Blood Safety Without Borders: Addressing Immunization Gaps and Inappropriate Transfusion Trends in the Post-Flood Landscape of Khyber Pakhtunkhwa
1
Pathology, Peshawar Institute of Cardiology-MTI, Peshawar, Pakistan
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Since the enactment of the Khyber Pakhtunkhwa Blood Transfusion Safety Authority Act in 2016, Peshawar has undergone a significant transition toward a centralized and regulated blood transfusion system. Despite these reforms, the city faces a persistent demand-supply gap, a 99.6% reliance on replacement donors, and the continued use of whole blood over component therapy. This study evaluates current transfusion safety, clinical appropriateness, and the prevalence of TTIs in Peshawar's tertiary care settings.
METHODS:
A retrospective clinical audit and observational study were conducted across major healthcare institutions in Peshawar. The study analyzed transfusion records (n=1,700–2,000 samples) to assess compliance with national screening standards (HBV, HCV, HIV, Syphilis, and Malaria) and the appropriateness of blood component utilization.
RESULTS:
The overall prevalence of TTIs among donors was 4.9%. Specifically, Hepatitis B (HBV) was the most frequent (2.6%), followed by Hepatitis C (1.0%), Syphilis (0.9%), and HIV (0.4%). No malaria cases were detected in recent screenings. A clinical audit of 632 patients revealed that 73.6% of PRBC (Packed Red Blood Cell) transfusions were inappropriate, primarily in the Obstetrics and Gynecology departments (95.5% inappropriate rate). While component therapy is increasing, whole blood still accounts for nearly 38% of all transfusions, which remains significantly higher than international benchmarks. Assessment of 152 registered nurses showed high proficiency in transfusion indications (75.7%) but significant gaps in patient involvement and the recognition of transfusion reactions (62.5%).
CONCLUSIONS:
While legislative frameworks are in place, there is a critical need for standardized clinician training on "Rational Use of Blood" and a transition from replacement to voluntary non-remunerated donation (VNRD). To ensure "Health Without Borders," Peshawar must strengthen its bi-directional tracking systems (vein-to-vein) and establish hospital-based transfusion committees to minimize wastage and cross-contamination risks.
Since the enactment of the Khyber Pakhtunkhwa Blood Transfusion Safety Authority Act in 2016, Peshawar has undergone a significant transition toward a centralized and regulated blood transfusion system. Despite these reforms, the city faces a persistent demand-supply gap, a 99.6% reliance on replacement donors, and the continued use of whole blood over component therapy. This study evaluates current transfusion safety, clinical appropriateness, and the prevalence of TTIs in Peshawar's tertiary care settings.
METHODS:
A retrospective clinical audit and observational study were conducted across major healthcare institutions in Peshawar. The study analyzed transfusion records (n=1,700–2,000 samples) to assess compliance with national screening standards (HBV, HCV, HIV, Syphilis, and Malaria) and the appropriateness of blood component utilization.
RESULTS:
The overall prevalence of TTIs among donors was 4.9%. Specifically, Hepatitis B (HBV) was the most frequent (2.6%), followed by Hepatitis C (1.0%), Syphilis (0.9%), and HIV (0.4%). No malaria cases were detected in recent screenings. A clinical audit of 632 patients revealed that 73.6% of PRBC (Packed Red Blood Cell) transfusions were inappropriate, primarily in the Obstetrics and Gynecology departments (95.5% inappropriate rate). While component therapy is increasing, whole blood still accounts for nearly 38% of all transfusions, which remains significantly higher than international benchmarks. Assessment of 152 registered nurses showed high proficiency in transfusion indications (75.7%) but significant gaps in patient involvement and the recognition of transfusion reactions (62.5%).
CONCLUSIONS:
While legislative frameworks are in place, there is a critical need for standardized clinician training on "Rational Use of Blood" and a transition from replacement to voluntary non-remunerated donation (VNRD). To ensure "Health Without Borders," Peshawar must strengthen its bi-directional tracking systems (vein-to-vein) and establish hospital-based transfusion committees to minimize wastage and cross-contamination risks.
| eISSN: | 2654-1459 |
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