NATIONAL BLOOD REQUIREMENT, SERUM ALT AND HEPATITIS IN ETHIOPIAN BLOOD-DONORS

To appraise the national blood requirement and supply, and to determine the impact of alanine aminotransferase (ALT) and hepatitis B surface antigen (HBsAg) screening on the blood supply, 407 random blood donor sera were tested for HBsAg, human immunodefficiency virus (HIV), and ALT activity. HBsAg and anti-HIV antibody were determined by the enzyme linked immunosorbent assay (ELISA) technique using Hepanostica and Welcozyme kits, respectively. The Western Blot test was performed to confirm anti-HIV positive sera by the ELISA technique. ALT was determined by an automated photometer using ALAT kits and serologic testing for syphilis was done by the rapid plasma reagin (RPR) test. The amount of blood required in Ethiopia and the actual supply was calculated on the basis of the number and type of hospital beds in Addis Abeba and the amount of blood transfusions in units per hospital bed. The results showed that the combined donor and unit rejection rate was 34.6%. The annual blood requirement was 7 units for emergency and 4 units for nonemergency beds. The national blood requirement in 1989 was 64,350-80,000 units, but the supply met only a third of the requirement. The mean and 2SD cut off ALT levels were 28 and 69 IU/L, respectively. ALT was elevated in 9.1% of HBsAg positive but apparently healthy donors, while HBsAg screening eliminated 25% of those with elevated ALT activity. This data suggests that there is a serious blood shortage in Ethiopia and that the currently supplied blood is relatively unsafe in terms of hepatitis. Thus, HBsAg screening should be done together with the implementation of a blood policy that ensures the procurement of sufficient blood for haemotherapy in Ethiopia.