PeshawarRBC AnnualProgressReport2020

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Peshawar Regional Blood Centre – Annual Progress Report 2020
PESHAWAR REGIONAL BLOOD CENTRE

Department of Health, Government of
Khyber Pakhtunkhwa
Peshawar Regional Blood Centre

ANNUAL PROGRESS REPORT
2020
© Peshawar Regional Blood Centre 2021
Some rights reserved. Any individual or organization may copy, redistribute and adapt the
work for noncommercial purposes, provided the work is appropriately cited, as indicated
below. In any use of this work, there should be no suggestion that Peshawar Regional Blood
Centre endorses any specific organization, products or services.
Editors:
Dr. Noor e Saba
Dr. Jamal Abdul Nasir
Suggested citation: Saba N, Nasir JA. Annual Progress Report 2020. Peshawar Regional
Blood Centre, Department of Health, Government of Khyber Pakhtunkhwa, Pakistan. 1st Ed.,
2021, ISBN 978-969-2254-00-7.
Printed in Peshawar, Khyber Pakhtunkhwa, Pakistan

i
CONTENTS
Abbreviations and Acronyms ii
Message by the Secretary Health iii
Acknowledgements v
1. Introduction 1
2. Data Analysis and Interpretation 4

2.1 Number of blood donations 4
2.2 Gender-wise distribution of blood donations 4
2.3 Types of blood donations 5
2.4 Components Preparation 6
2.5 Screening for transfusion-transmitted infections 6
2.6 Donor haemovigilance 7
2.7 Prevalence of blood groups among blood donors 9
2.8 Waste Disposal 9
3. Events Gallery 10
4. Photographic Glance at Peshawar RBC 27
5. Publications 29
6. Team Peshawar RBC 32

ii
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
ICT immuno chromatographic technique
ISBT international society of blood transfusion
ISO international organization for standardization
KfW german development bank
KTH khyber teaching hospital
LRH lady reading hospital
NAT nucleic acid testing
NBP national blood policy
NGO non-governmental organization
NSF national strategic framework
PC platelet concentrates
PCR polymerase chain reaction
QA quality assurance
QC quality control
RBC regional blood centre
RCC red cells concentrates
RDT rapid diagnostic test
SBTP safe blood transfusion programme
SDG sustainable development goal
SOP standard operating procedure
VNRBD voluntary non-remunerated blood donor
WHO world health organization
iii
MESSAGE BY THE SECRETARY HEALTH
The government of Pakistan is fully committed to promote blood

safety and improve the standard of regulation and service delivery
in the blood transfusion sector. The Government of Pakistan
formulated a draft National Health Policy in 2010, which for the
first time included transfusion safety as a priority area. Similarly,
the National Health Vision (2016-25) endorsed by all provinces,
advocates the need for safe blood transfusion and reduction in the
transfusion-dependent thalassaemia patients. Pakistan has one of the highest
hepatitis B and C populations in the world. Also, we have regular epidemics of HIV
and dengue for the last few years. All these infections are transfusion transmissible
and we have to make sure that transfusions in our community are safe from these
infections. The development of a centrally coordinated blood transfusion service in
the country to ensure timely access to blood for all was thus imperative.
The provision of quality assured blood products entails a paradigm shift from the
current unsafe fragmented service delivery system to a more centrally coordinated de-
centralized system. This ambitious goal is being achieved through structural and
functional reorganization of the system with the assistance provided by the German
Government.
The provincial government of Khyber Pakhtunkhwa attaches great significance to the

health sector and blood safety continues to be among the government’s core priorities
within the health sector. 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. The Khyber Pakhtunkhwa government
initiated the reformation into centralized supply-driven blood transfusion services.
This included the establishment of a network of Regional Blood Centres (RBC)
connected with existing hospital blood banks (HBB). The Phase I PC-1 (2010-16) of the
safe blood project in Khyber Pakhtunkhwa was worth PKR 190.17 million (FEC 77.95
million, LC 112.22 million). In Phase I of the project, one large modern RBC was
developed in Peshawar and six existing Hospital Blood Banks in Peshawar were
upgraded and equipped through the German government grant. This infrastructure
is now functional and is providing much-improved services and safety standards. In
iv
the ongoing Phase II (2017-21) of the project, another RBC has been developed in Swat.
The Phase II PC-1 is worth PKR 676.856 million (FEC 385.895 million, LC 290.970
million).
Since the establishment of Peshawar Regional Blood Centre in 2016, we are now well
on our way to establishing an internationally recommended blood transfusion system
in the province. The new system is gradually replacing and phasing out the current
fragmented demand-driven scattered system.
The promotion of voluntary blood donations is the cornerstone of the Peshawar RBC.
I am very pleased to inform you that RBC conducts regular activities throughout the
year to attract young people to become regular blood donors through a structured
plan and strategy. The efforts of the RBC and the stakeholders to bring about a
behavior change in the community and shift our current reliance on ‘Family
Replacement Donors’ to the internationally recommended safe regular “voluntary
non-remunerated blood donors” is most praiseworthy.
The reforms in the service delivery system are also being complemented by reviving
and strengthening the blood regulatory system in the province. In 2016, a new blood
safety legislation was enacted entitled ‘The Khyber Pakhtunkhwa Blood Transfusion
Safety Authority Act, 2016’, and a new regulatory authority ‘KP Blood Transfusion
Authority’ was established. The KP Blood Transfusion Authority is housed within the
premises of Peshawar RBC. Blood banks across the province are now being registered,
licensed, and properly regulated.
Indeed the Peshawar RBC is a ‘success story’ and the health department and the
government are very proud of the achievements and their contribution to building a
healthy society. I would like to congratulate Dr. Niaz Muhammad, Director General
Health, Dr. Jamal Abdul Nasir, Director Administration, and Dr. Noor e Saba,
Consultant Haematologist, Peshawar RBC, for successfully managing the RBC and
bringing out this annual progress report. Their exemplary spirit and zeal is most
praiseworthy.
On behalf of the Government of Khyber Pakhtunkhwa, I assure full support and

commitment to the Peshawar Regional Blood Centre and wish it the best of luck in its
efforts.
Syed Imtiaz Hussain Shah

Secretary Health
Government of Khyber Pakhtunkhwa Peshawar, January 2021
v
ACKNOWLEDGEMENTS
The Peshawar Regional Blood Centre (RBC) is pleased to present

its Annual Progress Report for 2020. The Report provides an
annual review of the RBC activities, the publication of research
work, and the data analysis and interpretation. The Peshawar
RBC is indebted to Mr. Taimur Saleem Khan Jhagra, Provincial
Health Minister, for his support and encouragement. The Centre
also expresses gratitude to Mr. Syed Imtiaz Hussain Shah,
Secretary Health, for his cooperation and guidance. The RBC is
also grateful to Dr. Niaz Muhammad, Director General Health, for his support and
facilitation to the Centre to enable it to perform its assigned role.
The support and guidance received from the Safe Blood Transfusion Programme,
Ministry of National Health Services, is highly appreciated. The enthusiasm, keen
interest, and cooperation of the SBTP team was pivotal for the RBC operationalization.
The RBC is grateful to the German government for their continued support through
the KfW (German development bank). From time-to-time, WHO has been providing
technical assistance which has proved to be very valuable for the RBC and highly
appreciated.
We would also like to express our gratitude to our blood donors. The donated blood
does not belong to us; it belongs to the community – to you – ensuring that safe blood
and blood components are available whenever needed.
The publication of this annual progress report would not have been possible without
the wholehearted support from Dr. Noor e Saba, who is managing the RBC since 2017
in the most professional manner. Her technical and administrative skills have proven
to be critical for the quality assured performance of RBC. All the RBC staff and the
management of the affiliated hospital blood banks deserve appreciation for extending
all possible cooperation. We look forward to their continued support in 2021.
Dr. Jamal Abdul Nasir

Director Administration / Chairman-Peshawar RBC Board
Directorate General Health Services, Department of Health,
Government of Khyber Pakhtunkhwa Peshawar, January 2021
1
1. INTRODUCTION
Blood transfusion services are an integral part of the health-care

system. Blood transfusion is an indispensable, potentially life-saving
medical intervention. Millions of lives are saved each year through
blood transfusions. The provision of safe blood and blood components
is the responsibility of the national health care system. Safety of blood
has assumed greater importance and relevance in developing
countries where HIV, hepatitis B, and hepatitis C are becoming
diseases of greater public health importance. Globally, 118.2 million
blood donations are collected with 58% in low and middle-income
countries. According to the WHO, safe blood transfusion is a universal human right. Safe
blood means blood that will not cause harm to the recipient and that has been fully screened
and is not contaminated by any blood-borne disease such as HIV/AIDS, hepatitis, malaria, or
syphilis; is free of infections or contamination due to drugs or other chemical substances; is
used within the specified time period and stored in the right conditions, correctly labeled, and
properly sealed. 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, makes
contribution to the sustainable development goals (SDGs).
It is estimated that 2.7 million blood donations are collected in Pakistan annually from
approximately 650 blood centres of varying workloads.1 The blood transfusion service in
Pakistan is compromised, largely due to fragmentation and 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. Hepatitis B and C are among the
most serious health problems burdening the health care system in Pakistan.2 The chronic
recipients, e.g. thalassaemics have much higher prevalence rates when compared to the
general population.3
The population of Khyber Pakhtunkhwa is 30,523,371 and has an area of 74,521 sq. km. There
are 36 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.4 All the stakeholders
1 Zaheer HA, Waheed U, Nasir K, et al. National Data Collection Report 2018. SBTP, M/o NHSR&C, Islamabad.
2 Waheed U, Abdella YE, Saba N, et al. Evaluation of screening effectiveness of HBsAg and anti-HCV rapid test kits in Pakistan.
J Lab Physicians 2019;11(4):369-372.
3 Kiani RA, Anwar M, Waheed U, et al. Epidemiology of transfusion transmitted infection among patients with β-thalassaemia
major in Pakistan. J Blood Transfus. 2016;2016:8135649.

4 Saba N. Restructuring of blood transfusion services in Khyber Pakhtunkhwa. Medical Review. Vol 30, No. 1, Jan 2018.
2
worked 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.
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 increasethe quality and safety of blood products and to
improve cost-effectiveness.
Accordingly in 2010, the Government of Pakistan, supported by a grant-in-aid from the

Government of Germany, initiated the Safe Blood Transfusion Project.5 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 collecting, testing,
processing, and distributing blood to hospital blood banks which will store and select blood
and blood components and issue them to clinical wards. 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. A 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. The
RBC was made operational in April 2016.
The Peshawar Regional Blood Centre 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 Blood Centre is mobilization of voluntary non-remunerated blood donors,
collection of blood donations, it’s processing, TTI screening, component preparation and
storage, distribution to attached hospital blood banks, haemovigilance, and research and
development. 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 data management/BTMIS section.
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
reliance on family replacement donors is gradually decreasing and the concept of VNRBD is
5 Zaheer HA, Waheed U. Blood safety system reforms in Pakistan. Blood Transfus. 2014;12(4):452-457.
3
being promoted through blood camps, seminars, and other promotional activities. In addition,
blood is being collected from all attached Hospital Blood Banks (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,
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 RBC has become the hub of blood transfusion-related training activities in the province.
Regular training activities are being held 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.
The RBC team is actively involved in research and development. Several research manuscripts
were published in national and international journals. In addition, research work has also
been presented at national and international conferences.
Dr. Noor e Saba

MBBS, MSPH, MPhil (Haematology), Dip. Procurement & Supply Chain
PGD Transfusion Medicine (Iran), Dip. Healthcare Quality, FELTP Fellow
Consultant Haematologist / Manager
Regional Blood Centre, Department of Health
Government of Khyber Pakhtunkhwa
4
2. 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 transfusion information system
(BTIS) 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.
2.1 Number of blood donations

In 2020, 17,975 blood donors were attended. Out of these, 182 donors were deferred due to
numerous causes as mentioned in section 2.6. Hence, the total blood collections were 17,793.
Necessary administrative measures are needed to ensure that all blood collected in attached
HBBs is processed in the RBC and prepared blood components are shifted back to the
respective HBB.
2.2 Gender-wise distribution of blood donations

Out of the total of 17,793 whole blood donations collected in 2020, 17,657 (99.2%) were donated
by male blood donors and only 136 (0.8%) were donated by female donors (Fig. 1). This is
much lower than the national statistics according to which less than 5% of females donate
blood.6 Low female donation rate is a source of concern. Earlier studies have highlighted a set
of belief systems prevalent in the society which steer the process of female donations.7 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.8 The study generated some interesting results and identified 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.
6 Los APM, Waheed U, Kohorst P, et al. Creation of an enabling environment for voluntary blood donation in Pakistan.
Vox Sang.
2012; 103(Suppl. 1):100.
7 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.
8 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.
5
2.3 Types of blood donations

Out of the 17,793 blood donations, 16,068 (90.30%) donations were collected from family
replacement donors while only 1,725 (9.70%) donations were collected from voluntary donors
(Fig. 2). Out of these, 1,361 (7.65%) were collected in the RBC while 16,432 (92.35%) were
collected from blood camps and collection points in the attached HBBs (Fig. 3). The
recruitment and retention of blood donors are a global challenge. Blood is a scarce human
resource, and the demand for blood is ever-increasing. World Health Organization
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 has a fragmented demand-driven blood system 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, 9
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 as
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
0.8% VNRBD
9.70%
Male
99.2% Family Replacement
90.30%
Fig. 1: Gender-wise distribution of Fig. 2: Types of blood donations:

blood donations VNRBD vs Replacement donations
2.4 Components Preparation
In 2020, 16,431 (92.34%) blood donations were processed into at least three blood components,
i.e. Red Cell Concentrates (RCC), Fresh Frozen Plasma (FFP), and Platelet Concentrates (Fig.
4). In addition, 93 units of platelet aphaeresis, and 10 units of cryoprecipitate were prepared
on demand. The situation regarding blood component preparation was unsatisfactory before
9Waheed 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.
6
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
7.66%
In-house
7.65%
Camps
92.35% Components Prepared
92.34%
Fig. 3: Types of blood donations:

Fig. 4: Components preparation
In-house vs camps
2.5 Screening for transfusion-transmitted infections

The screening of blood for five TTI markers, i.e. HIV, HBV, HCV, syphilis, and malaria are
mandatory under clause 15, section (f) of the Khyber Pakhtunkhwa Blood Transfusion
Authority Safety Act, 2016.10 All 17,793 blood donations collected in 2020 were screened for
these five transfusion-transmitted infections and 4.61% (n=821) were reactive for one of the
five TTIs. Among the five TTIs tested, 39 (0.21%) were reactive for HIV, 352 (1.97%) for HBV,
279 (1.56%) for HCV, 145 (0.81%) for syphilis, and 6 (0.03%) 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 less than 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 4.61%. This finding compares favorably to an earlier study from Lahore,
Pakistan which reported a percentage prevalence of 4.0%.11 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 seroprevalence of 5.8%,12 14.34%,13 and 6.55%,14
respectively. Despite of the well-recognized significance of assessing the epidemiology of
10 Available at http://www.pakp.gov.pk/2013/wp-content/uploads/blood-transfusion0001.pdf
11 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.
12 Arshad A, Borhany M, Anwar N, et al. Prevalence of transfusion transmissible infections in blood donors of Pakistan. BMC
Hematol. 2016;16:27.
13 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.
14 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.
7
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 201815 on a sample size of 1,400 but with no information on the study site.
Transfusion of blood and blood components is a life-saving intervention and supports
countless patients globally. At the same time, however, transfusion of contaminated blood has
a key role 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
voluntary blood donation, sensitization and recruitment 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 17,793 39 (0.21%)
HBV CLIA 17,793 352 (1.97%)
HCV CLIA 17,793 279 (1.56%)
Syphilis CLIA 17,793 145 (0.81%)
Malaria ICT 17,793 6 (0.03%)
Total 17,793 821 (4.61%)
2.6 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,
182 donors (1.01%) were deferred at the pre-donation stage (Table 2) while 821 (4.61%) 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
15 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.
8
is a dejected experience for both the blood donor and the respective blood centre.16 The
identification of the causes for deferrals can steer the process of amendments in blood donor
motivation and recruitment and retention strategies.17
Table 2: Causes of pre-donation deferral
Causes Total
Low haemoglobin 42 (23.07%)
Underweight 22 (12.08%)
Medications 22 (12.08%)
Obesity 18 (9.89%)
Menstruation 16 (8.79%)
High/low blood pressure 15 (8.24%)
Gastroenteritis 13 (7.14%)
Fasting 10 (5.49%)
Recent blood donation 8 (4.39%)
Fever 7 (3.84%)
Over/under age 5 (2.75%)
Total 182 (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.18 There are 12 studies published so far and have reported data from
different regions of Pakistan (Table 3). 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.
16 Waheed U, Zaheer HA. Evaluation of deferral pattern among the blood donors in Islamabad, Pakistan. Glob J Transfus Med
2016;1(2):81-4.
17 Saba N, Nisar M, Nasir JA, et al. Blood donation deferral pattern among prospective blood donors in northwest region of
Pakistan. Ann Pak Inst Med Sci. 2020;16(2): 63-68.
18 Waheed U, Kruzik H, Knels R, et al. Analysis of management information system in blood transfusion services, Pakistan. J
Blood Disorders Transf 2015, 6:3.
9
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%),
6.37%
Peshawar low haemoglobin (8.28%), underweight (5.97%)
Saeed et al., (2020) Hepatitis C (13.3%), hepatitis B (6.1%), syphilis (4.0%),
25.2%
Mandi Bahauddin malaria (2.4%), diabetes mellitus (1.9%)
Iqbal et al., (2020) Anaemia (50.3%), hepatitis C (19.2%), hepatitis B (11.3%),

12.9%
Multan syphilis (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
Karachi
untreatable 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%),
12.2%
Karachi thrombocytopaenia (19.35%)
Nadeem et al., (2016) Hepatitis C (28.6%), anaemia (24%), hepatitis B (16.8%),
7.4%
Rawalpindi syphilis (10.4%)
Waheed et al., (2016) Hepatitis B and C, anaemia (41%), low body weight (22.5%),
10.14%
Islamabad low blood pressure (5.1%), under/overage (5.9%)
Tufail et al, (2013) Anaemia (4.9%), hepatitis C (3.1%), thrombocytopaenia
13.58%
Islamabad (1.8%), hepatitis B (0.81%)
Khan et al., (2012) Hypotension (22.22%), anaemia (13.33%), jaundice history

8.70%
Peshawar (9.52%), underweight (6.03%)
2.7 Prevalence of blood groups among blood donors

In 2020, out of 17,793 blood donors, 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.
2.8 Waste Disposal

Out of 17,793 blood collections in 2020, 821 blood units were TTI positive and were discarded
due to TTI positivity, 160 were discarded due to low bleed, and 1 was discarded due to
leakage/broken seal.
10
3. EVENTS GALLERY
Awareness Session at the School of Health Sciences, Peshawar, December 2020
MPA Rabia Basri visited Peshawar RBC, December 2020
Seminar on Waste Management in Blood Banks, November 2020

11
Blood Donation Camp at Mohmmand Agency, November 2020
Manager, Peshawar RBC participated as a Guest Speaker at Blood Safety Training

Workshop in Mirpur, November 11, 2020
Visit of Blood Donation Society Pakistan, November 2020

12
Blood Donation Camp at the Police Lines, Peshawar, October 2020
Certificate Distribution Ceremony in collaboration with Malgeri Doctaran, October 2020

13
Blood Donation Camp at Civil Defense, Mardan, September 2020
Meeting with Mr. Abasyn Yousafzai and Blood Donation Camp at the Islamia College,
Peshawar, September 2020
14
Blood Donation Camp at the Skans School of Accountancy, Peshawar, August 2020
Independence Day celebrations at RBC, Peshawar, August 2020

15
Blood Donation Camp in collaboration with JZT Team, Peshawar, June 2020
Blood Donation Camp at the Khyber Medical University, Peshawar, May 2020
Awareness Session for Blood Heroes Society, Peshawar, May 2020

16
Blood Donation Camp at the Alqalam College, Peshawar, April 2020
Blood Donation Camp at the University of Agriculture, Peshawar, February 2020
Secretary Health and Chief HSRU donated blood at the Peshawar RBC, November 2019
17
Peshawar RBC team visited the Iranian Blood Transfusion Organization (IBTO), Iran for a study tour,
April 19 to May 2, 2019
18
Inspection of Peshawar RBC by the KP Blood Transfusion Authority, Peshawar, April 9, 2019
Peshawar RBC Team attended the SBTP Quarterly Review Meeting, Islamabad, March 20, 2019
Orientation Session for Inspection Committee of KP Blood Transfusion Authority, March 14, 2019
19
Peshawar RBC team participated in the SBTP Social Media Kick-Off Meeting, Islamabad, January 22, 2019
Peshawar RBC team participated in the SBTP Quarterly Review Meeting, Islamabad, September 12, 2018
Seminar on Clinical Use of Blood, Peshawar, September 5, 2018

20
Peshawar RBC Team attended a Workshop on Immunohaematology, Islamabad, August 6-8, 2018
Peshawar RBC Team visited Multan RBC and Nishtar Hospital, Multan, July 17-18, 2018
21
Minister for Health and Secretary Health, KP, visited the Peshawar RBC, June, 2018
Peshawar RBC Team participated in the Quality Audit Meeting for Auditors of Thalassaemia Centre
Blood Banks, Karachi, January, 2018
KfW Representatives Meeting with the Secretary Health, Government of KP, Mr. Abid Majeed,
Peshawar, January 24, 2018
22
Peshawar RBC Team participated in the National Consultation on Blood Donor Management,
Islamabad, December 2018
Peshawar RBC Team participated in the National Consultation on Blood Regulation, Karachi,
December 2018
German Ambassador to Pakistan, H.E. Mr. Martin Kobler, visited the Peshawar Regional Blood
Centre, September 12, 2017
23
Workshop on Role of Peshawar RBC and Blood Donor Management Practices, September 20, 2017
39th Annual Conference of Pakistan Association of Pathologists - Pre-conference Workshop on

Transfusion Medicine, November 24, 2016
24
Inauguration of Peshawar RBC by the provincial Minister for Health, Mr. Shahram Khan Tarakai,
November 9, 2016
Workshop on Quality Control and Haemovigilance in Transfusion Medicine held at the Peshawar
RBC, October 29, 2016
25
SBT KP team at the dissemination ceremony of National Blood Policy and Strategic Framework,
chaired by Federal Minister for Health, Ms. Saira Afzal Tarar, Islamabad, March 5, 2015
SBTP KP team participation in the Round Table Working Group Meeting – Strategic Planning 2014-
20, Islamabad, June 25-26, 2014
26
SBT KP team participation in the Round Table Gap Analysis and Strategic Planning 2014-20,
Islamabad, May 21-22, 2014
Workshop on Quality Management in Blood Transfusion Services, HMC, Peshawar, May 5-7, 2014
SBTP Islamabad team meeting with Prof. Zubair Khan, Executive Director, HMC, and Prof. Tahir
Khan, Project Director SBT KP, to discuss provision of land for construction of RBC, April 8, 2012
27
4. PHOTOGRAPHIC GLANCE AT RBC

28
29
5. PUBLICATIONS
 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.
 Saba N. Restructuring of blood transfusion services in Khyber Pakhtunkhwa.
Medical Review; A Medical Current Affair. Vol 30, No. 1, Jan 2018.
 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.
 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.
 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.
 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.
 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
 Waheed U, Saba N. Thalassaemia major patients in COVID-19 crisis in Pakistan.
Transfusion Today 2020 Sept; 123:31.
 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.
 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 2020;10(2):
 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. Hepatitis E virus RNA in Pakistani

blood donors: An emerging transfusion-transmitted infection. Glob J Transfus
Med. 2020;5(2): 233.
 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.
 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.
 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.
 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.
 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.
 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.
 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. Pak. J. Zool. 2020;
 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.
 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.
 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.
 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.
 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.
 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.
31
 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.
 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.
 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.
 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.
32
6. TEAM PESHAWAR RBC
S. No. Name Designation
1. Dr. Noor e Saba Haematologist / Manager

2. Dr. Muhammad Nisar Khan Medical Officer
3. Dr. Sara Noreen Women Medical Officer
4. Dr. Safia Nawaz Quality Assurance Manager
5. Dr. Saba Hameed Quality Assurance Manager
6. Dr. Zahina Latif Genetic Counselor
7. Muhammad Khalid Clinical Technologist
8. Iqbal Muhammad Clinical Technologist
9. Sami ul Haq Accountant
10. Shams-ur-Rehman Computer Operator
11. Abdul Qayyum I.T. Assistant
12. Zeeshan Khan I.T. Assistant
13. Kosar Nazli Charge Nurse
14. Javeria Bibi Charge Nurse
15. Sara Noreen Charge Nurse
16. Amin Jan Social Organizer
17. Fawad Muhammad Social Organizer
18. Umar Iqbal Lab. Technician
19. Anwarullah Lab. Technician
20. Ali Hasnain Lab. Technician
21. Muhammad Waqas Lab. Technician
22. Umar Arsalan Lab. Technician
23. Muhammad Zubair Lab. Technician
24. Ali Umair Lab. Technician
25. Baroz Khan Lab. Technician
26. Faiz ur Rehman Lab. Technician
27. Shahid Badshah Lab. Technician
28. Arshad Iqbal Lab. Technician
33
29. Burhanullah Lab. Technician

30. Mian Noshad Lab. Technician
31. Shakeel Jan Lab. Technician
32. Abdul Latif Lab. Technician
33. Nadeem Khan Lab. Technician
34. Imran Ali Lab. Technician
35. Mohsin Kamal Biomedical Technician
36. Adnan Khan Biomedical Technician
Donor Motivation and QA Team
RBC Collection Point Team

34
RBC Technical Team
RBC Technicians Team

PESHAWAR REGIONAL BLOOD CENTRE

Hayatabad Medical Complex, Department of Health
Government of Khyber Pakhtunkhwa
Ph: 091-9217925; Email: rbc.peshawar@gmail.com
Facebook: www.facebook.com/RBCPeshawar1
Website: www.rbcpeshawar.gov.pk
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Annual Progress Report 2020 - Peshawar Regional Blood Centre

Book · January 2021

Noor e Saba Jamal Abdul Nasir

SEE PROFILE SEE PROFILE

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PESHAWAR REGIONAL BLOOD CENTRE

Peshawar Regional Blood Centre

© Peshawar Regional Blood Centre 2021

Printed in Peshawar, Khyber Pakhtunkhwa, Pakistan

Abbreviations and Acronyms ii

Message by the Secretary Health iii

2. Data Analysis and Interpretation 4

4. Photographic Glance at Peshawar RBC 27

6. Team Peshawar RBC 32

ABBREVIATIONS AND ACRONYMS

AIDS acquired immunodeficiency syndrome

MESSAGE BY THE SECRETARY HEALTH

The government of Pakistan is fully committed to promote blood

The provincial government of Khyber Pakhtunkhwa attaches great significance to the

On behalf of the Government of Khyber Pakhtunkhwa, I assure full support and

Syed Imtiaz Hussain Shah

The Peshawar Regional Blood Centre (RBC) is pleased to present

Dr. Jamal Abdul Nasir

Blood transfusion services are an integral part of the health-care

major in Pakistan. J Blood Transfus. 2016;2016:8135649.

Accordingly in 2010, the Government of Pakistan, supported by a grant-in-aid from the

Dr. Noor e Saba

2. DATA ANALYSIS AND INTERPRETATION

2.1 Number of blood donations

2.2 Gender-wise distribution of blood donations

2.3 Types of blood donations

Fig. 1: Gender-wise distribution of Fig. 2: Types of blood donations:

Fig. 3: Types of blood donations:

2.5 Screening for transfusion-transmitted infections

Table 1: Blood donations reactive for transfusion-transmitted infections

Screening No. of donations No. of donations

HIV CLIA 17,793 39 (0.21%)

HBV CLIA 17,793 352 (1.97%)

HCV CLIA 17,793 279 (1.56%)

Syphilis CLIA 17,793 145 (0.81%)

Malaria ICT 17,793 6 (0.03%)

Total 17,793 821 (4.61%)

2.6 Donor haemovigilance

Table 2: Causes of pre-donation deferral

Low haemoglobin 42 (23.07%)

High/low blood pressure 15 (8.24%)

Recent blood donation 8 (4.39%)

Over/under age 5 (2.75%)

Total 182 (100%)

In developing countries, anaemia is a grave public health problem. In Pakistan, an

Table 3: Deferral percentage with common causes in studies from Pakistan

Iqbal et al., (2020) Anaemia (50.3%), hepatitis C (19.2%), hepatitis B (11.3%),

Khalid et al., (2018) Anaemia (52.4%), TTIs (34%), leukocytosis (19.7%),

Therapeutic injections (31.2%), low haemoglobin (22.7%), ﬂu,

Sultan et al., (2017) Anaemia (91.8%), leukocytosis (3.7%), polycythaemia (3.3%),

Khan et al., (2012) Hypotension (22.22%), anaemia (13.33%), jaundice history

2.7 Prevalence of blood groups among blood donors