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HIV/AIDS Transmission
through unsafe blood
transfusion in Pakistan
PASS
(Project for AIDS Screening
and surveillance)
WHO
DEFINITION
WHO
Global estimates for adults and children, 2007
WHO
Regional and National estimates for
adults and children, 2007
Larkana IDUs
NACP
20 incident
Formed
HIV Care
First
ANC started
case MSWs
10 Study (GFATM)
detected ?
General
IDUs
Population
1987
1989
1994
2001
2003
2004
2005
2006
2007
HIV prevalence among injecting drug users in Pakistan,
2004–2007
60
51.3
50
40
30 29.8
% 30 27
23
19.6
20 16.5
13 13.3
9 10 9.5
10 5.3 6.5
3.7 2.2
0.5 0 0.5
0
0
5
6
5
6
4
5
4
5
5
6
5
6
7
6
5
2 00
2 00
2 00
2 00
200
20 0
20 0
200
200
200
200
200
200
20 0
200
200
200
200
200
200
Source: Ministry of Health Pakistan. HIV Second Generation Surveillance in Pakistan, National Report Rounds I and II.
Modes of Transmission
• Unprotected sexual intercourse (vaginal or anal)
or oral sex with an infected person
• Transfusions of contaminated blood
• Sharing of contaminated needles
• Sharing of syringes or other sharp instruments
• Mother to child during pregnancy, childbirth and
breastfeeding
WHO
High Risk Groups
• Injecting drug users
• People who engage in sexual behavior that puts
them at risk
• Migrant workers
• Long distance Truck drivers and associated
population
• Jail inmates
• Sexual partners, spouses and children of the
people in these groups
• Most at Risk Adolescents
NACP
Transmission in Pakistan
Heterosexual
IDUs
WHO
Facts about Blood Transfusion
• It is estimated that 40 percent of the 1.5 million annual
blood transfusions in Pakistan are not screened for HIV.
• About 20 percent of the blood transfused comes from
professional donors.
• Professional Blood donors include
– People who are typically poor
– Drug Users
– Who give blood for money
• 20% Hep. C +ve, 10% Hep. B +ve and 1% HIV +ve.
(Study conducted by World Bank on Professional blood
donors)
District Quetta
Rationale
• The majority of research studies focused on High Risk Groups and Sexual
transmission of HIV/AIDS but unfortunately little work is done particularly on
Transmission of HIV/AIDS through unsafe blood transfusion.
• RATIONALE:
– This Project will not only prevent the transmission of HIV/AIDS through
unsafe blood transfusion but also will serve as a tool to provide base line
data regarding HIV prevalence among general population. The data will
also serve to formulate new as well help in improving existing policies.
Additionally it will benefit to reduce the disease burden both at the national
& international level thus achieving MDG-6.
District Quetta
• Capital of Balochistan Province
• Population 114000
• Area 2.65 km2
• Population Density 281/km2
• Tehsils 3
• Zones 27
• Teaching Hospitals 2
• HIV prevalence among IDUs 10%
Aims and Objectives
• Aims
– To decrease the morbidity and mortality due to HIV/AIDS
and to prevent its transmission through unsafe blood
transfusion in Pakistan
• Objectives:
– Ensure mandatory screening of blood and blood products
for HIV in 100% public and private sectors Blood Banks of
District Quetta
– Raise awareness among general population of District
Quetta to promote voluntary blood donation
– Develop Quality Surveillance Systems for public and
private blood banks to ensure that all blood is properly
screened for HIV.
Organogram of PASS
EDO (H)
(Chairman)
District Surveillance
Coordinator
(Epidemiologist)
Total RS 30
millions
Strategies
• First Step: Situational Analysis/Base
line Survey
– # of Blood Banks (Public and Private) operational in
the District
– # of Blood Banks Registered
– # of Blood Banks following National Guidelines for
blood donation
– # of Blood Banks following SOPs for Blood
transfusion
– # of staff properly trained for Blood Banks
– # of donors +ve screened by these blood banks
– # of Paid professional blood donors
Strategies
• 2nd Step: Implementation and Management
– Registration of 100% of blood Banks
– Repair and renovation of Blood Banks
– Capacity building of staff in Blood Bank
– Provision of National Guideline for blood donation
– Provision of HIV screening Kits
– Awareness in People regarding voluntary blood donation (Mass
media, local methods, IEC material)
– BCC
– Display of voluntary Blood donation Promotional materials in
Blood banks
– Regular Supportive supervision and monitoring
– Formulation of District HIV/AIDS Prevention and Control
Committee
Surveillance Activities
• DSC will visit all the High Priority sites (Blood Banks)
every week, MP site every fortnightly an LP sites
monthly (According to the tentative monthly plan)
• Weekly zero report for HIV cases will be collected from
all sites (blood banks)
• DSC will conduct a detailed Epidemiological case
investigation of any Positively screened donor.
• DSC will maintain District WZ chart and AS visit Charts
in EDO-H office.
• DSC will submit Progress report to EDO-H every month.
Evaluation
• % of Blood Banks having National
guidelines
• % of Blood Banks following National
guidelines
• % of Blood Banks following SOPs for blood
transfusion
• # of Blood bags delivered
• # of donations by Paid/professional donors
• % of Blood donors screened +ve for HIV
Slogan of PASS
THANKS