Trends in blood donations, blood donors' knowledge, practices and expectations during the COVID-19 pandemic in Cameroon.

INTRODUCTION: The COVID-19 pandemic, caused by a novel coronavirus, has already affected over 99 062 people in 53 African countries and killed 3082. The pandemic threatens blood supply but we do not yet know its impact on blood donations or on the perceptions and expectations of donors. METHODS: We conducted a cross-sectional study in four hospital-based blood services in Cameroon, using a survey design and focusing on the subjective and cultural aspects of donors. Using a semi-structured questionnaire, we collected the participants' responses as to their understanding of COVID-19 and of current protection measures, and their expectations. Data on trends of blood donations were collected retrospectively for the period from 1st January to 30th April 2019 and the same period in 2020. RESULTS: Of 494 donors included, 432 (87·4%) were enrolled from fixed blood collection sites and 62 (12·6%) were contacted by phone. A total of 464 (93·9%) participants believed that the COVID-19 is a lung disease, but some declared it to be imaginary (7·7%), a foreign disease (8·3%) or a blood-borne disease (3·2%). The participants reported that the distribution of face masks and hydroalcoholic solutions (92·5%), social distancing and hygiene (6·3%) are the most important measures that need to be in place for safe donation. The number of blood donations dropped by 21·5% between 2019 and 2020. CONCLUSION: Most of the donors know COVID-19, its transmission routes and manifestations. In the absence of barrier measures, they perceive blood donation as a threat to their health. Distribution of masks and hydroalcoholic solution might motivate more donors and improve the blood supply.

The use of the GeeniusTM HIV-1/2 Rapid confirmatory test for the enrolment of patients and blood donors in the WHO Universal Test and Treat Strategy in Cameroon, Africa.

BACKGROUND AND OBJECTIVE: In the WHO Universal test and treat strategy, false-positive HIV blood donors and patients may be unnecessarily put under antiretroviral treatment and false-negative subjects may be lost to follow-up. This study assessed the false positivity rate of the Cameroonian national HIV screening testing algorithm and the benefit of a confirmation test in the enrolment of patients and donors in the HIV care programme. METHODS: We included initial HIV reactive blood donors and patients in a cross-sectional study conducted in two Cameroonian hospitals. Samples were retested according to the Cameroon national algorithm for HIV diagnosis. A positive or discordant sample was retested with the Geenius Bio-Rad HIV 1&2 (Bio-Rad, Marnes-la-Coquette, France) for confirmation. The Geenius HIV-1-positive results with 'poor' profiles were retested for RNA as well as the Geenius indeterminate results. RESULTS: Of the 356 participants, 190/225 (84·4%) patients and 76/131 (58%) blood donors were declared positive with the national algorithm; 257 participants (96·6%) were confirmed HIV-1-positive. The study revealed that about 34/1000 blood donors and patients are false-positive and unnecessarily put on treatment; 89/1000 blood donors and patients declared discordant could have been included immediately in the HIV care programme if confirmatory testing was performed. The second test of the algorithm had a false-negative rate of 3%. Eleven samples (3·1%) were Geenius poor positive and NAT negative. CONCLUSION: The universal test and treat strategy may identify and refer more individuals to HIV care if a third rapid confirmatory test is performed for discordant cases.

Assessing the quality of care for haemophilia at the Yaoundé reference treatment Centre of Cameroon.

With a recently established Haemophilia Treatment Centre (HTC) in Yaoundé, Cameroon, over a hundred people living with haemophilia have been recruited and followed up at this centre. This study aimed at assessing the quality of haemophilia care provided at the HTC, in order to monitor and improve patient care. In February 2014, the HTC was assessed using recommended markers. Although few, the logistics and reagents for the diagnosis and treatment of haemophilia were available. There were seven trained workers involved with haemophilia care, but the multidisciplinary care team was incomplete. A total of 113 people living with haemophilia (all males) had been registered and regularly followed up at the HTC. This study showed that the HTC of the Yaoundé University Teaching Hospital, although not yet ideal, allows for some degree of haemophilia patient care. Hence, it may be recommended to improve the centre and make it fully established in Cameroon.

Haemostatic trends in HIV-infected individuals in Yaoundé, Cameroon: a pilot study.

Bleeding disorders are haematological manifestations that are frequently observed during HIV infection. This study intends to describe the haemostatic trends in HIV-infected patients in Cameroon. This cross-sectional descriptive study was carried out at the haematology unit of the Yaoundé University Teaching Hospital from March to June 2012. It included consenting HIV-positive patients, aged 18 years and above, naive to antiretroviral treatment or not. The coagulation profile was measured with Stago reagents (Stago Diagnostics, Asnières sur Seine, France) using a chronometric technique on a semi-automate (Stago Diagnostics). Platelets count was estimated on a human count automate (Human Diagnostics, Wiesbaden, Germany) by flow cytometry. A total of 139 HIV-infected patients were included in this study, out of which 106 were females (76.3%) against 33 (23.7%) males, giving a sex ratio of 0.3 (M/F). Mean age was 38.85 years (range 22-73 years) and median CD4 count was 353 cells/µl (Interquartile range 200-500 cells/µl). Hyperfibrinogenaemia was the most frequent bleeding disorder in the studied population [40 of 139 (28.78%)], followed by low prothrombin time (PT) [22 of 139 (15.83%)], thrombocytopenia [19 of 139 (13.67%)], hypofibrinogenaemia [18 of 139 (12.95)], prolonged activated partial thromboplastin time (7.91) and by thrombocytosis which was less frequent [6 of 139 (4.32%)]. Out of the six haemostatic disorders, only low PT was significantly associated with CD4 count (P = 0.02). This study showed that bleeding disorders are very frequent in the HIV-infected patients studied. Low PT was significantly associated with CD4 count, hence it may be recommended to systematic screen for bleeding disorders in severe immune-depressed (CD4 ≤ 200 cells/µl) HIV-infected patients.