Blood Transfusion Safety Research Articles

The effect of learning management system on ICU nurses' sustained learning about safe blood transfusion: A quasi-experimental study.

Background and AimsTransfusion of blood products is an important part of the health care system. Since one of the significant challenges in nursing education is using an effective method that provides depth and stability of learning, this study aimed to assess using a learning management system (LMS) for intensive care unit (ICU) nurses' sustained learning about safe blood transfusion in southeast Iran.MethodsThis was a quasi‐experimental study in southeast of Iran in 2021 in two groups, control and intervention. Two ICUs received lecture training and two ICUs received LMS. The samples 80 nurses were selected by random convenience sampling. In the LMS group, the educational content was presented using Edmodo software. The control group received no intervention except for traditional education (lecture). The questionnaires were completed immediately, 1 month, and 3 months after the intervention.ResultsThe mean score of knowledge immediately, 1 month and 3 months after the intervention were 9.53 ± 1.82, 9.46 ± 1.85, and 8 ± 2.94, in the lecture group and 8.91 ± 1.59, 9.47 ± 2.46, and 8.09 ± 1.94 in the LMS group, respectively. The mean score of practice immediately, 1 and 3 months after the intervention were 59.69 ± 39.6, 70.63 ± 7.4, and 83.70 ± 43.6 in the lecture group and 45.68 ± 55.5, 67.69 ± 4.56, and 35.70 ± 46.4 in the LMS group, respectively. The mean score of knowledge and practice in the two groups significantly increased immediately and 1 month and 3 months after intervention (p < 0.001). No significant difference was observed between the two groups (p > 0.05).ConclusionsLMS method has a significant effect on improving the sustained learning of ICU nurses, and no significant difference was observed between the two educational methods. Hence, considering the busy work schedule of nurses, lack of staff, and the impossibility of physical attendance in lecture classes, it seems that LMS‐based methods are appropriate alternatives to traditional learning methods.

ABO and Rh Antigen Distribution Among Pregnant Women in South Western Uganda.

IntroductionABO and Rh are the major blood group systems in Transfusion Medicine, the ABO system based on two red cell antigens (A, B) while the Rh has about 50 antigens of which five are highly clinically significant (D, C, c, E, e). These vary among races and ethnic groups. Blood type phenotype incompatibility between mother and fetus may result in antigen mismatch, triggering alloimmunization, and thus causing hemolytic transfusion reaction (HTR), which results in hemolytic disease of fetus and newborn (HDFN). This study aimed to determine the frequencies of ABO and rhesus blood group antigen in the pregnant women in South Western Uganda.MethodsA cross-sectional study was carried out on 1369 pregnant women who were recruited and provided consent to participate during their regular antenatal visits between August 2020 and July 2021. Four milliliters (4mL) of EDTA-anti-coagulated blood samples were collected and ABO and Rh-blood grouping including Rh antigen screening was done using the agglutination technology comprised of glass beads and reagent contained in a column of the Ortho Biovue ID Micro Typing System (Ortho Clinical Diagnostics, New Jersey, USA). The Rh antigen phenotypes and frequencies were then determined.ResultsThere was percentage distribution of 99.8%, c 99.3%, D 94.3%, C 19.2% and E 15.9%, with Rh cDe/cDe (65.1%) being the most common phenotype followed by cDe/CDe (15%), cDe/cDE (10.8%) and cDE/cDE 0.1% least common. The ABO grouping frequency was obtained as O 49.4%, A 29.5%, B 17.0% and AB 4.1%, with D positivity at 94.3%.DiscussionPopulation genetic variations result in varied expressions of red cell antigens that may have clinical complications. Knowledge of the presence of these Rh antigen distributions and phenotype frequencies during pregnancy help in rational management of the pregnancy, alloimmunization and better approach to safe blood transfusion.

Prevalence of Irregular Red Cell Antibodies in Healthy Blood Donors at a Stand-Alone Blood Centre in Gujarat

Background: Blood transfusion therapy involves multiple steps to ensure selection of safe blood component for transfusion. This includes testing for infectious markers, full ABO compatibility, free from any irregular red cell antibodies especially which are reacting at wide thermal amplitude and acceptable donor's red cell survival rates without destruction of recipient's red cells. Objective: This study was aimed to assess prevalence and type of irregular red cell antibodies in a large number of blood donor population at a standalone blood centre in Gujarat. Methods: This retrospective observational study included blood donor samples for antibody screening from January 2018 to March 2022. A total of 2,16,576 healthy blood donors including 2,00,493 (92.57%) males and 16,083 (7.43%) females were screened. Results: The prevalence of irregular red cell antibodies was 0.03 per cent in our donor population. Of the total 66 donors with red cell antibodies, 53(80.30%) had alloantibodies, 8(12.12%) had autoantibodies and 6 donors (9.09%) showed positive antibody screening with inconclusive results. We also found one case of cold antibody. Conclusion: Alloimmunization to red cell antigens is a challenging task for current transfusion practices. The antibody screening in blood donors may improve the quality and safety of blood transfusion in the recipients. It also reduces the risk of complications from incompatible blood transfusions. Keywords: antibody screening, allo-antibody identification, autoantibody, safe blood transfusion, hemolytic transfusion reaction.

Study of donor deferral during blood donation: A single centre teaching hospital study

Background: Safe blood transfusion can be a crucial lifesaving intervention in many clinical situations.For safe blood products donor selection is the first and foremost measure of blood donation. Objective:Aim of the study to determine the incidence and causes for deferral in blood donors. Materials and Methods: This cross-sectional retrospective study was done at Transfusion medicine department in Delta Medical College and Hospital, Bangladesh during 6 months period. In current study data were extracted from the register book and analyzed. Prospective donors were confidentially interviewed and examined and screened for causes of temporary and permanent deferral of blood donation. Data were presented as charts, table and analyzed with Microsoft Excel. Result: A total of 2215 directed donors were studied,of them, 1555 (73.52%) were male and 560 (26.48%) females. Predominantly blood donors belonged to 31–40 years of age group (38.01%). Out of 2115 directed donors, 423 (20%) were deferred. Deferral was significantly more likely in female. The most common cause for deferralwere history of anemia (27.66%). Other causes were antibiotic &amp; medications, high blood pressure, low blood pressure, frequent donation, Positive HBsAg, HCV markers, suspected addiction, and vaccination. Conclusion: Effective measures are required for documenting the deferred donors and appropriate preventive intervention program should be undertaken for prevalent causes of deferrals, like low Hb, Infections with HBV etc. Anemia is the most prevalent reason of temporary deferral for blood donation in this region of Bangladesh. Other reasons were hypertension, hypotension,suspected addiction, vaccination etc. Bangladesh Journal of Medical Science Vol. 21 No. 03 July’22 Page: 645-647

Development of the Chinese Haemovigilance Network and reporting of adverse transfusion reactions from 2018 to 2020.

To advance blood transfusion safety, the Chinese Haemovigilance Network (CHN) was put into operation in 2018. This report describes the development of the CHN and evaluates its role by analysing reported adverse transfusion reactions (ATRs) from 2018 to 2020. All data in this study were obtained from the CHN online reporting platform. A timeline of CHN development is presented, and the activities of CHN-enrolled facilities are analysed by year. The reported ATRs were analysed in detail for ATR types, blood components involved and adherence to case definition, severity and imputability criteria. Incidence rates were calculated and compared with international examples. During 2018-2020, a total of 3061 ATRs were reported through the CHN online reporting system. The rate of reported ATRs in all facilities and the 10 highest reporting facilities was 0.7‰ and 1.8‰, respectively. When analysed by year, the incidence rate showed an increasing trend from 2018 to 2020. Allergic (68.2%) and febrile non-haemolytic transfusion reaction (27.1%) were the most common. The vast majority of ATRs (92.0%) were not serious, but serious cases of transfusion-associated circulatory overload, transfusion-associated dyspnoea and hypotensive reaction were common. Most (86.0%) of reported cases were definitely or probably associated with transfusion. Under-reporting of ATRs occurs in many Chinese hospitals, but the establishment of CHN has increased ATR recognition and management. More effort will be needed in the future to detect transfusion problems and improve transfusion practice in China.

Research Progress on the Mechanism of Persistent Low-Level HBsAg Expression in the Serum of Patients with Chronic HBV Infection.

Among HBV-infected persons, there is a group of people with hepatitis B surface antigen (HBsAg) showing persistently low levels of expression. The production of low-level HBsAg does not mean a good outcome of chronic HBV infection. Patients still have virus replication and sustained liver damage, and they have the potential to transmit the infection. This risk poses a challenge to clinical diagnosis and blood transfusion safety and is a major concern of experts. However, the mechanism behind persistent low-level HBsAg expression in serum is not completely clear, and complete virus clearance by the host is vital. In this review, we summarize the research progress on the mechanism behind low-level expression of HBsAg in patients with chronic HBV infection in recent years.

Blood supply and transfusion safety during the COVID-19 pandemic

Introduction: The COVID-19 pandemic has put a strain on transfusion practices and safety. The Scientific Committees consider that the COVID-19 pandemic presents a potential risk of reducing and compromising the blood product supply and expressed considerable concern about transfusion safety. Method: In this concise review, we provide an overview of the implications of COVID-19 for blood safety and sufficiency during the initial phases of the pandemic. We searched the PubMed database, the websites of the World Health Organization, the European Centre for Disease Prevention and Control, the US Communicable Diseases Center. We used the keywords COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the impact of COVID-19 on the blood supply, impact of COVID-19 on blood collection, COVID-19 and transfusion safety, the transmission of SARS-CoV-2 through blood transfusion, COVID-19 symptoms, asymptomatic blood donor, COVID-19 patients. Results: Data provided from blood transfusion centers and blood banks worldwide show that the COVID-19 pandemic has affected the activities of the blood supply system. It has impacted blood collections and caused a significant decrease in blood donors. The estimated asymptomatic infection rate was 15–46% of SARS-CoV-2 infections. The estimated incubation ranges are between 2 and 11 days, and almost all infections developed symptoms by day 14. The RNAemia phase of SARS-CoV-2 appears to be brief and low level, is typically associated with more severe disease, and is not demonstrated to be an infectious virus. It is detectable in only a tiny proportion of patients. Post-donation, post-transfusion information, and molecular testing of swab samples collected from asymptomatic donors at risk for COVID-19 provided data supporting the absence of transfusion transmission (TT) of COVID-19. The TT risk is currently theoretical. To prevent and minimize respiratory transmission of SARS-CoV-2 to donors and staff while donating blood, blood centers have had to activate their emergency plans and propose appropriate response measures. Conclusion: The COVID-19 pandemic has a significant impact on blood transfusion activities worldwide. The risk of transmission of COVID-19 through transfusion of blood collected from asymptomatic individuals is now only theoretical and likely minimal. Blood systems should adopt a national approach for coherence and coordination to ensure public confidence in blood safety and supply.

Prevalence of viral hepatitis B markers among blood donors in the Republic of Guinea

The problem of transfusion safety in relation to parenteral viral hepatitis still remains relevant. Viral hepatitis B (HB) remains the most common viral infection transmitted through transfusion procedures. One of the natural phases of chronic hepatitis B (CHB) is occult hepatitis B infection (OBI), characterized by an undetectable HBsAg (regardless of the other serological markers content) in the presence of hepatitis B virus (HBV) DNA in the liver tissue and an extremely low, up to undetectable, level of viral load in the blood. In the Republic of Guinea, as in most countries on the continent, the prevention of HBV transmission through transfusion is still based on HBsAg serological testing of donors only. In this connection, OBI remains as a potential threat to blood transfusion safety. Detection of HBV DNA is a reliable preventive measure against transmission of the virus from donors with HBsAg-negative HBV infection, especially in highly endemic regions. In this regard, the study was conducted to substantiate recommendations for improving blood safety against the background of significant HBV prevalence in the Republic of Guinea.The aim of the work was the evaluation of serological and molecular markers of HBV infection in blood donors in the Republic of Guinea. We examined 250 blood samples obtained from donors living in Conakry, Republic of Guinea. Samples were tested for the presence of serological (surface antigen, HBsAg; antibodies (ABs) to surface (anti-HBs IgG) and core (anti-HBc IgG) antigens) and molecular (DNA) markers of HBV infection. The overall detection rate of hepatitis B markers was 83.2%; HBsAg was detected in 16.4% of all individuals. The high incidence of HBsAg in men (19.55%) compared to women (8.45%) was shown, the relative risk of HBV infection with the formation of HBsAg-positive chronic hepatitis B in males was also significantly higher. The prevalence of the HBV DNA in the study group was 30.4%, the OBI cases accounted for 15.6%. The prevalence of this form of the disease was shown in donors aged 30-49 years (24.78%), in the group of people younger than 30 years, the incidence was lower (8.73%), and at the age of over 50 years, OBI was not detected. Based on the phylogenetic analysis of 76 virus isolates, it was shown that genotype E prevails in the examined group (85.53%).Cases of pathogen DNA detection occurred in HBsAg-negative blood donors in the presence of anti-HBs IgG (n = 4), as well as in the simultaneous presence of ABs anti-HBs IgG and anti-HBc IgG (n = 7). The viral load exceeded 200 IU/ml in OBI samples. Escape mutations were detected by sequencing in each OBI sample, contributing to the virus escaping from diagnostic based on screening for HBsAg. Assessment of the prevalence viral hepatitis B markers in blood donors, determination of genotypes and clinically significant mutations of virus variants are necessary to ensure safe medical manipulations, control and prevention of the spread of this infectious agent.

Baseline assessment findings of the Africa Society for Blood Transfusion Step‐Wise Accreditation Programme in 10 sub‐Saharan African countries, 2016–2018

Background and ObjectivesThe accreditation of blood services promotes continuous quality improvement in blood and transfusion services. The Africa Society for Blood Transfusion (AfSBT) conducted 20 baseline assessments of National Blood Transfusion Services (NBTS) or blood banks as part of the Step‐Wise Accreditation Programme (SWAP) in 10 sub‐Saharan African (SSA) countries from 2016 to 2018. This paper aims to elucidate the process and findings of the baseline assessments.Materials and MethodsThis is a descriptive study of 20 baseline assessments of NBTS. Eleven sections of the AfSBT assessment were reviewed, and 48 out of 68 standards and 356 out of 466 criteria were assessed. Each standard was assigned a value of 1 if it was fully achieved, 0.5 if partially achieved and 0 if not achieved. We defined average section scores >75% as having ‘met AfSBT Standards’, ≤25% as not meeting standards, 26%–50% as needs major improvement, and 51%–75% as needs some improvement and >75% as meets standards.ResultsThe AfSBT SWAP standards were met in 4 out of the 11 sections: donor management, blood collection, component production and compatibility testing. Three sections were determined to need some improvement (quality system; handling, transport and storage and testing of donated blood), and three sections were determined to need major improvement (haemovigilance, blood administration and national blood service accreditation). One section (receipt, ordering, and issuing of blood) did not meet standards.ConclusionDespite improvements in the quality of blood services in SSA over the past two decades, governments may consider the importance of prioritizing investments in NBTS, ensuring these institutions meet international accreditation standards that are aligned with safe blood transfusion services.

Efficacy and safety of autologous blood transfusion during cesarean section for placenta previa: a single-center retrospective study

Background: Postpartum hemorrhage is a life-threatening pregnancy complication and we want to evaluate the safety and efficacy of autologous blood transfusion during cesarean section in women with placenta previa to deal with postpartum hemorrhage. Methods: We conducted a retrospective study concentrating on all cases of placenta previa using autologous blood recovery during cesarean section in a single-center from August 2016 to July 2018, and then grouped and compared the clinical and patient characteristics. Linear regression analysis was conducted to analyze the linear relationships between estimated blood loss and recovered autologous blood volume, recovered autologous blood volume and transfused autologous blood volume, and transfused autologous blood volume and estimated blood loss. Results: In our study, autologous blood recovery technology was used during cesarean section for 294 patients with placenta previa, and a total of 266,660 mL of blood was collected and 134,342 mL of autologous blood was transfused, saving 746 U of red blood cell suspension. Recovered and transfused blood volumes were higher in patients with suspected placenta accreta and resection of the uterus. There were no serious adverse reactions related to autologous blood recovery and transfusion. Conclusions: The use of autologous blood transfusion during cesarean section in patients with placenta previa is safe and can save blood resources.

Blood Group Testing.

Red blood cell (RBC) transfusion is one of the most frequently performed clinical procedures and therapies to improve tissue oxygen delivery in hospitalized patients worldwide. Generally, the cross-match is the mandatory test in place to meet the clinical needs of RBC transfusion by examining donor-recipient compatibility with antigens and antibodies of blood groups. Blood groups are usually an individual's combination of antigens on the surface of RBCs, typically of the ABO blood group system and the RH blood group system. Accurate and reliable blood group typing is critical before blood transfusion. Serological testing is the routine method for blood group typing based on hemagglutination reactions with RBC antigens against specific antibodies. Nevertheless, emerging technologies for blood group testing may be alternative and supplemental approaches when serological methods cannot determine blood groups. Moreover, some new technologies, such as the evolving applications of blood group genotyping, can precisely identify variant antigens for clinical significance. Therefore, this review mainly presents a clinical overview and perspective of emerging technologies in blood group testing based on the literature. Collectively, this may highlight the most promising strategies and promote blood group typing development to ensure blood transfusion safety.

Discussion on Quality Control and Blood Transfusion Safety in Blood Transfusion Laboratory

Discussion on Quality Control and Blood Transfusion Safety in Blood Transfusion Laboratory

Prevalence and Factors Associated With Transfusion-Transmitted Infections Among Blood Donors at the National Blood Transfusion and Research Center, Sana’a, Yemen, 2017

Background Yemen is facing major challenges in ensuring the safety and availability of blood transfusion to meet the increased demand due to the protracted conflict. However, transfusion-transmissible infectious agents (TTIs) such as hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), syphilis, and malaria remain the greatest threats for blood transfusion safety in such fragile, conflict-affected, and vulnerable settings. Objective The aim of this study was to determine the magnitude of TTIs among blood donors attending the National Blood Transfusion and Research Center (NBTRC) and the associated factors. Methods A cross-sectional study was conducted on 340 blood donors at the NBTRC during November and December 2017. Data were collected through face-to-face interviews using a predesigned questionnaire that covered sociodemographic characteristics and possible TTI-associated factors. Blood samples were drawn and tested for HBV surface antigen (HBsAg), HCV antibodies, HIV1, and HIV2 using electrochemiluminescence immunoassays, and syphilis and malaria antibodies were screened with rapid immunochromatographic techniques. Results The overall prevalence of TTIs was 8.8%, with HBV, HCV, HIV, syphilis, and malaria accounting for 2.5%, 1.2%, 0.3%, 1.2%, and 3.2% of all TTIs, respectively. HBV was significantly associated with a history of jaundice and cupping. Furthermore, urethro-vaginal excretion was significantly associated with syphilis, whereas malaria detection was significantly higher among donors from malaria-endemic areas. Nearly three-quarters of donations were from replacement donors who had a significantly higher TTI prevalence than that of the voluntary donors (10.4% vs 3.3%; odds ratio 3.4, 95% CI 1.1-11.6). Conclusions Although the prevalence of TTIs is low, they still pose a serious risk for blood recipients, especially in fragile, conflict-affected, and vulnerable settings where the needs for blood transfusion are increasing and resources are limited. Therefore, using more sensitive screening methods and establishment of a TTIs surveillance system should be considered. Efforts should be made to improve donor recruitment procedures and increase the proportion of regular and voluntary blood donation.

INCIDENCE OF HEPATITIS B &amp; HEPATITIS C VIRUS INFECTIONS IN POTENTIAL BLOOD DONORS IN BAHAWALPUR REIGON, PAKISTAN

Introduction: Hepatitis is commonly transmitted during blood transfusion. The study aimed to find the incidence of hepatitis B &amp; C among blood donors in Bahawalpur region and try to find relation of incidence with socio-demographic variables.&#x0D; Material and Methods: The study was conducted in Bahawal Victoria Hospital Bahawalpur (BVH). The data was collected by trained nurses working in blood bank in supervision of investigator through a structured record review check list developed by investigator in English. The investigator checked data for completeness and cross check from registers. The collected data had been coded before analysis. Descriptive analysis was done to determine the incidence of hepatitis B &amp; C virus in the study population and its distribution categorized by independent variables i.e. age, gender, marital status, residence and education status of blood donor.&#x0D; Results: The results indicated that 20 – 23 years old persons have high incidence rate 54.2% for Hepatitis B &amp; 50.0% for Hepatitis C. Males are affected more (93.3% for Hepatitis B &amp; 92.6% for Hepatitis C) as compared to females. Ratio of incidence was also high in uneducated people 39.2% for Hepatitis B &amp; 37.5% for Hepatitis C. Hepatitis B and C were more common in married people 68.3% and 76.1% respectively. People residing in rural areas were also having a higher incidence 58.3% and 64.8% for Hepatitis B and C respectively.&#x0D; Conclusion: By providing awareness of screening and safe blood transfusion, increasing the literacy rate, better sanitation and disposal facilities for community and preventive measures for avoiding hepatitis transmission to married and people residing in rural areas could be very beneficial in controlling and decreasing the incidence of hepatitis in this area.

Analysis of Reasons of Blood Donor Deferral at a Tertiary Care Institute in India and Its Reflections on Community Health Status

INTRODUCTION: Safe blood donors form the backbone of safe blood transfusion services. Donor eligibility policies are a critical layer of blood safety designed to ensure selection of healthy donors and to protect recipients from any harm. This study was planned to analyze the pattern of whole blood donor deferrals, its characteristics and reasons at a tertiary care institute in Northern India, as the pattern varies according to epidemiology of diseases in different demographic areas.&#x0D; &#x0D; MATERIAL &amp;amp; METHODS: It was a cross sectional study of 2 years duration from December 2015 to November 2017. The data of the potential donors who were deferred was recorded on a separate proforma which included their demographic details, type of donation- voluntary donor (VD) and replacement donor (RD); first time (FT) and repeat donor (RPT); type of deferrals (permanent and temporary) and the reasons of deferrals. &#x0D; &#x0D; RESULTS: Three thousand one hundred and thirty-three donors (voluntary-1446 and replacement-1687) donated and 597 donors were deferred (deferral rate- 16%) during this period. Majority of the deferrals i.e. 525 (88%) were temporary, 72 (12%) were permanent. The most common reason of temporary deferral was anemia. The commonest reason of permanent deferrals was a medical history of jaundice.&#x0D; &#x0D; CONCLUSION: Our study results indicate that the blood donor deferral can have subtle variations based on regional aspects that should be considered when national policies are developed as pattern of deferral varies according to epidemiology of diseases in different demographic areas.

Retrospective analysis of molecular biology mechanism of ABO blood group typing discrepancy among blood donors in Jinan blood station.

To accurately identify ABO blood typing in pre-transfusion testing is very important to ensure blood transfusion safely, which is a major responsibility of blood station. Eighty-one blood donors samples with ABO blood group typing discrepancy was collected among 61952 donor samples in our blood station from January 2019 to July 2020. Blood group serological method was used to detect ABO blood group. DNA Sequencing was used to determine the genotype. The antibody screening test detects antibodies other than ABO. In total, 61,952 donor samples were analysed for ABO typing discrepancies. The incidence among blood donors was 0.13% (81/61952). The most common reason of ABO typing discrepancies was due to specific antibody or non-specific agglutination (54.32%, 44/81), mainly anti-M antibody, cold autoantibody, anti-D antibody, anti-N antibody and anti-Lea antibody. The major cause of forward typing discrepancies among blood donors was ABO subgroups (25.93%, 21/81), including 10 cases of A subtype (1 case of A2, 2 cases of A3, 2 cases of Ax, 3 cases of AxB, 1 case of Ael, 1 case of Ahm), 6 cases of B subtype (2 cases of B3, 1 case of Bel, 3 cases of AB3), 2 cases of B subtype (A), 1 case of cisAB, and 2 cases of acquired B. The serum antibody was weakened in 16 cases (19.75%). The blood types should be correctly identified by combining serology with gene sequencing to ensure the safety of clinical blood transfusion, when the forward and reverse typing discrepancies among the blood donors.

Hepatitis B in Senegalese Blood Donors: Low Prevalence after Five Blood Donations?

Background: Over the past two decades, blood transfusion safety has made significant advances in the fight against infectious diseases. However, hepatitis B is still a problem in blood banks due to its high endemicity in Senegal. In this context, we proposed to first determine the prevalence of HBs antigen (HBsAg) in regular and new blood donors. Second, to determine the influence of the number of blood donations on the prevalence of hepatitis B. Materials and Method: We conducted a retrospective transversal study using data from all blood donations received at the Principal Hospital of Dakar Blood bank from July 2007 to December 31, 2021. Hepatitis B testing was carried out with Automaton E411 (Roche Diagnostics). For all donors, information on age, sex, hepatitis B serology, and the number of donations was collected through the lab’s computer system. Data entry and statistical analysis were performed with Epi-info version 7. Results: HBsAg carriers were identified in 4311 primary donors, corresponding to a prevalence of 12.39% (IC 95% = 12.04 - 12.74). The prevalence of the HBsAg antigen was higher in men (12.9%) than in women (6.85%). Men are twice as likely to be infected with HBV as women (OR = 2.00 (IC 95% = 1.85 - 2.17)). The highest prevalence (12.4%) was found in young adults (23 - 29) years old. After 10 donations, the prevalence of the HBs antigen was stable at around 1%. Individuals with a single blood donation and individuals with 2 to 5 blood donations are 9 and 7 times more likely to carry the HBs antigen than regular donors (more than 10 blood donations), respectively. Conclusion: Our results demonstrate the endemic nature of hepatitis B in Senegal. On the other hand, the non-negligible prevalence of the virus in first-time donors reminds us of the need for continuous improvement in donor selection. These first-time donors, particularly young adults, are important indicators of transmission of the virus to the general population. This study also demonstrates the need to develop strategies to maintain the pool of regular donors, which represent significant barriers to the spread of hepatitis B.

Safety and Feasibility of Preoperative Hemodilutional Autologous Blood Donation and Transfusion in Dogs and Cats

Safety and Feasibility of Preoperative Hemodilutional Autologous Blood Donation and Transfusion in Dogs and Cats

Nucleic Acid Test versus Enzyme Linked Section Immunosorbent Assay for Screening of Human Immunodeficiency Virus in Donated Blood Units: A Comparative Study at a Blood Centre in Western Rajasthan, India

Introduction: With a population of 1.3 billion people and a frequency of Human Immunodeficiency Virus (HIV) (0.17-0.29%), Hepatitis B Virus (3-4%), and Hepatitis C Virus (0.09-15%) in the general population, maintaining blood safety is a difficult undertaking in India. The fourth-generation Enzyme Linked Immunosorbent Assay (ELISA), which can be used in place of Nucleic Acid Amplification Test (NAT) testing in situations with limited resources, has been recommended as the minimal HIV test to increase the safety of blood transfusions. Aim: To compare the fourth generation ELISA with NAT in the screening of transfusion transmissible HIV infection in blood donors. Materials and Methods: A cross-sectional study was carried out at the Blood Centre, Department of Immuno-Haematology and Transfusion Medicine, Sardar Patel Medical College and Associated Groups of Hospitals, in Bikaner, Rajasthan, India. A total of 2000 voluntary and replacement blood donors were recruited consecutively between January 2020 to December 2021 (two years), and their samples were screened using fourthgeneration ELISA. All of these samples were sent to AIIMS in Jodhpur for NAT to identify HIV RNA, HCV RNA and HBV DNA. Results: In this study, when the fourth generation ELISA negative samples were subjected to NAT, no sample was found to be reactive for HIV in NAT, i.e. there was no NAT yield for HIV. Conclusion: As a bare minimum, the fourth-generation ELISA test should be used for blood donor screening and can be considered a cost-effective and reliable test in a resource limited setting. However, additional tests can be advocated for an additional layer of blood safety.

RHCE*E and RHCE*e genotype incompatibility in a southern Thai Muslim population.

CONTEXT:The formation of red cell alloantibodies resulting from both transfusion and pregnancy can cause adverse effects from allogeneic blood transfusions. Alloanti-E is commonly detected among Thai and Asian populations.AIMS:This study aimed to determine RHCE*E and RHCE*e genotype incompatibility in a southern Thai Muslim population and to compare it with those previously reported for other populations.SUBJECTS AND METHODS:Nine hundred and twenty-seven DNA samples obtained from 427 unrelated healthy blood donors from southern Thai Muslims and 500 samples from Central Thais were included. Samples were genotyped for RHCE*E and RHCE*e using an in-house polymerase chain reaction with the sequence-specific primer technique.RESULTS:Significant differences were found when we compared the allele frequencies of the RHCE*E and RHCE*e between southern Thai Muslims and Central Thais: RHCE*E 0.162 versus 0.197 and RHCE*e 0.838 versus 0.803 and also found in Chinese, American native, Japanese, Korean, Alaskan native, Hawaiian, South Asian, Brazilian Japanese-descendant, and Malay Malaysian populations (P < 0.05). In addition, the E/e incompatibilities among southern Thai Muslims and Central Thais were 24.23% and 26.71%, respectively.CONCLUSIONS:This study was the first to determine the RHCE*E and RHCE*e genotype incompatibility among southern Thai Muslims, enabling the estimation of their potential alloimmunization risk. These data could be useful to provide safe blood transfusions across ethnic populations.