Blood sharing in LMICs; A risky practice in African blood transfusions


Blood transfusion is a life-saving medical procedure that plays a critical role in healthcare systems worldwide. In Low- and Middle-Income Countries (LMICs), such as those in Africa, blood is often a scarce resource, and healthcare providers face challenges in ensuring the safety and effectiveness of the procedure. Unfortunately, in some cases, blood sharing from a single pint without a sterile connector has emerged as a risky practice, raising concerns about patient safety and the spread of infections. This article explores the dangers associated with this practice and provides real-life examples from African countries. 

The practice of blood sharing without a sterile connector 

Blood sharing without a sterile connector is a practice where a single pint of donated blood is split and shared between multiple patients without the use of appropriate equipment to maintain sterility. While the intent behind this practice may be to stretch limited resources, it exposes patients to numerous risks, including the transmission of bloodborne infections, bacterial contamination, and compromised transfusion effectiveness. 

Risks and consequences 

Infection transmission: Bloodborne infections such as HIV, hepatitis B, and hepatitis C can be easily transmitted through shared blood. Using a single pint of blood for multiple patients without proper precautions significantly increases the risk of infection transmission, endangering both the recipients and the broader community. 

Bacterial contamination: Without a sterile connector, the blood unit becomes vulnerable to bacterial contamination, which can lead to serious infections in the recipients. Bacteria introduced into the blood can trigger septic reactions, jeopardizing the health of patients who are already in a weakened state. 

Mismatched blood compatibility: Blood transfusions must adhere to strict compatibility protocols to prevent adverse reactions. Sharing blood without proper compatibility testing can lead to hemolytic reactions, where the immune system attacks the transfused blood cells, causing potentially fatal complications. 

Reduced therapeutic efficacy: Blood is often transfused to provide essential oxygen, nutrients, and clotting factors to patients in need. Sharing a pint of blood between multiple patients may not provide adequate quantities of these crucial components, rendering the transfusion less effective. 

Real-life examples 

In some rural Ugandan healthcare facilities, the scarcity of blood supply has led to the practice of splitting a single pint of blood between multiple patients. This practice has been linked to a rise in cases of post-transfusion infections, including hepatitis and bacterial sepsis. 

In Nigeria, inadequate blood supply has forced healthcare providers to adopt blood sharing practices, resulting in several documented cases of patients developing severe infections after receiving shared blood units. These infections have led to prolonged hospital stays and increased healthcare costs. 

Addressing the issue 

Public awareness: Raising awareness among healthcare providers, patients, and communities about the risks associated with blood sharing is essential. Education campaigns can emphasize the importance of safe transfusion practices and encourage reporting of any suspicious practices. 

Improved blood donation: Encouraging regular blood donation and establishing reliable blood donation centers can help mitigate the scarcity of blood supply in LMICs. This would reduce the temptation to resort to unsafe practices due to resource constraints. 

Infrastructure enhancement: LMICs need support to enhance their healthcare infrastructure, including blood testing and storage facilities. Properly equipped blood banks can ensure the availability of safe and compatible blood units, reducing the need for sharing. 


Blood sharing from a single pint without a sterile connector is a risky practice that undermines the safety and efficacy of blood transfusions, particularly in LMICs like those in Africa. The associated risks of infection transmission, bacterial contamination, and compromised therapeutic outcomes cannot be ignored. To address this issue, a multi-pronged approach involving public awareness, improved blood donation practices, and enhanced healthcare infrastructure is crucial. By working together, healthcare stakeholders can ensure that blood transfusions remain a safe and life-saving procedure for patients across the continent.