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Resume L’endemie stable du paludisme dans nos pays justifie le non-depistage du plasmodium pour la qualification du sang. Mais cette attitude fait courir des risques de paludisme grave aux jeunes enfants, femmes enceintes et sujets neufs transfuses. L’objectif de l’etude etait d’evaluer la realite et l’importance du paludisme transfusionnel et en determiner les facteurs favorisants. L’etude a porte sur 141 unites de culots globulaires transfuses a 77 receveurs hospitalises, ne souffrant pas de paludisme et n’ayant pas ete transfuses les deux dernieres semaines. Chaque unite de culot globulaire attribuee a un patient a ete testee avant utilisation. Quatre-vingt-seize heures apres la transfusion, la goutte epaisse (GE) et le frottis sanguin (FS) ont ete controles. Un suivi clinique etait effectue a l’hopital puis a domicile apres l’exeat. Au total, 13,47 % des culots globulaires transfuses etaient positifs pour la GE. Les GE et FS de controle etaient tous negatifs 96 heures apres la transfusion, meme chez les 19 patients qui avaient recu les unites de sang parasitees ! Le suivi a domicile avait permis de constater que 15,78 % des patients transfuses avaient developpe un paludisme clinique. Une densite parasitaire ≥ 240 parasites/mm3 semble en etre le facteur favorisant. Le paludisme transfusionnel est une realite dont il convient de tenir compte. L’introduction du depistage du paludisme dans les tests de qualification des dons de sang simultanement avec un encadrement des donneurs de sang paraissent la solution durable pour esperer a terme limiter les evictions de poches de sang excessives attendues.

The goal of this work is to assess the modalities of blood typing achievement in Benin with the view of their improvement.On the basis of a questionnaire including the detailed operative process, a prospective investigation has been achieved in public and private health centers laboratories.It came out that the execution of ABO and Rh blood typing took place globally on the fringe of the standards. We note that 72.4% of the private laboratories and 48.9% of the public ones lacked at least one equipment and 51.3% at least one material for blood withdrawal; 38.2% of the laboratories did not respect blood withdrawal standards; 1.32% of the laboratories applied the 4×2 rule. The assessment revealed that respectively 10.8% and 30.7% of the blood centers and non-blood centers achieved the globular test solely; the same 40.5% and 46.2% used reagents of different brands. Anti-A1 and anti-H sera, and A1 and A2 red cells were not available in any laboratory. More than 64% of laboratories have senior technicians and biomedical analysis engineers but only 6.6% of the laboratories were directed by biologists, and 9.2% of the laboratories function with only one technician.Instead of some assets, the laboratories assessment noted important non-conformities we ought to raise as a matter of urgency. It is a challenge whose resolution must give blood transfusion centers a reference position relatively to blood grouping when facing blood typing difficulties.

Malaria endemic status of our countries supports avoiding malaria screening for the blood qualification. But this attitude makes young children, pregnant women and people without semi-immunity incur a high risk of malaria. The goal of the survey was to value the reality and the importance of transfusion-transmitted malaria and to assess its determining factors. The study included 141 packed-red-cells units transfused to 77 hospitalized recipients, not suffering from malaria and not having been transfused the last two weeks. Every packed-red-cells assigned to a patient was tested for malaria before use. Thick and thin blood film were performed 96hours after transfusion. A clinical follow-up was undertaken as well as in the hospital and at home after release. In all, 13.47% of the transfused packed-red-cells were positive for the thick blood film. Plasmodium research in patients was negative 96hours after transfusion, even in the 19 patients who had received parasitized blood units! The home follow-up had permitted to note that 15.78% of blood recipients had developed clinical malaria. Parasitic density ≥240 parasites/mm(3) seems to be a determining factor. Transfusion-transmitted malaria is a reality we ought to consider. Introduction of malaria screening in donated blood qualification testings simultaneously with a framing of the blood donors appear the lasting solution to hope in the future to limit the waited excessive blood evictions.

The National Agency for Blood Transfusion (NABT) was created to ensure the smooth functioning of the transfusion system and made available in real time, quality blood products.