Blood donation. "Hospitals should start using diversion pouches — small bags that collect the first few millilitres of blood, which often carry skin bacteria. These should be discarded before the main collection begins.”
Collince Ogolla was 28 years old when, as a laboratory technologist, he was assigned to a Regional Blood Transfusion Centre during the Covid-19 pandemic. Like the other 54 professionals in his cohort, he arrived with hope, proud to serve the country at a time of crisis.
But it didn’t take long for his excitement to give way to unease.
He handled bags of donated blood every day — matching
types, processing samples, and preparing them for transfusion. But there was one
thing no one ever talked about, and no one ever tested for.
Especially for platelets. They are stored at room temperature and are known globally to carry the highest risk of bacterial contamination.
“I developed a deep concern regarding certain critical gaps in blood safety practices, particularly the absence of routine bacterial screening for donated blood products, including platelets,” Ogolla recalls. “These blood components were frequently issued to recipients without bacterial contamination screening, including platelets, which normally pose the highest risk of bacterial contamination.”
It felt wrong. It is this quiet discomfort that pushed him to dig more, through a study at a level 5 hospital in the country.
What he discovered was worse than he feared: more than one in five ready-to-transfuse blood units were contaminated with bacteria that could kill.
The research, which he conducted at Kisii Teaching and Referral Hospital in 2022-2023, revealed that 21.3 per cent of blood meant for transfusion carried bacteria that could cause severe illness, and even death, if transfused into patients.
“A contamination rate of this level is alarmingly high and exceeds global safety thresholds, indicating an urgent need for intervention,” he told The Star. “Such contaminated blood can lead to infections ranging from fever and sepsis to multi-organ failure and death, especially in patients with weakened immune systems.”
The findings of the study, which he co-authored with Dr
Rodgers Demba, have been published in Advances in Hematology, under the title:
“Evaluation of Bacterial Contamination in Donated Blood for Transfusion
Purposes at Kisii Teaching and Referral Hospital.”
“This isn’t just a Kisii [Hospital] issue,” Ogolla says. "Blood collection procedures are generally standard across Kenya. So if we found this level of contamination in one hospital, we have to assume other centres may face the same risk, or worse.”
They found the most common contaminants were Staphylococcus epidermidis, S. aureus, E. coli, and Bacillus species, all bacteria commonly found on the skin or in the environment. While harmless in other parts of the body, they become dangerous when introduced directly into the bloodstream.
Kenya’s blood safety efforts have mainly focused on screening for viruses such as HIV and hepatitis. But bacterial contamination, often caused by poor collection practices or lack of proper screening, has received far less attention.
Ogolla says that must change.
“There is currently no routine bacterial screening in many
of Kenya’s blood transfusion centres,” he said. “We issue blood, including
platelets, without confirming whether it is bacterially safe. That’s a serious
gap in our system.”
Collince Ogolla. He says there should be routine bacterial screening, especially for high-risk products like platelets.In developed countries such as the United States and France, bacterial contamination of donated blood is estimated at just 0.1 to 0.2 percent. In contrast, a 2018 Kenyan study recorded a contamination rate of 18 per cent. That was already high by global standards.
But the new finding of 21.3 per cent contamination at a major referral hospital suggests the problem may be far worse and more widespread than previously known.
Ogolla now wants to expand his research to include other blood banks across the country and even the wider East African region.
The study also found that blood from donors aged 21–30 years, and those with blood group A-positive, were more likely to be contaminated. The reasons for this are still unclear, but Ogolla suspects it may be linked to the frequency of donations or how collection procedures are handled for these groups.
He recommends several simple but effective interventions to fix the problem.
“First, proper disinfection of the donor’s skin before drawing blood is essential,” he says. “You need to use alcohol-iodine antiseptics and allow them to dry for at least 30 seconds before inserting the needle.”
“Second, we need to train and retrain phlebotomists and laboratory staff on aseptic techniques.”
“Third, hospitals should start using diversion pouches — small bags that collect the first few millilitres of blood, which often carry skin bacteria. These should be discarded before the main collection begins.”
“And lastly, there should be routine bacterial screening, especially for high-risk products like platelets. We already have the technology, such as the BD BACTEC system, which can be standardised across the country.”
He also recommends that the Ministry of Health and the Kenya Tissue and Transplant Authority (successor of the Kenya National Blood Transfusion Service) review national protocols and set mandatory safety benchmarks for all blood banks.
“Kenya urgently needs a national conversation around blood safety,” Ogolla said. “Lives are at stake, and the public trusts our health system to protect them. That trust must be earned through action.”
If funding becomes available, Ogolla hopes to carry out a nationwide audit of bacterial safety in blood donations and work with policymakers to strengthen regulation, staff training, and monitoring.
In the 2024 performance audit on the management of blood transfusion services, the Auditor General also flagged serious shortcomings in Kenya’s national blood service system.
The audit found that blood safety protocols were inconsistently implemented, with inadequate screening, testing, and quality assurance at many transfusion centres.
The report said regional centres lacked standardised protocols for bacterial screening, diversion pouch use, or aseptic collection techniques, leaving national guidelines unimplemented. These governance gaps were marked as high risk, given their potential to result in unsafe transfusions and patient harm.
“KNBTS has inefficiencies in blood collection, testing, processing and transfusion, which may affect the quality and safety of blood. Further, KNBTS is not leveraging modern technology to maximise utilisation of the available blood units,” said the report, titled Performance Audit Report On Management of Blood Transfusion Services by the Kenya National Blood Transfusion Service-Predecessor To Kenya Tissue And Transplant Authority.
