Dr. Lundie R. Richards, Contributor
INFORMATION OF Human Immunodeficiency Virus heralded in the early 1980s, however today there is strong evidence that this plague may have been around for quite a long while before.
The effects of this virus is seen worldwide, latest data (UNAIDS/WHO report November 28, 2002) suggests that over 42 million persons are infected and some 3.1 million people died of the effects of the disease in the last year. The same source also said that over the same period, there were five million new cases, one million of who are under 15 years old. Sub-Saharan Africa is reported to have over 30 million cases, 3.5 million in the past year. It is also believed that more than 30 per cent of the populations of Zimbabwe, Swaziland, Lesotho and Botswana are positive for the HIV. The latest figures out of the USA show approximately 950,000 persons infected as well.
In June 2002, Dr Peter Figueroa reported that this region has the second highest HIV prevalence rate in the world after sub-Saharan Africa. The numbers of cases have risen steadily since 1982.
Since 1982 the numbers of HIV positive persons in Jamaica have moved in leaps. In 2001, over 900 cases and already by June 2002 some 511 reported cases. Since 1982 over 6,000 persons have been tested positive for the HIV in Jamaica.
Since HIV has come to the forefront in Jamaica we have seen a drastic decrease in the blood supply. Leading up to the early 1980s blood collection have fallen from about 40,000 units per annum to the mid '20s. This is largely due to the myth that because a needle is used in the process of giving blood, then persons may contract the disease. This fear unfortunately lives on today and adversely affects our donor programme. Other potential blood donors hesitate to give blood as well because their social behaviour may be questionable and are fearful that they may be diagnosed HIV positive. The stigma associated with HIV infection is devastating but there are other blood borne infections such as Hepatitis B & C as well as HTLV1 which are potentially as dangerous and should always be considered.
Safe blood
Blood services world-wide have the responsibility to provide safe blood in adequate amounts to meet demand. Safe blood is that which is free from all infectious agents or contaminants and compatible with the recipients. While we cannot guarantee adequate amounts of blood we should always be in a position to assure the public that the blood or blood product received is safe. In sub-Saharan Africa and South East Asia the blood supply is not considered safe and it is believed that as high as 10 per cent of HIV transmission is through tainted blood.
There is also a huge risk associated with importation of blood products. An August 28, 2002, report out of London showed that for many years blood infected with HIV and Hepatitis were being shipped from South Africa to India and China, labelled as safe for human use. Worse yet, animal blood was also shipped as human blood.
Prior to 1985 when blood-screening tests for HIV began, it was not possible to quantify the numbers of individuals that have been transfused with blood tainted with HIV. World-wide figures do show, however that persons who were multiple transfused such as haemophiliacs as well as those with renal failure on dialysis had a high incidence. Over the past 17 years, however, the incidence of transfusion-related HIV has been quite low except those regions previously mentioned. Certainly it is not a norm in the more developed nations such as the USA, Canada and UK, however sporadic cases have been reported in the last 5 years, at least in the case of USA and UK. On July 19, 2002, two cases out of Florida and February 9 one out of Texas, there may have been one case in the UK in the last 5 years.
Today I am proud that despite our hardships, despite the levels of crime and violence that touches the heart of every Jamaican and the chaos that this has created and its negative impact on our image, economics, tourism blood supply etc., the PAHO has ranked our blood as one of the safest in the world. This is a record we are proud of and we are asking all Jamaica to identify with us to keep this going. We take great pride in proper screening ensuring that the blood donors are healthy and also checking meticulously guaranteeing that every unit of product released is safe for use.
In 2001 we collected 23,784 units of blood of which 0.54 per cent were positive for HIV, HBV (hepatitis B virus) 0.76 per cent, HCV (hepatitis C virus) 1.37 per cent, Syphilis 1.2 per cent, and HTLV1 3.9 per cent.
Up to October 31, 2002 we have collected 22,984 units of blood and the infectious markers are as follows: HIV 0.58 per cent, HBV 1.26 per cent, HCV 0.45 per cent, Syphilis 1.64 per cent and HTLV1 2.08 per cent. As shown, HIV remains quite low among our blood donor population, however we intend to improve our donor programme to decrease this figure.
As mentioned before the staff in the blood collection centres island-wide and the blood donor organisers have been doing an excellent job but there is room for improvement. The safest donors are those who voluntarily walk in the centre and pay homage to their civic duty, giving that gift of life to someone in need.
We will again fall below our projected target this year. It means that you will continue to hear pleas for more blood. The National Blood Transfusion Service needs approximately 300 pints of blood per day to cover the whole island. We need well over 50,000 pints per year. Unfortunately, over the years we have only managed to collect approximately 25,000 units annually which is not sufficient to adequately meet the nation's needs.
Dr. Lundie R. Richards MD Cuba, DM-Haem UWI, MSc-TTS UK is Director, National Blood Transfusion Service, Jamaica. He was speaking recently at the general meeting of the Jamaica Chapter of The University of New Orleans Alumni.
