units in total. Now in 2010, 22.3% of our donor base is black donors. That is high. It’€™s has gone up more than four times since we started’€, says Reddy.

Through the NAT system, SANBS is not only able to detect HIV, but also forms of Hepatitis, also known as HBV and HCV. In the five years that the system has been in place and after 3.6 million donations, only one sample of blood that reached a user was found to be contaminated with Hepatitis.

‘€œIt was a donor who had come back and we found him to be Hepatitis-B positive and we had to look back to see who received blood from that donor. The donor details were a 47 year-old white male. We had a negative donation from him in November 2008. His red cells were transfused to the patient in December 2008. And then we got a positive donation in January 2009, upon where our medial team started to do a look-back investigation. Three months later, we were then able to get the recipient’€™s sample in March 2009 and it was strongly HBV-positive’€, says Marion Vermeulen, manager of the SANBS’€™s NAT system.