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Audit of pre-transfusion testing practices in hospital blood banks across Tanzania: A national survey
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DOI：10.4102/ajlm.v15i1.2986.png)
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Abstract
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Background: Blood transfusion is a lifesaving procedure performed across all healthcare levels in Tanzania. Despite significant investment in blood collection and screening, hospital transfusion practices have received less attention. With haemovigilance systems still in development, the understanding of pre-transfusion testing quality remains limited. Objective: This study aimed to evaluate hospital blood bank practices in conducting pre-transfusion procedures prior to issuing blood for transfusion. Methods: This descriptive cross-sectional study was conducted from January 2024 to March 2024 in 31 referral hospitals in Tanzania. Data on facility characteristics, testing methods, staffing, and equipment were collected through a validated questionnaire. Data were analysed using STATA version 18. Descriptive statistics were used to present key findings whereby continuous variables were presented as means, and categorical variables were presented as frequencies and percentages. Results: Among 31 participating facilities, ABO and Rhesus blood group systems typing and cross-matching were universally available (100%), while antibody screening was available in 13 out of 31 facilities (42.0%). Two out of 31 facilities (6.5%) used the less sensitive tile method for ABO typing. Critical reagents including Anti-D (immunoglobulin G), Anti-Human Globulin, and polythene tubes were available in only 21 out of 31 facilities (67.7%). While all facilities had standard operating procedures (SOPs) for basic tests, blood warming SOPs were available in 9 (29.0%) and fresh frozen plasma thawing SOPs were available in 14 (45.2%) out of 31 facilities. Conclusion: Significant gaps exist in pre-transfusion testing capabilities, SOPs, and essential reagents in Tanzanian referral hospital blood banks. Addressing these shortcomings is crucial for improving transfusion safety and strengthening haemovigilance. What this study adds: This study presents the first national audit of hospital blood bank practices in Tanzania, highlighting major gaps in antibody screening and cross-matching, resource shortages such as key reagents, and quality management deficiencies. It offers evidence-based, phased recommendations to strengthen pre-transfusion testing and improve safety in resource-limited settings.
Keywords:
pre-transfusion testing
blood transfusion
hospital blood banks
Tanzania
haemovigilance
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