DUSHANBE, June 14, Asia-Plus  -- Retesting of blood samples finds risk of spreading HIV, hepatitis B, hepatitis C, and syphilis through transfusions and medical malpractice, according the World Bank repot "Blood Services in Central Asian Health Systems: A Clear and Present Danger of Spreading HIV/AIDS and Other Infectious Diseases." 

The health systems in Central Asian countries have an urgent need to improve their screening efforts in order to prevent the use of infected blood in transfusions and the accidental transmission of communicable diseases to unsuspecting patients. After rescreening samples from 7500 donors, the results showed a clear and present danger that blood contaminated with HIV, hepatitis B, hepatitis C and syphilis may be entering into the countries'' blood supply, the report said.  

 Blood transfusions are a small but preventable contributor to communicable disease transmission compared to other well-reported modes, but until recently little was known about blood transfusion systems in Central Asia and their contribution to disease transmission.  Direct transfusion of blood is 100 times more efficient in spreading HIV than intravenous drug injection with a contaminated syringe.

The re-testing found prevalence of communicable diseases in the blood samples to be 0.20 percent for HIV, 2.7 percent for hepatitis B, 3.0 percent for hepatitis C, and 3.6 percent for syphilis.

The report''s findings underscore the need to strengthen screening of blood donors on the occasion of each donation and other prevention and control measures to guarantee the safety of the blood supply in the health systems of Central Asia countries, and reduce the risk of involuntary infection to the unsuspecting population.

The report discusses inter-related parts of blood transfusions systems, and presents an overview of the parts that need to be strengthened in Central Asia. It finds that parts of the system are in serious need of organizational restructuring, new investment and increased budgetary support for operation and maintenance. The report sets them out such that each can be addressed in turn – and some simultaneously.

The report also discusses the health threat posed by alarmingly low levels of blood supplies, fostered by a culture that places little value on donating blood, public fear of being infected by giving blood, and the near absence of donor promotion campaigns.

In an effort to solve some of the challenges contributing to the problem, the report recommends that efforts to address the systemic deficiency of blood transfusion services in Central Asia should be part of broader health system strengthening programs and regional activities that need to be supported by national governments and the international community.

Globally, HIV is the fourth leading cause of the burden of disease.  A 2006 report estimated that of the 33–36 million people estimated to be HIV positive worldwide, 5–10 percent were infected by a contaminated blood transfusion.  More than 92 percent of HIV contaminated transfusions result in infection, while less than 1 percent of intravenous drug injections with a contaminated syringe do, the report said.  

Central Asia is experiencing four overlapping epidemics—drug use, HIV, STIs (sexually transmitted infections), and TB.21 This region’s HIV epidemic is concentrated, affecting less than 1 percent of adults, but even so, about 90,000 people are estimated to have the virus.  The driver of the HIV epidemic in Central Asia is injecting drug use.  Other modes of HIV transmission include unprotected sexual relations and mother-to-child perinatal transmission. Transfusions of infected blood or its products and nosocomial infection are other important modes of HIV transmission in Central Asia.  These countries also have some of the highest incidence rates of TB and multi-drug-resistant TB in the Europe and Central Asia region.  TB/HIV co-infection is associated with higher morbidity and mortality and increased TB transmission among the general population.

On the stage of the HIV/AIDS epidemic by country, the report said that in Tajikistan, more than 10,000 people are estimated to be infected with HIV. Prevalence among IDUs (Injecting drug users) increased between 2005 and 2006 from 16 percent to 24 percent in the cities of Dushanbe and Khujand.  Also of concern is the sudden rise in prevalence among sex workers in those cities (from 0.7 percent to 3.7 percent over the same period).