COVID-19 impact on Nigeria's National Blood Transfusion Service-lessons for low-and middle-income countries (LMICs)

Oreh, A.; Irechukwu, C.; Biyama, F.; Nnabuihe, A.; Ihimekpen, A.; Oshiame, D.; Bozegha, T.; Izedonmwen, O.; Oga, E.; Suberu, E.; Odiabara, K.; Amedu, O.

Introduction: On the 27th of February 2020, Nigeria's Federal Ministry of Health officially announced the country's first case of COVID-19. As case numbers started to rise, what ensued was government-led interventions similar to those instituted across the world in the form of non-pharmaceutical interventions such as lockdowns, curfews, restrictions on mass gatherings and other physical distancing measures. These measures negatively affected blood donor mobilisation activities. Nigeria, like many other countries in sub-Saharan Africa prior to COVID-19 had encountered challenges with recruiting sufficient voluntary blood donors to meet the huge blood needs in the country, and so dire consequences of these infection prevention measures on national blood supplies were anticipated. A noticeable decline in blood donations and available safely screened blood for transfusions thus followed. We aimed to assess the blood service activities across seventeen (17) National Blood Transfusion Service centres in Nigeria, including numbers of blood donations, mobile blood drives, blood units screened, outcomes of screening, number of hospitals the NBTS provided services to and number of blood units discarded over the study period. Method: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in seventeen (17) NBTS centres in Nigeria, comparing the months of January to December 2019 (pre-COVID-19) to the months of January to December 2020 (peri-COVID-19). Results: A 100% decline was observed in mobile blood donation drives in the first two months following government-imposed lockdowns, and numbers of all blood donations and voluntary blood donations declined by 9.8%. An 11.9% decline was also observed in the number of blood units screened;while the number of blood units that screened positive for transfusion-transmissible infections reduced by 28.6%. The number of discarded blood units declined by 3.1%;however, a 32.6% increase was observed in the number of hospitals that accessed blood for transfusion purposes from NBTS. Conclusions: The COVID-19 pandemic affected NBTS operations in Nigeria. However, by strengthening hospital linkages and employing innovative strategies, NBTS ensured continuity of operations, thereby significantly managing the challenges of COVID-19 to voluntary blood donor recruitment and the availability of safe blood for transfusion.