First-time Donors Research Articles

Epidemiology, Management, Quality of Testing and Cost of Syphilis in Germany: A Retrospective Model Analysis.

BackgroundA multi-dimensional model can be a useful tool for estimating the general impact of disease on the different sectors of the healthcare system. We chose the sexually transmitted disease syphilis for our model due to the good quality of reported data in Germany.MethodsThe model included gender- and age-stratified incident cases of syphilis (in- and outpatients) provided by a German statutory health insurance company, as well as seroprevalence data on syphilis in first-time blood donors. Age standardized rates were calculated based on the standard German population. The test quality was assessed by extrapolating the number of false-positive and false-negative results based on data from Europe-wide external quality assessment (EQA) schemes. The model analysis was validated with the reported cases and diagnosis-related group (DRG)-statistics from 2010 to 2012. The annual direct and indirect economic burden was estimated based on the outcomes of our model.ResultsThe standardized results were slightly higher than the results reported between 2010 and 2012. This could be due to an underassessment of cases in Germany or due to limitations of the dataset. The number of estimated inpatients was predicted with an accuracy of 89.8 %. Results from EQA schemes indicated an average sensitivity of 92.8 % and an average specificity of 99.9 % for the recommended sequential testing for syphilis. Based on our model, we estimated a total average minimal annual burden of €20,292,110 for syphilis on the German healthcare system between 2010 and 2012.ConclusionsThe linking of claims data, results from EQA schemes, and blood donor surveillance can be a useful tool for assessing the burden of disease on the healthcare system. It can help raise awareness in populations potentially at risk for infectious diseases, demonstrate the need to educate potential risk groups, and may help with predictive cost calculations and planning.

Genotype Distribution and Demographic Characteristics of Hepatitis C Virus Nucleic Acid Testing Yield Cases Among US Blood Donors.

Hepatitis C virus (HCV) infection rates among US blood donors have been well characterized; however, few studies evaluated HCV genotypes among blood donors. Monitoring trends in disease and demographic patterns contributes to understanding the safety of the blood supply. We examined the demographic characteristics and distribution of HCV genotypes/subgenotypes for nearly a 16-year period among blood donors confirmed positive for HCV RNA but antibody negative (defined as nucleic acid testing [NAT] yield). A retrospective assessment of demographic characteristics and testing data was used to determine temporal trends and geographical distribution of HCV genotypes/subgenotypes among American Red Cross blood donors confirmed positive as HCV-NAT yield. From 2003-2018, 343 donors (0.38/100 000 donations; 95% CI, .35-.43) were confirmed positive as HCV-NAT-yield cases. Temporal analysis revealed a significant increase in HCV-NAT-yield cases of 54.1% between 2009 and 2014 (P = .014), followed by a significant decline of 31.4% between 2015 and 2018 (P = .002). Significantly more HCV-NAT-yield cases were detected among first-time donors, non-Hispanic Whites, donors aged 20-29 years, equally likely to be males as females, with the highest frequency in the South (0.52/100 000 donations). Subgenotype 1a (49.6%) was most frequent, followed by 3a (18.7%), 2b (12.5%), 1b (8.5%), and 2a (1.7%). Voluntary nonremunerated blood donors are at low risk for HCV infection. Since 2015, the frequency of HCV-NAT-yield cases decreased despite an increase in acute HCV infection in the general population. HCV subgenotypes 1a and 3a continue to remain predominant among US blood donors with recent HCV infection.

The impact of nucleic acid testing to detect human immunodeficiency virus, hepatitis C virus, and hepatitis B virus yields\xa0from a single blood center in China with 10-years review

BackgroundSince 2010, the Blood Center of Zhejiang province, China, has conducted a pilot nucleic acid amplification testing (NAT) screening of blood donors for Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human immunodeficiency virus (HIV). This study aims to assess the results of NAT testing over 10 years to establish the effects and factors influencing NAT yields of HBV, HCV, and HIV.MethodsBlood donations from seven different blood services were screened for HBV DNA, HCV RNA, and HIV RNA using 6 mini pools (6MP) or individual donation (ID)-NAT method between August 1, 2010, and December 31, 2019, at the NAT centralized screening center. We compared 3 transcription-mediated amplification (TMA) assays and 2 polymerase chain reaction (PCR) assays. Further, HBV, HCV, and HIV NAT yields were calculated and donor characteristics and prevalence of HBV NAT yields analyzed. Donors with HCV and HIV NAT yield were also followed up.Results1916.31 per million donations were NAT screening positive overall. The NAT yields for HBV, HCV, HIV and non-discriminating reactive were 1062.90 per million, 0.97 per million, 1.45 per million, and 850.99 per million, respectively, which varied in the seven blood services and different years. HBV NAT yields were higher than those of HCV and HIV and varied across demographic groups. Risk factors included being male, old age, low education level, and first-time donors. We found no differences in NAT yields of HBV, HCV, and HIV between the 3 TMA and 2 PCR assays; nonetheless, statistically, significant differences were noted between the five assays.ConclusionIn summary, NAT screening in blood donations reduces the risk of transfusion-transmitted infections and shortens the window period for serological marker screening. Therefore, a sensitive NAT screening method, ID-NAT workflow, and recruitment of regular low-risk donors are critical for blood safety.

Burden of chronic hepatitis B and C infections in 2015 and future trends in Japan: A simulation study

SummaryBackgroundDetermining the number of chronic hepatitis B (HBV) and C virus (HCV) infections is essential to assess the progress towards the World Health Organization 2030 viral hepatitis elimination goals. Using data from the Japanese National Database (NDB), we calculated the number of chronic HBV and HCV infections in 2015 and predicted the trend until 2035.MethodsNDB and first-time blood donors data were used to calculate the number of chronic HBV and HCV infections in 2015. A Markov simulation was applied to predict chronic infections until 2035 using transition probabilities calculated from NDB data.FindingsThe total number of chronic HBV and HCV infections in 2015 in Japan was 1,905,187–2,490,873 (HCV:877,841–1,302,179, HBV:1,027,346–1,188,694), of which 923,661–1,509,347 were undiagnosed or diagnosed but not linked to care (“not engaged in care”), and 981,526 were engaged in care. Chronic HBV and HCV infections are expected to be 923,313–1,304,598 in 2030, and 739,118–1,045,884 in 2035. Compared to 2015, by 2035, the number of persons with HCV not engaged in care will decline by 59·8 – 76·1% and 86·5% for patients in care. For HBV, a 47·3 – 49·3% decrease is expected for persons not engaged in care and a decline of 26·0% for patients engaged in care.InterpretationAlthough the burden of HBV and HCV is expected to decrease by 2035, challenges in controlling hepatitis remain. Improved and innovative screening strategies with linkage to care for HCV cases, and a functional cure for HBV are needed.FundingJapan Ministry of Health, Labour and Welfare.

The impact of immediate adverse donation reactions on the return of volunteers undergoing platelet apheresis

IntroductionImmediate adverse reactions experienced during donation decrease return rates among whole-blood donors, but little is known about this effect among platelet apheresis donors. We investigated the impact of immediate adverse reactions on the return rates of volunteer apheresis platelet donors. MethodsIn a sample of 4108 consecutive platelet apheresis donors seen from August 2016 through June 2019, we evaluated whether immediate adverse reactions were associated with returning for a subsequent platelet apheresis donation within a 12-month period. We used propensity score matching to compare donors with and without adverse reactions. ResultsAn immediate adverse reaction occurred in 312 (7.6%) donors; 98.5% were mild, and 0.3% were severe. Of the original 4108 platelet apheresis donors, only 3211 (72.3%) returned for a subsequent donation within 12 months. Experiencing an immediate adverse reaction during the donation process significantly decreased the return rate for a subsequent donation [HR= 0.74 (0.63–0.87)], especially among female donors [HR= 0.70 (0.53–0.93)], donors aged < 30 years [HR= 0.71 (0.54–0.94)], with a high school educational level [0.63 (0.49–0.81)], donors donating for the first time [HR= 0.73 (0.59–0.90)], and repeat donors with a previous platelet apheresis donation more than 180 days prior [HR= 0.68 (0.50–0.93)]. ConclusionEven mild adverse events reduce the return rates for a subsequent donation among platelet apheresis donors. Female donors, younger donors, and first-time donors are at higher risk of not returning after an immediate adverse reaction. Preventing the incidence of immediate adverse reactions during platelet apheresis donation may increase the rate of donor retention.

Seroprevalence of the Human T Lymphotropic Virus (HTLV 1 and HTLV 2) in Blood Donor Candidates in the State of Pará, Northern Brazil

The present study describes HTLV seroprevalence in potential blood donors from the Brazilian state of Pará, and the sociodemographic characteristics of the infection in this state. This descriptive, retrospective, and cross-sectional study is based on secondary serological and sociodemographic data on potential blood donors who were rejected for presenting reactive results in the serological HTLV screening between January 2010 and December 2020. The mean HTLV seroprevalence was 0.2%. The highest frequency of reactivity was recorded in first-time donors, women, individuals over 30 years old that were single and had a relatively low level of education. There have been many advances since the discovery of HTLV, although it is still considered to be a neglected etiological agent in Brazil. Further research on data from hematological services will be necessary to refine regional infection profiles, which will be fundamental for the development of adequate prophylactic practises to control and prevent infection, as well the dissemination of information on the dangers of HTLV to the general population.

Prevalence and Risk Factors for Human T-Cell Lymphotropic Virus (HTLV) in Blood Donors in Brazil-A 10-Year Study (2007-2016).

It is unknown whether HTLV-1/2 prevalence has been stable or changing with time in Brazil. We present a 10-year (2007–2016) analysis of HTLV-1/2 infection in first-time blood donors from four blood banks in Brazil. The Brazilian blood centers participating in this multicenter Recipient Epidemiology and Donor Evaluation Study (REDS) are located in Recife in the Northeast and in São Paulo, Rio de Janeiro and Belo Horizonte located in the Southeast of the country. A previous REDS study using the same database from 2007 to 2009 showed that the prevalence per 100,000 donors was 222 in Recife, 83 in Belo Horizonte and 101 in São Paulo. From 2007 to 2016, HTLV-1/2 prevalence was calculated by year, blood center and birth cohort. Covariates included age, gender, schooling, self-reported skin color and type of donation. From 1,092,174 first-blood donations, in the general analysis, HTLV-1/2 infection predominated in females, donors over 50 years of age, black skin color and less educated. The average prevalence was 228 per 100,000 donors in Recife, 222 in Rio de Janeiro, 104 in Belo Horizonte and 103 in São Paulo. In the 10-year analysis, HTLV-1/2 prevalence was stable, but a trend was observed toward an increase in HTLV-1/2 infection among younger people (p < 0.001), males (p = 0.049), those with white skin color (p < 0.001), and higher education (p = 0.014). Therefore, this 10-year surveillance of the infection showed stable HTLV-1/2 prevalence overall but a trend toward increased prevalence among the younger and more educated donors despite Brazilian policies to control sexually transmitted infections being in place for more than 10 years.

The distribution of ABO RhD blood groups in Australia, based on blood donor and blood sample pathology data

To determine the distribution of ABO RhD blood groups in Australia in 2019. Retrospective analysis of blood group data for blood donors (Australian Red Cross Lifeblood National Blood Management System) and for people whose blood type was determined in samples submitted for analysis by hospital-based or private pathology agencies. All Australian states and territories, 1 January - 31 December 2019. Proportions of donors and patients, by ABO blood group and RhD status. These proportions were compared with published data for 1993-94 first-time blood donors. A total of 1318751 valid ABO RhD blood group results were provided by 28 of 41 invited pathology agencies (including 245 of 324 approved health providers, 76%). Valid ABO RhD data were available for 490491 blood donors, including 103798 first-time donors (21.2%). Blood group prevalence based on samples typed by pathology services was O RhD+, 38.4%; O RhD-, 6.5%; A RhD+, 32.0%; A RhD-, 5.6%; B RhD+, 11.8%; B RhD-, 1.5%; AB RhD+, 3.7%; and AB RhD-, 0.5% (totals: RhD+, 85.9%; RhD-, 14.1%). The distribution based on typing of first-time blood donors was similar. The overall proportion of RhD+ first-time donors rose from 81% in 1993-94 to 83.8% in 2019; the proportion of groups B and AB RhD+ RBC units issued declined from 9.8% in 2010-11 to 6.9% of all RBC units in 2019-20, while that of O RhD- RBC units increased from 11.7% to 17.4%. Our national assessment of ABO RhD prevalence in Australia provides updated information for re-evaluating blood and blood product collection and holdings in light of changes in population demographic characteristics.

Clinical performance evaluation of Elecsys HIV Duo, Anti-HCV II, HBsAg II, Anti-HBc II, and Syphilis assays for routine screening of first-time blood donor samples at a French blood donation center.

Implementing fully automated analyzers has become a crucial safety step in blood donation centers. The Elecsys® assays were evaluated on the cobas e 801 module (Roche Diagnostics) for routine first-time blood donor screening. Five Elecsys infectious disease assays were tested on the cobas e 801 module at Etablissement Français du Sang, Montpellier, France (March-April 2018). The performance of Elecsys HIV Duo, Anti-HCV II, HBsAg II, Anti-HBc II, and Syphilis assays was compared with PRISM HIV O Plus, HCV, HBsAg, HBcore, and newbio pk TPHA assays (specificity analyses)/ARCHITECT Syphilis TP (sensitivity analyses), respectively. Specificity was determined in residual fresh serum samples from unselected first-time blood donors (n≥5195 per parameter). Elecsys assay sensitivity was tested using 30 preselected, positively characterized samples per assay and compared with archived routine testing data for comparator assays. Across all parameters, specificities for repeatedly reactive samples ranged from 99.81-100.00% for Elecsys assays and 99.71-99.98% for comparator assays. Sensitivities of Elecsys and comparator assays were the same for hepatitis C (85.19%), hepatitis B surface antigen (70.00%), hepatitis B core antigen antibodies (100.00%), and syphilis (100.00%). The sensitivity of the Elecsys HIV Duo assay was higher than the comparator assay (83.33% vs. 76.67%), but the difference was not statistically significant. Elecsys infectious disease assays on the cobas e 801 module demonstrated high specificity and sensitivity for screening first-time blood donor samples, and were comparable with other commercially available assays. The Elecsys assays are reliable tests for screening blood donations.

Factors influencing voluntary blood donation practice among university students of Bangladesh

Although voluntary blood donation among young people, particularly university students, is increasing and saving many valued lives, it is unclear which characteristics of the students have the most influence on their willingness to participate in voluntary blood donation. We aimed to identify the correlates that might influence voluntary blood donation practice. In total, 439 students from different universities in Bangladesh participated in this study. Data were collected using an e-questionnaire. To better understand students’ perception regarding voluntary blood donation, exploratory data analysis and the Pearson Chi-square test were performed. The degree of association of the possible risk factors was evaluated using odds ratios (OR) from a backward selection binary logistic regression model. 54 % (237) of the respondents voluntarily donated blood at least once. The odds of male students voluntarily donating blood were 7.28 (95 % CI: 4.14–12.78) times higher than their counterparts. University students who participated in various volunteer organizations were 2.43 [95 % CI: 1.49–3.96], p = 0.005) times and students, who had seen advertisements of blood donation on social media or a part of social media-based blood donation campaign were 4.72 [95 % CI: 2.57–8.65] times more likely to donate blood than their counterparts. The majority of the first-year students were discovered to be first-time blood donors. Moreover, BMI was also found to be significantly associated (positively) with blood donation practice. We found that females, students with lower BMI, and students who are not involved in any voluntary organization are less involved in voluntary blood donation.

Prevalence of Occult Hepatitis B Virus Infection in Blood Donors with Negative ID-NAT in Switzerland

Introduction: Screening of hepatitis B surface antigen (HBsAg) and individual-donation nucleic acid amplification testing (ID-NAT) of blood donors have become standard to detect hepatitis B virus (HBV) infection. However, there is still a residual risk of HBV transmission by blood components of donors suffering from occult HBV infection (OBI). Therefore, many countries implemented universal testing of anti-HBV core antigen (anti-HBc) antibodies in order to increase blood safety. In Switzerland, anti-HBc testing is not part of the routine blood donor-screening repertoire. Therefore, we sought to assess prevalence of donors with OBI in a Swiss blood donor collective. Methods: Blood donations were prospectively investigated for the presence of anti-HBc antibodies during two time periods (I: all donors, March 2017; II: first-time donors only, April 2017 until February 2018). Anti-HBc-positive findings were confirmed by an anti-HBc neutralization test. Discarded plasma samples of anti-HBc-confirmed positive donors were ultracentrifuged and subsequently retested by regular HBV-ID-NAT to search for traces of HBV. Results: During time period I, 78 (1.6%) individuals out of 4,923 donors were confirmed anti-HBc-positive. Sixty-nine (88%) anti-HBc-positive samples were available and processed by ultracentrifugation followed by repeat HBV-ID-NAT. Four samples (5.8%) were found positive for HBV DNA. Sixty-five (94.2%) samples remained HBV NAT-negative upon ultracentrifugation. During time period II, 56 (0.9%) donor samples out of 6,509 exhibited anti-HBc-confirmed positive. Fifty-five (98%) samples could be reassessed by HBV-ID-NAT upon ultracentrifugation. Three (5.5%) samples contained HBV DNA and 52 (94.5%) samples remained HBV NAT-negative. Conclusion: Overall, we detected 7 viremic OBI carriers among 11,432 blood donors, which tested negative for HBV by standard HBV-ID-NAT and HBsAg screening. In contrast, OBI carriers showed positive anti-HBc findings which could be confirmed in 83.8% of the cases. Thus, OBI might be missed by the current HBV screening process of Swiss blood donors. We suggest to review current HBV screening algorithm. Extended donor screening by anti-HBc testing may unmask OBI carriers and contribute to blood safety for the recipient of blood products.

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.

Experiences, Challenges, and Their Mitigation during COVID Convalescent Plasma Donation Management

Background and Objectives: ICMR conducted a multicentric trial “PLACID” that allowed COVID convalescent plasma (CCP) as an experimental drug for the management of moderate COVID-19 disease and the authors' institute was one of the participating centers. The efficacy of CCP in COVID-19 is still debatable. However, unlike therapeutic efficacy, there is not enough literature on issues and challenges faced by health-care institutions in donor recruitment, and the entire vein-to-vein process and approach of CCP transfusion. The authors would like to share their experiences, challenges faced, and their mitigation during the course of donor recruitment, screening, testing, apheresis donation, storage, inventory management, and issue and transfusion of CCP including the regulatory provisions, as their evolution. Methods: This retrospective study was conducted over a period of 7 months at a large tertiary care hospital in north India. Based on ICMR guidelines, the study analyzed the screening process and donation from all consecutive potential CCP donors. The study also identified various issues and challenges faced by the institute and how they were resolved. Results: Prospective donors registered at the blood center were 843. Majority were males (96.6%), first-time CCP donors (93%), age interval 31–45 years (52.2%), who had a history of mild COVID-19 symptoms (86.9%), and were home-quarantined (83.8%). The most common blood group was B positive (50.6%). Only 6.3% of donors were deferred due to the absence of anti-COVID-19 antibodies. Of 843, 705 selected CCP donors donated 1488 CCP units and six donors (0.8%) experienced mild adverse reactions. Challenges faced by authors included donor recruitment, lack of regulatory approval for plasmapheresis, revisions of COVID-specific selection criteria, no “anti-COVID-19 antibody” kit, and CCP inventory management. Conclusion: This study provides real-world comprehensive data on process management of CCP donors and their donations. This understanding of the process, its challenges, and their mitigation could be a template for any possible future pandemic.

Reference interval of platelet counts and other platelet indices in apparently healthy blood donors in North India according to Clinical and Laboratory Standards Institute guidelines: Need to redefine the platelet count cutoffs for repeat plateletpheresis donation?

In clinical practice, laboratory results are of great importance for the diagnosis and treatment. Reference intervals of different parameters aid health-care professionals in the interpretation of results. There are very few studies on reference intervals from India. This prospective study was conducted to determine the reference intervals for platelet count (PLT) and PLT indices; mean PLT volume (MPV), PLT distribution width (PDW), and PLT large cell ratio (P-LCR). These values can be obtained as a part of a routine complete blood count (CBC) and have diagnostic and prognostic significance in certain diseases. PLT count is an important criterion for the selection of donors for repeat plateletpheresis donation. Sixteen hundred and thirty-four first-time healthy volunteer plateletpheresis donors were enrolled for the study. CBC was done, values of PLT, MPV, PDW, and P-LCR were noted, and the results were analyzed. The 95% of the reference distribution was estimated using the 2.5th and 97.5th percentiles following Clinical and Laboratory Standards Institute guidelines. Adverse donor reactions, if any and quality parameters of single donor PLTs (SDP) were also studied. Reference range values of PLT, MPV, PDW, and P-LCR were 137,825-355,175/μl, 8.1-13.9/fl, 9.1-22.5/fl, and 11.7%-52.9%, respectively, and compared well with other published studies from India. It was observed that reference values of PLT count obtained in the study were lower than reference values that are currently used in most laboratories (150,000-450,000/μl) in India. Based on our results, we are of the opinion that the PLT count cutoffs for repeat plateletpheresis donation may need to be revised downwards for our country which would also mitigate the scarcity of apheresis donors.

Factors Affecting Blood Donation Intervals And Patterns Of Return Based On A Sample In Southern Iran: A Follow-Up Design

Objectives — The main goal of blood transfusion centers is to recruit and retain more qualified blood donors. This study aimed to identify the factors influencing the return of volunteer blood donors. Material and Methods — A cohort study was conducted on all blood donors who donated blood for the first time, from March 21, 2013, to March 20, 2014. They were followed up for five years (up to March 20, 2018). Demographic characteristics, type of blood donation and time interval between two blood donations were recorded as recurrent events. Data were then analyzed using Logit Model for Multinomial Responses and Cox's shared frailty model. Results — Of the 2010 blood donors, 33.7% as the repeated donor and 16.2% as the regular donor had regular donations. The frequency of blood donation was in the range of 1 to 20 with a mean of 4.54±3.29. There was a significant reverse relationship between the number of donations and the time interval between two donations. The variables of gender, marital status and occupation had a significant effect on the blood donation of the repeated and regular donors. Genders, age at the time of the first donation, marital status and occupation had a significant effect on the intervals between blood donations. Conclusions — Most of blood supply of Iran is provided by men and first-time donors. Since the decision to donate and keep donating blood involves many complex issues applied programs are require to convert women and first-time donors into regular donors.

Analyses of blood donor samples from eight provinces in Lao PDR suggest considerable variation concerning HBV exposure and carriage.

IntroductionHepatitis B is endemic in Lao PDR and about 9% of the adult population is chronically infected. In this study, we investigated regional, occupational, age and sex-related differences in hepatitis B epidemiology in Lao blood donors.Methods5017 voluntary blood donors from 8 different provinces were tested for hepatitis B markers by ELISA. Predictors for the prevalence of hepatitis B surface antigen (HBsAg) and antibodies against the core antigen (anti-HBc) were assessed by bivariate and multivariable analyses.ResultsIn total, 41% of the participants were positive for anti-HBc; the HBsAg prevalence was estimated at 6.9% among all participants (9.2% among first-time donors and 3.9% among repeat donors). Among first-time donors, HBsAg positivity was associated independently with being male (p<0.001), being from the North (p<0.001) and being soldier (p<0.001). Participants were more likely to be anti-HBc positive when they were male (p<0.001), from the Northern provinces (p<0.001) and older than 20 years (p<0.01).ConclusionIn conclusion, our study confirmed an overall high HBsAg and anti-HBc prevalence in Lao PDR, albeit with considerable regional variation. The identification of a sizeable number of HBsAg positives among repeat donors warrants a thorough investigation of current blood screening, record keeping, donor identification and counselling practises.

Utility of reticulocyte haemoglobin content and immature reticulocyte fraction in early diagnosis of latent iron deficiency in whole blood donors.

The present study was planned to assess the clinical utility of reticulocyte haemoglobin content (CHr) and immature reticulocyte fraction (IRF) in the early detection of latent iron deficiency in blood donors. The prospective longitudinal observational study was conducted using the purposive sampling method. Written informed consent was obtained and donors were allocated into the first-time (FTD) and regular donor (RD) group. The enrolled blood donors (n= 205 in each group) were followed up for two subsequent whole blood donations. Haemoglobin (Hb), CHr, IRF and serum ferritin values were recorded at enrolment and two follow-ups. The sensitivity of CHr in detecting iron-deficient erythropoiesis (serum ferritin values ≤ 26 μg/dl) was 45% and 56.7%, specificity 96.7%, positive predictive value (PPV) 85.6% and 90.8% and negative predictive value (NPV) 80.1% and 78.7%, respectively in FTD and RD cohorts. The sensitivity of IRF was 45.1% and 44.8%, specificity 93.4% and 97.1%, PPV 74.8% and 90.4% and NPV 79.6% and 74.5%, respectively in both the cohorts. The sensitivity of CHr in detecting absent iron stores (serum ferritin values ≤ 15 μg/dl) was 66.2% and 74.4%, specificity 92% and 90.6%, PPV 56.7% and 68.7% and NPV 94.5% and 92.8% among FTD and RD cohort, respectively. The sensitivity of IRF was 72.7% and 65.3%, specificity 90.3% and 94.3%, PPV 54.4% and 76% and NPV 95.4% and 90.8%, respectively in both the cohorts. Reticulocyte hemoglobin content and IRF can be used along with complete blood count for early detection of iron deficiency in blood donors using the same blood sample at no extra cost.

Prevalence of Transfusion Transmissible Infections Among Blood Donors in South Khorasan Province, Iran: An 11-Year Study

Background: Transfusion transmissible infections (TTIs) are the most frequent complication of blood transfusions. This fact stresses the need for regular evaluation and monitoring of TTIs in blood donors. Objectives: This study was done to determine the prevalence of the hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis among blood donors at the South Khorasan Transfusion Center (SKBTC) in South Khorasan Province, Iran. This report is the first of its kind that has been performed in this region. Methods: A retrospective study was carried out on 165,267 blood donors at the SKBTC from 2006 to 2016. Data were analyzed on the metrics of donation status, age, gender, educational level, and serologic results for the infectious markers. Statistical analysis was performed using SPSS software (version 16.0). Results: The overall seroprevalence rates of HBV, HCV, and HIV infections per 100,000 donations were 247, 21, and 0.6, respectively. There was no positive donor for syphilis. HBV and HCV infections in first-time donors were present at significantly higher rates than in regular and repeat donors (P &lt; 0.001 and P = 0.003, respectively). Although gender was not found to be significantly associated with HBV and HCV (P = 0.32), there was a significant relationship between younger age (P &lt; 0.001) as well as lower educational level and hepatitis agents (P &lt; 0.001). Moreover, being single evinced a significant association with HCV seropositivity (P = 0.001). Conclusions: This report found a decreased prevalence of TTIs relative to the most of previous reports. This decrease may have resulted from public health programs, improved donor selection, improved recruitment of repeat/regular donors, and the use of highly sensitive kits for the screening procedure.

Effects of repeated blood donation on iron status of blood donors in Zimbabwe: A cross-sectional study.

IntroductionIron deficiency is a major complication of repeated blood donation. However, most of the blood screening methods employed by blood collection agents do not include iron status markers, leading to possible subclinical iron deficiency. The aim of this study was to evaluate the effects of repeated blood donation on the iron status of this vulnerable population in Zimbabwe.MethodsAll donors were categorized into groups based on number of donations made in the previous 2‐year period prior to enrolment into the study. Serum iron, total iron‐binding capacity (TIBC), and ferritin were analyzed on automated chemistry analyzers while transferrin saturation (TSAT) was calculated. The Wilcoxon rank‐sum and ANOVA tests were used to assess the variation of iron profiles by gender and frequency of donations. All data analysis was performed using Stata software v13.ResultsStudy participants included 170 repeat donors and 20 first‐time blood donors. The median (IQR) age was 23 (19‐27) years, while the majority were males 57% (n = 109/190). The overall prevalence of iron deficiency and reduced iron stores was 12.6% and 38.9%, respectively. There were statistically significant differences between males and females in all the iron status parameters (P < .05). TIBC increased with number of donations, while iron, ferritin, and TSAT decreased with increased number of donations.ConclusionA high proportion of blood donors had iron deficiency despite being eligible to donate. Repeated blood donation may lead to substantial reduction in iron stores among blood donors. Inclusion of iron biochemical markers may enhance proper screening and monitoring of blood donors in Zimbabwe to prevent development of iron deficiency anemia.

Risk of HBV infection among male and female first-time blood donors born before and after the July 1986 HBV vaccination program in Taiwan

BackgroundIn July 1984, Taiwan officially began a nationwide hepatitis B virus (HBV) vaccination program where only infants born to HBsAg-positive mothers were vaccinated free of charge until June 1986. However, from July 1986, all infants were vaccinated against HBV. The impact of the July 1986 HBV vaccination program on first-time blood donors has not been exhaustively studied. We, therefore, determined the risk of HBV among male and female first-time blood donors born before and after the July 1986 HBV vaccination program in Taiwan.MethodsInitially, we recruited 857,310 first-time blood donors whose data were collected between 2013 and 2018 from 5 blood donation centers in Taiwan. However, we excluded donors with incomplete and outlying data (n = 12,213) and those born between July 1984 and June 1986 (n = 21,054). The final study participants comprised 9118 HBV positive and 814,925 HBV negative individuals. We divided the participants into two birth cohorts (born before and after July 1986) and assumed that those born before July 1986 were not vaccinated at birth while those born after July 1986 were vaccinated.ResultsThe prevalence of HBV among those born before and after July 1986 was 4.53 and 0.25%, respectively. Individuals born after July 1986 had a lower risk of HBV than those born before July 1986. The adjusted odds ratio (OR), 95% confidence interval (CI) was 0.16, 0.13–0.19. Men had a higher risk of HBV than women (OR = 1.40, 95% CI = 1.34–1.47). The interaction between sex and birth date was significant (p-value = 0.0067). Stratification of participants by birth date revealed a higher risk of HBV in men compared to women in both birth cohorts. The OR, 95% CI was 1.47, 1.40–1.55 for those born before July 1986 but declined to 1.15, 1.02–1.29 for those born after July 1986.ConclusionsThe risk of HBV was lower among those born after than those born before the July 1986 vaccination program. In both cohorts, the risk was high in men relative to women. The seemingly protective effect among those born after July 1986 was higher in women than men.