By Dr Nivedita Dhingra
Six-year-old Ankit, is suffering from thalassemia major, a genetic disorder in which his life depends on regular blood transfusions. His father is a daily wage worker and he lives with his family in a remote area where medical facilities are very limited. He has to travel long distances to get blood transfusions every month. When Ankit became seriously ill with jaundice and abdominal pain his parents took him to a doctor, who informed them that Ankit had contracted hepatitis which was most likely due to a transfusion of contaminated blood. Ankit’s story is similar to many patients with thalassemia who suffer grave consequences due to inaccessibility to safe blood products.
Thalassemia is a genetic condition in which the body is unable to make sufficient amounts of haemoglobin, a protein that resides in the red blood cells and carries oxygen to all parts of the body. Thalassemia patients require life-long blood transfusions to maintain their haemoglobin levels and prevent serious growth retardation and organ damage. The disease occurs in 4.4 per 10,000 live births across the globe but is especially common in the Mediterranean region, Middle East and Asia. In India, it is estimated that 150 000 people are living with a severe form of thalassemia. Despite the alarming number of cases in the country, access to systematic and safe blood transfusion for patients is still a challenge. According to the World Health Organization (WHO), blood donation by 1% of a country’s population is usually taken as the minimum need to meet the basic requirement for blood. India with a population of 1.4 billion requires 14 million units of blood annually. But the supply is only 93%, leaving a gap of around one million units of blood.
Survival of thalassemia patients depends on safe blood
As thalassemia patients need regular blood transfusions, the quality of blood is of utmost importance as unsafe blood can lead to Transfusion Transmissible Infections (TTIs) which can even be fatal. It is mandatory to screen all collected blood units for HBV (Hepatitis B), HIV and HCV (Hepatitis C), syphilis, and malaria by serological tests. However, despite these mandatory tests, those receiving blood are still at risk of contracting TTIs due to the window period for certain infections, where the screening test can be falsely negative, and the constant development of new variants that evade even modern screenings. Therefore, there is an immediate unmet need for improving blood safety measures across the country.
NAT: A necessity, not an option
Thanks to advancements in science and technology, there is a more effective test called NAT (nucleic acid test) that picks up viral infections much earlier. NAT plays a big role in enhancing blood safety and is being adopted increasingly by many countries. In India, NAT is a recommended test for screening of TTIs because of its higher sensitivity. However, due to a lack of proper awareness, infrastructure, and resources, only 7% of the total collected blood undergoes NAT testing. As of now only five states – Rajasthan, Uttar Pradesh, Uttarakhand, Jharkhand, and Karnataka have implemented NAT testing. Other states are yet to share proposals with the Centre as a part of their Programme Implementation Plan.
Access to safe and quality blood products is a basic right of every patient. As the fight against TTIs is gaining momentum across the country, NAT acts as a valuable addition to screening that adds an extra layer of safety. It is pivotal that the government collaborates with both public and private players to provide the necessary infrastructure and resources for making the NAT test available across all blood banks at an affordable cost to ensure safe blood for the citizens.
(The author is a Sr Consultant – Haematology, Max Hospital, Patparganj. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)