First-time Donors Research Articles

Effects of Performing Applied Muscle Tension during Recovery after Phlebotomy in Young, First-Time Donors: A Pilot Study.

Vasovagal reaction (VVR) compromises donor safety and reduces the subsequent return rates. Performing applied muscle tension (AMT) during phlebotomy may reduce the incidence of VVR. However, the effectiveness of performing AMT after phlebotomy to reduce delayed VVR remains unclear. With ethics approval, 12 young, first-time donors (YFTD) were recruited to study the effects on stroke volume (SV), cardiac output (CO) and systemic vascular resistance (SVR) while performing AMT from needle insertion to end of recovery. Measurements from 12 matched control YFTD were used for comparison. Pre-donation anxiety and VVR severity were assessed. Compared to controls, donors who performed AMT had higher SV (Control: 57 mL vs. AMT: 69 mL, p = 0.045), higher CO (Control: 3.7 L·min−1 vs. AMT: 5.2 L·min−1, p = 0.006) and lower SVR (Control: 1962 dyn·s·cm−5 vs. AMT: 1569 dyn·s·cm−5, p = 0.032) during mid-phlebotomy. During recovery, the AMT group retained higher SV, higher CO and lower SVR than the control, but not reaching statistical significance. Practicing AMT during recovery resulted in sustained haemodynamic improvements beyond the donation period, despite the reduction in delayed VVR was insignificant compared to the control group. A larger sample size is needed to validate the effectiveness of performing AMT after donation to mitigate delayed VVR.

Burden of Chronic Hepatitis B and C Infections in 2015 and Future Trends in Japan

Background: Determining 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. Methods: NDB 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. Findings: The total number of chronic HBV and HCV infections in 2015 in Japan was 2,001,221–2,487,881 (HCV:890,902–1,302,179, HBV:1,110,319–1,185,702), of which 1,019,695–1,506,355 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 991,388–1,302,438 in 2030, and 796,585–1,044,043 in 2035. Compared to 2015, by 2035, the number of persons with HCV not engaged in care will decline by 59·8 – 74·7% and 86·5% for patients in care. For HBV, a 47·3 – 48·2% decrease is expected for persons not engaged in care and a decline of 26·0% for patients engaged in care. Interpretation: Although the burden of HBV and HCV is expected to decrease by 2035, challenges in controlling hepatitis remain. Improvements in screening and linkage to care for HCV and functional HBV cure are needed. Funding Information: This study was funded in part by the Ministry of Health, Labour and Welfare, Japan, grant number 19HC1001. Declaration of Interests: The authors declare no conflict of interest. Ethics Approval Statement: Data from the NDB were obtained in accordance with the Guidelines for the Provision of Information on Receipt and Specified Health Examination established by the MHLW (approval number MHLW-H-0722-13).Before donating blood, all donors signed an informed consent form stating that their laboratory test results could be used for research purposes. The ethics committee for epidemiological research of Hiroshima University waived the requirement for further consent (approval number E-1082).All study procedures were performed following the applicable regulations and guidelines.

Donation-induced iron depletion is significantly associated with low hemoglobin at subsequent donations.

Blood donation is associated with a loss of hemoglobin (Hb)-bound iron. Hb levels recover relatively fast by using stored iron. However, it takes more time to replenish iron stores, potentially resulting in iron deficiency. Hb and ferritin levels were measured in 5056 new, first-time, and repeat whole blood donors. We investigated whether increasing numbers of donations are associated with lower ferritin levels. Furthermore, we tested whether low ferritin levels are associated with low-Hb deferral at the subsequent donation attempt by performing logistic regression adjusted for age and stratified by sex. Whereas mean Hb levels are relatively stable, ferritin levels significantly decrease with increasing numbers of donations and were approximately 50% lower for donors with >50 donations compared with those with 2-10 donations. Despite the poor correlation of ferritin and Hb levels, cross-sectional, iron-deficient donors (ferritin <15 ng/ml) had 21.8 (8.5-55.6) higher odds in men, 10.1 (6.1-16.5) in premenopausal women, and 11.7 (5.2-26.4) in postmenopausal women for Hb deferral at a subsequent visit. To conclude, repeated donations may induce iron deficiency, which corresponds with an over tenfold increased risk of having insufficiently restored Hb levels at a subsequent donation attempt. Longer donation intervals and/or higher dietary or supplemental iron intake are warranted to prevent accumulated iron depletion and subsequent low-Hb deferral in whole blood donors.

Prevalence of positivity to antibodies to hepatitis C virus among volunteer blood donors in China: a meta-analysis

ObjectivesSafe blood transfusion plays an important role in the prevention of transfusion-transmissible infections, and hepatitis C virus (HCV) infection is one of the major problems associated with this procedure. This meta-analysis aimed to determine the prevalence of HCV infection in Chinese blood donors. Study designThe study design of this study is a meta-analysis. MethodsEligible studies were retrieved from PubMed, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database and Wanfang literature databases from 2010 to 2020. The effect measure was presented as HCV prevalence with a 95% confidence interval (CI). Q test was used to assess the heterogeneity, and the I2 statistics was determined to decide whether a random effects model or a fixed effects model should be used as the pooling method. Subgroup analyses were also conducted. ResultsA total of 62 eligible studies, including 9,007,220 HCV blood donors, were analysed. Of the total blood donors, 35,017 were infected with HCV. The pooled HCV prevalence was 0.415% (95% CI: 0.371–0.458). The subgroup analysis revealed that the prevalence of positivity to anti-HCV antibodies was significantly different in each year (P < 0.05). However, no significant difference was observed in HCV prevalence in terms of sex. Moreover, the prevalence of positivity to anti-HCV was remarkably higher in first-time blood donors than in repeat blood donors (P < 0.05), and the rate of HCV infection among university students was significantly lower than that among soldiers (P < 0.05). ConclusionsThe rate of HCV infection showed a downward trend from 2010 to 2014, increased in 2015–2016, and finally decreased in 2017–2018. Thus, the prevalence of HCV infection has decreased in Chinese blood donors after comprehensive prevention and treatment.

Fear is associated with attrition of first-time whole blood donors: A longitudinal examination of donor confidence and attitude as potential mediators.

Elevated fear and anxiety regarding donation-related stimuli (e.g., needles, pain, blood, fainting) has been associated with reduced blood donor recruitment and retention. The present longitudinal study tests the notion that this inverse relationship may be accounted for by lower donation confidence and more negative donation attitudes among fearful first-time donors. In a sample of 1479 first-time whole blood donors [67.9% female; mean age=19.3 (standard deviation (SD)=2.5) years], path analyses were conducted to examine relationships among donor ratings of fear of blood draw and donation anxiety obtained approximately 1 week after donation, donation confidence and attitudes assessed approximately 6 weeks later, and donation attempts over the 14 months following the original donation. Path analyses indicated that both fear of blood draws and donation anxiety were associated with fewer attempted donations, and that these effects were indirectly mediated by a combination of lower donor confidence and more negative donation attitudes. Because retention of new blood donors is essential to maintain a healthy blood supply, the results of the present study suggest that first-time donors should be assessed for fear and anxiety so that appropriate strategies can be provided to address their concerns, bolster their confidence and attitudes, and ultimately promote their long-term retention.

Comparative analysis of hematological parameters of first-time and repeat blood donors: Experience of a blood bank in southern Nigeria

IntroductionThe safety of a blood transfusion practice is anchored on safe blood from a healthy donor, while further protecting the donor from future harm. This study aimed to evaluate the hematological parameters of blood donors in view of their donor category to aid in assessing the safety threshold in terms of donation frequency. MethodsThis study made use of the descriptive cross-sectional design. The blood donors were bled and their samples analyzed using a hematology autoanalyzer. ResultsA total of 178 male blood donors were recruited. Most of the donors were aged 18 to 39 years and were mostly students. A greater part of them were repeat donors who had donated blood more than four times. First- and second-time donors constituted the majority of the voluntary donors. While the total red cell count was significantly lower in repeat third-time donors, the hemoglobin and hematocrit of the first-time donors were significantly higher than those of the repeat fourth-time donors. The mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) of the first-time donors were significantly higher than those of the repeat fifth-time donors. The red cell distribution width (RDW) and mean platelet volume (MPV) were significantly lower in the first-time donors from those of the sixth- and seventh-time donors, respectively. Most of the fifth-time donors have subclinical anemia. There was more subclinical anemia in commercial donors than in voluntary donors. ConclusionRepeat donors more than fifth-time donors are at risk of donation-induced iron deficiency anemia.

Epidemiological and molecular profile of blood donors infected with HTLV-1/2 in the state of Pará, northern Brazil.

The Human T-lymphotropic virus (HTLV) is a retrovirus of the genus Deltaretrovirus, which belongs to the family Retroviridae. The most important types are HTLV-1 and HTLV-2. It is estimated that between five and 10 million individuals are infected with HTLV-1, worldwide. Studies in the state of Pará indicate that it has the third highest prevalence of HTLV infections of any Brazilian state. The present study describes the epidemiological, serological, and molecular profile of blood donors from the state of Pará that were classified as unfit due to infection by HTLV-1 and 2. The present study is based on a descriptive, retrospective, and cross-sectional review of the epidemiological, serological, and molecular data on blood donations, between January 2015 and December 2019. The data were obtained from the blood bank system and were digitalized to form a database in the Statistical Package for Social Sciences program, version 20. Descriptive statistics were used to determine the absolute and relative frequencies of the qualitative variables. For the quantitative variables, the mean, standard deviation, and minimum and maximum values were calculated. A p < 0.05 significance level was adopted for all analyses. A total of 632 samples were analyzed, of which 496 (78%) had no detectable proviral DNA and 136 (22%) had detectable HTLV. The HTLV-1 was detected in most (78%; 106/136) of these samples, while only 30 (22%) were detected for HTLV-2. The HTLV proviral DNA was detected primarily in females (69.1%), with a mean age of 40years, with the highest frequencies of detection being recorded in single individuals (66.2%), first-time donors (74.3%), and individuals that had graduated high school (44.1%). The molecular confirmation of HTLV showed that three-quarters (78%) of the serologically reactive individuals were negative for either types 1 or 2, so the epidemiological profile of these individuals was significantly different from their detectable profile. The HTLV is neglected in Brazil; there is thus a clear need for further research in the area of regional hemotherapy and hematology services, in order to contribute to the definition of regional infection profiles, that will be fundamental to the development of effective prophylactic practices for the prevention of the infection and the dissemination of knowledge on the dangers of HTLV in the community.

Motivators, barriers and communication channels for blood donation in relation to students at a university in Spain

BackgroundTargeting young people to donate blood is a particularly promising option. The aim of this work was to know the motivators, barriers and preferred communication channels for blood donation among university students, and to determine the factors that explain why donors give blood. Materials and methodsA questionnaire was distributed to 420 students (response rate: 88.3 %) attending the University of Huelva (Spain). Data were gathered on sociodemographic variables, blood donation history, motivators and barriers to donation, and communication channels. Non-parametric contrasts were used to determine possible differences in the sociodemographic characteristics or donation history, and logistic regression to determine the factors associated to donation. Results67.38 % of the students surveyed were non-donors, 12.94 % were first-time donors, 11.05 % were infrequent donors and 8.63 % were frequent donors. “Solidarity” was the main motivator for donating blood (40 %). “Lack of information on where and how to give blood” was the main barrier for non-donors (26.4 %), with “medical reasons” cited by first-time donors (22.2 %). 93.8 % of donors wished to be notified about their next donation appointment. The majority of those surveyed preferred e-mail to receive alerts and information on donation campaigns. The factors that explained blood donation were over 26 years of age and place of residence. ConclusionThe study identified differences in the motivators, barriers and choice of communication channel among the university students in terms of blood donation, and the factors that explain blood donation. This knowledge is a useful source of information when designing blood donation campaigns that target young people.

The frequency of detection of anti-HBc in blood donors from four regions of Russia

Introduction. Occult hepatitis B virus (HBV) revelation in HBV nuclear antigen testing is of particular importance to prevent transfusion infection.Aim — the identification of factors affecting the anti-HBc detection rate in donated transfusable blood components from different regions of Russia.Materials and methods. A cohort screening single-stage epidemiological study was conducted with 2,000 donor blood samples, 500 samples per each of four regions of the country, the Republics of Crimea (Simferopol) and Sakha (Yakutia), the cities of Saransk and Orenburg. Data on 968 blood samples from the National Research Center for Hematology’s donor bank were used as reference. The testing targeted HBV nuclear antigen antibodies. Positive donated blood samples were additionally tested for IgM and virus surface antigen antibodies using Abbott and Vector-Best commercial reagent kits.Results. Donor demographic profiles differed insignificantly across members of the Russian Federation. Males predominated among the donors (69.6 %). Anti-HBc was detected in 219 of 2,000 samples examined (10.9 %). The donor blood sample anti-HBc detection rate ranged from 6.0 to 21.6 %, depending on the region. Anti-HBc-positive proportions in Orenburg, Crimea, Mordovia and Sakha comprised 8.2, 8.0, 6.0 and 21.6 %, respectively (p &lt; 0.01). First-time donors had anti-HBc in 8.06, regular donors — in 11.29 % cases. The anti-HBc detection rate varied with donor’s age, being zero or near 1 % in 20-yo or younger people. Acute HBV antibodies had zero rate in Orenburg at zero or low-titre (&lt; 100 mIU/mL) protective antibodies; 31 total samples, 15 low-titre and 16 negative for protective antibodies. In Simferopol, acute phase antibodies were negative in 7 blood samples containing high-titre protective antibodies (&gt; 100 mIU/mL) and in 5.0 % samples with their low or zero levels. In Yakutian donors, acute phase antibodies were revealed only at protective antibodies negative. In Saransk, this marker was equal-proportion at zero and high-titre protective antibodies (3.3 % each).Conclusion. Transfusion component procurement from younger donors should be prioritised as enhancing haemotransfusion viral safety. Positive occult HBV tests were less common in regions with low HBV incidence.

Vasovagal syncope after blood donation in active duty military personnel of the Spanish Army

All studies of vasovagal syncope (VVS) after blood donation have been performed with civilian donors. We hypothesized that military donors have a lower incidence of VVS and a particular set of predisposing factors. Retrospective case-control study matching every case of VVS seen from 2011 to 2019 with two controls without VVS from the same blood drive. We used the odds ratio (OR) and its 95% confidence interval (CI), estimated by multivariate logistic regression, to identify independent predictors of VVS. There were 105 episodes of VVS among 65.481 whole blood donations (0.15%). VVS was more frequent among donors from military academies than from other military units (0.37% vs. 0.10%, p< .001) and in collections conducted in mobile inside setups than in mobile buses (0.23% vs. 0.06%, p< .001). In the multivariate analysis, the only independent predictors of VVS were the status of first-time donor (OR 2.6, 95% CI 1.5-4.4; p< .001) and pre-donation systolic blood pressure (SBP) < 120 mm Hg (OR 1.9, 95% CI 1.1-3.3; p= .01). Donors with both risk factors had a 5.5-fold increased risk of VVS than donors without any risk factor. Age and female sex were not predictive of VVS. Active duty military blood donors have a lower incidence of VVS than that reported in civilian donors. First-time donors and donors with SBP < 120 mm Hg should be temporarily deferred when immediate reincorporation to hazardous or strenuous duty tasks after donation is inescapable.

An intervention study for the prevention of vasovagal reactions and evaluating donors' experience: Analysis of donors' return for subsequent donation.

The EPISoDe (Experience Success in Donation) study investigated the effect of interventions on self-reported vasovagal reactions (VVRs) in first-time and novice (second to fourth donation) whole blood donors aged ≤30 years, demonstrating a 23% reduction of VVR from water drinking shortly before donation in the novice donors. Because donation experience and complications affect donor retention, we analysed intervention group donors' return for subsequent donation, a predefined secondary outcome. The interventions were as follows: 330 ml water, 500 ml water, ball squeezing before phlebotomy (placebo) and a control group. All donors received an online questionnaire about their experience within a week after donation. In the Netherlands, eligible donors are invited at least yearly depending on hospitals' needs. We analysed attendances within 421 days through return percentages and binomial logistic regression. Of the 8300 EPISoDe participants, 6538 (78.8%) returned within 421 days. Return did not differ between the two water groups, whereas odds for return were significantly higher in both water and placebo intervention donors compared to the control group (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.00-1.29 and 1.22, 1.05-1.43, respectively) after adjustment for occurrence of VVR, unsuccessful collection, gender and donation history. Staff-recorded or self-reported VVR at index donation was associated with reduced odds for return (OR 0.47, 95% CI 0.37-0.60 and OR 0.53, 95% CI 0.46-0.61, respectively). In this cohort of younger inexperienced blood donors, 78.8% returned for subsequent donation. Donors who received an active study intervention, either water or placebo, were more likely to return than control group donors.

Plasmavigilance-Adverse events among US Source plasma donors.

BackgroundSource plasma (SP) is the primary starting material for 87% of plasma‐derived medicinal products globally. Plasmavigilance is a program designed to collect, analyze, and monitor donor adverse events (AEs) across the SP collection industry. Donor retention depends on donors having a safe and satisfactory experience. This study analyzes AE rates and SP donor characteristics that may be predictors of an AE.Study Design and MethodsDonation data for 1.1 million donors making 12,183,182 SP donations over a 4‐month period were analyzed. This represented approximately 72% of the donations collected by the U.S. plasma industry. The Standard for Recording Donor Adverse Events was used for AE definitions and classifications.ResultsThe overall AE rate was 15.85/104 donations. The two AEs with the highest rates were Hypotensive and Phlebotomy events (8.32 and 5.91/104 donations, respectively). Females had higher overall AE rates than males (25.76 vs. 9.85/104 donations), and first‐time donors had higher overall AE rates than repeat donors (136.66 vs. 12.37/104 donations). Weight, body mass index, age, and pre‐donation estimated blood volume also were predictors of AE.DiscussionSP donors have low AE rates with 90% being events classified as Hypotensive or Phlebotomy. Special attention and mitigation strategies should be directed to donors who are young, lightweight (between 100 and 124 pounds), female, or first‐time donors to further reduce the incidence of AE, continue to ensure the donor has a safe experience, and facilitate donor retention.

Results from the blood donor competence, autonomy, and relatedness enhancement (blood donor CARE) randomized trial.

This study aimed to promote competence, autonomy, and relatedness among first-time whole blood donors to enhance intrinsic motivation and increase retention. Using a full factorial design, first-time donors (N=2002) were randomly assigned to a no-treatment control condition or to one of seven intervention conditions designed to promote donation competence, autonomy, relatedness, a combination of two (e.g., competence and autonomy), or all three constructs. Participants completed donor motivation measures before the intervention and 6 weeks later, and subsequent donation attempts were assessed for 1 year. There was no significant group difference in the frequency of donation attempts or in the number of days to return. Significant effects of group were observed for 10 of the 12 motivation measures, although follow-up analyses revealed significant differences from the control group were restricted to interventions that included an autonomy component. Path analyses confirmed direct associations between interventions involving autonomy and donor motivation, and indirect mediation of donation attempts via stronger donation intentions and lower donation anxiety. Among young, first-time, whole blood donors, brief interventions that include support for donor autonomy were associated with direct effects on donor motivation and indirect, but small, effects on subsequent donation behavior.

Undisclosed HIV status and antiretroviral therapy use among South African blood donors.

Undisclosed antiretroviral drug (ARV) use among blood donors who tested HIV antibody positive, but RNA negative, was previously described by our group. Undisclosed ARV use represents a risk to blood transfusion safety. We assessed the prevalence of and associations with undisclosed ARV use among HIV-positive donors who donated during 2017. South African National Blood Service (SANBS) blood donors are screened by self-administered questionnaire, semi-structured interview, and individual donation nucleic acid amplification testing for HIV. Stored samples from HIV-positive donations were tested for ARV and characterized as recent/longstanding using lag avidity testing. Of the 1462 HIV-positive donations in 2017, 1250 had plasma availability for testing of which 122 (9.8%) tested positive for ARV. Undisclosed ARV use did not differ by gender (p= .205) or ethnicity (p= .505) but did differ by age category (p< .0001), donor (p< .0001), clinic type (p= .012), home province (p= .01), and recency (p< .0001). Multivariable logistic regression found older age (adjusted odds ratio [aOR] 3.73, 95% confidence interval [CI] 1.98-7.04 for donors >40 compared with those <21), first-time donation (aOR 5.24; 95% CI 2.48-11.11), and donation in a high HIV-prevalence province (aOR 9.10; 95% CI 2.70-30.72) compared with Northern Rural provinces to be independently associated with undisclosed ARV use. Almost 1 in 10 HIV-positive blood donors neglected to disclose their HIV status and ARV use. Demographic characteristics of donors with undisclosed ARV use differed from those noted in other study. Underlying motivations for nondisclosure among blood donors remain unclear and may differ from those in other populations with significant undisclosed ARV use.

Adverse reactions to the Donation of Platelet by Apheresis and Related Factors in a Tertiary Level Care Blood Center

Background and Objectives: Although blood donation by apheresis is very safe, it is essential to identify the adverse reactions that happen and address the factors related to it so as to improve the donation experience both to the donors and the center accepting donations. This study was designed to assess the frequency of adverse reaction in donors undergoing apheresis for platelet donation and delineate the factors associated with the occurrence of such adverse donor reactions, if any. Methodology: This was an analytical retrospective study on the available data of all the donors who donated single-donor apheretic platelets in our blood center from January 2014 to October 2018. Results: The overall donor reaction rate was 8.3%, with the majority (4.7%) being a local reaction in the form of a hematoma. The other 3.6% were systemic reactions, among which 2.1% were citrate reactions and 1.5% vasovagal reactions (VVRs). The variables associated with a VVR were body weight &lt;75 kg and diastolic blood pressure of &lt;70 mmHg, whereas for citrate-related toxicities, it was the duration of the procedure and the amount of anticoagulant used. 4.7% of them were localized reactions in the form of the hematoma, which were more common in first-time donors. Conclusion: Adverse donor reactions to plateletpheresis are notable (8.3%) but generally mild. Auditing them to look for factors associated helps us review the policies and improve competencies among the staff to improve the safety of donors.

Stop Frightening and Start Donating

Background and Objectives: One of the observed fears that keep people hesitant to donate blood is anemia. We conducted this study to investigate the hemoglobin (Hb) level post donation in first-time donors and compared it with healthy nondonor group. Methods: An analytical cross-sectional study was conducted from February 2018 to December 2018 after approval from the institutional ethics committee. There were two study groups: Group 1 which included donors who donated blood as per the National Blood Donor Policy. Group 2 comprised gender matched healthy participants. Laboratory investigations included complete blood counts. Informed consent was taken from participants of both the groups. Anemia was defined as Hb of &lt;14 g/dl in males and &lt;12 g/dl in females. SPSS version 23.0 was used for inferential statistics. Results: A total of 928 donations were included, with 9 (1%) females and 919 (99%) males. Out of 919 male donors, 601 (65%) were donating blood for the first time. Out of 601 first-time donors, 175 (29%) participants were recruited for analysis. An equal number of gender-matched healthy nondonor participants were included in the analysis. The age range was 18–55 years in both the groups. Independent t-test was applied, and the mean difference in Hb level in both the groups was found statistically nonsignificant (P = 0.713). Conclusion: Our study revealed a similar mean Hb level in both the groups. Some other factors we encountered were scarcity of voluntary and female participation in blood donation.

Prevalence and risk factors of Hepatitis B virus infection among blood donors in Gabonese National Blood Transfusion Center: A cross-sectional and analytic study

Hepatitis B virus (HBV) infection is prevalent in Gabon and poses a potential risk of transmission by blood transfusion. However, few studies have examined epidemiological data regarding HBV infection of Gabonese blood donors. This article reports on research conducted to estimate the seroprevalence of HBV and associated risk factors in the urban population of Gabon. A cross-sectional and analytic study survey of blood donors attending at the Gabonese National Blood Transfusion Center, was carried out between June and August 2020. The ELISA technique (Evolis®, BioRad) and the chemiluminescence technique (Cobas® e601, Roche) had been used for the detection of hepatitis B surface antigens in the plasma of donors. Repeatedly reactive hepatitis B surface antigen levels among first-time and repeat donors were used to assess prevalence and risk factors using multivariable logistic regression. Results revealed that a total of 3665 donations were collected at the Gabonese National Blood Transfusion Center, of which 100 were con?rmed HBV positive. The seroprevalence of HBsAg among total blood donors was 5.5% (95% confidence interval [CI] = 4.4 - 6.7) indicating a moderate burden. In our multivariate analysis controlling for age, HBsAg positivity was associated with first-time donor status (aOR = 6.5) and residence outside of Libreville (aOR = 1). The prevalence of HBsAg among Gabonese blood donors is at a moderate-level endemicity among first-time donors, indicating the need to further limit the burden. In this Gabonese context, status of first-time blood donor and living in rural settings are primary risk factors of HBV-infection, and henceforth considered as exclusionary criteria for blood donation in Gabon. Key words: Hepatitis B, prevalence, risk factors, blood donor

An assessment of hepatitis B virus prevalence in South African young blood donors born after the implementation of the infant hepatitis B virus immunization program: Implications for transfusion safety.

The prevalence of hepatitis B surface antigen is estimated to be 6.7% in the South African population and in April 1995 the nation introduced universal hepatitis B virus (HBV) vaccination for newborns and infants. We studied the temporal association of this program with HBV prevalence in young blood donors and the contemporary HBV incidence and residual risk of transfusion-transmitted HBV infection (TT-HBV). We used blood donation data from January 2011 to December 2019. Estimation of HBV prevalence donations made by first-time blood donors were analyzed by birth cohort and covariates. To estimate the incidence and residual risk of TT-HBV, mathematical models used data from both first time and repeat donors. HBV prevalence in first-time donors decreased from 0.84% (95% confidence interval [CI] 0.78-0.90) in 2011 to 0.66% (95% CI 0.61-0.70) in 2019. The post-1995 birth cohort had a significantly lower HBV prevalence of 0.14% (95% CI 0.13-0.15) than the pre-1985 birth cohort of 1.29% (95% CI 1.25-1.33) and the odds of HBV infection were reduced in a multivariable model (odds ratio [OR]=0.28, 95% CI 0.24-0.34). The residual risk of TT-HBV occurring from window-period, occult, and possible vaccine breakthrough infections were estimated at 36.9, 5.8, and 2.2 per million red blood cell transfusions, respectively. Donors born after the start of routine HBV immunization had significantly lower prevalence of HBV infection, supporting the effectiveness of the vaccination program. The contemporary residual risk of TT-HBV has decreased and should decline further as more vaccinated young people join the donor pool.

Characteristics and causes of pre-donation deferrals at a Chinese blood center

ObjectivesThe purpose of this retrospective analysis was to understand the causes and characteristics of the pre-donation deferral, so as to enhance blood safety and improve donor satisfaction. BackgroundBlood transfusion is crucial in managing a variety of different medical and surgical needs. Its benefits are manifold but there are risks for the recipients. Thus some blood donors are deferred from donating when they do not meet certain criteria. An in-depth understanding of the underlying causes of donor deferral will not only improve donor selection but also ensure blood safety and avoid donor complaints. Materials and methodsThis single-center experience was carried out from 26th July 2018 to 25th July 2019 on all whole blood donors in Tianjin, China. Donors’ demographics and information were retrieved; comparisons between deferral data were summarized by the Chi-square test using Statistical Product and Service Solutions (SPSS) application version 22. The difference between groups were considered statistically significant when p < 0.05. ResultsA total of 190,846 participants were included; whereby 119,951 (62.85 %) of participants were first-time blood donors. The pre-donation deferral rate was 9.26 %, and deferral was more likely seen in first-time donors, male donors, and donors of age above 35 years (p < 0.05). Overall, raised alanine aminotransferase (ALT) contributed to 48.46 % of all temporary deferrals, followed by lipaemia (20.71 %). For female donors, low hemoglobin was the leading cause of temporary deferral. Positive hepatitis B surface antigen (Hepatitis B) and syphilis were the two common causes of permanent deferrals, with incidence at 11.65 % and 3.93 %, respectively. ConclusionPre-donation deferral remains a significant problem in China and accounted for 9.26 % of participants in this study. Raised ALT and lipaemia were common temporary deferrals, especially among first-time donors, males, and older donors. Appropriate interventions should be taken to address the blood quality, improve the donor retention strategies in order to secure an adequate and safe blood supply.

Hepatitis B virus prevalence in first-time blood donors in Flanders, Belgium: Impact of universal vaccination and migration.

Transfusion-transmissible infections such as hepatitis B virus (HBV) remain a major concern for the safety of blood transfusion. This cross-sectional study aimed to assess the trend of HBV prevalence and associated risk factors among a first-time donor population in a low endemic country. Between 2010 and 2018, blood samples were collected from first-time donors presented at donor collection sites of Belgian Red Cross-Flanders. They were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibodies (anti-HBc), and HBV DNA, HIV and hepatitis virus C (HCV) antibodies and RNA, and syphilis antibodies. A total of 211,331 first-time blood donors (43.7% males, median age 25 years) were analyzed. HBsAg prevalence decreased from 0.06% in 2010 to 0.05% in 2018 (p= .004) and this declining trend was accompanied by an increased number of donors in the HBV vaccinated birth cohort (p< .001). HBsAg prevalence was 0.33% in foreign-born donors and 0.02% in Belgian natives (p< .001). Multivariate risk profiling showed that anti-HBc positivity was significantly associated with mainly foreign-born donors (odds ratio [OR]=9.24) but also with older age (OR=1.06), male gender (OR=1.32), year of blood donation (OR=0.94), and co-infections with HCV (OR=4.31) or syphilis (OR=4.91). The decreasing trend in HBV prevalence could mainly be explained by the introduction of the universal HBV vaccination. Being born in endemic areas was the most important predictor for HBV infection while the co-infections with syphilis suggest unreported sexual risk contacts.