Chagas Disease: Parasitemia Identified via Serial Hemoculture in Blood Donor Candidates Infected with Trypanosoma cruzi.

Chagas Disease Recommendations for Solid-Organ Transplant Recipients and Donors.

International migration has changed the global distribution of Chagas disease, with the emerging importance of non-endemic regions. We aimed at better documenting the Australia and New Zealand risk of Chagas disease and needs for interventions. We reviewed Chagas disease-related evidences, policies and practices in Australia and New Zealand and calculated the estimated prevalence. Australia hosts a rapidly growing population at risk and had 1928 infected residents in 2011; New Zealand had 98 in 2006. These figures underestimate the real situation, as they do not consider non-permanent residents. The only existing policy in both countries is the identification of blood donors with a history of or a risk of infection via questionnaire. There is no programme of detection and care of patients. The lifetime economic burden of disease for society is potentially very high. Chagas disease is an emerging health risk with potential high human and economic costs in Australia and New Zealand in the absence of public health attention. Implementing strategies to screen high-risk groups and prevent transmission should be considered. Moreover, migration between the Western Pacific and Chagas endemic regions and the presence of vectors means this risk applies in the whole region.

During the 1950s, 25% of recipients of four or more whole blood transfusions in New York City, USA, developed jaundice, and this was accepted as a ‘fact of life’. At that time, the only transfusion transmitted infectious diseases (TTID) of importance were syphilis and ‘serum hepatitis’, later recognized as hepatitis B. Syphilis screening was introduced in the 1940s and the first assays for hepatitis B surface antigen in the early 1970s. In the early 1980s, the tragedy of AIDS brought serious consequences for blood recipients but also brought attention and resources to the prevention of TTID, resulting in the introduction of additional screening tests in the U.S. and in several other countries [1]. As new screening tests, donor screening procedures and quality systems were developed, they were cumulatively added to the list of donor eligibility and blood processing requirements. Obsolete procedures were removed only under exceptional circumstances. Gradually, multiple layers of safety became part of regulatory requirements including in addition to testing and quality systems, more extensive donor history questionnaires in which donors are asked about potential exposure to transmissible agents (e.g. history of risk behaviours, travel); deferral files listing donors who were deferred because of travel, risk behaviour or reactive screening tests results; quarantine of untested and unsuitable components, kept separately to avoid inappropriate release for transfusion. It should be noted that donor history questions [2] and deferral files [3] have lower sensitivity and poorer predictive value than donor screening tests. In addition, requirements for donor notification and counselling after positive test results were instituted under the presumption that knowledge about their positive results would discourage positive donors from returning to donate. Also, the movement towards volunteer, non-remunerated donations as opposed to replacement donations (made by donors referred by a patient to ensure admission to a hospital) or paid donations was intensified.

In this article we will review the major interventions conducted to date in Mexico as part of the National AIDS Prevention and Control Program. We will also review the available data published in journals or presented at the International AIDS Conferences for insights into Mexican HIV prevention successes and failures that may have implications for AIDS programs in other developing countries. (excerpt)

Objective To explore the influences of seasonal recruitment mode of voluntary blood donation on blood collection and supply of whole blood and erythrocyte components. Methods A total of 239 949 voluntary blood donors who participated in whole blood and erythrocyte components donation during January 2013 to December 2018 in Binzhou Blood Center were chosen as subjects. There were 165 564 male donors and 74 385 female donors in the subjects, whose age ranged from 18 to 55 years. The Qiao Information Management System v9.0 (Tangshan Qiao Technology Co., Ltd.) was used to collect all the blood donation data of 239 949 blood donors in this study, such as the time of participating in blood donation, the mode of blood donation, the amount of blood collection and supply of whole blood and erythrocyte components. The blood collection amount of whole blood and erythrocyte components, the seasonal ratio of blood collection, the blood supply amount of whole blood and erythrocyte components, the seasonal ratio of blood supply, as well as the difference between seasonal ratios of blood collection and blood supply in Binzhou Blood Center in each season from 2013 to 2018 , were calculated respectively. The total blood collection and supply amount of whole blood and erythrocyte components in Binzhou Blood Center in four seasons from 2013 to 2018 were compared by variance analysis, and the least significant difference (LSD) method was used for comparison between two seasons. The procedures followed in this study were in line with the requirements of the revised Helsinki Declaration of the World Medical Association in 2013. Before blood donation, all the blood donors signed the Informed Consent of Blood Donors. Results ① In this study, the seasonal ratios of blood collection of whole blood and erythrocyte components of Binzhou Blood Center in the spring, summer, autumn and winter from 2013 to 2018 were 95.8%, 93.8%, 113.4% and 97.0%, respectively. Among them, the seasonal ratios of group blood collection were 39.9%, 56.7%, 190.3% and 113.2%, respectively; the seasonal ratios of street blood collection was 117.9%, 108.5%, 83.1% and 90.6%, respectively. In spring, summer, autumn and winter form 2013 to 2018, the blood collection amount of whole blood and erythrocyte components of Binzhou Blood Center were (15 877.0±924.3) U, (15 548.2±1 105.3) U, (18 790.8±1 057.7) U and (16 065.7±1 062.3) U, respectively. There was a statistically significant difference in blood collection amount among four seasons (F=12.418, P 0.05). ③ The difference of seasonal ratios between the total blood collection and supply of whole blood and erythrocyte components of Binzhou Blood Center in spring, summer, autumn and winter from 2013 to 2018 were -5.9%, -3.0%, 13.8% and -4.9%, respectively. Only the blood collection in autumn could meet the supply requirements, and there were shortages in other three seasons. Conclusions In recent years, there are seasonal insufficiency of blood collection and supply in Binzhou. Recruitment methods of voluntary blood donation should be coordinated and complemented by group blood collection and street blood collection according to the characteristics of local seasonal climate change, so as to ensure the balance of blood collection and supply to meet the clinical needs. Key words: Blood; Seasonal recruitment; Voluntary blood donors; Blood collection; Blood supply; Group donation; Blood donation on street

Improving Transfusion Practices Through Patient Blood Management Programs

To explore the trends in blood collection from 2006 to 2014 in Guangdong, China. Although the Blood Donation Law of the People's Republic of China was implemented in 1998, voluntary non-remunerated blood donation (VNRBD) has been promoted fully for only a decade. The provincial and local governments of Guangdong, one of the most well-developed provinces in China, have promoted blood donation by various means. Official data on blood donation from 2006 to 2014, including the number of blood donations and the family replacement/mutual blood donation (FRMBD) rate, were collected from all blood collection and supply institutions in Guangdong. These data were analysed to explore trends in blood donation in Guangdong Province, and to detect differences among the province's four regions. The number of blood donations in Guangdong increased by 38·23% from 2006 to 2014; overall, the rate increased annually, although it fluctuated in the eastern region. Family replacement/mutual whole blood and platelet donation rates decreased dramatically from 2006 to 2014 (from 39·99% to 20·16% and from 64·15% to 26·51%, respectively), but remained high. Marked disparities in blood donation development were detected among the four regions. With nearly a decade of efforts, blood donation in Guangdong has developed rapidly and sustainably. All blood collection and supply institutions must strengthen efforts to improve awareness of blood donation among the population, retain repeat and regular donors and reduce the rate of FRMBD in favor of the development of VNRBD.

Donation testing and transfusion transmissible infections

Strategies for prevention of transfusion-associated Chagas' disease

Blood collection to cover national needs in sub-Saharan Africa: the reality of the Ivory Coast.

Challenge of donor recruitment

Donation testing

Screening Blood Donors at Risk for Malaria: Reply to Hänscheid et al.

Introduction. Epstein–Barr virus (EBV) is equally widespread in the endemic and non-endemic world regions for nasopharyngeal cancer (NPC). High incidence of NPC in endemic countries and low in non-endemic countries suggest there are different mechanisms and conditions for tumor occurrence and, possibly, different clinical significance of EBV-associated markers. However, significance of these markers for determining NPC in non-endemic regions is still poorly understood. Objective – to determine clinical significance of titers of IgG/IgA antibodies to EBV capsid antigen and concentrations of the viral DNA in patients’ blood plasma as diagnostic and monitoring markers for NPC in a non-endemic region of Russia. Materials and methods. Titers of EB-specific antibodies were determined by indirect immunofluorescence, and concentration of the viral DNA in plasma was measured using a quantitative polymerase chain reaction in real time. Study group included patients with NPC (n = 96), and control group – blood donors (n = 171) and patients with other head and neck tumors (n = 33).Results. Titers of IgG/IgA antibodies to EBV capsid antigen, being an important diagnostic marker of nasopharyngeal cancer, did not always correlate with patients’ clinical condition. Humoral response to emerging events often delayed due to inertia of the immune system. Concentration of EBV DNA in patients’ blood plasma clearly reflected the dynamics of the pathological process: it decreased to background values in remission and increased while the disease progressed. In contrast to endemic regions, we did not find any correlation between the studied EBV markers and clinical manifestations of the disease, evaluated in accordance with the TNM classification (Tumor, Nodus and Metastasis).Conclusion. In non-endemic countries, such as Russia, serological and molecular markers of EBV can be successfully used for the primary diagnosis of NPC. However, for the disease monitoring, it is preferable to use the value of the concentrations of circulating EBV DNA, which, in contrast to the values of IgG/IgA antibody titers to VCA EBV, more accurately reflect the patient’s clinical condition.

Will Genotyping Replace Serology in Future Routine Blood Grouping? – Opinion 2