New risk model for blood ignores race

Published Feb 16, 2005

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Race will no longer be used to determine the risk profile of blood donors.

This comes after the department of health and the South African National Blood Service (SANBS) met in Cape Town on Tuesday.

Stakeholders at the meeting, including Health Minister Manto Tshabalala-Msimang and the SANBS's Professor Anton Heyns, agreed that all blood donors who met the necessary health criteria would be accepted as donors.

All blood donations would be screened for transmissible diseases.

Allegations that race was used to categorise donors arose late last year during a ruling by the Commission for Conciliation, Mediation and Arbitration on a case between the SANBS and the Health and Other Service Personnel Trade Union over the dismissal of a union member.

Poppie Bereng, a nurse, was dismissed because she opposed the SANBS's policy of not using the blood of black or coloured donors because it was considered to be too much of a risk.

The health minister said at the time that such profiling "smacked of racism", and she instructed the SANBS to develop a new risk model for blood donation that excluded race as a risk factor.

Underpinning the development was the right of patients to have access to safe blood.

Department of health spokesperson Sibani Mngadi explained that the most significant threat to the safety of blood was posed by the window period. Laboratory tests now in use could not detect the presence of viruses (for example HIV and hepatitis) in the blood during the window period.

The new model aimed to minimise this risk, he said.

It was based on using donor status as the primary risk indicator. Repeat donors were categorised as low risk.

Under the new model, first-time donors' blood would be used mainly for screening for transmissible diseases. Their plasma would be quarantined and would be issued only after the donor had donated for a second time and had been found to be free of infectious diseases.

"After the donor has donated more than three times, it will then be accepted that the risk, due to the window period, has been significantly reduced and the red cells can be used for treatment," Mngadi added.

Donors who gave blood more than three times consecutively would be seen as low risk.

"Those who have donated more than seven units of blood in the previous 24 months will be regarded as very low risk and their donations will be used for all types of treatment," Mngadi said.

Blood from all three risk groups would be stringently tested every time the person donated, and donors were encouraged to avoid risky behaviour.

Mngadi said nucleic acid technology (NAT) screening of all donations would be introduced and it would cut the window period. The new model, with NAT screening, would reduce the risk of transmitting infections through transfusions.

On average, in the low-risk group, zero to nine donations per 100 000 tested positive for HIV; in the high-risk group, between 200 and 3 000 donations per 100 000 tested positive.

Mngadi said it was agreed that all systems relating to the new model must be in place within the next six months. - Health and Science Reporter

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