The impact of AIDS on blood transfusion services in South Africa
Grobbelaar, B.G.
Medicine and Law 11(7-8): 495-500
1992
ISSN/ISBN: 0723-1393 PMID: 1302768 Document Number: 275825
In South Africa the incidence of AIDS in the white community has remained relatively low, and largely confined to homosexuals, intravenous drug users, and prostitutes. In the black population it is primarily a heterosexual disease spread by normal heterosexual contact. A national epidemiological survey among women attending antenatal clinics was carried out by the South African Department of National Health in 1990. 14,376 antenatal samples were anonymously tested: Whites - 0.06% HIV positive; Coloreds - 0.16% HIV positive; and Blacks - 0.89% HIV positive. An analysis of blood donors showed a similar prevalence and revealed that the incidence was doubling every 8-10 months. The Border Blood Transfusion Service (BBTS) served a population of 5,731,000, comprising 5,594,000 Blacks and 137,000 Whites. In the area served by the BBTS, the incidence of HIV positivity in the white population was 0.02%. In the black community the incidence had reached 0.45%, and was doubling every 8-10 months. In the BBTS, 67% of the blood collected was from black donors. By applying exclusion criteria to high-risk groups in the white community, there had not been a single HIV positive among 102,724 donations collected since the inception of HIV testing in 1985. In the black community, out of 183,802 donations collected since the inception of HIV testing, 115 HIV positives were found. 114 were in the 17-39 year old group regarded as high risk, and only 1 occurred in the 40-year and older age group. Therefore, a recruiting program to be widely advertised was devised in which the individual would receive regular health reports after every 3rd blood donation, including his HIV status, at no cost. Routine tests done for every blood donor would be supplemented by carrying out additional tests: a more extensive clinical history and examination; a full hematological profile; a blood cholesterol level; and a careful appraisal of the donor's height and weight.