The cost-effectiveness of predonation screening for transfusion transmissible infections using rapid test kits in a hospital-based blood transfusion centre

• Published in: The Nigerian postgraduate medical journal 2017-07, Vol.24 (3), p.162-167
• Main Authors: Dosunmu, Adedoyin Owolabi, Akinbami, Akinsegun Abduljaleel, Ismail, Ayobami Kamal, Olaiya, Modupe Adebimpe, Uche, Ebele Ifeyinwa, Aile, Igbinoba Kingsley
• Format: Article
• Language: English
• Subjects: Antigens; Blood & organ donations; Blood Banking - methods; Blood Banks - economics; Blood Donors; Blood Safety - economics; Blood Safety - methods; Blood Transfusion; Blood transfusions; Committees; Cost analysis; Cost-Benefit Analysis; elisa screening; Government agencies; Hematology; Hepatitis; Hepatitis C - prevention & control; HIV; HIV Infections - prevention & control; HIV Infections - transmission; Human immunodeficiency virus; Humans; Immunoglobulins; Infections; Mass Screening - economics; Mass Screening - methods; Nigeria; rapid test screening; Syphilis; Transfusion Reaction; transfusion transmissible infections; Viral infections; Viruses
• ISSN: 1117-1936; 2468-6875
• DOI: 10.4103/npmj.npmj_33_17

Blood transfusion practice emphasises safety, efficacy and appropriate use. These require cost-effective programme management. This study focused on the cost of screening for transfusion transmissible infections (TTI). This was a 1 year (2016) analysis of screening in a hospital-based transfusion centre. The cost of screening all blood donors by ELISA was compared to the cost of serial screening starting from rapid kit, taking into account, the estimated cost of blood bags prevented from discard after ELISA screening (attributable cost). The cost of voluntary donor drive plus cost of ELISA screening was compared with the present cost of screening. A total of 5591 donors were screened for HIV, hepatitis B and C using the rapid kit, 291 donors were deferred (5.2%). A total of 5300 units were further screened by ELISA. A total of 435 blood units (8.2%) were discarded due to TTI positivity. TTI positivity rate was 12.98%. Only 2.36% were voluntary donors and among these 9.1% were TTI positive. The attributable cost of serial screening was 55,653.5 USD while that of screening by ELISA only was 55,910 USD. The attributable cost of rapid screening for only hepatitis B and then ELISA was 53,313.9 USD taking into consideration that 187 blood units would be prevented from undue discard. This analysis demonstrated that with proper donor selection, rapid screening for hepatitis B virus only before ELISA screening is more cost-effective. This will also reduce the waiting time for donors and counselling if HIV positive.