The global need for products for blood transfusions exceeds the supply of blood products, particularly in low- and middle-income countries, according to results from a modelling study that were published in The Lancet Haematology.
Researchers used data from the 2016 World Health Organization (WHO) Global Status Report on Blood Safety and Availability to determine the availability of whole blood donations and individual component preparation (red blood cells, platelets, and plasma) for transfusion in 195 countries.
To calculate global need, the researchers used data from the National (Nationwide) Inpatient Sample in the United States and the State Inpatient Databases from the Healthcare Cost and Utilization Project to determine annual blood product usage per prevalent case for 20 causes between the years of 2000 and 2014. Of these annual rates, the lowest for each cause, designated the ideal blood usage, was then multiplied with disease-specific prevalence estimates obtained from the Global Burden of Disease 2017 study for the same 195 countries.
The researchers found a global need for 304,711,244 blood product units, while the global supply was only 272,270,243 units, yielding a need-to-supply ratio of 1.12 (95% uncertainty interval [UI], 1.07-1.16). In the 119 countries where need was greater than supply, there was a blood product shortage of 1849 units per 100,000 people.
Denmark had the greatest supply of blood products at 14,704 units per 100,000 people, and South Sudan had the least supply, with 46 units per 100,000 people. Blood need per population was greatest in Bulgaria and least in Laos. Per 100,000 people, 2 countries had fewer than 100 red cell products, 17 countries had 1 plasma unit or less, and 21 countries had 1 platelet unit or less.
Blood supply was insufficient to meet needs in every country in central, eastern, and western sub-Saharan Africa, Asia, and south Asia, but in no countries in Australasia, southern Latin America, and western Europe.
“The amount of unmet blood products need globally reinforces that the target of 10 to 20 donations per 1000 population [set by WHO] is inadequate to fulfil transfusion needs for the vast majority of countries,” the researchers wrote. According to their model, 21% of countries needed 30 donations per 1000 population, and 4 countries needed more than 40 donations per 1000 population, to meet transfusion needs.
1. Roberts N, James S, Delaney M, Fitzmaurice C. The global need and availability of blood products: a modelling study [published online October 17, 2019]. Lancet Haematol. doi:101016/S2352-3026(19)30217-0