Availability, safety, and quality of blood for transfusion in the Americas.
OBJECTIVE
This article has two objectives: (1) to present for countries and territories of the Region of the Americas data on the number of blood donations, proportion of voluntary blood donors versus remunerated blood donors, coverage of screening for infectious agents, and separation of donated blood into its components and (2) to explore the relationships of those characteristics with economic and organizational factors in the countries and territories.


METHODS
We carried out comparative analyses using population and health information gathered annually by the Pan American Health Organization (PAHO) from national health officials from the countries in the Americas, as well as economic information (gross national product (GNP) per capita) obtained from publications of the World Bank.


RESULTS
There is a direct correlation between the availability of blood for transfusion and GNP per capita. Seven countries with a GNP per capita above US$ 10 000 per year account for 38% of the Regional population but 68% of the Regional blood donations. Voluntary blood donation is more common in the countries with better blood availability. There is no association between GNP per capita and coverage of screening for infectious agents. Nevertheless, of the six countries with a GNP per capita below US$ 1 000, only one of the six screens all units for human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B surface antigen (HBsAg). Countries with a higher proportion of voluntary blood donors tend to have lower prevalence rates of infectious markers. Separation of blood into its components is also more common in countries with higher blood donation rates.


CONCLUSIONS
The availability, safety, and quality of blood for transfusion in the Americas needs to be improved. As part of that effort, national policies and strategies must be put into place so that the resources already allocated for blood services are better utilized.
Pan American Health Organization, Laboratory and Blood Services, Washington, D.C., United States of America. cruzjose@paho.org
José Ramiro
JR
Cruz
María Dolores
MD
Pérez-Rosales
D001771:Blood Banks / Q000458:organization & administration*; D001803:Blood Transfusion / Q000592:standards*; D006801:Humans; D007843:Latin America; D008403:Mass Screening; D010175:Pan American Health Organization; D012449:Safety; D012959:Socioeconomic Factors