SCREENING FOR BLOOD

TRANSFUSION
 PRINCIPLES OF SCREENING

To detect high risk donors

Deffer those who are positive
Prevent transmission of infection to the recipients
To promote Voluntary Blood Donation
 INFECTIOUS AGENTS

Virus: HIV, HBV, HCV

Bacteria: Tryponema, Cholera
Protozoa: Malaria, Tryponosoma
Fungus
DONOR SCREENING AND DEFERRAL

Education
History
Examination
Donation
Screening
Deferral
 VOLUNTARY BLOOD DONATION
Safe donor : Regular, voluntary,non remunerated
donors from low risk population
High risk donors : Family/ replacement and paid
donors
Activities to promote voluntary blood donation :
1. National blood donor programme
2. Training of staff
3. Records
4. Donor education
5. pre & post donation counselling
6. Monitoring of infection in donor
7. Evaluation of blood donor programme
 SCREENING ASSAY

Test samples
Types of screening:
Elisa
Particle agglutination assay
Simple rapid assay

Test results
APPROPRIATE ASSAY

Principle of the assay

Incubation period
Sensitivity
Specificity
Availability
Cost
 SCREENING
HIV

Window period :following infection and before the

appearance of antibody.

Antibody detection is commonly done by Elisa.

Confirmed by western blot.

Viral RNA is first to be detected- not done

Western blot
HBV
Acute HBsAg +ve
HBeAg +ve
IgM anti HBC+ve
DNA +ve
Chronic HBsAg +ve
HBeAg +ve
IgManti HBC+ve
DNA +ve
Anti HBe +
Recovered HBsAg - ve
HBeAg - ve
IgManti HBC+ve
DNA - ve
Anti HBe +
Vaccinated Anti HBs + ve
HCV
Viral RNA : First marker
Anti HCV : Main serological marker
HCVAg : Now used for screening

HTLV 1 & 2
Viral RNA in lymphocytes
Anti HTLV : Detected after 30 - 90 days
Persists for life
TRYPONEMA PALLIDUM
Non specific : VDRL, RPR
Specific : TPHA, Elisa

PLASMODIUM SPECIES :
Detection of parasites
Detection of antibody

TRYPONOSOMA :
Protozoa in blood film
Blood culture
Antibody
PERIPHERAL SMEAR
FACTORS INFLUENZING SCREENING
PROGRAMMES
Staff training
Equipment & reagent required
Supply of assay kits
Storage of assay kits
Condition of the sample to be tested
Supply of external quality control samples
Cost of screening
 PREVENTION

Careful selection of donors

Direct screening of donated blood

Promoting self exclusion
 REFERENCE

1. WHO
2. Transfusion medicine - Lawrence.D.Petz