SBTA flags safety risks from informal blood collection

Regulator cites weak oversight, unsafe practices and TTI risks; vows tighter enforcement and improved screening

KARACHI: Unregistered or informal blood collection activities pose a significant risk to transfusion safety in Sindh due to the absence of standardised screening, licensing and regulatory oversight, the Sindh Blood Transfusion Authority (SBTA) has said, highlighting continuing challenges in bringing such operators under formal regulation.

In response to queries regarding blood safety and transfusion-transmissible infections (TTIs), the authority’s Secretary, Dr Dur-e Naz Jamal, stated that informal collectors increase the likelihood of unsafe transfusions and heightened transmission risks, as they operate outside established quality-control systems.

She acknowledged that regulating independent or informal collectors remains complex. Among the key challenges are difficulty in identifying unregistered operators, limited enforcement resources, legal constraints, and public reliance on low-cost or informal services. Lack of awareness about blood safety laws also contributes to the problem.

However, the authority’s leadership said SBTA continues efforts to curb such practices through random inspections of small-scale health facilities and laboratories, responding to public complaints, and circulating updated lists of registered blood banks to healthcare institutions and on its website for public facilitation.

SBTA Secretary Dr Dur-e Naz Jamal

TTI prevalence and interpretation

Responding to data indicating around a 5% prevalence of TTIs among blood donors, SBTA described the figure as a cumulative ratio compiled from public and private blood banks across the province. The percentage represents all five screened infections — HIV, hepatitis B, hepatitis C, syphilis and malaria — detected among individuals presenting for donation.

According to the authority, current prevalence rates among screened donations stand at: Hepatitis C (2.1%), Hepatitis B (1.5%), Syphilis (1.2%), HIV (0.1%) and Malaria (0.2%).

SBTA attributed TTI positivity among donors to broader public health factors, including unsafe medical practices such as reuse of syringes, inadequate sterilisation in informal healthcare settings, unsafe barbering and circumcision practices, high-risk behaviours including unprotected sex and injecting drug use, and limited public awareness regarding transmission routes and prevention.

Safeguards and screening systems

Under the SBTA regulatory framework, mandatory registration and licensing of blood banks is enforced, and only licensed facilities are permitted to collect, test, process, store and issue blood units. Unlicensed centres are prohibited from operating.

All donated blood is screened for TTIs before release, and any reactive units are recorded and discarded in accordance with standard operating procedures (SOPs) and waste disposal mechanisms.

The authority said surveillance and data collection systems require regular reporting from blood establishments to monitor TTI patterns and maintain quality control. Inspection and enforcement actions — including suspension or sealing of facilities found supplying unsafe or untested blood — are undertaken where violations are identified.

Public-sector regional blood centres and licensed private facilities operate under standardised and regulated testing protocols to support a safe blood supply across Sindh.

Quality assurance and laboratory controls

SBTA stated that screening quality is ensured through licensing requirements, inspections, standardised SOPs, periodic audits and corrective actions where needed.

To address laboratory testing errors and window-period risks, mandatory screening of every donated unit undergoes testing using approved and validated methods such as ELISA, CLIA and NAT. Internal quality control samples are run in each testing batch, while external quality assessment and proficiency testing are used to verify laboratory accuracy. Equipment, kits and procedures are subject to validation protocols, with regular audits to ensure compliance. In suspicious cases, PCR testing is undertaken for further confirmation.

Donor screening and follow-up

Pre-donation screening involves a detailed donor history questionnaire, confidential interview, physical assessment and defined eligibility and deferral criteria. SBTA Secretary Dr Naz stressed that while the system is comprehensive and risk-based, its effectiveness depends on consistent enforcement and honest donor disclosure.

“When a donor tests TTI-positive, confirmatory testing is conducted, confidentiality is maintained, and post-test counselling is provided. Donors are referred for follow-up medical care through infectious disease control programmes, while reactive blood units are discarded and records maintained for traceability.”

The authority said it monitors compliance through inspections, audits and reporting reviews to ensure blood banks properly counsel and refer TTI-positive donors.

SBTA emphasised that strengthening trained counselling staff, improving confidentiality practices, and promoting voluntary non-remunerated blood donation remain key priorities to further reduce transfusion risks across the province.   --MA

Originally published by Social Track, Karachi (February 27, 2026)

Photos courtesy: ST and SBTA

Chart: SBTA