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REDS-III Transfusion Medicine Research Program in South Africa

 

Recipient Epidemiology and Donor Evaluation Study-III (REDS-III)

The goal of the REDS-III Program is to improve the safety and effectiveness of Blood Banking and Transfusion Medicine Practices in South Africa by performing laboratory and epidemiological research. The South African National Blood Service (SANBS) collaborates in this research initiative with scientists from the University of California San Francisco (UCSF) and Blood Systems Research Institute (BSRI) in San Francisco. UCSF and BSRI had been collaborating with transfusion medicine investigators in South Africa for 15 years prior to REDS-III. This productive collaboration served as a foundation for the REDS-III program in South Africa.

The South African National Blood Service (SANBS)

The SANBSOffsite icon is a not-for-profit organization which procures blood exclusively from voluntary, non-remunerated blood donors. Its Corporate Mission is to provide all patients in need of blood transfusion, with sufficient, safe, high quality blood products coupled with the medical services related to blood transfusion, in an equitable and cost effective manner. SANBS’s Vision is to be acknowledged nationally and internationally as a center of excellence in the discipline of blood transfusion.

SANBS operates in eight of the nine Provinces in South Africa, and collects approximately 85% of the blood within the country. The Western Province Blood Transfusion Service (WPBTS) covers the blood supply for the remainder of the country. The operation of Blood Services in South Africa is somewhat unique in that, in addition to procuring blood from volunteer donors and performing all required laboratory tests on every blood donation (including blood group serological tests and tests for markers of transfusion-transmissible infections) the Blood Services operate the compatibility testing and distribution laboratories (Blood Banks) in various State and Private Hospitals throughout the country.

SANBS Headquarters are situated in Johannesburg and, country-wide, the organization employs just over 2500 staff. SANBS currently operates 86 fixed-site donor clinics and, in addition, approximately 66 blood drives (mobile blood donor clinics) are held daily. In order to meet the transfusion needs of patients, SANBS aims to collect 810,000 whole blood donations annually (approximately 2200 donations per day). In addition to whole blood, SANBS collects approximately 16,000 apheresis platelet donations annually and a similar number of random-donor pooled ‘buffy-coat’ platelet units are provided annually to patients who need platelet transfusions. Income for the operation of the Blood Services in South Africa is derived entirely on a ‘fee for service’ basis.

Donation testing for the entire SANBS network is carried out in two centralized donation testing laboratories in Johannesburg and Durban. Tests for transfusion-transmissible infections include serological as well as individual donation nucleic acid tests (ID NAT) for HIV, hepatitis C and hepatitis B. SANBS provides cross-matched blood to over 600 State (Provincial) and Private sector hospitals. Furthermore, with significant support from PEPFAR, SANBS has placed dedicated refrigerators in over 400 rural hospitals to ensure that un-cross-matched group O blood (‘emergency group O blood’) is immediately available for use in clinical emergencies, especially peripartum hemorrhage. SANBS also plays a role in supporting neighboring countries in the region. SANBS utilizes an electronic data warehouse system which covers all operational areas within the Blood Service. This data warehouse will be used to provide data for REDS-III.

REDS-III Projects

The following projects are currently either planned or have already been completed as part of the seven-year term of REDS-III program.

  • Donor and donation database.  One of the aims of the REDS-III project is to establish a research donation and donor database, which will be used to evaluate donor and donation characteristics such as the prevalence and incidence of HIV (and other transfusion-transmissible infections) among donors. The database will include information on donors compiled over a period of six years.

  • HIV Molecular Epidemiology study (More info)

  • Transfusion in Pregnancy (TIP) (More info)

  • Incident HIV and HBV Infections in South African Blood Donors (More info)

  • Blood Donor Recruitment and Retention in South Africa (More info)

  • Monitoring and Acute Treatment of HIV Study – MATHS (More info)

  • Human subjects' research.  All study protocols are approved by the SANBS Research Ethics Committee as well as RTI and the UCSF Committee on Human Research. All facets of the study will comply with NIH and International Research Ethics Guidelines. Human subjects participating in all REDS-III studies will provide informed consent.

     

Education and Training

The REDS program in South Africa also serves as a platform for training junior and mid-level investigators in South Africa thus building capacity for downstream study.


Investigators by Organization

Edward L. Murphy, MD, MPH
US Principal Investigator, UCSF

Brian Custer, PhD, MPH
US Co-Principal Investigator, BSRI

Evan M. Bloch, MD, MS
US Co-Investigator, BSRI


 

Ute Jentsch, MD
South Africa Co-Investigator, SANBS

Ravi Reddy, MBA
South African Co-Investigator, SANBS

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