Safety of blood supply in the Caribbean countries: role of screening blood donors for markers of hepatitis B and C viruses.
BACKGROUND
Blood transfusions carry risks of untoward reactions, including the transmission of infections, such as hepatitis B and C. Proper blood donor recruitment and selection, and adequate laboratory screening for infectious markers diminish the risk of transfusion-transmitted infections.


OBJECTIVE
To estimate the potential risk of acquiring transfusion-transmitted infections by hepatitis B or hepatitis C in 24 Caribbean countries during the period of 1996 to 2003.


METHODS
Official national reports for 1996, 2000-2003 of the yearly number of blood donors, screening coverage, and prevalence of serological markers for infectious diseases were used to estimate the risk of patients receiving an HBV- or HCV-positive unit of blood, and of developing an infection after receiving a positive unit. Estimates of number of infections transmitted through transfusion and number of infections prevented by screening of blood were also obtained.


RESULTS
During the period analyzed, HBV screening coverage among blood donors was 100% in all countries with the exception of Grenada (0% in 1996) and Saint Lucia (99.5% in 2002). For HCV, only 10 countries reported universal screening in 1996, while 15 did in 2003. The number of countries that did not screen any units for HCV decreased from 11 in 1996 to five in 2003. In general, high prevalence rates of HBV (10-75 per 1000 donors) and HCV (7-19.3 per 1000 donors) markers were found in the majority of countries. We estimated that 235 infections by HCV (1:12471 donations) and two infections by HBV (1:1465373) were transmitted through transfusion because of lack of screening. On the other hand, screening of blood for transfusion prevented 21 005 HCV and 22 100 HBV infections.


CONCLUSIONS
Blood donor recruitment and coverage of screening for transfusion-transmitted infections, especially HCV, must be improved in the Caribbean countries.
Cruz
Jose R
JR
Pan American Health Organization, Regional Office of the World Health Organization for the Americas. 525 23rd. St, NW, Washington, DC 20037, USA. cruzjose@paho.org
Pérez-Rosales
Maria Dolores
MD
Zicker
Fabio
F
Schmunis
Gabriel A
GA
D015415:Biomarkers / Q000097:blood; D001782:Blood Donors; D017691:Caribbean Region / Q000453:epidemiology; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006510:Hepatitis B Antibodies / Q000097:blood*; D006526:Hepatitis C / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D065227:Transfusion Reaction; D014766:Viremia / Q000097:blood / Q000175:diagnosis
D015415:Biomarkers; D006510:Hepatitis B Antibodies; D018937:Hepatitis C Antibodies