Benefits of HIV screening of blood transfusions in Zambia

Blood transfusion continues to be an important route of transmission of HIV in developing countries, especially for young children following the perinatal period. Testing for HIV is costly and reliable donor support for the purchase of test kits is often essential, yet difficult to secure. The costs of screening of transfusions for HIV and the financial benefits in terms of savings on treatment costs averted were calculated for a district hospital in Zambia where seroprevalence among donors was 15·9%. Financial benefits exceed costs by a factor of 2·7-3·5. In 1991, 1073 transfusions were given and an estimated 150 cases of transfusion-related AIDS were prevented by screening, of which 59% were in children aged 5 years or under and 31% were in women. The total cost of HIV screening was £3061 ($4745), and the cost per case of HIV infection prevented was £20·40 ($31·62); the cost of this protection for the population served by the hospital was £0·02 ($0·03) per person. An estimated 3625 undiscounted healthy years of life were saved, of which nearly 69% were in children under 6, at a cost of £0·85 ($1·32) per year of life saved. It is essential that financial and political support for HIV screening of blood for transfusion is maintained.