Govt plans mandatory blood group testing

A section of government scientists have proposed testing blood groups of all Ugandans and indicating the information in the national identity cards (IDs) to ease blood collection and provision of emergency services to patients.

The Uganda Blood Transfusion Service (UBTS) and clinical team leader, Mr Samuel Davis Wante, said they are struggling to get enough blood from people with rare blood type, Rhesus negative, and yet many patients are in need.

“To increase the capacity of the blood bank to reach people who are Rhesus negative, our government can improve the policy of ensuring that on our national ID, our blood group and blood type is included,” he told this publication yesterday.

“So, in the process, we (UBTS) shall be able to go in the archive of government and find how many people are Rhesus negative and people who are Rhesus positive, so that we can reach those who are Rhesus negative and encourage them to participate in blood donation,” he added.

Asked whether the Ministry of Health would support such an initiative, Dr Charles Olaro, the director of curative services at the Ministry, said it is an important plan that would save the lives of more patients.

“Not only that [improving blood collection], but also important for individuals in case of an emergency needing blood transfusion. This information could ideally be embedded in your [national] ID or driving permit,” he said.

“Knowing the Rhesus states for women in the reproductive age group is important, so [they can] access anti-D immunoglobulin to prevent fetal loss among others,” he added.

Mr Wante said the Rhesus factor is a protein found on the surface of the red blood cell and its presence is determined by the genetic materials one inherits from parents. Those whose blood cells have the protein are termed Rhesus positive while if your blood type is negative, then your blood cells lack the Rhesus (Rh) protein.

He said blood type (which is either Rh positive or Rh negative) is different from blood group. Blood groups include A, B, AB, and O. Each of these [blood groups] will either be Rh positive or Rh negative, such as A- and A+.

The UBTS clinical team leader said details about blood group and blood type are important in determining whether there will be compatibility during a blood transfusion or the possibility of Rhesus disease. Rhesus disease is a condition where antibodies in a pregnant woman’s blood destroy her baby’s blood cells, usually causing anaemia, jaundice (yellowing of the skin and the whites of the eyes) and death. It can be prevented through injection with Anti-D treatment.

Mr Wante said although the number of people with Rh-negative blood type is small in Uganda, their population has been rising because of intermarriages and immigration and so the increased demand for such types of blood.

“We had a blood donation campaign in Nansana recently and of the 638 people who donated blood, only three were Rh negative and these included a Korean and two Rwandans. Yet, only one (Rh negative) woman with birth complication may require all the three units of blood,” he said.

A 2016 study report by Richard Onyuthi Apecu and colleagues from Mbarara University indicates that in South Western Uganda, Rh-negative individuals were about two percent of the population.

“The distribution of ABO blood group was; blood group O (50.3 percent); blood group A (24.6 percent); blood group B (20.7 percent) and blood group AB (4.5 percent). The proportions of Rhesus positive and Rhesus negative were 98 percent and two percent respectively,” the report reads.

The low number of people with Rh negative blood type is reflected in the information circulating on social media and the UBTS principal blood donor recruiter William Mugisha, said it “is public information.” The document, detailed bloodstock in Nakasero Blood Bank and four centres. 

According to information in the document, the four facilities of Hoima, Jinja, Kitovu and Masaka didn’t have A- (Rh negative blood group A), except Nakasero Blood Bank which had 19 units. However, for A+ (Rh positive blood group A), Hoima had 19 units, Jinja had six units, Kitovu had 68 units and Masaka had 19 units while Nakasero had 313 units.

This was a similar situation with AB- where only two of the four facilities, Hoima and Jinja, had a total of four units while Nakasero had four units. Also for B-, of the four facilities, Jinja Kitovu and Masaka, each had one unit and Hoima had none.

Mr Wante said although the shortage of Rh-negative blood is imminent, they are only collecting 80 percent of the blood required to meet the need in the country because of the low willingness of people to donate and the hardship in reaching the potential donors. He appealed to Ugandans to donate to save lives and also know their blood group, blood type and their health status.

Mr Mugisha on the other hand said there is enough blood. “Nakasero blood bank alone has a total of 1,406 units of blood, that is a lot of blood,” he said.  The document showed that other centres such as Hoima had a total of 36 units of blood, Jinja (45 units), Kitovu (195) and Masaka (87).