RESUMO
In 2007, the blood collection rate in Nicaragua was 106.6 units per 10,000 inhabitants. Voluntary donation was 39%. The health authorities decided to pursue self sufficiency of blood by eliminating replacement donation and consolidating blood processing in two centers. Replacement donation was terminated in 2009, voluntary donation reached 100% in 2010, and the blood collection rate increased to 125.9 in 2011. The rate of red blood cell transfusion improved from 96.0 to 119.1 units per 10,000 during the 4-year period. The political will of the government, pertinent technical leadership, and a country-wide approach were essential for attaining those goals.
Assuntos
Doadores de Sangue/provisão & distribuição , Transfusão de Sangue/métodos , Transfusão de Eritrócitos/métodos , Eritrócitos/citologia , Humanos , América Latina , NicaráguaRESUMO
The risk of acquiring both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in patients with hematological-oncological disorders has been documented. However, the impact and risk factors for such infections from different geographical areas vary, and the use of both immunological and molecular assays to determine HCV infections has been our approach. Children from a hematology-oncology unit (HOU) in Nicaragua were studied for both HBV and HCV serological markers; studies for the latter used both immunological (anti-HCV) and molecular (HCV RNA) assays. The children from the HOU included patients with leukemia, lymphoma, other neoplasias, and anemia and a smaller group with other hematological diseases. As a control group, children from other units at the same hospital were enrolled, as well as health care workers attending both patient populations. Pertinent clinical and personal data for each child at the HOU were obtained for statistical analysis. Of the 625 children from the HOU enrolled in this study 53.3% were infected with HCV and 29.4% had a prior or present HBV infection. In the child patient control group 3.2% had HBV markers and all were negative for HCV. The group of children with leukemia had the highest infection rate for both HBV and HCV. However, the determination of anti-HCV was found to have an overall low sensitivity in children from HOU, and a retest consisting of a molecular assay to determine HCV RNA was performed to better establish the total number of HCV-infected subjects in this group. The highest independent risk factor for infection was hospitalization. The very high prevalence rates for both HBV and HCV infection in this patient group indicate an urgent need to implement better control of known risk factors and to consider the use of both immunological and molecular assays for HCV diagnostic purposes.