Annual Report 2021 - Peshawar Regional Blood Centre

Annual Progress Report 2021
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Regional Blood Centre Peshawar

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Annual
Progress
Report
2021

Health Department, Govt. of Khyber Pakhtunkhwa
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© Regional Blood Centre Peshawar, Health Department, Govt. of Khyber Pakhtunkhwa, Pakistan
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means,
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The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not
identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary
rights.
First Edition 2021
Publishing Director: Jamal Abdul Nasir

Cover and Interior Design: Noor e Saba & Muhammad Nisar
Interior Photographs: Abdul Qayyum & Shams ur Rehman
Suggested citation: Saba, N., Nisar, M., Nasir, J.A (2021). Annual Progress Report. 1st ed. Regional
Blood Centre Peshawar, Khyber Pakhtunkhwa, Pakistan. ISBN 9789692254014.
Printed and bound in Peshawar, Khyber Pakhtunkhwa, Pakistan
An official publication by the Regional Blood Centre Peshawar, Health Department, Govt. of
Khyber Pakhtunkhwa, Pakistan
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EDITORS - ANNUAL REPORT 2021
Dr. Noor e Saba

MBBS; MPH; MPhil Haematology; Fellowship Field Epidemiology (CDC, USA)
PG Cert. Transfusion Medicine (Iran); Dip. Procurement & Supply Chain; CQP
Consultant Haematologist / Manager

Health Department, Govt. of Khyber
Pakhtunkhwa, Pakistan
Dr. Muhammad Nisar

MBBS; MPhil Haematology
HR Manager
Dr. Jamal Abdul Nasir

MBBS; MPH, Dip. Quality of Health (Harvard School of Public Health (Boston, USA)
MBA (Healthcare Finance), Dip. Health Planning, Management & Hospital Administration (Nuffield, UK)
Chairman Board, Regional Blood Centre Peshawar

Director Administrator
Directorate General of Health Services
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ABBREVIATIONS AND ACRONYMS

AIDS acquired immunodeficiency syndrome
BTA blood transfusion authority
BTS blood Transfusion service
CLIA chemiluminescence immunoassay
CUB clinical use of blood
DOH department of health
ELISA enzyme-linked immunosorbent assay
FFP fresh frozen plasma
HBB hospital blood bank
HBV hepatitis B virus
HCV hepatitis C virus
HIV human immunodeficiency virus
HMC hayatabad medical complex
HTC hospital transfusion committee
HV haemovigilance
IBTO iranian blood transfusion organization
ICT immuno chromatographic technique
ISBT international society of blood transfusion
ISO international organization for standardization
KfW german development bank
KMU khyber medical university
KTH khyber teaching hospital
LRH lady reading hospital
NAT nucleic acid testing
NBP national blood policy
NGO non-governmental organization
NSF national strategic framework
PCR polymerase chain reaction
PIMS peshawar institute of medical sciences
QA quality assurance
QC quality control
RBC regional blood centre
RCC red cells concentrates
RDT rapid diagnostic test
SBTP safe blood transfusion project
SDG sustainable development goal
SOP standard operating procedure
VNRBD voluntary non-remunerated blood donor
WHO world health organization
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TABLE OF CONTENTS
Acknowledgements ....................................................................................................... 1
Preface ........................................................................................................................... 2
Introduction and Background ....................................................................................... 4
Annual Data Analysis and Interpretation ................................................................... 11
Number of Blood Donations .................................................................................................. 11

Gender-wise Distribution of Blood Donations ........................................................................ 11
Types of Blood Donations ..................................................................................................... 12
Components Preparation ...................................................................................................... 13
Screening for Transfusion-Transmitted Infections ................................................................. 13
Donor Haemovigilance .......................................................................................................... 15
Prevalence of Blood Groups among Blood Donors ............................................................... 17
Waste Disposal ..................................................................................................................... 17
Photographic Glance of Regional Blood Centre ....................................................... 18

World Blood Donor Day 2021: COVID-19 and Blood Safety ..................................... 21
World Hepatitis Day 2021: Hepatitis and Blood Safety ............................................. 25
Workshop on Biosafety, Waste Management and Haemovigilance ........................ 27
Photographic Gallery .................................................................................................. 29
List of Publications...................................................................................................... 37
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ACKNOWLEDGEMENTS
I am honoured and pleased to present the the Centre to enable it to perform its assigned
Annual Progress Report of the Regional Blood role of providing safe blood. The RBC team owe
Centre (RBC) Peshawar for the year 2021. The a lot to the cooperation and guidance received
report provides an annual review of the RBC from Chairman Board RBC, Dr. Jamal Abdul
activities, the publication of research work, and Nasir, who has always been an ardent
the data analysis and interpretation. The data supporter of the quality assured blood
collection, management, and subsequent transfusion services in the province.
analysis are essential for improved planning The RBC is grateful to the German
and evaluation of services. During the government for their continued support
reporting period, the RBC has managed 48,213 through the KfW (German development bank),
blood donors and has provided approximately and GIZ (German International Technical
150,000 units of blood and blood components to Cooperation). From time to time, WHO has
the needy patients in hospitals and been providing technical assistance which has
thalassaemia centres of Peshawar. These proved to be very valuable for the RBC and
figures speak for the remarkable effort the RBC highly appreciated.
team has put into the foundations of this We would also like to express our gratitude
Centre. to our blood donors. The donated blood does
The RBC Peshawar is indebted to Mr. not belong to us; it belongs to the community –
Taimur Saleem Khan Jhagra, Provincial Health to you – ensuring that safe blood and blood
Minister, for his support and encouragement. components are available whenever needed.
The Centre also expresses gratitude to Mr. All the RBC staff, the management of the
Muhammad Tahir Orakzai, Secretary Health, affiliated hospital blood banks, and our great
for his cooperation. The RBC is also grateful to blood donors deserve appreciation for
Dr. Niaz Muhammad, Director General Health, extending all possible cooperation. We look
for his wholehearted support and facilitation to forward to their continued support in 2022.
Dr. Noor e Saba

MBBS; MPH; MPhil Haematology; Fellowship Field Epidemiology (CDC, USA)
PG Cert. Transfusion Medicine (Iran); Dip. Procurement & Supply Chain; CQP
Consultant Haematologist / Manager

Peshawar, January 1, 2022
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PREFACE
The vision of the government of Khyber The Department of Health under the
Pakhtunkhwa is to work for the promotion of dynamic leadership and continuous support of
Health-for-all, a vision that strives for access, the Honorable Minister Mr. Taimur Saleem
equity, efficiency and effectiveness of essential Khan Jhagra, is striving hard to ensure access to
health interventions catering to the rights, safe, efficacious, and affordable blood, to all
needs and dignity of all segments of the and it will become a reality in the near future.
population. As the provincial government In 2008, the Khyber Pakhtunkhwa government
attaches great significance to the health sector, initiated the reformation into centralized
blood safety continues to be among the supply-driven blood transfusion services. This
government’s core priorities within the health included the establishment of a network of
sector. Regional Blood Centres (RBC) connected with
The Health Department is fully committed existing hospital blood banks (HBB). The Phase
to promoting blood safety and improving the I PC-1 (2010-16) of the safe blood project in
standard of regulation and service delivery in Khyber Pakhtunkhwa was worth PKR 190.17
the blood transfusion sector. The National million (FEC 77.95 million, LC 112.22 million).
Health Vision (2016-25) endorsed by all In Phase I of the project, one large modern RBC
provinces, advocates the need for safe blood was developed in Peshawar and six existing
transfusion and reduction in transfusion- Hospital Blood Banks in Peshawar were
dependent thalassaemia patients. Pakistan has upgraded and equipped through the German
one of the highest hepatitis B and C populations government grant. This infrastructure is now
in the world. Also, we have had regular functional and is providing much-improved
epidemics of HIV and dengue for the last few services and safety standards. I am very
years. All these infections are transfusion pleased to state that based on this successful
transmissible and we have to make sure that implementation, the German government
transfusions in our community are safe from committed to supporting the second phase of
these infections. The development of a centrally the project also. And in the second phase, more
coordinated blood transfusion service in the infrastructure and associated technical work
country to ensure timely access to blood for all were performed to enhance the coverage area
was thus imperative. of the services. In Phase II (2017-21) of the
The provision of quality assured blood project, RBCs have been developed in Swat,
products entails a paradigm shift from the D.I. Khan, and Abbottabad. The Phase II PC-1
current unsafe fragmented service delivery is worth PKR 676.856 million (FEC 385.895
system to a more centrally coordinated de- million, LC 290.970 million).
centralized system. It is a matter of great The government of Khyber Pakhtunkhwa
satisfaction that a project that was conceived acknowledges the generous grant provided to
and planned in 2008 has in a very short span of the blood safety project by the government of
time developed into a very inspiring public the Federal Republic of Germany through its
health programme in the shape of a Regional Technical and Financial Cooperation
Blood Centre and linked public sector Hospital components funded by GIZ (German Int’l
Blood Banks (HBBs). Technical Cooperation) and KfW (German
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Development Bank), respectively. Indeed, the international and national research journals.
German government commitment to this During the past five years, the RBC got
project is very praiseworthy. The World Health published more than 30 research articles in
Organization (WHO) is also acknowledged for international journals of repute with high
providing technical support to the Regional impact factors.
Blood Centre Peshawar for the awareness and The exciting developments taking place in
prevention of transfusion transmittable the blood sector through the Regional Blood
infections and the promotion of voluntary Centre are keenly followed and supported by
blood donations. the international blood community. The WHO
Since the establishment of Regional Blood (World Health Organization), ISBT
Centre Peshawar in 2016, we are now well on (International Society of Blood Transfusion),
our way to establishing an internationally Austrian Red Cross, German Embassy, IBTO
recommended blood transfusion system in the (Iranian Blood Transfusion Organization),
province. The new system is gradually members of the Provincial Legislative
replacing and phasing out the current Assembly, and other key stakeholders have
fragmented demand-driven scattered system. appreciated the services rendered by the
The promotion of voluntary blood Regional Blood Centre Peshawar. Capacity-
donations is the cornerstone of the RBC building activities have been conducted in
Peshawar. This is in line with the National collaboration with the ISBT, WHO, GIZ, and
Blood Policy and Strategic Framework which the KfW. Indeed the RBC Peshawar is a big
identifies donor management including achievement and the health department and
community interface as a key priority area. I am the government are very proud of the
pleased to inform you that RBC conducts accomplishments and its contribution to
regular activities throughout the year to attract building a healthy society.
young people to become regular blood donors I sincerely congratulate the dedicated and
through a structured plan and strategy. The committed team of the Regional Blood Centre
efforts of the RBC and the stakeholders to bring Peshawar, for their hard work, commitment,
about a behaviour change in the community and zeal. I especially acknowledge the
and shift our current reliance on ‘Family leadership role of Manager RBC for making this
Replacement Donors’ to the internationally very important project a success and steering it
recommended safe regular “voluntary blood very professionally and ably and taking it to
donors” is most praiseworthy. greater heights. Indeed, an irreversible
The RBC Peshawar has been promoting the momentum has now been generated for the
culture of research and development in the promotion of blood safety in the province and
transfusion sector. The RBC regularly will lead to the provision of safe and quality-
publishes its research work in reputed assured blood products.
Dr. Jamal Abdul Nasir

Director Administration / Chairman Board, RBC Peshawar
Directorate General Health Services, Health Department,
Govt. of Khyber Pakhtunkhwa, Pakistan
Peshawar, January 1, 2022
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INTRODUCTION AND BACKGROUND
Blood safety and availability is an important public health matter. According to the WHO, safe
blood transfusion is a universal human right. While substantial work is ongoing to identify replacement
therapies and minimize the use of blood, transfusion services remain a critical component of the
healthcare system. Globally, 118.2 million blood donations are collected with 58% in low and middle-
income countries.
The process of blood transfusion includes transfusion of donated blood in the form of blood
components, blood derivatives, or in rare and very specific situations as whole blood. The most
appropriate blood transfusion therapy should provide for the missing or reduced element. Blood
component therapy is used to treat conditions in which the specific element is missing; for example,
packed red cell administration in the case of severe anaemia (a reduction in oxygen supply to vital
organs) or platelet concentrates transfused for an abnormal decrease in the number of platelets. Climate
change and increased cross-border movement led to revised geographical distributions of emerging
and reemerging pathogens transmittable through the blood which brought to the centre-stage, the
importance of ‘safe’ blood transfusion service.
The term blood transfusion service includes various aspects of the blood transfusion chain, from the
potential donor (selection of donors, blood collection, screening, processing, storage, haemovigilance,
and blood transportation) to the potential recipient (selection and distribution of appropriate
components for transfusion), and should link to the clinical interface and patient follow-up. It is
important to note that donor promotion and awareness of blood donation is also part of blood
transfusion service activities. This complex work is usually carried out by dedicated organizations/
institutions or departments that operate at the national, regional, or local levels. A safe blood
transfusion service can make a significant contribution to reducing the occurrence of HIV, hepatitis B,
and C. The risk of poverty resulting from ruinous health expenditure is also reduced. The blood
transfusion services, therefore, contributes to the sustainable development goals (SDGs).
It is estimated that 2.9 million blood donations are collected in Pakistan annually from
approximately 665 blood centres of varying workloads.1 The blood transfusion service in Pakistan is
compromised, largely due to fragmentation and the lack of a coordinated blood transfusion system.
The result is the emergence of a large number of private and NGO sector blood banks operating without
any regulatory oversight. Across the system, there is a lack of proper initial screening of donors for high
risk behaviours through blood donor interviews and physical health examination. As a result even
blood from high risk donors is collected increasing manifold the risk of transmission of infections
through transfusions. Hepatitis B, Hepatitis C, and HIV/AIDS are among the major transfusion
transmitted infections burdening the health care system in Pakistan. 2,3 The chronic recipients, e.g.
1 Waheed U, Saba N, Wazeer A, Qasim Z. Textbook of laboratory techniques in haematology and transfusion medicine. 2022; 3rd ed. Islamabad, Pakistan, ISBN 978969235250 5.
2 Ahmad M, Saeed M, Hanif A, Waheed U, Arshad M, Ain NU, Rasheed F, Hussain S. Slump of trends in transfusion-transmissible infectious diseases: Is syphilis alarming in
Pakistan?. Glob J Transfus Med 2019;4(1):45-51.
3 Waheed U, Arshad M, Bryde L, Arshad A, Umair M, Zaheer HA. The changing dynamics of HIV/AIDS burden and screening strategies in Pakistan. Ann. Pak. Inst. Med. Sci. 2017;
13(1):103-110.
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thalassaemics have much higher prevalence rates for transfusion-transmitted infections when
compared to the general population. 4,5
The population of Khyber Pakhtunkhwa province is 30,523,371 and has an area of 74,521 sq. km.
According to one estimate, there are 40 public sector and 68 private/NGO sector blood banks that are
functioning. The situation regarding blood safety in the province of Khyber Pakhtunkhwa is not
different from the rest of the country and until recently the system was not organized according to the
internationally accepted centralized model of blood transfusion services. 6 All the stakeholders work in
isolation in the fragmented system. The system lacks a reliable healthy donor base and a registry of
voluntary non-remunerated regular donors, therefore most of the blood donors are replacement-based
family donors.
Blood banks are managed alternatively by medical officers or pathologists, as blood bank services
are often provided through general pathology laboratories. There is not yet a separate qualification in
blood banking and transfusion medicine, and most in-charges do not have a related post-graduate
qualification. The situation is similar for the level of laboratory technologists. There is a large number
of laboratory assistants trained on the job by the respective hospital. The limited content of blood
banking in most curricula completely neglects some of the most important areas, namely, quality
control and quality assurance, quarantine of blood, issue of blood and inventory control, whereas blood
grouping and cross-matching and anticoagulants are well covered. Internal specialization is limited,
staff may perform any function related to the collection of donations, testing, processing, and storage
up to the issuance of blood. There are no specified job assignments to the various blood bank
specialities, in accordance with the Functional Brief for Regional Blood Centres.7
In 2004, the National AIDS Control Programme (NACP) submitted a proposal to the Economic
Affairs Division (EAD), within the framework of the Pakistan-German Government Cooperation to
enhance blood safety in Pakistan. A feasibility study was conducted in 2007 by a joint mission of NACP
and German Technical and Financial Development Cooperation. The study recommended converting
the fragmented system of public and private blood establishments into a centralized system of blood
collection and processing that is consistent with WHO standards, in order to increase the quality and
safety of blood and blood components and to improve cost-effectiveness.8
Accordingly from 2008 onwards, the Government of Pakistan, supported by a grant-in-aid from the
Government of Germany, initiated the National Blood Transfusion Project9 (now called Safe Blood
Transfusion Project). The overall objective of this project was to reform the blood transfusion system
towards a ‘nationally coordinated system’ based on a centralized model with regional blood centres
(RBCs) and attached hospital blood banks (HBBs). The detailed operational planning and
implementation lies in the responsibility of federal, state, and provincial health departments through
the PC-1s. The Khyber Pakhtunkhwa province PC-1 budgeting 190.17 million in Phase 1 (2010-16) was
successfully completed. This regional blood centre (RBC) having a capacity of 50,000 blood units per
year was established on an area of 16,686 sq ft within the premises of Hayatabad Medical Complex. The
construction cost of the RBC was 55,643,460 PKR. The construction work which started in July 2013,
was completed in March 2016, when a unique advanced facility emerged on the medical map of
Pakistan after painstaking efforts by many professionals especially Prof. Fazle Raziq (former Project
Director, SBTP Khyber Pakhtunkhwa), Prof. Hasan A. Zaheer (former Director SBTP Islamabad), and
4 Waheed U, Saba N, Wazeer A, Ahmed S. A systematic review and meta-analysis on the epidemiology of Hepatitis B virus and Hepatitis C virus among 𝛽-Thalassaemia major
patients in Pakistan. J Lab Physicians 2021;13(3):270-276.
5 Waheed U, Farooq A, Arshad M, Usman J, Zaheer HA. Surveillance of human immunodeficiency virus in blood donors of Islamabad, Pakistan: A meta-analysis. Pak Armed
Forces Med J 2017; 67 (5): 860-67.
6 Saba N. Restructuring of blood transfusion services in Khyber Pakhtunkhwa. Medical Review. Vol 30, No. 1, Jan 2018.
7 Sibinga CT, Kohorst P, Ahmed R, Waheed U. Functional brief for regional blood centre. 2011; 1 st ed. National Blood Transfusion Programme, Ministry of Health, Islamabad,
Pakistan, ISBN 978 969 9881 08 4.

8 Zaheer HA, Waheed U. Blood safety system reforms in Pakistan. Blood Transfus 2014; 12(4): 452-457.
9 Zaheer HA, Waheed U. Legislative reforms of the blood transfusion system in Pakistan. Transfus Med. 2014;24(2):117-9.
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Dr. Usman Waheed (former Advisor GIZ/SBTP, Islamabad). The RBC was made operational in April
2016, and formally inaugurated by the Provincial Health Minister and German Ambassador on
November 9, 2016.
In the centralized blood banking system (figure 1) RBC is the main site, i.e. mother ship, responsible
for performing donor collection, component preparation, blood processing including blood grouping,
and infectious disease testing. Blood components are delivered to the linked Hospital Blood Banks
(HBBs), according to their needs. At the HBB level, blood products are only stored, compatibility testing
of patient and donor blood is performed, and haemovigilance is practiced.
Fig. 1: Centralized blood banking system
The Regional Blood Centre Peshawar is serving as a blood collection and distribution centre,
ensuring quality systems to regulate all activities. The Centre serves a total population of about 4.26
million of Peshawar city, which is 12% of the provincial population. Essentially the role of the Regional
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Blood Centre is the mobilization of voluntary non-remunerated blood donors, collection of blood
donations, its processing, TTI screening, component preparation and storage, distribution to attached
hospital blood banks, haemovigilance, and research and development. 10 Development of a system of
traceability through proper identification and record maintenance as well as surveillance of adverse
reactions, reagents standardization, and evaluation also falls in the domain of the Centre. All these
activities are being carried out in line with the principles of Good Manufacturing and Laboratory
Practices (GMP & GLP). The Centre is comprised of various sections namely the donor management
section, TTI screening section, immunohaematology section, processing section, quality management/
haemovigilance section, and blood bank management information system (BBMIS) section.
The collection of blood from voluntary, non-remunerated blood donors (VNRBDs) is an important
measure for ensuring the safety, quality, availability and accessibility of blood transfusions. The WHO
recommends that all countries should be self-sufficient in all blood products and that every blood
donation should be voluntary, anonymous and non-remunerated. World Health Assembly (WHA)
resolutions WHA 28.72 (1975)11 and WHA 58.13 (2005)12 urged the Member States to develop national
blood transfusion services based on voluntary non-remunerated blood donation. 13 Similarly, the
WHO’s Melbourne declaration (2009)14 on 100% VNRBD and the Rome declaration (2013)15 on
achieving self-sufficiency in safe blood and blood products based on VNRBD emphasize the vital
importance of safe blood donations (i.e., voluntary non-remunerated) in preserving adequate and
sustainable national blood supplies and healthy populations.
The VNRBD activities in the RBC is becoming very frequent and gaining momentum. Regular
mobile camps are being organized and ‘walk-in donors’ are increasing in numbers. The substantial
reliance on family replacement donors,16 as witnessed earlier is gradually decreasing and the concept
of VNRBD is being promoted through blood camps, seminars, and other promotional activities. The
RBC team is actively using social media platforms namely WhatsApp and Facebook17 for advocacy of
voluntary non-remunerated blood donations. RBC Peshawar team in collaboration with the Mirpur
RBC conducted a research study18 on utilization of WhatsApp for blood donor mobilization campaigns
during COVID-19 pandemic. The study was highly appreciated by peers both nationally and
internationally and got published in a very prestigious journal (ISBT Science Series) published by the
International Society of Blood Transfusion (ISBT).
Establishing a pool of safe blood donors requires long-term commitments to education, information,
and social involvement. Efforts in this regard have been mainly enhanced with the World Blood Donor
Day (WBDD), launched in 2004, and endorsed by the World Health Assembly in 2005 as global annual
event.19 As mentioned above, the RBC conducts regular planned activities throughout the year to attract
the young people to become regular blood donors through a structured plan and strategy. These
activities gain increased momentum in the days and weeks leading to WBDD on June 14 every year.
The impact of these celebrations has resulted in increasing awareness about voluntary blood donations.
The WBDD activities are receiving more and more coverage in the electronic and print media which is
10 Saba N, Nasir JA, Waheed U, Aslam S, Mohammad I, Wazeer A, Ahmed S, Nisar M. Seroprevalence of transfusion-transmitted infections among voluntary and replacement
blood donors at the Peshawar Regional Blood Centre, Khyber Pakhtunkhwa, Pakistan. J Lab Physicians 2021;13(2):162-168.
11 World Health Assembly’s 28th Session (1975). WHA 28.72 Utilization and supply of human blood and blood products. Available at:
https://www.who.int/bloodsafety/en/WHA28.72.pdf
12 World Health Assembly’s 58th Session (2005). WHA 58.13 Blood safety: proposal to establish World Blood Donor Day. Available at:
https://apps.who.int/iris/bitstream/handle/10665/20363/WHA58_13-en.pdf
13 Abdella Y, Zaheer HA, Waheed U, Sibinga S. Status of blood transfusion in World Health Organization-Eastern Mediterranean Region (WHO-EMR): Successes and challenges.
Transfus Apher Sci. 2018;57(4):515-516.

14 WHO (2009). The Melbourne declaration on 100% voluntary non‐remunerated donation of blood and blood components. Available at:
https://www.who.int/worldblooddonorday/Melbourne_Declaration_VNRBD_2009.pdf
15 WHO (2013). The Rome declaration on achieving self‐sufficiency in safe blood and blood products, based on voluntary non‐remunerated donation. Available at:
http://fidas.it/wp/wp-content/uploads/2010/03/dichiarazionediroma2013.pdf
16 Ahmed M, Saeed M, Waheed U, Mujtaba A, Hanif A, Khalid A, Rashed F. Perception of blood donation among Pakistani youth. Pak Armed Forces Med J 2020; 70 (5): 1360-65.
17 Zaheer HA, Waheed U, Tahir S, et al. Promotion of voluntary blood donation thorough Facebook blood donation feature in Pakistan. Vox Sanguinis 2019; 114 (Suppl. 1): p 23.
18 Waheed U, Wazeer A, Saba N, Qasim Z. Effectiveness of WhatsApp for blood donor mobilization campaigns during COVID-19 pandemic. ISBT Science Series 2020;15:378-80.
19 World Health Assembly’s 58th Session (2005). WHA 58.13 Blood safety: proposal to establish World Blood Donor Day. Available at:
https://apps.who.int/iris/bitstream/handle/10665/20363/WHA58_13-en.pdf
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a reflection of the sustained and committed efforts of the RBC. As the RBC Peshawar has remained at
the forefront in the fight against COVID-19, on the eve of WBDD 2021, the RBC organized a scientific
seminar, targeted at the ongoing COVID-19 pandemic. The seminar was titled ‘Resilience of Blood
Transfusion Services to Combat COVID-19 Challenge in Pakistan’ and attended by over 50 key stakeholders.
In addition to the lectures related to the WBDD 2021, the scientific session included state-of-the-art
presentations on original research studies that have been conducted over the past year by our Centre
specifically dealing with blood safety issues during the COVID-19 pandemic generating evidence-
based data. A summary of this seminar is included in the later part of this report.
The RBC is managing the collection of blood from all attached HBBs which is then processed in the
RBC. Processed blood components are being supplied to linked HBBs according to their needs and
requirements and include blood banks of Lady Reading Hospital, Khyber Teaching Hospital, Institute
of Kidney Diseases, Burns and Plastic Surgery Centre, Peshawar Institute of Cardiology, City Hospital,
Naseer Ullah Babar Memorial Teaching Hospital, and Hayatabad Medical Complex. The role of these
HBBs is now primarily focusing on patient-oriented transfusion medicine functions, namely; storage,
distribution, compatibility testing, and haemovigilance. For the rational use of blood, the hospitals have
activated their hospital transfusion committees (HTCs), which carry periodical meetings, create
awareness among clinicians, nursing staff, and any other staff associated and improve the status of
transfusions taking place in the hospitals. The training of clinicians in the appropriate and judicious use
of blood and blood components is an important endeavor that requires constant updates not only
regarding scientific progress and technologies but also the availability of and access to alternatives to
transfusion therapy. As the strengthening of coordination with clinicians and nurses in the hospital
may help reduce blood usage, the HTC meetings are held regularly and mostly attended by RBC
representatives.
In addition, during recent years, the concept of patient blood management (PBM), has gained more
and more attention. The PBM is primarily based on the principles of the clinical rational use of blood
as mentioned above. The three pillars of PBM focus on optimization of red cell mass, reduction of blood
loss/bleeding and optimization of the physiological reserve of anaemia.20 Explaining the benefits and
risks of blood transfusion to patients and families is an important element in creating the necessary
understanding of this apparently simple procedure. As the PBM is an evolving phenomenon in many
developing countries, we are trying to include this concept in HTC meetings. Advocacy seminars in
this regard for hospital staff are in the pipeline for the year 2022.
The Regional Blood Centre is the first of its kind in the province of Khyber Pakhtunkhwa,
established in accordance with the international WHO standards and guidelines for blood transfusion
services. Since its inception in 2016, this Centre has emerged as the best facility in the province to
provide quality assured blood services that is comparable to such centres of the developed world. Over
the last five years, our facility has managed almost 150,000 blood donors and has provided over 400,000
units of blood and blood components to the needy patients in hospitals and thalassaemia centres of
Peshawar. The roadmap RBC has followed is very structured and systematic and had a huge impact
on the overall quality of blood transfusion services in the provincial capital.
The RBC has become the hub of blood transfusion-related training activities in the province. The
RBC has continued to scale up visibility through a series of strategies and training workshops for all
the different levels of workers in the blood banks. The highlight of the trainings has remained the
evident enthusiasm of the participants who are always most eager to learn and willing to concentrate
for long hours every day in the workshop to enhance their professional skills and knowledge. Many of
these trainings have been conducted in collaboration with key international partners including the ISBT
20 Isbister J.P. The three pillar matrix of patient blood management – An overview. Best Pract. Res. Clin. Anaesthesiol. 2013;27(1):69–84.
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(International Society of Blood Transfusion), 21 WHO (World Health Organization), KfW (German
Development Bank), GIZ (German International Technical Cooperation), among others.
During the course of the current year, the RBC has collaborated and provided technical assistance
to the Afghan National Blood Safety and Transfusion Service (ANBSTS). Research studies have been
conducted, manuscripts prepared and published in reputed international journals. During the course
of 2022, a team from Afghanistan’s ANBSTS is expected to visit Pakistan to study the practical and
successful model of blood services’ centralization in the form of RBC and HBBs.
The RBC has been licensed by the Khyber Pakhtunkhwa Blood Transfusion Authority (BTA). The
technical team of RBC assisted the Khyber Pakhtunkhwa Blood Transfusion Authority (BTA) and
conducted inspections in different parts of the province. The Khyber Pakhtunkhwa BTA has in a very
short time developed a very successful model of regulation in Pakistan based on a constructive non-
punitive approach. As a result, there are now marked and visible improvements in the standard of
blood banks that are being inspected. Earlier in 2016, Khyber Pakhtunkhwa became the first province
to approve the revised and updated blood safety legislation. The RBC team had provided technical
input during the deliberations of blood safety legislation in the parliament. Since then, all confederating
units of the country have approved the new legislation (figure 2).
Fig. 2: Legislative framework of blood transfusion services in Pakistan
21 Saba N. World Hepatitis Day 2021: Seminar on Hepatitis and Blood Safety in Pakistan. ISBT Transfusion Today 2021 December; 129:26-27.
Page | 9

The RBC team is actively involved in research and development. Several research articles were
published in national and international journals and were highly rated by the blood transfusion
fraternity. In addition, research work has also been presented at national and international conferences.
Some of these articles included novel studies linked to the ongoing COVID-19 pandemic,22,23,24,25 studies
related to haemovigilance,26 and molecular epidemiology of emerging transfusion-transmitted
infections including Hepatitis E virus,27 Hepatitis D virus,28 and Torque Teno virus.29 A detailed list of
publications is included at the end of this report under the heading ‘List of Publications’.
The RBC Peshawar acknowledges the national and international experts who provided technical
input to the ongoing blood transfusion service reform process. The international experts included Prof.
Cees Th. Smit Sibinga (Netherlands), Prof. Jean-Claude Faber (Luxemburg), Paul Kohorst (Germany),
Dr. Hynek Kruzik (Czech Republic), Dr. Ralf Knels (Germany), Dr. Nasim Hosseini (Iran), Dr. Lundy
Keo (Australia), Peter Heimer (Germany), Hans Molijn (Netherlands), Dr. Levent Sadgur (Turkey), Dr.
Philippe Henri-Conte (France), Dr. Gunnar Strote (Germany), Ton (A) PM Los (Netherlands), Dr. Fariba
Seighali (Iran), Dr. Günter Merk (Germany), Ronald Brown (USA), Prof. Dr. Saeed Ahmed (Saudi
Arabia), Dr. Rainer Riha (Germany), Prof. Wim de Kort (Netherlands), Dr. Johann Peter Steinmann
(Germany), Dr. Yetmgeta E. Abdella (WHO Egypt), Dr. Lars Eberhart (Austria), Junping Yu (WHO
Switzerland), and Dr. Mahtab Maghsoodlu (Iran). We are fortunate to have a very fertile community
of pathologists in the country many of whom were instrumental in supporting the RBC services. These
include Prof. Syed M. Irfan (Karachi), Brig. Prof. Javaid Usman (Rawalpindi), Prof. M. Farooq Khattak
(Islamabad), Dr. Abdul Latif (Gilgit), Prof. Hasan A. Zaheer (Islamabad), Prof. Zahida Qasim (Mirpur),
Brig. Dr. Nadir Ali (Islamabad), Dr. Shabneez Hussain (Karachi), Dr. Usman Waheed (Islamabad),
Assoc. Prof. Nazish Saqlain (Lahore), Dr. Akhlaaq Wazeer (AJK), Dr. Faiza Rafiq (Multan), and
colleagues from Peshawar namely Prof. Fazle Raziq (RMI), Dr. Tariq Humayun (B&PSC), Assoc. Prof.
Yasar M. Yousafzai (KMU), Assoc. Prof. Huma Riaz (HMC), Dr. Rashid Azeem (PIC), Dr. Muhammad
Idrees (KTH), Assoc. Prof. Saima Abid (Peshawar PIMS), Dr. Mohammad Qasim Khan (Provincial
Epidemiologist), Badar Hussain (Fatimid Foundation), Dr. Aman Ullah Khan (LRH), Sahibzada M.
Haleem & Dr. Fakhar Zaman (Frontier Foundation), and Ijaz Ali (Hamza Foundation).
22 Waheed U, Saba N, Wazeer A. COVID-19 and convalescent human plasma: Prospects and challenges. Ann Pak Inst Med Sci. 2020; 16(2): 55-57.
23 Waheed U, Wazeer A, Saba N, Qasim Z. Detection of Severe Acute Respiratory Syndrome Coronavirus 2 RNA in blood donations. J Lab Physicians 2020;12(2):163-164.
24 Waheed U, Wazeer A, Saba N, Qasim Z. Coronavirus pandemic: Implications on blood transfusion needs of thalassaemia major pati ents. Glob J Transfus Med. 2020;5(2):235-
236.
25 Waheed U, Farooq A, Wazeer A, Saba N, Noor FA, Cheema NA, Qasim Z, Arshad M. Knowledge and attitudes concerning SARS-CoV-2 among healthcare workers in Mirpur,
Azad Jammu and Kashmir, Pakistan. Liaquat National Journal of Primary Care 2020; 2(2): 56-62.
26 Waheed U, Ahmed S, Saba N, Wazeer A, et al. Haemovigilance as a quality indicator in transfusion medicine: Pakistan’s perspective. Ann Pak Inst Med Sci. 2020; 16(1): 46-51.
27 Saba N. Waheed U, Muhammad I, Wazeer A. Hepatitis E virus RNA in Pakistani blood donors: An emerging transfusion-transmitted infection. Glob J Transfus Med. 2020;5: 233.
28 Waheed U, Saba N, Wazeer A, Farooq A, Arshad M, Zaheer HA. Molecular epidemiology of Hepatitis Delta virus among blood donors in Islamabad, Pakistan. Glob J Transfus
Med. 2020;5(1): 96-97

29 Basharat N, Waheed U, Arshad M, Saba N, Masood I, Farooq A, Wazeer A, Moneeba S, Rauf A, Zaheer HA. Prevalence of torque teno virus infection in blood donors and its
implication on blood safety in Pakistan. Pakistan J. Zool., 2021;53(3): 1177-1180.
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DATA ANALYSIS AND INTERPRETATION
The objective of data collection is to generate credible statistics, compile the data, and analyze it for
improvement in services, policy planning, actionable insights, and improved utilization of the scarce
resources. The professional management of data and information lays the foundation for strengthening
governance and leadership and development of an effective quality system. The RBC uses a
computerized-based blood bank management information system (BBMIS) database for data collection.
The collected data for 2020 were subsequently aggregated and analyzed in order to improve service
and quality of care in the RBC. The data generated are expected to support the policymakers to prepare
a plan of action and introduce the concept of good governance in blood establishments.
NUMBER OF BLOOD DONATIONS

In 2021, 48,213 blood donors were attended. Out of these, 210 donors were deferred due to numerous
causes as mentioned in the section on donor haemovigilance. Hence, the total blood collections were
48,003. Besides, an additional 208 units of platelet concentrates were collected through aphaeresis
mostly to cater the needs of patients. This is a 2.7 times increase when compared to 2020 when the
number of donations collected were 17,793. The designed capacity of the RBC is 50,000 blood donations
per year and during the reporting period 97% of this target was successfully achieved. These numbers
are evident of the extraordinary work RBC has put in to sensitize blood donors in the community and
an increased collaboration and coordination with the attached hospital blood banks to convert existing
family replacement donors into regular voluntary blood donors. This is in line with the national blood
donor policy (2011)30 which states the sensitization of university or community-based donor
organizations and the conversion of family replacement donors into voluntary blood donors.
GENDER-WISE DISTRIBUTION OF BLOOD DONATIONS

Out of the total of 48,003 whole blood donations collected in 2021, 47,183 (98.30%) were donated by
male blood donors and only 820 (1.70%) were donated by female donors (Fig. 1). This is much lower
than the national statistics according to which approximately 5% of females donate blood.31 Low female
donation rate is a source of concern, although in contrast to 2020, there has been a slight increase in the
number of female donations (0.8% vs 1.70%). Earlier studies have highlighted a set of belief systems
prevalent in the society which steer the process of female donations.32 It is believed that lack of female-
friendly facilities, poor privacy, misconceptions, nutritional status, cultural and social factors contribute
to low female donation rates. To understand the existing levels of knowledge and awareness regarding
blood donation in both males and females, a nationwide KAP survey was conducted by the national
safe blood transfusion programme. 33 The study generated some interesting results and identified
30 Kohorst P, Ahmed R, Waheed U, National Steering Committee. National blood donor policy. 1st ed., 2011. National Blood Transfusion Programme, Ministry
of Health, Pakistan.
31 Los APM, Waheed U, Kohorst P, Smid WM. Creation of an enabling environment for voluntary blood donation in Pakistan. Vox Sang. 2012; 103(Suppl.
1):100.
32 Waheed U, Azmat M, Zaheer HA. Knowledge, attitude and practices towards blood donation in Pakistan: a nationwide survey. Hematol Transfus Int J.
2015; 1:83–86.
33 Mumtaz Z, Bowen S, Mumtaz R. Meanings of blood, and bleeding and blood donations in Pakistan: implications for national vs. global safe blood supply
policies. Health Policy Plan 2011; 27:147–155.
Page | 11

possible causes of gender discrepancy in blood donations. The findings informed a public awareness
campaign which is yet to be launched addressing the issue of female donations as one of the core target
areas, among others. This intervention would strive to reduce prejudices, misconceptions and to lower
the barriers erected by the gatekeepers of family, community, and society. An encouraging step in this
regard was witnessed during the last week of November 2021. Mobilink Jazz, a leading cellular network
of Pakistan, launched a motivational video on blood donation targeting young (female) donors.
Hopefully it will draw young donors especially females overcoming prejudice and misconceptions
regarding blood donation (available at https://www.facebook.com/watch?v=985637875632289).
TYPES OF BLOOD DONATIONS

Out of the 48,003 blood donations, 43,049 (89.68%) donations were collected from family replacement
donors while 4,954 (10.32%) donations were collected from voluntary blood donors (Fig. 4). This is a
slight increase when compared to 9.70% voluntary donors in 2020. Out of 48,003 donations, 5,888
(12.26%) were collected in the RBC while 42,115 (87.74%) were collected from blood camps and
collection points in the attached HBBs (Fig. 5). Last year, 7.65% units were collected in the RBC as
compared to 12.26% during 2021. The recruitment and retention of blood donors are a global challenge.
Blood is a scarce commodity, and the demand for blood is ever-increasing. The World Health
Organization (WHO) recommends that all countries should be self-sufficient in all blood products and
that every blood donation should be voluntary, anonymous, and non-remunerated. The collection of
blood from voluntary, non-remunerated blood donors is an important indicator of safety and quality.
Unfortunately, voluntary donations are not common in our country. This problem is worsened by the
fact that the country had a fragmented demand-driven blood system for nearly six decades with a heavy
reliance on family replacement donors. This scenario is largely attributed to a lack of education and
awareness about the need for safe blood and the myths and misconceptions, 34 associated with blood
donation. However, in times of national crisis, droves of volunteers throng the blood banks for blood
donations to save the lives of unknown recipients are witnessed in many natural and man-made
calamities in the recent past. This implies that the lack of voluntary blood donors in routine times is
due to a lack of a proper system to manage the voluntary donors and channelize the spirit of altruism
in society. The RBC is organizing regular awareness sessions and blood donation camps to inform the
general public of the RBC and the friendly environment it is proving to the blood donors. The strategy
however needs to be institutionalized in attached HBBs as well to wean away the dependence from the
patients’ families to the voluntary blood donors.
Female
1.70% VNRBD
10.32%
Male
98.30% Family Replacement
89.68%
Fig. 3: Gender-wise distribution of blood donations Fig. 3: Types of blood donations

34 Waheed U, Azmat M, Zaheer HA. Knowledge, attitude and practices towards blood donation in Pakistan: a nationwide survey. Hematol Transfus Int J.
2015; 1:83–86.
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COMPONENTS PREPARATION
In 2021, 43,546 (90.71%) blood donations were processed into at least three blood components, i.e. Red
Cell Concentrates (RCC), Fresh Frozen Plasma (FFP), and Platelet Concentrates (Fig. 6). In addition, 208
units of platelet aphaeresis, and 50 units of cryoprecipitate were prepared on demand. The situation
regarding blood component preparation was unsatisfactory before the operationalization of RBC in
2016. Due to continuous sensitization by the RBC team in attached HBBs, a significant increase in
component utilization has been witnessed.
Whole
Blood
9.29%
In-house
12.26%
Camps
87.74% Components Prepared
90.71%
Fig. 5: Types of blood donations: In-house vs Fig. 6: Components preparation

camps/collection points
SCREENING FOR TRANSFUSION-TRANSMITTED INFECTIONS

The screening of blood for five TTI markers, i.e. HIV, HBV, HCV, TP (causing syphilis), and MP
(causing malaria) are mandatory under clause 15, section (f) of the Khyber Pakhtunkhwa Blood
Transfusion Authority Safety Act, 2016.35 All 48,003 blood donations collected in 2021 were screened
for these five transfusion-transmitted infections and 4.46% (n=2,141) were reactive for one of the five
TTIs. Among the five TTIs tested, 76 (0.15%) were reactive for HIV, 963 (2.0%) for HBV, 710 (1.48%) for
HCV, 387 (0.80%) for syphilis, and 5 (0.01%) were reactive for malaria. Screening for HIV, HBV, HCV,
and syphilis was performed on an automated CLIA–based analyzer while screening for malaria was
undertaken on rapid ICT devices (Table 1).
There were not any significant sex differences as the number of female donations was too low. The
prevalence of TTIs was slightly less in voluntary blood donors, however, it was not statistically
significant as the number of voluntary donors was approximately 10%. Substantial differences related
to seroprevalence and trends of specific TTIs were witnessed, e.g. the most common type of TTI in our
data was hepatitis B whereas earlier studies had observed a higher prevalence for hepatitis C. We
established that the overall collective prevalence of TTIs in donated blood was 4.46% compared to 4.61%
in 2020. The findings compare favorably to an earlier study from Lahore, Pakistan which reported a
percentage prevalence of 4.0%.36 However, it is less than the results reported from previous local studies
in the country. For example, earlier studies from Karachi, Islamabad, and Faisalabad reported a
35 Khyber Pakhtunkhwa Blood Transfusion Authority Safety Act, 2016 Available at http://www.pakp.gov.pk/2013/wp-content/uploads/blood-
transfusion0001.pdf
36 Ahmad M, Saeed M, Hanif A, et al. Slump of trends in transfusion-transmissible infectious diseases: Is syphilis alarming in Pakistan? Glob J Transfus Med
2019;4(1):45-51.
Page | 13

seroprevalence of 5.8%,37 14.34%,38 and 6.55%,39 respectively. Despite of the well-recognized

significance of assessing the epidemiology of TTIs, available data on TTIs burden in Khyber
Pakhtunkhwa is scanty. In Peshawar for example, there has been no published study on TTIs
prevalence in blood donors during the last decade. The only available study is regarding the prevalence
of HCV in blood donors, published in 2018 40 on a sample size of 1,400 but with no information on the
study site. During the reporting period, the RBC team, however, published an article giving a
comprehensive overview of the seroprevalence of TTIs in Peshawar (available at
https://pubmed.ncbi.nlm.nih.gov/34483564/)41.
Although the WHO has set targets for safe blood by 2025, Pakistan remains confronted with multi-
factorial issues that compromise blood safety especially screening with poor quality assays.42 The
progress in blood safety in Pakistan in the 2010s was in large part due to intervention by the German
Government, the WHO, and other foreign governmental bodies, coupled with an influx of external
funding. This has markedly increase the awareness regarding blood safety. However, transfusion of
contaminated blood remains a key player in the transmission of blood-borne infectious agents. In low-
income countries including Pakistan, the prevalence of TTIs is relatively high and quite far from
achieving a zero-risk level. The financial implications of TTIs include but not limited to the need for
medical care, increased levels of dependency, and the loss of a useful workforce, placing great burdens
on already overstrained health and social services and the national budget. The high prevalence
necessitates additional studies to detect the main risk factors and formulate intervention strategies. To
limit the risk of TTIs, recommendations include the promotion of VNRBD, sensitization of more female
donors, screening of donated blood through highly sensitive screening assay, and further research
utilizing nucleic acid technology. As blood donors are considered to represent a healthy population,
the prevalence of TTIs in donors is a clear indication of these infectious agents in our population.
Table 1: Blood donations reactive for transfusion-transmitted infections
Screening No. of donations No. of donations

TTI
Technique screened reactive (%)
HIV CLIA 48,003 76 (0.15%)
HBV CLIA 48,003 963 (2.0%)
HCV CLIA 48,003 710 (1.48%)
Syphilis CLIA 48,003 387 (0.80%)
Malaria ICT 48,003 5 (0.01%)
Total 48,003 2,141 (4.46%)
37 Arshad A, Borhany M, Anwar N, et al. Prevalence of transfusion transmissible infections in blood donors of Pakistan. BMC Hematol. 2016;16:27.
38 Waheed U, Khan H, Satti HS, et al. Prevalence of transfusion transmitted infections among blood donors of a teaching hospital in Islamabad. Ann Pak Inst
Med Sci. 2012;8(4):236–9.
39 Rauf R, Cheema A. Potential risk of transfusion-transmissible infections among blood donors in district Faisalabad of Pakistan. Clin Med (Lond).
2019;19(Suppl 3):27.
40 Rehman N, Orakzai MB, Hayat A, et al. Prevalence of Hepatitis C virus and its risk factors in blood donors in district Peshawar. Pak J Pharm Sci.
2018;31(1):83‐87.
41 Saba N, Nasir JA, Waheed U, Aslam S, Mohammad I, Wazeer A, et al. Seroprevalence of Transfusion-Transmitted Infections among Voluntary and
Replacement Blood Donors at the Peshawar Regional Blood Centre, Khyber Pakhtunkhwa, Pakistan. J Lab Physicians. 2021;13(2):162-168.
42 Waheed U, Abdella YE, Saba NE, Arshad M, Wazeer A, Farooq A, et al. Evaluation of screening effectiveness of hepatitis B surface antigen and anti-HCV
rapid test kits in Pakistan. J Lab Physicians. 2019;11(4):369-372.
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DONOR HAEMOVIGILANCE
The objective of donor haemovigilance (DHV) is to continuously improve donor safety and satisfaction
through monitoring, analyzing, and researching adverse events associated with blood donation just
prior to, during, and after the donation event. During the reporting year, 210 blood donors (0.43%)
were deferred at the pre-donation stage (Table 2) while 2,141 (4.46%) were deferred at the post-donation
stage after they were reactive for one of the transfusion-transmitted infection (Table 1). Donor deferral
is a global issue being faced by most blood centres in both developing and developed countries. On the
whole, the blood donor deferral is a dejected experience for both the blood donor and the respective
blood centre.43 The identification of the causes for deferrals can steer the process of amendments in
blood donor motivation and recruitment and retention strategies.
Table 2: Causes of pre-donation deferral
Total
Causes
Low haemoglobin 53 (25.23%)
Underweight 25 (11.90%)
Medications 23 (10.96%)
Obesity 20 (9.52%)
Menstruation 18 (8.57%)
High/low blood pressure 17 (8.09%)
Gastroenteritis 14 (6.67%)
Fasting 13 (6.19%)
Recent blood donation 11 (5.23%)
Fever 9 (4.29%)
Over/under age 7 (3.34%)
Total 210 (100%)
In developing countries, anaemia is a grave public health problem. In Pakistan, an overwhelming

majority of the general population is affected by anaemia. In our data, the commonest cause of pre-
donation deferral was low haemoglobin level (23.07%). Earlier studies have also mostly reported low
haemoglobin levels as the leading cause of deferral. It is pertinent to mention here that the incidence
and causes of blood donor deferrals are generally not well studied in Pakistan as the data management
practices and reporting are still not well developed. 44 There are 12 studies published so far and have
43 Waheed U, Zaheer HA. Evaluation of deferral pattern among the blood donors in Islamabad, Pakistan. Glob J Transfus Med 2016;1(2):81-4.
44 Waheed U, Kruzik H, Knels R, Zaheer HA. Analysis of management information system in blood transfusion services, Pakistan. J Blood Disorders Transf
2015, 6:3.
Page | 15

reported data from different regions of Pakistan (Table 3).45 The percentage of deferral pattern in these
studies ranges from 7.4% to 25.2%. This data show a cross-cutting comparison of our findings with the
data reported earlier.
Table 3: Deferral percentage with common causes in studies from Pakistan
Deferral
Author (year) and City Common causes of donor deferral
percentage
Saba et al., (2020) Hepatitis B (30.38%), hepatitis C (21.59%), syphilis (14.16%), low
6.37%
Peshawar haemoglobin (8.28%), underweight (5.97%)
Saeed et al., (2020) Mandi Hepatitis C (13.3%), hepatitis B (6.1%), syphilis (4.0%), malaria
25.2%
Bahauddin (2.4%), diabetes mellitus (1.9%)
Anaemia (50.3%), hepatitis C (19.2%), hepatitis B (11.3%), syphilis

Iqbal et al., (2020) Multan 12.9%
(8.3%)
Wazeer et al., (2019) Anaemia (47.3%), underweight (21.1%), other medical causes
12.1%
Mirpur, AJK (22.5%), menstruation (3.4%)
Khalid et al., (2018) Anaemia (52.4%), TTIs (34%), leukocytosis (19.7%),

9.7%
Rawalpindi thrombocytopenia (4.8%)
Therapeutic injections (31.2%), low haemoglobin (22.7%), ﬂu,

Jamal et al., (2018)
24% nausea, cough, headache symptoms (8.9%), severe untreatable
Karachi
ailment (4.2%)
Sultan et al., (2017) Anaemia (91.8%), leukocytosis (3.7%), polycythaemia (3.3%),

8.39%
Karachi thrombocytopaenia (1.0%)
Khurram et al., (2016) Hepatitis B (4.7%), low haemoglobin (30.76%), thrombocytopaenia

12.2%
Karachi (19.35%)
Nadeem et al., (2016) Hepatitis C (28.6%), anaemia (24%), hepatitis B (16.8%), syphilis
7.4%
Rawalpindi (10.4%)
Waheed et al., (2016) Hepatitis B and C, anaemia (41%), low body weight (22.5%), low
10.14%
Islamabad blood pressure (5.1%), under/overage (5.9%)
Tufail et al, (2013) Anaemia (4.9%), hepatitis C (3.1%), thrombocytopaenia (1.8%),

13.58%
Islamabad hepatitis B (0.81%)
Khan et al., (2012) Hypotension (22.22%), anaemia (13.33%), jaundice history (9.52%),
8.70%
Peshawar underweight (6.03%)
45 Saba N, Nisar M, Nasir JA, Shaukat A, Majeed N, Wazeer A, Waheed U. Blood donation deferral pattern among prospective blood donors in northwest
region of Pakistan. Ann Pak Inst Med Sci. 2020;16(2): 63-68.
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PREVALENCE OF BLOOD GROUPS AMONG BLOOD DONORS

In 2021, out of 48,003 blood donations, 28.3% belonged to the type A blood group, 32.1% had type B,
28.2% had type O while 11.1% had type AB. In addition to this, 91.8% of the donors were Rhesus
positive while 8.1% were Rhesus negative.
WASTE DISPOSAL
Out of 48,003 blood collections in 2021, 2,141 blood units were TTI positive and were discarded due to
TTI positivity, 429 were discarded due to low bleed, and 2 were discarded due to leakage/broken seal.
Fig. 5: Screenshot of BBMIS of Peshawar RBC
Page | 17

PHOTOGRAPHIC GLANCE OF RBC
Page | 18

Page | 19

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WORLD BLOOD DONOR DAY 2021:

COVID-19 AND BLOOD SAFETY
On the occasion of World Blood Donor Day 2021, the Regional Blood Centre in Peshawar organized
a seminar titled “Resilience of blood transfusion services to combat COVID-19 challenge in Pakistan”.
Considering the impact of the ongoing pandemic, it was planned to dedicate this year’s WBDD to
COVID-19 and related blood safety issues. The COVID-19 pandemic has had an enormous impact on
almost all aspects of life, including the blood transfusion practice, number of blood donations, blood
safety and movement of consumables used for blood transfusion screening.
Besides presentations on the World Blood Donor Day 2021, the seminar included presentations and
discussion on the seven original research studies that have been conducted over the past one year by
the Regional Blood Centre Peshawar in collaboration with key stakeholders. The studies got published
in international impact factor journals and specifically dealt with blood safety issues during the COVID-
19 pandemic. The speakers shared their experience in implementing safety measures in the blood banks
in maintaining blood supply and safety during COVID-19 pandemic.
Speakers on the occasion included Dr. Usman Waheed, Assistant Professor Virology, Dr. Noor e
Saba, Haematologist, RBC Peshawar, Dr. Muhammad Nisar, HR Manager, RBC Peshawar, Dr. Akhlaaq
Wazeer, Microbiologist, Ministry of NHSR&C, Dr. Rashid Azeem, Haematologist, PIC, Dr. Aman Ullah
Khan, Blood Bank Officer, LRH, and Dr. Sara Noreen, Medical Officer, RBC Peshawar.
Page | 21

Speakers emphasized that the COVID-19 pandemic has reduced the supply of blood and blood
components, and adversely affected blood system activities across the country. Therefore, blood
transfusion services must be prepared and move quickly in response to pandemic of COVID-19, during
which blood sufficiency is most likely to be affected, ideally this should be through the development,
implementation and activation of their emergency response plans. It was also stressed the blood banks
should strive hard for recruitment and retention of blood donors during the pandemic. This includes
the use of social media tools especially WhatsApp to mobilize young donors. Meanwhile, COVID-19
convalescent plasma can be made available on an experimental basis through local production
provided that ethical and safety criteria are met for its preparation and use. Detailed risk assessment
must always be conducted to ensure that the blood transfusion service has sufficient capability to safely
collect, process and store these specific blood components in a quality-assured manner in compliance
with established standards and requirements for plasma for transfusion.
The valedictory session was chaired by Dr. Jamal Abdul Nasir, Director Administration, provincial
Department of Health, Khyber Pakhtunkhwa. He said that the Department of Health under the
dynamic leadership and continuous support of the Honorable Minister Mr. Taimur Saleem Khan
Jhagra, is striving hard to ensure access to safe, efficacious, and affordable blood, to all and it will
become a reality in the near future. Since the establishment of Regional Blood Centre Peshawar in 2016,
we are now well on our way to establishing an internationally recommended blood transfusion system
in the province.
Page | 22

The new system is gradually replacing and phasing out the

current fragmented demand-driven scattered system. The RBC
Peshawar has remained on the forefront in the fight against
COVID-19. In addition, the technical team was able to generate
evidence based data which also got published in international
journals. Therefore, it was vital to disseminate this research
with our colleagues and in doing so we will learn from each
other practices. He urged all participants to be Ambassadors of
RBC and share the new knowledge learnt today with everyone
at respective work place.
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WORLD HEPATITIS DAY 2021: HEPATITIS

AND BLOOD SAFETY IN PAKISTAN
A seminar was organized by the Regional Blood Centre Peshawar in collaboration with the
International Society for Blood Transfusion (ISBT) to mark World Hepatitis Day (WHD) 2021. The
seminar participants included policy-makers from the provincial ministry of health, clinicians, blood
bank managers, haematologists, microbiologists, and postgraduate residents. The objectives of the
seminar were to brief the participants on the World Hepatitis Day 2021 and its significance; to update
the participants on the spread of hepatitis through the blood transfusion process; to shed light on the
rising prevalence of hepatitis B and C in replacement blood donors; and to formulate recommendations
for the government especially to stringently regulate the blood services and quality check on the use of
poor quality rapid screening devices.
The WHD was observed under this year’s theme, ‘Hepatitis Can’t Wait’, with the aim of bringing
the world together under a single theme to raise awareness of the global burden of viral hepatitis to
influence real change and to act without any further delay to stop this manic.
The speakers of the seminar included eminent public health specialists, haematologists,
microbiologists, and physicians. The speakers briefed about the global, regional, and national aspects
of the hepatitis epidemic. The global strategy and response to halt and prevent the spread of hepatitis
were also discussed. The speakers informed that the international effort led by the World Health
Organization is supported by all the member states of the United Nations. Pakistan is also a signatory
to these international commitments made in the UN General Assembly in 2015 which adopted the 2030
Agenda for Sustainable Development that called on the international community to eliminate hepatitis.
These commitments were articulated in the ‘Global Health Sector Strategy on Viral Hepatitis (2017-21)’
presented in the World Health Assembly in 2016.
The speakers emphasized that Pakistan faces a high socioeconomic burden of infectious diseases
including hepatitis. All five main types of viral hepatitis (A, B, C, D, and E) are epidemic in the country.
Viral hepatitis claims nearly 150,000 lives every year being a direct cause of death or as co-morbidity
and it means that over 400 people are losing life to hepatitis every day here in the country. One of the
important modes of transmission of hepatitis in Pakistan is unsafe contaminated blood transfusions.
Some population groups are heavily affected by hepatitis B and hepatitis C including transfusion-
dependent thalassaemia patients. Preliminary data were presented on the detection of Hepatitis E and
Hepatitis D among the blood donor population and their potential as emerging transfusion-transmitted
infections.
The panel discussion deliberated on the fact that there are various types of screening assays
available for the screening of blood. However, not all assays are suitable in all situations and each assay
has its limitations that need to be understood and taken into consideration when selecting assays. In
Pakistan, poor quality rapid devices are being used in most parts of the country. As a result, the multi-
transfused patients in particular and other recipients in general, carry a high risk of acquiring hepatitis
B and C. Regarding the ongoing pandemic of COVID-19 and the troubles it has caused, the hepatitis
crisis has become even more serious. The COVID-19 pandemic has affected hepatitis prevention,
testing, treatment, and vaccination services globally including Pakistan. Hepatitis B and C are bigger
killers compared to the ongoing pandemic of COVID-19.
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The panel discussion provided an excellent opportunity for an interactive session where the
participants engaged in a knowledgeable debate with eminent experts about hepatitis control, and
prevention. A consensus was developed that a national baseline survey is imperative to confirm the
actual frequency of hepatitis viruses across the country in various settings that in turn may lead to
better management of the hepatitis syndrome in the country. The government should enforce policies
to guarantee only quality assured screening kits are imported in the country. The organizing team and
the participants lauded the efforts of ISBT to support the event. Souvenirs and certificates were
awarded to the speakers and participants respectively.
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WORKSHOP ON BIOSAFETY, WASTE

MANAGEMENT, AND HAEMOVIGILANCE
The American Society for Clinical Pathology (ASCP) Board of Certification (BOC) Pakistan in
collaboration with the THQ Hospital Murree organized a training workshop on ‘Biosafety, Waste
Management, and Haemovigilance’. Manager, RBC Peshawar was invited as an invited speaker and
also collaborated in the management of the training workshop. The overall aim of the training was to
develop an awareness of the health, safety, and environmental issues relating to healthcare waste, and
how these can affect hospital employees in their daily work. It highlighted the roles and responsibilities
of healthcare personnel in the overall management of biosafety and waste management. In addition,
the workshop also dealt with key concepts namely haemovigilance, vein-to-vein transfusion chain, and
screening dilemmas for hepatitis B and hepatitis C in Pakistan.
The training session was attended by hospital consultants, SMOs, MOs, WMOs, head nurses,
pharmacy staff, lab staff, and support staff. Guest speakers included Dr. Noor e Saba, Consultant
Haematologist, RBC Peshawar, Dr. Abdul Sami, Consultant Surgeon, Dr. Usman Waheed, Assistant
Professor Virology, Dr. Akhlaaq Wazeer, Consultant Microbiologist, and Dr. Muhammad Rehan,
Senior Registrar, PIMS, Islamabad.
The speakers emphasized that the two biggest factors that come into the forefront of biosafety are
(1) containment and (2) risk assessment. When these two measures are combined, it prevents exposure
to those working in the laboratory and exposure outside of the laboratory. Promotion of the appropriate
handling and disposal of medical waste is important for healthcare worker’s safety and the overall
community health. The management of healthcare waste cannot be effective unless it is applied
carefully and consistently. The training of healthcare personnel in implementing biosafety and waste
management is thus critical if a waste management programme is to be successful. Health and safety
in the hospital workplace and environmental awareness are the responsibility of all and in the interests
of all. Concerning the ongoing COVID-19 pandemic, the concept of biosafety has gained more
importance as the prevention deeply depends on safety measures rather than treatment.
Regarding haemovigilance in hospital settings, the speakers informed that the concept of
haemovigilance has emerged during the last three decades. It is structured and systematic surveillance
of the entire vein-to-vein transfusion chain and a powerful quality tool. It helps increase safety and
improves quality during blood donation and blood transfusion, from the blood donor to recipient of
blood and blood components. The haemovigilance can be successfully implemented and maximum
benefit obtained if the data analysis and resulting conclusions are mutually shared with the
shareholders. In Pakistan, the implementation of this key principle has been made mandatory under
Page | 27

the blood safety legislation, therefore, the THQ hospital management should apply the haemovigilance
tool in earnest to ensure blood safety in the whole transfusion chain. This can be achieved through the
hospital transfusion committee headed by the hospital administrator with membership from every
specialty.
The valedictory session was chaired by Dr. Abdul Salam Abbasi, Medical Superintendent, THQ
Hospital Murree. He said infectious waste management has always remained a neglected public health
problem in developing countries, resulting in a high burden of environmental pollution which
eventually affects the general masses. Healthcare workers are the key personnel who are responsible
for the management of infectious waste at any hospital, however, their proper training and education
are a must for optimal performance. Proper periodic training is therefore needed to improve the
knowledge, attitude, and practices of health workers who are handling the waste in routine. For that
reason, the THQ Hospital Murree hosted the workshop to generate awareness and train hospital staff
on these key concepts. He recommended to hold a refresher workshop in a few months’ time to see the
progress of training. The training proved to be successful as evident from the enthusiasm of the
participants who were eager to learn more. Souvenirs and certificates were distributed among the
speakers and participants.
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PHOTOGRAPHIC GALLERY
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LIST OF PUBLICATIONS
1. Saba N, Waheed U, Nisar M. Impact of ABO blood groups on Severe Acute Respiratory Syndrome
Coronavirus 2 susceptibility. Glob J Transfus Med. 2021;6(1): 114-115.
2. Saba N, Nasir JA, Waheed U, Aslam S, Mohammad I, Wazeer A, Ahmed S, Nisar M.
Seroprevalence of transfusion-transmitted infections among voluntary and replacement blood
donors at the Peshawar Regional Blood Centre, Khyber Pakhtunkhwa, Pakistan. J Lab Physicians
2021;13(2):162-168. doi: 10.1055/s-0041-1729485
3. Nisar M, Yousafzai Y, Saba N, Waheed U, Khalid M. Seroprevalence of SARS-CoV-2 in blood
donors during the second wave of COVID-19 pandemic in Peshawar, Pakistan. Vox Sanguinis 2021;
116 (Suppl. s1): p 146-147. DOI: 10.1111/vox.13117.
4. Hashemi E, Waheed U, Saba N. Challenges in blood transfusion services during conflicts and
humanitarian emergencies: Perspective and initiatives from Afghanistan. Glob J Transfus Med.
2021;6(2): 244-245.
5. Nisar M, Khan H, Shahzad M, Ibrahim M, Arif M, Kibria Z, Waheed U, Saba N, Yousafzai Y.
Seroprevalence of Sars-Cov-2 Antibodies among Eligible Blood Donors of Peshawar, Pakistan
(submitted – under review)
6. Muhammad I, Qasim M, Ali S, Saba N, Waheed U, Muhammad N, Nisar M, Ullah W. Epidemiology
and risk factors of Syphilis in blood donors of Khyber Pakhtunkhwa province in Pakistan.
Conference proceedings, 1st international conference on Emerging Innovative Research Trends in
Biology, Kohat, Pakistan. Aug 11-12, 2021, p 97.
7. Waheed U, Saba N, Wazeer A, Qasim Z, Hussain W. First report of hepatitis B virus and hepatitis
C virus epidemiology among multi-transfused beta thalassaemia major patients in Azad Jammu
and Kashmir, Pakistan (submitted – under review)
8. Waheed U, Wazeer A, Saba N, Qasim Z. Coronavirus pandemic: Implications on blood transfusion
needs of thalassaemia major patients. Glob J Transfus Med. 2020;5(2):235-236.
9. Muhammad N, Qasim M, Khan TA, Ali S, Khan AS, Khan MT, Muhammad I, Basir A. Novel
mutations in MPT64 secretary protein of Mycobacterium tuberculosis complex isolated from
Khyber Pakhtunkhwa, Pakistan. Conference proceedings, 1st international conference on Emerging
Innovative Research Trends in Biology, Kohat, Pakistan. Aug 11-12, 2021, p 66.
10. Noor FA, Qasim Z, Saba N, Farhan Y, Kaleem M, Wazeer A. Coping strategies and impact of disease
among people living with HIV/AIDS: A qualitative study. Ann Pak Inst Med Sci. 2020; 16(1): 3-9.
11. Saba N. Restructuring of blood transfusion services in Khyber Pakhtunkhwa. Medical Review: A
Medical Current Affair. Vol 30, No. 1, Jan 2018.
12. Waheed U, Saba N, Wazeer A, Farooq A, Qasim Z, Ahmed S, Zaheer HA. Transmitted HIV drug
resistance in blood donors in Pakistan. (submitted)
13. Ullah I, Waheed U, Arshad A, Saba N, Wazeer A, Qasim Z, Arshad M. Genotyping of platelet
alloantigens by DNA sequencing in the Pakistani population (submitted – under review)
14. Saba N. Diagnostic accuracy of rapid ICT and ELISA methods in the detection of Hepatitis B and
C. Seminar on World Hepatitis Day organized by Ministry of National Health Services, Karachi,
August 6, 2019.
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15. Hashemi E, Waheed U, Saba N, Wazeer A. First report from Afghanistan on the prevalence of
blood-borne infections among blood donors: A retrospective cross-sectional multicentre study for
an epidemiological assessment. J Blood Med. 2021. http://doi.org/10.2147/JBM.S344180.
16. Waheed U, Saba N, Wazeer A, et al. Can rapid screening kits for Syphilis be trusted? Comparative
evaluation of rapid screening tests for Syphilis in Pakistan (submitted – under review)
17. Saba N. Epidemiology of Transfusion Transmitted Infections among blood donors: Experience
from Regional Blood Centre, Peshawar. HAEMCON 2018 – 20th Annual International Conference
of Pakistan Society of Haematology, 1-4 March, 2018, Rawalpindi, Pakistan.
18. Zaheer HA, Ahmed S, Waheed U, Wazeer A, Saba N, et al. National guidelines for quality control
in transfusion medicine (2020). Safe Blood Transfusion Programme, Ministry of National Health
Services, Pakistan. 3rd Edition. ISBN 978 969 9881 473.
19. Saba N, Waheed U, Nasir J, Mohammad I, Wazeer A, Nisar M, Ahmed S. Epidemiology and trends
of transfusion transmissible infection among voluntary and replacement blood donors at a Regional
Blood Centre in Pakistan. Vox Sanguinis 2021; 116 (Suppl. s1): p 53-54. DOI: 10.1111/vox.13117.
20. Waheed U, Saba N, et al. A systematic review and meta-analysis of the epidemiology of hepatitis
C virus among blood donors in Pakistan (submitted – under review)
21. Waheed U, Wazeer A, Saba N, Qasim Z. Textbook of laboratory techniques in haematology and
transfusion medicine. 3rd ed. 2020, Islamabad, ISBN 978 969 23525 0 5
22. Waheed U, Saba N. Thalassaemia major patients in COVID-19 crisis in Pakistan. Transfusion Today
2020 Sept; 123:31.
23. Wazeer A, Waheed U, Saba N, et al. Outbreak of Hepatitis E virus among the internally displaced
people (IDPs) from Afghanistan (submitted – under review)
24. Waheed U, Saba N, Wazeer A. Textbook of microbiology in laboratory medicine. 1st ed. 2022,
Islamabad, Pakistan.
25. Uzair M, Waheed U, Shahpal K, Rehan M, Iqbal T, Idrees A, Jabbar A, Wazeer A, Akhtar J, Arshad
M. Knowledge and attitudes toward COVID-19 among Pakistani population (submitted – under
review)
26. Saba N. Diagnostic accuracy of ICT and ELISA methods in the detection of Hepatitis B and C virus
among blood donors. HAEMCON 2020 – 22nd Annual International Conference of Pakistan Society
of Haematology, 14-16 February, 2020, Lahore, Pakistan.
27. Azeem R, Khan K, Azeem F, Idrees M, Saba N, Malik SN. Study on causes of wastage of blood at
the public and private hospitals of Pakistan. Acta Scientific Medical Sciences 2021;5(10): 43-46.
28. Farooq A, Waheed U, Saba N, Kaleem M, Majeed N, Wazeer A, Cheema NA, Ahmed S, Arshad M.
Molecular and genetic characterization of hepatitis B virus among multitransfused thalassaemia
patients in Islamabad, Pakistan. J Family Med Prim Care 2021;10(2):998-1002.
29. Waheed U, Farooq A, Wazeer A, Saba N, Noor FA, Cheema NA, Qasim Z, Arshad M. Knowledge
and attitudes concerning SARS-CoV-2 among healthcare workers in Mirpur, Azad Jammu and
Kashmir, Pakistan. Liaquat National Journal of Primary Care 2020; 2(2): 56-62.
30. Saba N, Waheed U, Muhammad I, Wazeer A, Ahmed S Can rapid screening kits for Syphilis be
trusted? Comparative evaluation of rapid screening tests for Syphilis in Pakistan (submitted)
31. Saba N. Waheed U, Muhammad I, Wazeer A. Hepatitis E virus RNA in Pakistani blood donors: An
emerging transfusion-transmitted infection. Glob J Transfus Med. 2020;5(2): 233.
32. Moneeba S, Waheed U, Wazeer A, Saba N, Shaukat A, Aslam S, Ahmed S. PCR-based efficacy
assessment of hepatitis B core antibody and hepatitis B surface antigen screening tests in the blood
donor population. Ann Pak Inst Med Sci. 2020; 16(4):175-79.
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33. Saba N, Nisar M, Nasir JA, Shaukat A, Majeed N, Wazeer A, Waheed U. Blood donation deferral
pattern among prospective blood donors in northwest region of Pakistan. Ann Pak Inst Med Sci.
2020;16(2): 63-68.
34. Waheed U, Wazeer A, Saba N, Qasim Z. Effectiveness of WhatsApp for blood donor mobilization
campaigns during COVID-19 pandemic. ISBT Science Series 2020;15(4):378-80.
35. Waheed U, Ahmed N, Hussain W, Wazeer A, Saba N, Qasim Z, Zaheer HA. Implementation of
blood safety legislatrion in Azad Jammu and Kashmir, Pakistan. Hematol Transfus Int J.
2020;8(4):86‒88.
36. Waheed U, Wazeer A, Saba N, Qasim Z. Detection of Severe Acute Respiratory Syndrome
Coronavirus 2 RNA in blood donations. J Lab Physicians 2020;12(2):163-164.
37. Hashemi E, Waheed U. Blood transfusion services in Afghanistan during the humanitarian crisis.
ISBT Transfusion Today 2021 December; 129:33.
38. Uzair M, Waheed U, Wazeer A, Farooq A, Saba N, Arshad M. Knowledge, Attitude and Practice
toward COVID-19 among Pakistani Population: An Online Cross-Sectional Study (submitted)
39. Wazeer A, Waheed U, Saba N, Arshad M, Zaheer H. Epidemiology of Syphilis in blood donors in
Pakistan. Vox Sanguinis 2020; 115 (Suppl. s1): p 217.
40. Saba N, Nisar M, Nasir JA. Annual Progress Report 2021. Peshawar Regional Blood Centre,
Provincial Department of Health, Government of Khyber Pakhtunkhwa, Pakistan. 1st Ed., 2021,
ISBN 978-969-2254-01-4.
41. Wazeer A, Waheed U, Saba N, Hwang M, Hong S, Arshad M, Zaheer H. Evaluation of the
automated Fluorescent Immunoassay System anti-hepatitis C virus assay for the detection of
hepatitis C virus infection. Vox Sanguinis 2020; 115 (Suppl. s1): p 198.
42. Waheed U, Wazeer A, Saba N, Qasim Z, Zaheer HA. Haemovigilance as a quality indicator in
transfusion medicine: Pakistan’s perspective. Ann Pak Inst Med Sci. 2020; 16(1): 46-51.
43. Hashemi E, Waheed U, Saba N. Afghanistan needs a regulatory framework for blood transfusion
services. (accepted)
44. Wazeer A, Waheed U, Saba N, Farooq A, Arshad M, Zaheer H. Molecular epidemiology of hepatitis
delta virus among blood donors in Islamabad, Pakistan. Vox Sanguinis 2020; 115 (Suppl. s1): p 229.
45. Muhammad I, Saba N, Waheed U, Ullah W, Qasim M, Ahmed S, Ali S, Muhammad N. A systematic
review and meta-analysis on the prevalence of ABO and Rhesus blood groups in Pakistani
population. J Haem Stem Cell Trans 2021;1(2):102-110.
46. Waheed U, Saba N, Wazeer A, Farooq A, Arshad M, Zaheer HA. Molecular epidemiology of
Hepatitis Delta virus among blood donors in Islamabad, Pakistan. Glob J Transfus Med. 2020;5(1):
96-97.
47. Basharat N, Waheed U, Arshad M, Saba N, Masood I, Farooq A, Wazeer A, Moneeba S, Rauf A,
Zaheer HA. Prevalence of torque teno virus infection in blood donors and its implication on blood
safety in Pakistan. Pakistan J. Zool., 2021;53(3): 1177-1180.
48. Waheed U, Muhammad A, Saba N, Wazeer A. COVID-19 and convalescent human plasma:
Prospects and challenges. Ann Pak Inst Med Sci. 2020; 16(2): 55-57.
49. Waheed U, Saba N, Wazeer A, Arshad M, Zaheer HA. Epidemiology of syphilis in blood donors in
Pakistan. Glob J Transfus Med. 2020;5(1): 100-101.
50. Saba N. World Hepatitis Day 2021: Seminar on Hepatitis and Blood Safety in Pakistan. ISBT
Transfusion Today 2021 December; 129:26-27.
51. Waheed U, Wazeer A, Saba N. Reshaping blood donation campaigns through WhatsApp: A pilot
study from Pakistan during the COVID-19 pandemic. Transfusion Today 2021 June; 126:06.
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52. Waheed U, Saba N, Wazeer A, Ahmed S. A systematic review and meta-analysis on the
epidemiology of Hepatitis B virus and Hepatitis C virus among 𝛽-Thalassaemia major patients in
Pakistan. J Lab Physicians 2021;13(3): 270-76. doi.org/10.1055/s-0041-1731110.
53. Saba N, Waheed U, Nisar M. ABO blood types and COVID-19: A pilot study to assess the risk of
infection. Vox Sanguinis 2021; 116 (Suppl. s1): p 165. DOI: 10.1111/vox.13117.
54. Waheed U, Saba N, Wazeer A, Ahmed S. The epidemiology of Hepatitis B and Hepatitis C among
thalassaemia major patients in Pakistan: A systematic review and meta-analysis. Vox Sanguinis
2021; 116 (Suppl. s1): p 53. DOI: 10.1111/vox.13117.
55. Waheed U, Abdella YE, Saba N, Arshad M, Wazeer A, Usman J, Arshad A, Zaheer HA. Evaluation
of screening effectiveness of HBsAg and anti-HCV rapid test kits in Pakistan. J Lab Physicians
2019;11(4):369-372.
56. Waheed U, Saba N, Wazeer A, Arshad M, Farooq A, Zaheer H. Molecular characterization of HIV-
1 in asymptomatic blood donors in Islamabad, Pakistan. Vox Sanguinis 2020; 115 (Suppl. s1): p 214.
57. Abid S, Tahir M, Saba N. Thalassemia & Covid-19 In Khyber Pakhtunkhwa (KP) Pakistan. J Saidu
Med Coll Swat 2021;11(3):121-122.
58. Waheed U, Hwang M, Saba N, Hong S, Saeed M, Wazeer A, Arshad M, Usman J, Zaheer HA.
Evaluation of the AFIAS anti-HCV assay for the detection of Hepatitis C virus infection. Glob J
Transfus Med. 2019;4(2): 198-203.
59. Saba N, Nasir JA. Annual Progress Report 2020. Peshawar Regional Blood Centre, Department of
Health, Government of Khyber Pakhtunkhwa, Pakistan. 1st Ed., 2020, ISBN 978-969-2254-00-7.
60. Waheed U, Noor FA, Saba N, Wazeer A, Qasim Z, Arshad M, Karimi S, Farooq A, Usman J, Zaheer
HA. Genetic diversity of human immunodeficiency virus Type 1 in asymptomatic blood donors in
Islamabad, Pakistan. J Lab Physicians 2020; 12(2): 092-097.
Page | 40

There will be no dearth of availability of blood to meet emergencies

and cater to the needs of diseases like Thalassemia and Dengue if two
per cent of the nation starts donating blood after every three months
on a regular basis.
H.E. Dr. Arif-ur-Rehman Alvi, President, Islamic Republic of Pakistan
Safe blood project in the form of a network of RBCs has built a solid
foundation of safe blood transfusion services in Pakistan.
H.E. Mamnoon Hussain, President, Islamic Republic of Pakistan (2013-18)
This (Peshawar RBC) is a very positive narrative from Pakistan and

I am happy to visit the Centre with excellent infrastructure and
equipment. Congratulations on a modern facility. The safe blood
transfusion project is a matchless experience for the Germans as well.
H.E. Martin Kobler, German Ambassador to Pakistan (2017-19)
RBC Peshawar is a “success story” and the Pak-German cooperation a

“model to emulate”.
Mr. Shahram Khan Tarakai, Provincial Minister for Health, Khyber
Pakhtunkhwa (2013-18)
……….I have visited a Regional Blood Centre and I was very

impressed with the standards, with the level of comfort. This will be a
very important resource to make sure that the blood system works
well across the country………..
H.E. Ina Lepel, German Ambassador to Pakistan (2015-17)
By taking one small step, together, we will be able to build a stable

and safe supply of blood to address these needs and deliver a life-
changing impact to countless individuals and families across Pakistan.
The global pandemic (COVID-19) has been a reminder that it is more
important than ever to accelerate voluntary blood donations across
Pakistan.
Dr. Zafar Mirza, Minister of State for National Health Services, Islamabad
Page | 41

Peshawar RBC team, congratulations on your great work.

Dr. Fariba Seighali, Director, International Relations, Iranian Blood
Transfusion Organization (IBTO), Iran
I am very much impressed how the (Peshawar) RBC has become a

functioning entity of the health system. Many more and more donors
come to give their blood for the good of the population in Peshawar
and the whole of Pakistan.
Christian Strosing, Consultant, German Development Bank (KfW), Frankfurt,
Germany
Had a very successful visit to RBC in Peshawar, Khyber Pakhtunkhwa.

I was very impressed with the state of the art equipment and with
the professionalism and competence of the doctors/health officials. I
think they are doing a wonderful job. Wish them all the help.
Akbar Jan Marwat, Provincial Minister for Health and Population Welfare,
Khyber Pakhtunkhwa
I have donated blood 22 times in the past, in addition to today’s one.

It is nothing short of a reward if someone’s blood saves anyone’s life.
Prime Minister Imran Khan appreciates social work a lot.
Dr. Firdous Ashiq Awan, Minister of State for Information and Broadcasting,
Islamabad
WBDD 2021: “Dear Dr. Noor, thank you very much for those wonderful
photos. I showed them to my staff and we agreed we need to bake a
cake for the World Blood Donor Day 2022!”
Dr. Lars Eberhart, Head of Donor Management, Blood Center for Vienna,
Lower Austria and Burgenland, Austrian Red Cross, Blood Center, Austria
Appreciate the hard work Peshawar RBC team is putting into blood
safety and awareness in the province.
Dr. Usman Waheed, Consultant, Afghan National Blood Safety and
Transfusion Service (ANBSTS), Ministry of Public Health, Afghanistan
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Very pleased to see RBC’s performance. Keep up!

Prof. Syed Muhammad Irfan, MBBS, FACP, FCPS, Consultant Haematologist,
Department of Pathology, Liaqat National Hospital, Karachi
Cristiano Ronaldo is serving as the first global ambassador for the BE THE
1donor movement to inspire and motivate young people around the world to
regularly donate blood and potentially help save a life. "As young people,
often we feel limited in the difference we can make. I saw firsthand
the challenges my teammate was going through. When I realized I
could make such a difference by doing something that was so quick,
easy and relatively painless, I couldn't imagine not doing it. That's why
I'm enthusiastic to be partnering with Abbott to bring awareness to
the importance of blood donation and to encourage people around the
world to become lifelong blood donors and help save lives."
Cristiano Ronaldo, GOIH, ComM – Top Soccer Player from Portugal
I was amazed to visit the Peshawar RBC. It is a world-class facility

with modern equipment. Quality control of all sections is well
maintained. Best wishes.
Dr. Akhlaaq Wazeer, Microbiologist, NTP, Ministry of National Health Services,
Islamabad, Pakistan
I am pleased to visit the Centre (Peshawar RBC). Very nice set-up.

Brig. Prof. Hamid Saeed Malik, MBBS, FCPS Haematology, Department of
Pathology, Combined Military Hospital, Peshawar
Great work, Peshawar blood centre team.

Dr. Alina Mirella Dobrota, MD, MSc, PhD, Director, Regional Blood Transfusion
Centre, Constanta, Romania
The Peshawar RBC is a “success story” and the health department

and the government are very proud of its achievements and
contribution to building a healthy society.
Syed Imtiaz Hussain Shah, Secretary Health, KP (2019-21)
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I appeal to the youth to come forward and donate blood at the

nearest regional blood centre. Your donation can save lives and it will
not harm your body, instead, it is helpful.
Dr. Tariq Fazal Chaudhry, Federal Minister, Capital Administration and
Development Division, Islamabad (2015-18)
Today I visited the RBC and I was amazed to see the change (very
impressive centre) with an extraordinary efficient staff. Highly
appreciate the leadership of DOH and the entire team of SBT and
RBC. Great work. Looking forward to a similar change in the rest of
the HBBs (hospital blood banks) in the province. Thanks a lot for the
visit facilitation. All the best!
Dr. Masuma Zaidi, Project Coordinator Health, German Development Bank
(KfW)
Donating blood is a noble and selfless deed. It gives satisfaction and

happiness to the donor. This act is an expression of love for humanity.
I request all the women to donate blood. Every woman can donate
three times a year. This will improve your health and save someone’s
life. So visit Regional Blood Centre and donate blood on a voluntary
basis regularly.
Mishi Khan, Famous Film/Television Actress and TV Host
It gives me real pleasure to have a “state of art” blood transfusion

centre within Khyber Pakhtunkhwa. The skilled personnel,
sophisticated machinery, quality control measures and storage is the
real mandate shown by the management and other skilled staff. Dr.
Jamal A. Nasir, Dr. Noor e Saba, Dr. Shams Afridi, Dr, Ghulam Farooq,
and their other colleagues have been showing extraordinary
coordination and quality activity. With this Centre to continue with the
quality service, the hospitals will be facilitated and moreover, the
Centre will produce trained manpower in the long run. Best!
Dr. M. Ayub Rose, Director General Health, Khyber Pakhtunkhwa (2017-18)
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It is indeed an honour to visit RBC in Hayatabad Peshawar as

Consultants NASA UNAIDS from Islamabad. This work they have
been performing with zeal and keen interest is really appreciated. In
short praying for the RBC to be more successful in future serving the
nation. And heartiest prayers to the Manager, I saw my daughter’s
face there.
Mahesh Sharma, UNAIDS Consultant, Nepal / Dr. Mariam Masood, UNAIDS
Islamabad / Dr. Fazl Khattak, Consultant UNAIDS
You don’t need to be a doctor to save someone’s life. Your single

donation of blood can save three lives. Visit your nearest regional blood
centre, donate blood, and become a regular voluntary donor.
Tauseeq Haider, Veteran Television (PTV) and Radio (FM) Anchor
Everyone is eligible to be a blood donor. One pint of blood can save the
life of three people. If you wish to be someone’s hero, register and
donate at your Regional Blood Centre which has been collecting
voluntary donations for its blood bank collection ensuring that every
man, every woman and every child can share this gift of life. In only 10
minutes, voluntary donors can share life by donating blood at their local
regional blood centres. One unit of blood can save the life of three
people. One donation of your blood will allow people with life-
threatening conditions to continue with higher standards of living.
Sharmeen Obaid-Chinoy, T.I., H.I. Journalist / Filmmaker from Karachi - 2
Oscars and 7 Emmy Awards Winner
WBDD 2021: Indeed it was a fantastic event which was organised

well, conducted very well and above all, the rhythm of the session was
never found broken. All presentations were superb but those delivered
by Dr. Usman were very informative and marvelous. My appreciation to
Dr. Jamal A. Nasir sahib and his team for making this event a real
success.
Badar Hussain, Administrator, Fatimid Foundation, Peshawar
Page | 45

It is always a pleasure visiting Pakistan. During my four visits to the

country to develop a harmonized blood transfusion management
information system, I have seen the progress of the safe blood
project. The new infrastructure in the form of regional blood centres
and attached hospital blood banks is very promising and will bring a
paradigm shift in the blood transfusion services of Pakistan. Good luck
to the network of regional blood centres and hospital blood banks.
Dr. Hynek Kruzik, Consultant BT-MIS, Prague, Czech Republic
Excellent work.
Dr. Agha Umer Draz Khan, Chief Pathologist, Civil Hospital, Karachi, and
Husaini Hematology & Oncology Trust, Karachi
Energetic and welcoming people in Peshawar and an amazing team.

Ton (A) PM Los, Medical Sociologist, Sanquin Consulting, Amsterdam,
Netherlands
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Page | 48

REGIONAL BLOOD CENTRE PESHAWAR

Department of Health, Khyber Pakhtunkhwa,
Hayatabad, Phase IV, Peshawar, Pakistan
Ph: 091-9217925; Email: rbc.peshawar@gmail.com
Facebook: www.facebook.com/RBCPeshawar1
Website: www.rbcpeshawar.gov.pk
Page | 49

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Annual Progress Report 2021

Regional Blood Centre Peshawar

Regional Blood Centre Peshawar

Regional Blood Centre Peshawar

Regional Blood Centre Peshawar

First Edition 2021

Publishing Director: Jamal Abdul Nasir

Printed and bound in Peshawar, Khyber Pakhtunkhwa, Pakistan

Regional Blood Centre Peshawar

EDITORS - ANNUAL REPORT 2021

Dr. Noor e Saba

Consultant Haematologist / Manager

Dr. Muhammad Nisar

Dr. Jamal Abdul Nasir

Chairman Board, Regional Blood Centre Peshawar

Regional Blood Centre Peshawar

ABBREVIATIONS AND ACRONYMS

Regional Blood Centre Peshawar

Number of Blood Donations .................................................................................................. 11

Photographic Glance of Regional Blood Centre ....................................................... 18

Regional Blood Centre Peshawar

Dr. Noor e Saba

Consultant Haematologist / Manager

Peshawar, January 1, 2022

Regional Blood Centre Peshawar

Regional Blood Centre Peshawar

Dr. Jamal Abdul Nasir

Peshawar, January 1, 2022

Regional Blood Centre Peshawar

INTRODUCTION AND BACKGROUND

Regional Blood Centre Peshawar

Pakistan, ISBN 978 969 9881 08 4.

Regional Blood Centre Peshawar

Fig. 1: Centralized blood banking system

Regional Blood Centre Peshawar

Transfus Apher Sci. 2018;57(4):515-516.

Regional Blood Centre Peshawar

Regional Blood Centre Peshawar

Fig. 2: Legislative framework of blood transfusion services in Pakistan

Regional Blood Centre Peshawar

Med. 2020;5(1): 96-97

implication on blood safety in Pakistan. Pakistan J. Zool., 2021;53(3): 1177-1180.

Regional Blood Centre Peshawar

DATA ANALYSIS AND INTERPRETATION

NUMBER OF BLOOD DONATIONS

GENDER-WISE DISTRIBUTION OF BLOOD DONATIONS

policies. Health Policy Plan 2011; 27:147–155.

Regional Blood Centre Peshawar

TYPES OF BLOOD DONATIONS

Fig. 3: Gender-wise distribution of blood donations Fig. 3: Types of blood donations

Regional Blood Centre Peshawar

Fig. 5: Types of blood donations: In-house vs Fig. 6: Components preparation

SCREENING FOR TRANSFUSION-TRANSMITTED INFECTIONS

Regional Blood Centre Peshawar

seroprevalence of 5.8%,37 14.34%,38 and 6.55%,39 respectively. Despite of the well-recognized

Table 1: Blood donations reactive for transfusion-transmitted infections

Screening No. of donations No. of donations

HIV CLIA 48,003 76 (0.15%)

HBV CLIA 48,003 963 (2.0%)

HCV CLIA 48,003 710 (1.48%)

Syphilis CLIA 48,003 387 (0.80%)

Malaria ICT 48,003 5 (0.01%)

Total 48,003 2,141 (4.46%)