Necessity of Implementing Ferritin Testing for Regular Blood Donors – A Cross-sectional Analysis of Serum Ferritin Levels in Individuals Donating Blood at Various Frequencies in a Year at a Regional Blood Transfusion Center

Abstract

Background and Objectives: The virtuous act of blood donations should be encouraged and promoted by all means while safeguarding the well-being of the donor. If regular blood donations lead to iron store depletion in any individual, it may be identified and preventive measures should be taken. The current practice of hemoglobin (Hb) testing alone before donation may not detect the depletion of iron stores. Yet, a policy to introduce tests for iron stores and iron supplementation in regular donors requires extensive research in this area because of the cost and feasibility concerns. The objectives were to study the prevalence of subclinical anemia among voluntary blood donors using serum ferritin levels attending the blood transfusion center and to compare the average Hb and serum ferritin levels of donors across different age groups, gender, and donation frequencies. Methods: A cross-sectional study was done on 300 consecutively enrolled voluntary whole-blood donors (December 2018–November 2019) who fulfilled eligibility criteria. Donors were further divided into four groups, depending on their number of donations. Their samples were tested for Hb and serum ferritin to check for reduced body iron stores. The data obtained were analyzed using SPSS version 23. Results: A total of 300 regular voluntary donors were included in the study. 57.7% of donors were in the age group of 20–29 years, of which 83.33% were males. The total prevalence of subclinical anemia was 16%, in whom 54.2% were males and 45.8% were females. Out of the total female donors in our study (50), 44% suffered from subclinical anemia. Out of the total male donors in the study (250), 10.4% suffered from subclinical anemia. There was a significant association between frequency of donation and subclinical anemia (odds ratio [OR] =6.36, P < 0.001). There was a significant association between subclinical anemia across gender (high for females; OR = 6.76, P < 0.001). There was a significant correlation between the frequency of donation and serum ferritin (Spearman correlation coefficient: −0.299), but there was no correlation observed between the frequency of donation and Hb levels. Conclusion: The study demonstrates the depletion of iron store with increasing donation frequency. This calls for continual supervision of body iron stores rather than Hb alone to ensure the continuous supply of healthy blood donors.