Providing safe blood banking in sub-Saharan Africa : An analysis of the blood transfusion services at a district hospital in Malawi

Background: Important efforts are made to organise sustainable, efficient and safe blood transfusion services in sub-Saharan Africa. Still, the adequate supply of safe blood products remains largely insufficient in this area. In this study, we analyse the quality and capacity of the equipment and technical procedures at a hospital based blood transfusion service in rural Malawi. Material and methods: The study was performed at Mangochi District Hospital in southern Malawi in December to January 2010. We observed and registered the presence and use of the equipment, test reagents, procedures, quality control for screening for infectious agents and storage of blood products. The services were evaluated according to WHO guidelines. For additional details, the Malawi Blood Transfusion Service (MBTS) guidelines were consulted. Results: During the observation period, a total of 280 units of blood were analysed and applied for transfusion at the hospital. The investigators observed twenty complete series of laboratory analyses of blood examined for transfusion. The equipment, test reagents, procedures, quality control of the transfusion services in this district hospital laboratory meet the main criteria for an adequate WHO stage of development. Conclusion: The findings indicate that blood transfusion services adapted to local conditions might be a sustainable solution for safe blood transfusion services in sub-Saharan Africa. Further and larger studies are needed to confirm these findings, and to explore other aspects required to maintain sustainable and safe blood transfusion services in economically limited settings