National Blood Transfusion Service Research Articles

Transfusion in hemoglobinopathies and red blood cell alloimmunization: data from Sicily, Sardinia and Malta.

Hemoglobinopathies are a group of diseases that include those due to globin gene mutations, such as thalassemia major (TM) and thalassemia intermedia (TI) or due to alteration of hemoglobin structure such as sickle cell disease (SCD), as well as a combination of these conditions such as thalasso-drepanocytosis (TD). They constitute the most frequent hereditary anemias requiring blood transfusion. In April 2022, a questionnaire was sent to the Transfusion Services (TS) of Sicily, Sardinia and the Maltese National Blood Transfusion (MNBT) service. The questionnaire was divided into a generic part including the number of patients followed and the type of hemoglobinopathy, and a section relating to transfusion therapy, including the number of units transfused, whether red blood cells (RBC) were washed and, finally, a section relating to the presence or absence of alloantibodies and their identification. Data was retrieved for 2,574 patients: 68.6% TM, 15.4% TI, 10.3% TD, 4.1% SCD, and 1.6% other hemoglobinopathies (OHA). The number of RBC units transfused was 76,974, equivalent to 24.5% of all the RBCU transfused from the total number of patients followed. The number of washed RBCU was 21.1% of all the units used; 337 patients (37%) were diagnosed with alloantibodies, the majority of which were patients with SCD (20.6%). Of the 485 alloantibodies found, 90.3% were identified. The antibodies found most frequently were related to the Kell system (41.7%) followed by antibodies to the Rhesus system (37.9%); 29.7% of patients had more than one antibody. From our study, certain indications can be formulated: complete the National Registry for patients with hemoglobinopathies; create a Registry of alloimmunized patients to ensure transfusion therapy is as safe as possible, considering antibody evanescence; and 3) increase the recruitment of blood donors of diverse ethnicities.

Analysis of Blood Donor Deferral Pattern during COVID-19 Pandemic at a Tertiary Care Hospital-based Blood Centre, Jammu and Kashmir, India: A Cross-sectional Study

Introduction: Blood donor deferral is vital for ensuring safe blood transfusion. However, with the unfolding Coronavirus Disease-2019 (COVID-19) pandemic, significant changes were made in donor screening and blood donation criteria, resulting in a shift in the pattern of donor deferrals. Aim: To estimate the blood donor deferral patterns during the COVID-19 pandemic. Materials and Methods: A retrospective cross-sectional study was conducted in the Department of Transfusion Medicine at SMHS Hospital/GMC Srinagar, Jammu and Kashmir, India. The study spanned two years, from March 2020 to February 2022. All blood donors were screened in accordance with the Ministry of Health and Family Welfare (MOHFW), National Acquired Immune Deficiency Syndrome (AIDS) control organisation (National blood transfusion services) 2017 guidelines. The data was analysed in Microsoft Excel, considering factors such as age, gender, type of deferral, and reasons for deferral. Results: Deferred blood donors were most common in the age group of 18-33 years. During the study period, a total of 19,895 blood donors (19493 males and 402 females) were registered for blood donation. Out of these, 3441 donors (17.30%) were deferred, with a male donor deferral rate of 3258/19493 (16.71%) and a female donor deferral rate of 183/402 (45.52%). Temporary blood donor deferrals accounted for 3272 (95.09%) cases, while permanent deferrals were 169 (4.91%). The most common cause of deferral was low haemoglobin, accounting for 991/3441 (28.80%) cases, followed by deferrals due to reasons attributable to the COVID-19 pandemic (786/3441, 22.84%) and hypertension (653/3441, 18.98%). Conclusion: The study observed a substantial increase in the total donor deferral rate, as well as a change in the donor deferral pattern during the COVID-19 pandemic.

Blood Transfusion Service Challenges and Patterns at Kampala International University Teaching Hospital, Ishaka-Bushenyi, Western Uganda: Insights from a Comprehensive Prospective Study

Uganda, a developing East African nation with nearly 20% of its populace living below the poverty line, faces significant constraints in its national blood transfusion service. Despite serving over 3 million individuals in Regional Referral Hospitals, a chronic scarcity of blood persists, impacting critical healthcare provisions, notably at Mulago, Uganda’s National Referral Hospital. This study conducted a meticulous assessment of the indications and influential factors shaping blood transfusion services at Kampala International University Teaching Hospital, Ishaka-Bushenyi, adopting a prospective descriptive cross-sectional design encompassing a 100% review of the target patient population receiving blood transfusions. Employing a pretested questionnaire as the data collection instrument, the gathered information underwent meticulous coding, sorting, entry, and analysis utilizing statistical software. Results were systematically presented through tables and charts. The findings revealed that a considerable proportion (42.3%) of transfused individuals fell within the age range of 20-39 years, with infants and young children (<5 years) comprising 22.4% of the recipients. Males accounted for 58.7% of the transfused population. Predominant indications for blood transfusions included anemia (30.4%), obstetric and gynecological conditions (23.4%), surgical operations (19.0%), infections (14.2%), and incidents involving road traffic accidents or assault (13.0%). The study identified the availability of a blood storage facility as a significant factor motivating the utilization of blood transfusion services, with an 87.4% availability rate reported. Notably, the demand for transfusions was notably high among females (56.1%) compared to males (43.9%), with anemia (53.3%) and blood group O (48.6%) constituting the majority of cases. Blood group distributions varied across different indications, with group O being predominant in most categories. Additionally, the Rh factor played a role, with Rh+ constituting 90.5% of cases and Rh- comprising 9.5%. Blood Group O had the highest occurrence of Rh+, while Blood Group A had the highest occurrence of Rh-. In summary, the study outlined several prominent factors influencing blood transfusion indications at KIUTH, notably anemia, obstetric and gynecological conditions such as postpartum hemorrhage and cesarean sections, surgical procedures (e.g., abdominal obstructions), infections (e.g., malaria), and incidents involving road traffic accidents or assault. These indicators are influenced by factors such as blood availability, age, gender, medical conditions, and blood type, with Blood Group O Rh+ being the most prevalent. Keywords: Blood transfusion, Gynaecology, Anaemia, Blood Group O.

Evaluation of the Performance of Copper Sulphate and Hemocue Methods for Haemoglobin Estimation Among Blood Donors in Dar Es Salaam, Tanzania

Background: The National Blood Transfusion Service (NBTS) in Tanzania uses the Copper Sulphate (CuSO4) gravimetric method to estimate hemoglobin (Hb) in blood donors. However, this and other point-of-care methods, including HemoCue, may provide false results. Therefore, this study aimed to evaluate the performance of CuSO4 and HemoCue methods for Hb estimation compared with automated haematology analyzer (AHA). Methods: The cross-sectional study was conducted among (N=204) blood donors in Dar es Salaam. Capillary blood samples were obtained for Hb estimation by CuSO4 and HemoCue methods, 3 mls of venous blood were also collected for Hb quantification by AHA (gold standard), HemoCue and CuSO4 gravimetric method. Data were analyzed by Epi info 7.2.2.6, statistical significance was defined at a P value of <0.05, and kappa agreement was calculated. Results: The median age of the study participants was 30 years (IQR: 20-39). The proportion of false eligible donors was 19.6%, and false deferral donors were 2.9% by the CuSO4 gravimetric method. The specificity, sensitivity, positive and negative predictive values, and Kappa agreement for CuSO4 were 28.6%, 95.9%, 78.0%, 72.7%, and 0.1, respectively. In contrast, the specificity, sensitivity, positive and negative predictive values, and Kappa agreement for HemoCue were 62.5%, 98.6%, 87.4%, 94.6%, and 0.63, respectively. Conclusion: Our study revealed that the performance of the CuSO4 gravimetric method in Tanzania is relatively poor, with a high proportion of false eligible donors than the HemoCue method. These findings warrant further studies to evaluate the quality control measures for CuSO4 gravimetric method and explore alternative point-of-care methods for Hb estimation among blood donors in similar resource limited-settings.

Haemovigilance: Giving it our best SHOT!

In 2022, the United Kingdom's Serious Hazards of Transfusion (SHOT) programme celebrated its 25th anniversary [1]. SHOT is not the first haemovigilance system internationally (the first national programme was established in Japan in 1993), but it is one of the best known and most influential. In this Commentary, we summarize some of SHOT's achievements and consider what we can all learn from their experience and findings that will help us into the future. Different definitions of haemovigilance exist, but all capture its broad scope (incorporating blood donor, product and transfusion recipient issues), its centrality to quality management and the importance of the systematic collection, analysis and reporting of robust data to improve blood systems, clinical practice and donor and patient outcomes [2, 3]. Haemovigilance itself has evolved from an initial focus on transfusion-transmitted infections (particularly HIV and hepatitis), which was the impetus for establishment of haemovigilance programmes in many parts of the world, to a much broader approach, as health systems have evolved over recent decades, and in response to lessons learned from haemovigilance itself. Haemovigilance links closely with national blood policy development, with patient blood management and with changes in blood product manufacturing. It also serves as a foundation for research efforts by identifying areas of unmet need and as a mechanism to measure the effects of changes as they are introduced [4]. Many gaps and challenges still exist. For example, evidence-based or consensus definitions for some important complications of donation or transfusion are still lacking or do not align well with the clinical picture—such as for some post-transfusion cardiopulmonary reactions. Frequently, data are incomplete or denominators unavailable, limiting analysis and comparison over time and between systems. Most haemovigilance systems struggle with availability of sufficient resources (people, tools and systems) to do their work effectively. Recommendations are often not taken up into policy or implemented into practice. In this context, it is worth briefly examining some of SHOT's achievements, and what we can all learn, from SHOT's experience. Firstly, let us consider some key elements of governance and structure. SHOT's professional independence enables it to conduct its activities and provide its reports freely and impartially. There is a demonstrated commitment to openness, transparency and reporting of findings, while not identifying or blaming individuals or organizations. Participation is high (see below) and is now professionally mandated. SHOT is affiliated to the UK Royal College of Pathologists (RCPath) and has established links with the UK Health Security Agency Epidemiology Unit (for transfusion-transmitted infection reporting and analysis) and the Medicines and Healthcare products Regulatory Agency (regarding product-focused safety issues). SHOT is managed by a small multidisciplinary team and supported by a wider expert group (see below). There are clear operational and reporting lines, and the programme has recruited (and retained) staff with relevant experience, including from both hospital and blood centre backgrounds and with data management expertise. Sustained funding from the four UK blood services (National Health Service Blood and Transplant [NHSBT, England], Northern Ireland Blood Transfusion Service, Scottish National Blood Transfusion Service and the Welsh Blood Service) has been secured. Some administrative functions are handled by NHSBT, permitting the SHOT team to focus on core activities. One of SHOT's strengths is the close collaboration with, and broad input from, across the professional spectrum (biomedical scientists, nurses, clinicians who prescribe transfusions, representatives of specialist colleges and societies) along with the UK blood services, clinical and laboratory transfusion experts, regulators and health safety experts. Very importantly, lay members, representing the voices of the broader community, have a seat at this table as members of the SHOT Steering Group. Founding members and former directors contribute corporate memory and ongoing advice in honorary roles. SHOT's Working Expert Group provides specialist input to targeted analyses, such as events affecting specific patient groups (e.g., paediatrics or patients with haemoglobin disorders) or settings (such as the emergency department) or specific blood products (such as the use of RhD immunoglobulin in pregnancy). They also serve as liaison with their specialties to provide input and disseminate messages from SHOT. Next, let us consider some of SHOT's activities and outputs. From 169 reports in 1996, more than 4000 cases were reported in 2021 from across the United Kingdom, both from the public (all NHS Trusts/Health Boards submitted at least one report) and private (non-NHS) sectors. Although participation has been very high for years, and is now professionally mandated, this is the first time that complete 100% national participation has been documented [1]. This is important because it gives confidence that SHOT's findings are truly representative of a national picture and that participation is valued and recognized as contributing to practice improvement. As is clear from its name, SHOT analyses reports of serious hazards of transfusion. There are different schools of thought on the ideal scope of haemovigilance reporting, with some systems including all cases of all severity, aiming to ensure a comprehensive picture of all adverse reactions and incidents. This can certainly be helpful in understanding the breadth and scale of potential clinical and procedural complications, as well as ensuring that cases that otherwise might have been missed are not. Many of the contributing factors are similar too, of course, whether serious or minor in consequence; however, this approach also creates a huge workload of cases for investigation that can distract from other, more clinically relevant events, which are SHOT's priorities. ‘Near-miss’ events are also an opportunity to learn, as many of the same factors contribute to these cases as those that result in patient harm; near misses are reportable to SHOT and account for a substantial proportion of cases. Transfusion is a complex process with many steps and interdependencies [1, 5]. SHOT has documented and analysed how human errors and inadequate systems can contribute to both near-miss events and actual incidents, with consequences ranging from no harm to fatal outcomes for patients, and major impact (psychologically and professionally) on staff and other participants. The importance of a safety culture, and a learning culture, to identify and address hazards, is emphasized. SHOT promotes a combined Safety-I and Safety-II approach and recently introduced SHOT-ACE: Acknowledging Continuing Excellence in Transfusion. Recognizing errors and identifying improvement actions to prevent recurrence is the primary focus when incidents are investigated, typical of a Safety-I approach. Safety-II, a more proactive approach, seeks to understand the ability of healthcare staff to adapt to problems and pressures, and considers organizational resilience. It focuses on productivity and ensuring the best possible outcomes. Combining Safety-I and Safety-II approaches helps provide a more holistic understanding of the underlying reasons for errors and procedural violations. Reporting and studying success augment learning, enhance patient outcomes and experience through quality improvement work, and positively impact workplace resilience and culture. The Annual SHOT Report is essential reading for those interested in haemovigilance and the ‘gold standard’ for haemovigilance reports internationally [1]. The effort necessary to compile, analyse, draft, edit and present the annual report—245 pages in 2021—cannot be underestimated, but neither can the value of this rigorous and up-to-date document, written for a broad readership and with concrete recommendations for action to stakeholders. A series of chapters presents analyses of incidents from the past year and relevant cumulative data. De-identified clinical vignettes engage the reader and are highly useful for teaching purposes. Donor haemovigilance data are provided by UK blood service representatives. Sections focus on high-risk areas for attention or topics of interest, and recommendations are framed in a clear, positive and practical way, indicating parties responsible for action. Annual SHOT symposia are open to all interested parties and supported by multiple professional organizations. Some have been collaborations with the International Haemovigilance Network, and for these, International Society of Blood Transfusion (ISBT) has provided ISBT Academy support to enable participants from low- and middle-income countries to attend, resulting in even greater international engagement. The symposia have an educational focus and include reviews of SHOT data and key themes from the annual reports, along with guest speakers and discussions. A communications expert participates in the meeting and distils important points into visual and written messages for wide distribution. SHOT regularly contributes to educational and professional activities, including through regional transfusion committee meetings, RCPath and other collaborative events, and peer-reviewed publications. SHOT's comprehensive website and social media presence help raise awareness of activities and findings. SHOT contributed to the ISBT-World Health Organization project to curate haemovigilance tools and resources and make these readily available to facilitate strengthening haemovigilance activities worldwide. These will be continuously updated and expanded to provide a comprehensive library of resources [2]. So, in summary, important messages from SHOT's 25-year experience are about being inclusive, collaborative and open to sharing resources and findings, with a focus on learning and practice improvement. It is also clear that haemovigilance takes time: SHOT is still making many of the same recommendations it has been making since the initial report in 1996, and many problems that prompted the establishment of haemovigilance programmes are still with us. However, much progress has been made in both understanding and improving transfusion safety, and SHOT has been a major contributor to this effort, across the United Kingdom and around the world. Congratulations to SHOT on this important anniversary—and to everyone working in haemovigilance internationally. This work is vital and must continue. The authors acknowledge Dr Shruthi Narayan, Serious Hazards of Transfusion Medical Director, for helpful discussions. E.M.W. wrote the first draft of the manuscript. All authors reviewed and edited the manuscript. Open access publishing facilitated by Monash University, as part of the Wiley - Monash University agreement via the Council of Australian University Librarians. The authors received no specific funding for this work. No conflict of interest is identified by the authors. Data sharing is not applicable to this article as no new data were created or analysed in this study.

Identification and Characterization of Hepatitis B Virus Immune Escape Mutants in Kenya

Hepatitis B Virus (HBV) infections affect about 400 million people globally and cause about 1.4 million deaths annually. The virus displays high levels of genetic variations/mutations, some of which are immune escape mutants. The prevalence of HBV infection in Kenya is high at about 8%. This study aimed at identifying and characterizing HBV immune escape mutants in Kenya. From 547 HBV sequences available in Kenya in NCBI, and HBVdb databases in July 2021, 120 full sequences were retrieved. The S gene sequences at position 1-225, which included the “a” determinant region of the gene were analyzed using various bioinformatics tools such as Bioedit software, and Emboss Cons. The clinical significance was flagged from the search of peer-reviewed journals. Forty-six HBV-positive blood donor samples were obtained from the Kenya National Blood Transfusion Services without personal identifiers, DNA extracted, and sequenced targeting positions 1 to 520 of S genes. Mutations were similarly identified from seventeen sequences after cleaning and analysis. Out of 120 sequences that were extracted from databases and analyzed, 79 different mutations were identified. Fifteen of them were of clinical importance with an occurrence frequency of at least 5% were obtained. The majority (64.6%, n = 51), with S207N and A194V being most dominant, could result in immune escape and reduced HBsAg detection signals while 24.1% (n = 19) could result in immune escape/reduced HBsAg detection signals and high probability of hepatocellular carcinoma. Most likely to occur on the amino acids Alanine, Lysine, Serine, Asparagine, and Valine in decreasing order. The most dominant genotype was found to be Genotype A (N = 10), while four sequences were Genotype D. In contrast to the in-silico studies, the sequences from HBV samples from blood donors did not demonstrate the presence of S207N and A194V mutations and all the genotypes were type A1. Only two (13.3%) samples showed the same mutations of sK122R and sT143S for both in-silico analysis and actual sequenced samples. This study did not identify G145R mutation which is the commonest mutation within the HBsAg immunodominant “a” determinant that is associated with immune escape. The concordance of mutations in “a” determinant region of HBsAg gene among various studies is minimal. The study identified new mutations (sA194Y, sS207, sA194S, sS207I, sP46A, sA194T, sS207I, sP46R, and sT143P) that had not been published before. Four (20%) of the mutations were clinically significant. These included sS207R, sT143S, sC76F and sK122R.

Analysis of blood collection of national blood transfusion service, Sri Lanka: A time series analysis

Analysis of blood collection of national blood transfusion service, Sri Lanka: A time series analysis

A nationwide study of blood transfusion in hip fracture patients : linked analysis from the Scottish Hip Fracture Audit and the Scottish National Blood Transfusion Service.

The aim of this study was to examine perioperative blood transfusion practice, and associations with clinical outcomes, in a national cohort of hip fracture patients. A retrospective cohort study was undertaken using linked data from the Scottish Hip Fracture Audit and the Scottish National Blood Transfusion Service between May 2016 and December 2020. All patients aged ≥ 50 years admitted to a Scottish hospital with a hip fracture were included. Assessment of the factors independently associated with red blood cell transfusion (RBCT) during admission was performed, alongside determination of the association between RBCT and hip fracture outcomes. A total of 23,266 individual patient records from 18 hospitals were included. The overall rate of blood transfusion during admission was 28.7% (n = 6,685). There was inter-hospital variation in transfusion rate, ranging from 16.6% to 37.4%. Independent perioperative factors significantly associated with RBCT included older age (90 to 94 years, odds ratio (OR) 3.04 (95% confidence interval (CI) 2.28 to 4.04); p < 0.001), intramedullary fixation (OR 7.15 (95% CI 6.50 to 7.86); p < 0.001), and sliding hip screw constructs (OR 2.34 (95% CI 2.19 to 2.50); p < 0.001). Blood transfusion during admission was significantly associated with higher rates of 30-day mortality (OR 1.35 (95% CI 1.19 to 1.53); p < 0.001) and 60-day mortality (OR 1.54 (95% CI 1.43 to 1.67); p < 0.001), as well as delays to postoperative mobilization, higher likelihood of not returning to their home, and longer length of stay. Blood transfusion after hip fracture was common, although practice varied nationally. RBCT is associated with adverse outcomes, which is most likely a reflection of perioperative anaemia, rather than any causal effect. Use of RBCT does not appear to reverse this effect, highlighting the importance of perioperative blood loss reduction.Cite this article: Bone Joint J2022;104-B(11):1266-1272.

Report on the GHPP-BloodTrain online workshop on “Authorisation and Licensing of Blood Establishments - Review of quality documentation of blood and blood components”, 5th-8th of July 2021

The GHPP BloodTrain team developed an e-learning concept in response to the COVID-19 travel restrictions, providing training formats with virtual stages that can be completed during the pandemic (and beyond) and on-site stages, where practical exercises and case reports in smaller groups can lead to a deeper understanding of the content. The virtual training workshop on “Authorisation and Licensing of Blood Establishments”, hosted by the PEI GHPP BloodTrain from the 5th to the 8th of July 2021, was the first application of this concept. The number of participants could be substantially increased compared to an on-site event thanks to the virtual setting. Participants came mainly from national regulatory authorities and national blood transfusion services. There were also some Ministry of Health representatives from 19 countries from the WHO regions of AFRO, EMRO, and from Indonesia in attendance. The virtual workshop focused on reviewing and evaluating the quality documentation required for approval of processes used by blood establishments to prepare blood components. Presentations were given by members of the GHPP BloodTrain team as well as by representatives of the German Red Cross. The program was complemented by contributions from the WHO HQ and presentations on country-specific experiences from Ghana and Zimbabwe.

807 The Association between Blood Transfusion and Outcome in Hip Fracture Patients

Abstract Aim Hip Fractures are endemic in older adults across Europe, with potential increases in incidence expected as the population ages. Management of blood loss and anaemia is a mainstay of care for these patients, but there is still significant debate regarding balance between benefit and risk of liberal versus restrictive transfusion policies. Understanding the association between providing blood products and adverse healthcare outcomes in hip fracture patients is a key component in the transfusion decision-making process. Method This retrospective cohort study uses national audit data from the Scottish Hip Fracture Audit (SHFA) and the Scottish National Blood Transfusion Service (SNBTS) to examine the association between blood transfusion and important hip fracture process of care measures and healthcare outcomes. Results A total of 28 461 patient records were included for assessment across 19 acute hospitals. Blood transfusion during admission was associated with a small but statistically significant decrease in survival at both 30 and 60 days. Those receiving blood transfusion during admission were less likely to be mobilised by the end of the 1st post-operative day, less likely to have a length of stay below the average and had far lower probability of discharge. Conclusion This study found that blood transfusion is associated with poor healthcare outcomes following hip fracture, even when adjusted for potential confounding factors. This likely reflects the potential harm of perioperative anaemia rather than any direct impact from transfusion. Further work to reduce perioperative blood loss is therefore key to improving important hip fracture outcomes.

Inside the UK’s brave new world of ATMP regulatory innovation

Jacqueline Barry is the Chief Clinical Officer, responsible for Clinical Translation and Delivery activities and an Executive Director of the Cell and Gene Therapy Catapult. She has extensive experience in the development of advanced therapy medicinal products and leads a multi-disciplinary team of Nonclinical, Regulatory, Clinical Operations and Programme Management specialists. She also leads the coordination of the UK Advanced Therapy Treatment Centre Network and is a Director of the Global Alliance for iPSC Therapies. She feels passionately about making advanced therapies available for patients and works closely with the MHRA and the NHS on the development of the ecosystems to support the adoption of these therapies. Prior her time at Cell and Gene Therapy Catapult, Jacqueline worked at the Scottish National Blood Transfusion Service where amongst other activities she designed the regulatory strategy for the Cellular Therapies for the Blood Transfusion Service and acted as Qualified Person for their release. She has a PhD from the University of Aberdeen and did post-doctoral research in neurophysiology at the University of Edinburgh.

Molecular Detection of Hepatitis B Virus Among Blood Donors from National Blood Transfusion Service Centre in Kaduna, Nigeria.

The survey was carried out to determine the molecular detection of Hepatitis B virus markers among blood donors between the age of 18-65 years from National Blood Transfusion Service (NBTS) centre in Kaduna, Nigeria. Blood samples were screened for Hepatitis B virus (HBV) using Diagnostic kit for HBV infection marker in whole blood. Hepatitis B serological markers were determined using polymerase chain reaction and confirmed. The socio-demographic factors associated with HBV infection were determined using structured questionnaires. The total prevalence rates of the five (5) HBV markers were: HBsAg 12(7.3%), HBsAb 5(3.0%), HBeAb 12(7.3%), HBcAb 18(10.9%), and all blood samples were negative for HBeAg. HBVDNA was detected in 3 out of 10 samples. Two out of the three samples were positive for HBsAg, HBeAb and HBcAb whereas one sample was positive for HBsAg, HBsAb and HBcAb. The high prevalence of HBcAb (10.9%) among HBsAg+ (7.3%) and (3.6%) among HBsAg- in this survey indicates that the virus is actively replicating in chronic HBV carriers and consistently increasing the spread within the population in the areas that are targeted.

Trends in Transfusion-Transmissible Infections Among Blood Donors at the National Blood Transfusion Service, Guyana

Aim: The most adverse effect of blood transfusion is the acquisition of transfusion-transmissible infections (TTIs), which poses a serious threat in developing countries. This study aims to identify the trends of transfusion-transmissible infections among blood donors.Materials and Methods: This study was a laboratory-based retrospective study conducted using blood donors’ records from January 2015 to December 2018, collected at the National Blood Transfusion Service, Guyana (NBTS). Analysis of data was performed using the Statistical Package for the Social Sciences (SPSS) version 22.0 software and the results were presented in tables and graphs. Chi-square and logistic regression were used to identify trends and influencing factors.Results: A total of 39,308 blood donors were included in this study, of whom 2,418 (6.2%) donors tested positive to at least one pathogen. Among those donors, 4.4% were coinfected with at least one of the sixteen dual infection combinations. The overall seroprevalence of HIV, HTLV, syphilis, HBV, HCV, Chagas, microfilaria, and malaria was 0.8%, 0.8%, 0.6%, 1.5%, 1.3%, 1.2%, 0.0%, and 0.0%, respectively. Trends of transfusion-transmissible infections showed an overall increase from the lowest prevalence, 5.1%, in 2015 to 7% in 2016, followed by decreases in 2017 (6.8%) and 2018 (5.8%).Conclusions: Even though 98.6% of the donor population are volunteers, this study has shown that a significant percentage of blood donors harbour transfusion-transmissible infections. Stringent screening and preventive measures are very important to ensure the safety of the transfusion recipient.

Donor Blood Procurement, Safety, and Clinical Utilization: A Study of Blood Transfusion Services in a Tertiary Care Hospital in Nigeria.

Background Donated blood is an essential component of the management of many diseases, and hospital-based blood banks in Nigeria are saddled with the responsibility of provision of safe blood and coordination of its appropriate utilization for patient care. Objective This study reviewed the extent to which the hospital blood transfusion service ensures adequate safe blood supply and utilization. Materials/Methods. This was a retrospective study of 2 years record of the blood bank service of Alex Ekwueme Federal University Teaching. Methods of donor blood procurement, transfusion transmissible infection status, the pattern of blood, and blood component usage across the hospital's clinical departments were evaluated. Statistical analysis was conducted using IBM SPSS, and data were presented as percentages. Fisher's tests were used to test significance, and p value <0.05 is significant. Results The highest proportion of donors was male family replacement donors aged 26–35 years (3634 (39.68%)) while total voluntary donors were 315 (2.65%). Hepatitis B had the highest seroprevalence 267 (2.22%) among blood-borne diseases screened. National Blood Transfusion Service (NBTS) supplied only 3 (0.03%) of total blood units used. The accident and emergency department had the highest proportion of persons who utilized whole blood; 4568 (99.96%). Conclusion The hospital blood bank relies heavily on family replacement donors with little or no assistance from the National Blood Transfusion Service. Family replacement donors have the highest risk of TTIs, and hepatitis B infection has the highest prevalence. The high cost of blood component therapy increases the need for whole blood.

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.

Barriers and drivers of voluntary blood donation in northern and Western Tanzania

Introduction: Every second, someone in the world needs blood due to surgery, trauma, severe anemia or pregnancy complications. There is a shortage of blood for transfusion worldwide, with the heaviest burden faced by sub–Saharan Africa. In countries like Tanzania, the major source of blood is voluntary blood donation, making its supply one of the most challenging in the health care system. This study assessed the magnitude of the deficit of blood in blood banks, and explored views of key stakeholders on the need, availability and opportunities for improving blood donations in northern and Western Tanzania. Methods: This was an explanatory sequential mixed method study done in the Mpanda and Moshi districts in the Katavi and Kilimanjaro regions. A quantitative component involved a questionnaire survey with 253 community members from the two districts and 24 months blood bank records. The survey explored awareness and perceptions of voluntary blood donation. A qualitative component involved four focus group discussions with registered voluntary blood donors and health care providers from the National Blood Transfusion Service in the two districts. Results: Blood bank records indicated that more blood was collected in Katavi compared to the Kilimanjaro region. Only 26% of the survey respondents had ever donated blood in their lifetime, three quarters of these were from Mpanda district. There was no significant association between socio-demographic factors and likelihood of blood donation. However, being male, older (51 years and above), having higher household income and secondary school education were significantly associated with higher awareness of voluntary blood donation. Community sensitization, education, incentives and availability of blood donation centers near communities were among the most important factors listed to improve blood donation. Conclusions: Significant efforts need to be placed on sensitization and improving knowledge and awareness of voluntary blood donations in order to improve its uptake.

Blood Donation Policy and Associated Social Values (Cote d’Ivoire)

Background: Blood transfusion is essentially based on blood donation. WHO has identified three types of blood donation (paid blood donation, family or alternative blood donation and voluntary, free blood donation). The one, she recommends (voluntary, anonymous and unpaid donation) which is rare in Africa. Objective: Our study was to identify the policy in force in Cote d’Ivoire and the values that blood donors associate with it. Method: Our study based on a questionnaire administered to 268 primary and regular blood donors and an interview guide with seven officials of the National Blood Transfusion Service (NBTS). The tools were taught at blood transfusion sites (BTS Daloa, Treichville and Yamoussoukro) during donation hours (from 7:30 am to 12 pm) and Data collected processed using Epidata 3.1 and Epidatanalysis. Result: In Cote d’Ivoire, blood donation policy has been in line with WHO recommendations since the creation of the NBTS in 1958. Our study has identified four values (solidarity and generosity, anticipatory action, voluntary, free and selfless act and medical value). However, the first value (solidarity and generosity) is high important regardless of the type of blood donation (regular or primary). This policy has always been the result of the main characteristics of ivorian communities (<i>"Country of hospitality" and "The homeland of true fraternity”</i>). Conclusion: The Cote d'Ivoire has only known voluntary, anonymous and unpaid donation whose the main value is solidarity and generosity, a characteristic value of the ivorian communities.

About The Author

Abdullahi Kawu is interested in research in Human-Computer Interaction, Digital Health and ICT4D, hence most of his works are in those domains. He is passionate about people and technology, in particular exploring their engagements with technology. He is currently a Lecturer at Ibrahim Badamasi Babangida University, Lapai, Nigeria and a PhD research fellow with TU Dublin under the Science Foundation Ireland (SFI) Centre for Research Training in Digitally-Enhanced Reality (d-real) program. Earlier on, he obtained an MSc in Advanced Computer Science (Distinction) with interest in Human-Computer Interaction from Newcastle University, UK. He has also worked as a Consultant Staff to international development organisations like Malaria Consortium, World Bank and UNDP where he had the rare opportunity to learn and apply technical, leadership, project management, and Monitoring and Evaluation (M&amp;E) skills in health projects.Email address: abdullahikawu@ibbu.edu.ng ORCID: 0000-0003-2531-9539Akinyinka Tosin Akindele is an instructional Designer and eTutor at LAUTECH Open and Distance Learning (LODLC), Nigeria. He also works as eLearning Consultant for Kampala International University, Uganda. He has over 8 years’ experience and is skilled in various eLearning technologies such as administration of LMS, curriculum and course authoring, creation and editing of multimedia (videos, animations and graphics) etc. He has trained diverse stakeholders on Blended Learning and actively participating in several eLearning projects locally and internationally including Partnership for Blended Learning (PEBL) West Africa sponsored by Association of Commonwealth Universities; Carbon Literacy for Youth Employability and Job Creation by British Council; Digital Innovation Skill Hub (DISH) by Dutch Ministry of Foreign Affairs Orange Knowledge Program etc. Mr Akindele holds an MSc degree in Computer Science from LAUTECH, Nigeria and he is presently pursuing his Ph.D. He has authored several articles on Distance Education and application of Artificial Intelligence to Health, Education and other related areas.Email address: akinyinka.akindele@kiu.ac.ug ORCID: 0000-0002-7027-466XAli Mtiraoui, a graduate of the Faculty of Medicine of Sousse (MD), the University of Montreal (MSc, community health) and the Pierre and Marie Curie University of Paris (statistics applied in epidemiology), is Director of the Laboratory of research “Quality of care and management of health services”, Former President of the University of Sousse, Honorary Dean and former Director of the Department of Family and Community Medicine of the Faculty of Medicine of Sousse. The quality of services and the management of services (education and health) are at the center of his professional concerns. He has worked at all levels of Tunisia's health care system and has carried out several consultation and expertise mandates in several fields, both nationally and internationally (development of intervention plans at the regard to health problems, design of curriculum &amp; training programs, management of health services &amp; mobilization of human resources, strategic planning, accreditation and certification, etc.).Email address: ali.mtiraoui@gmail.com ORCID: 0000-0002-6990-955XAliya Aktau received her MSc degree in Computer Science from Leiden University, The Netherlands, in 2020. She is now a PhD candidate at Leiden University Medical Center (LUMC) and teaching Data Collection, Wrangling, Analysis and Visualization at Suleyman University, Kazakhstan. Her research interests include FAIR Data Science and FAIR Data Management. She works as a data curator for medical health research.Email address: aleka.aktau@gmail.com; a.aktau@lumc.nl ORCID: 0000-0003-4942-2725Anthony Wachira graduated from the University of Nairobi with a BSc. Honors in Mathematics and Computer Science in 1988 and an MBA in Management Information Systems and Strategic Management for the same University in 2001. His MBA project was titled Ergonomic Factors Considered in Information Systems Implemented in Kenya: A Case of Firms in Nairobi. He is currently enrolled for PhD in Healthcare Management at the Institute of Healthcare Management of the Strathmore Business School — Strathmore University. He has been deeply involved in research on the provision of ICT solutions across many sectors and at various levels, the last two being ICT Services Director, Strathmore University and GM-ICT, Kenya Airports Authority. He chaired the inter-agency committee on border security in 2007, where one of the principal outcomes was the proposed single identification source for civil registration and vital statistics for all persons within the territory of Kenya using biometric data capture with the objective of creating Big Data.Email address: anto.wash@gmail.com ORCID: 0000-0002-0344-4403António Cartaxo (1987, Lisbon) visited in 2019 a research project on HIV prevention and care in Coastal Kenya, after which he became interested in access to healthcare. Since January 2020 he has been a PhD aspirant at Leiden University within the Globalisation Accessibility Innovation and Care network. His research focuses on participation in digital health innovation and health orientations in informal settlements in Nairobi, Kenya.Email address: am.cartaxo@gmail.com ORCID: 0000-0002-1276-1179Araya Abrha Medhanyie holds a PhD and is associate professor of public health at the School of Public Health at Mekelle University, Ethiopia. He has seventeen years of work experience in teaching, research, and community service. His research interests and professional career focus mainly in Global Health and Development. He is interested and has been building his research career in multidisciplinary and implementation research that integrates health systems, maternal and newborn health, health systems leadership and governance, health policy, digital Health and social transformation. Methodologically, he is interested and keen in specializing his capacity in implementation research, diffusion of innovations and scale-up of proven health interventions. He is passionate about serving humanity through research, education and leadership. He enjoys reading and writing about social change, leadership and development. He is Country Coordinator of VODAN-Africa.Email address: araya.medhanyie@gmail.com ORCID: 0000-0002-9328-684XAwotunde Joseph Bamidele received his B.Tech. degree in Mathematics/Computer Science from Federal University of Technology, Minna, Nigeria, in 2007. M.Sc. and Ph.D. degrees in Computer Science from the University of Ilorin, Ilorin, Nigeria, in 2014 and 2019 respectively. Since 2019, he has been a Lecturer with the Department of Computer Science, University, of Ilorin, Ilorin, Nigeria. He is the author of more than 40 articles, 30 chapter in book, and more than 25 Conference Proceedings in reputable outlets like Elsevier, Springer Taylor and Francis among others. His research interests include Information Security, Cybersecurity, Bioinformatics Artificial Intelligence, Internet of Medical Things, Wireless Body Sensor Networks, Wireless Networks, Telemedicine, Medical Imaging, Software Engineering, and Biometrics. He is a member of International Association of Engineers and Computer Scientist (MIAENG), Computer Professional Registration Council of Nigeria (MCPN), Nigeria Computer Society (MNCS), and Internet Society.Email address: awotunde.jb@unilorin.edu.ng ORCID: 0000-0002-1020-4432Balyejusa Gusite is a staff member in the directorate of research, innovation, consultancy and extension of Kampala international university serving as a data communications officer. He is also a data steward (Expert) in virus outbreak data network (VODAN-A). Gusite is currently pursuing a masters of science in information systems (Msc.IS) at Kampala International University, He holds a first class Bsc. Information technology from KIU. As an information technology personnel, Gusite is a freelancer developer, with bias in automation systems, data science, deep learning, Machine learning, computer vision and security systems.Email address: gusite.balyejusa@kiu.ac.ug ORCID: 0000-0003-4515-6052Bert Meerman is the Director of the GO FAIR FOUNDATION (GFF), based in Leiden, the Netherlands. Involved in different EOSC Projects (EOSC Secretariat and EOSC Nordic). GFF focus is on the promotion, protection and the correct implementation of the FAIR Principles, next to the transfer of knowledge on the application of FAIR.Email address: b.meerman@gofairfoundation.org ORCID: 0000-0002-0071-2660Dwy Bagus earned his Master degree in Electrical Engineering and Informatics from Institut Teknologi Bandung (ITB), Indonesia, in 2018. He is now a lecturer and software architect in Politeknik Statistika STIS, Indonesia. His research interests include software engineerings such as cloud computing, blockchain, and artificial intelligence.Erik Flikkenschild was educated in the early days of computer science as an electronic engineer (innovative curriculum by TU Delft, Antony Fokker school and MTS The Hague (1974). He is now an information manager and IT architect (LUMC) and Deputy Director (Go-FAIR foundation). His computer science interest is the design of the Internet of FAIR Data Services with a focus on data protection, starting with policy (risk assessment) translating in the IT design of access control measures.Email address: e.flikkenschild@lumc.nl Alternative email: erikf@gofair.foundation ORCID: 0000-0002-7285-1651Ezekiel Ogundepo In the fields of mathematics and statistics, Ezekiel is a knowledgeable and creative professional. He holds a master's degree from the African Institute for Mathematical Sciences (AIMS), Rwanda, where he received a scholarship from MasterCard, and a first-class degree in statistics from the University of Ilorin, Nigeria. He has experience with the Rwanda Revenue Authority (RRA) and is a leading expert in advanced statistical modelling. He worked on the RRA team that developed the interactive taxpayer data portal and automated key statistical reports needed by internal and external users. Ezekiel is currently employed by 54gene (a biotechnology company) as a Data Specialist and has made contributions to the ralger web scraping R package and the Big Book of R. He is a certified instructor for Rstudio Tidyverse, a data steward at Virus Outbreak Data Network (VODAN) Africa and Asia, and an active member of the Africa R programming community.Email address: ezekiel@datasciencenigeria.ai; ogundepoezekiel@gmail.comEzra Mwesigwa Highly enthusiastic about Health Informatics and ICT for development (ICT4D). Ezra has proficiency in Information Systems Analysis, Design and Development with over 6 years’ experience delivering electronic knowledge management solutions currently working as a DevOps Engineer at Makerere University Kampala (MAK) and Kampala International University (KIU). With a Msc. and Bsc in Information Systems, Ezra has been part of local and international project establishments in and outside Uganda serving within various technical capacities. Currently part of a wider multinational VODAN-Africa team developing and piloting a FAIR data architecture in 88 facilities across 7 countries in Africa, DevOps Consultant towards responsible anti-microbial use in refugee settlements within Uganda; a project funded by Pfizer, ICT consultant working through Makerere University Climate Change and Research Initiative-MUCCRI to develop a national climate change Knowledge Management System funded by Food and Agriculture Organization among many other notable involvements.Email address: mezra@cit.ac.ug ORCID: 0000-0003-2125-1012Esther Thea Inau is a PhD student studying in the Medical Informatics Department at the Universitätsmedizin (University of Medicine) Greifswald, Germany. Her PhD studies are based on implementing and evaluating the FAIRness of data obtained from health cohort studies in Germany.Email address: inaue@uni-greifswald.de ORCID: 0000-0002-8950-2239Francisca Oladipo, is a Professor of Computer Science and pioneer Director, Quality Assurance, Federal University Lokoja (FUL), Nigeria. She is a Consultant at the Tilburg School of Humanities and Digital Sciences of Tilburg University, Netherlands, and had served previously at Kampala International University (KIU), Uganda as the Director of Research, Innovations, and International relations. She has recently been appointed the Vice-Chancellor and Chief Executive Officer of Thomas Adewumi University, Nigeria.Email address: francisca.oladipo@kiu.ac.ug ORCID: 0000-0003-0584-9145Francis Kinyua Gathua facilitates development and implementation of appropriate youth and women livelihoods strategies; self and wage employment for self sustenance and resilience in Nairobi slums. With over 10 years in non-profit sector, Francis has solid, documented experience in project cycle management, behavioural/cognitive skills development, high maturity and knowledge of working with young people, team building, strategic planning, mentorship, collaboration, monitoring and evaluation. Francis is a certified life skills facilitator/trainer and manages Kamukunji Community Empowerment Initiative's (KCEI) vulnerable youth and women enablement project. Francis Holds a B.A and MA in Sociology from University of Nairobi.Email address: kgathua@gmail.comFredrick Obwanda is a healthcare management expert from Kenya, who worked at the Ministry of Health leading institutional, and policy agenda at the National Blood Transfusion Services, in addition to being a Sub-County Hospital Manager and Linked to Tangaza University at present.Email address: fobwanda@gmail.com ORCID: 0000-0002-8275-0926Gertjan van Stam has been involved with ICT in Africa since 1987. He holds a PhD in Culture Studies from Tilburg University, an MTech in ICT from Nelson Mandela University, and an engineering degree in telecommunications. His activities focus on mechanisms at the intersection of society and technology.Email address: gertjan@vanstam.net ORCID: 0000-0003-4618-6106Getu Tadele Taye is a lecturer in the department of Health Informatics at the college of health sciences Mekelle University (MU), Ethiopia. He has worked as a software engineer for almost 3 years prior to joining MU. He is an active member of digital health research and development center at MU. Currently, he is also working as country technical lead in the project Virus Outbreak Data Network Africa and Asia (VODANA). VODANA is a Global Open Findable, Accessible, Interoperable, and Reusable (GO FAIR) Implementation Network set up to help fight the COVID-19. He has vast research experience in Medical and IT Convergence technology and participated in national and international conferences and published journal papers on prestigious peer-review journals. He is interested in the concepts and technologies in data science, data FAIRification, eHealth Architecture (eHA) and making HISs interoperable. He holds a master's degree in Medical IT Convergence Engineering from Kumoh National Institute of Technology, South Korea.Email address: getu.tadele@gmail.com; getu.tadle@mu.edu.et ORCID: 0000-0002-9965-1801Hauwa Limanko Ibrahim is a research assistant with the New and Emerging Technology Research Group (NETReg), IBB University Lapai, Nigeria. She is interested in the design and evaluation of novel interactive technologies in low resource communities.Email address: ibrahimhauwa977@gmail.com ORCID: 0000000240566442Ibrahim Abdulahi is Head of the Department of Computer Science, Ibrahim Badamasi Babangida University, Lapai. He is Director ICT and Chairman New and Emerging Technologies Research group (NETREG). Ibrahim holds a PhD in Computing, a Senior Member of the IEEE. His research interest include: Future Internet (Information-Centric Networking), Operating Systems, Algorithms, AI, Bigdata, and Digital-Health. A Lecturer of Computing and the Director of Information and Communication Technology at IBB University, Lapai. Nigeria. He is a facilitator, editor and content writer of several Learning Management System (LMS) solutions.Email address: ibrojay01@gmail.com; ibrojay01@ibbu.edu.ng ORCID: 0000-0002-3467-1203Jamilu Yahaya Maipan-uku (Mr.) received his B.Sc. in Computer Science from Ibrahim Badamasi Babangida University Lapai (IBBUL, 2010), Niger State, Nigeria. Also, holds M.Sc. in Computer Networks from Universiti Putra Malaysia (UPM, 2016), Malaysia and Ph.D. (in view) in Computer Information Systems at Near East University, Cyprus with about 15 technical and international conference papers across SCOPUS, DBLP databases. His research interest includes; Grid Computing, Cloud Computing, Cyber Security, Artificial Intelligence, Machine Learning, and Deep Learning. He is a member of Nigeria Computer Society (NCS) and Internet Society of Nigeria (ISOC).Email address: jymaipanuku@ibbu.edu.ng ORCID: 0000-0001-8071-7295Mr. Joseph Elijah (M.Eng.) is a lecturer in the Department of Computer Science, Ibrahim Badamasi Babangida University, Lapai, Nigeria. He is a member of the council for the registration of Engineers in Nigeria, a member of the association for computing machinery, and the international association of Engineers (IAENG). His current research interests include intelligent systems, cognitive radio, microstrip antenna, and digital health.Email address: ibrojay01@gmail.com ORCID: 0000-0002-9922-9029Dr Katy Wolstencroft is an Assistant Professor in Bioinformatics at Leiden University. She has a Bachelor in Biochemistry (University of Leeds) and a Master and PhD in Bioinformatics (University of Manchester. Her research focuses on data and knowledge integration in the life sciences. She is an author of the FAIR guiding principles and is instrumental in the development of several FAIR data initiatives in systems biology, bioimaging and biomedicine, in addition to her activities in VODAN.Email address: k.j.wolstencroft@liacs.leidenuniv.nl ORCID: 0000-0002-1279-5133Klara Smits works at Tilburg University as a PhD candidate on the topic of human trafficking of Eritrean refugees in the digital era. Smits is interested in forced movement, and particularly the aspects of digitalisation, in the nexus of environmental, political and social problems. She has a MSc. in Forest and Nature Conservation with a specialisation in Sustainable Development Diplomacy.Email address: klarasmits@gmail.com ORCID: 0000-0003-1713-7057Kudakwashe Chindoza received his MCom Information Systems degree in 2015 (GZU), a BSc in Information Systems in 2006 (MSU) and a Post-Graduate Diploma in Higher and Tertiary Education in 2019 (GZU), Zimbabwe. He is a technical expert of VODAN-Africa in Zimbabwe. He is a PhD student with Tilburg University.Email address: chindozak@gmail.com; kchindoza@gzu.ac.zw (Official email) ORCID: 0000-0002-8346-5211Kibrom Fekadu Berhe is a Lecturer and researcher of Public policy and Development at Mekelle University, Ethiopia. He obtained MA degree in Public Policy and Sustainable Development from University of Gondar, Ethiopia in 2013 and Masters of Environmental Management from Massey University, New Zealand in 2015. He has over 10 years of experience in teaching research and community services in higher education institutions. He is currently working in consultancy, mediation, advocacy and research in Belgium.Email address: kiblid@gmail.com ORCID: 0000-0003-1728-5076Marek Suchánek is PhD student at Czech Technical University in Prague and University of Antwerp (double-degree programme). His research topic is about connecting conceptual modelling and software implementations beyond model-driven development. He obtained both master's and bachelor's degrees at CTU in Prague in Information Systems and Management. He actively participates on various projects such as Data Stewardship Wizard or FAIR Data Point.Email address: marek.suchanek@ds-wizard.org ORCID: 0000-0001-7525-9218Mariam Basajja is currently pursuing a PhD in Computer Science at Leiden University in the Netherlands. She obtained a master's degree in Advanced Computing, machine Learning and Data mining from the University of Bristol, UK and also has a master of Science in Computational Intelligence from University of Nairobi, Kenya. She also holds a bachelors in Applied Computer Technology with a concentration in Software Engineering from United States International University Africa. Her main areas of interest are around FAIR data, big data, databases, data analytics, cloud computing, ICT Infrastructure and others.Email address: mariam.basajja@gmail.com ORCID: 0000-0001-7710-8843Mariem Ghardallou received her Medical doctor degree from the Faculty of Medicine of Sousse, Tunisia, in 2011. She is now an Associate Professor in Community and Preventive Medicine at the Faculty of Medicine of Sousse, University of Sousse, Tunisia. She is currently the vice-dean of research and valorization of expertise at the Faculty of Medicine of Sousse and the country coordinator for Tunisia of VODAN Africa.Email address: ghardallou.m@gmail.com Alternative Adress: Mariem.Ghardallou@famso.u-sousse.tn ORCID: 0000-0001-9289-722XDr. Mia Stokmans is an associate professor at Tilburg University, Tilburg School of Humanities and Digital Sciences. Between 2008 and 2010 she was involved in the EUCIM-TE Comenius project co-funded by the European Commission, DG Education and Culture within the Lifelong Learning Programme to improve the pre- and in-service training of all teachers for their work with immigrant pupils by elaborating a competence-based European Core. Between 2011 and 2012 she participated in the ARKA-project about the valorisation of human capital of migrants in the European Union. She has participated in the NWO project Cost Benefit Analysis of Social Protection on Social Economic Resilience, the NWO project Mixed Migration Ethiopia, and the ZonMW project about care processes for dementia. Her main fields of interest are the role of attitudes and emotions in human decision making, social processes for behavioral change and mixed method approaches in doing research.Email address: M.J.W.Stokmans@tilburguniversity.edu ORCID: 0000-0002-7593-9632Mirjam van Reisen is Professor International Relations, Innovation and Care at Tilburg University and Professor of FAIR Data Science at the Leiden University Medical Centre (LUMC) at Leiden University. Van Reisen is Research Leader of the Globalization, Accessibility, Innovation and Care (GAIC) network. Her teaching experience includes, among others, the University of Pavia, Tilburg University, Amsterdam University College, Leiden University and the College of Europe. Van Reisen is the Director of the organisation Research Advisors &amp; Experts Europe (RAEE) in Brussels. Van Reisen is the Coordinator of the Virus Outbreak Data Network (VODAN) Africa implementation network. Van Reisen was a member of the Dutch Advisory Council on International Affairs (AIV) and Chair of the Development Assistance Committee (COS) from 2013 to 2020. Van Reisen received the Golden Image Award in 2012 by President Ellen Johnson Sirleaf.Email address: mirjamvanreisen@gmail.com ORCID: 0000-0003-0627-8014Misha Stocker is a consultant with Research Assistants and Experts Europe in Brussels. He studied European governance with a double major from the University of Konstanz, Germany, and the University of Utrecht, The Netherlands. He received his bachelor degree in Liberal Arts and Sciences with a major in political science from the University College Roosevelt from Utrecht University. He carried out his internship in the Go FAIR foundation and his thesis investigated the EU policy making on FAIR Data.Email address: mishastocker@gmail.com ORCID: 0000-0003-0347-9953Morgane Wirtz is a PhD student at Tilburg University, a freelance journalist and a researcher for EEPA. She focuses on human right abuses, security in Sahel, migration and human trafficking on the Central Mediterranean Road. Based in Tunisia, she works for Le Point Afrique, Inkyfada and Hans Lucas. She is also a documentary filmmaker.Email address: morgane.wz@gmail.com ORCID: 0000-0002-2514-5797Mouhamed Mpezamihigo born in Uganda, is Vice Chancellor of Kampala International University and leader of the programme of the Digital Innovation and Skills Hub (DISH), and Chair of the Virus Outbreak Data Network - Africa, VODAN-Africa. He is board member of the African Institute for Capacity Development (AICAD), and Executive Committee member of the Interuniversity Council for East Africa (IUCEA) among many other obligations he holds.Email address: vc@kiu.ac.ug ORCID: 0000-0002-9700-3034Munyaradzi Mawere is a double professor, being a Full Professor of African Studies at Great Zimbabwe University (GZU), Zimbabwe and a Professor Extraordinarius of Interdisciplinary Research at the University of South Africa (UNISA), South Africa. Mawere has 310 publications to his credit, including 91 books, and over 200 book chapters and peer-reviewed journal articles published with internationally acclaimed publishers.Email address: munyaradzimawerem@gmail.com ORCID: 0000-0002-3684-6089Nambobi Mutwalibi is a Vodan Expert of the Virus Outbreak Data Network (VODAN) Africa implementation network. He is also a research assistant at Motion Analysis Research Lab, Islamic University in Uganda. He was a research assistant in the Technical and Vocational Education (TVE) department at Islamic University of Technology, Bangladesh (IUT, 2018). He holds a BSc. Technical Education (Islamic University of Technology, Dhaka, Bangladesh) specializing in computer science and engineering. His research interest on Disruptive Innovations, FAIR Data, JTBD, Wargaming Strategy, Game theory, Coopetition, Blue Ocean Strategy, Blended learning, Green Skills, TVET and ICTs in developing countries. He can be reached via his website: www.nambobi.com, email: hello@nambobi.com and contact +256701044034 Email address: nambobi.mutwalibi@kiu.ac.ug ORCID: 0000-0001-6822-616XObinna Osigwe is a Digital Media Professional at Kampala International University, Uganda and the Communications Lead at Virus Outbreak Data Network Africa (VODAN-Africa). His experience and competence spans across Computer Networking, Digital Marketing, Data Analysis, Online Reputation Management, Performance Measurement and has Consulted for several organizations in Nigeria and Uganda. Obinna has a Bachelor of Science in Computer Science from Nnamdi Azikiwe University Nigeria, and is currently a Master's Student in Project Management.Email address: obinna.osigwe@kiu.ac.ug ORCID: 0000-0001-7825-3591Oluwole Olumuyiwa Afolabi has more than a decade of experience working in an international organisation and has over time built his proficiency in PHP, MySQL, JavaScript, Ajax and several other programming languages. He has proficient skills with CSS, Self-Developed Content Management System (CMS), Microsoft Office Packages, CorelDraw, and a very good understanding of design and the use of the Adobe Creative Suite. He has obtained professional certifications including; PHP OOP: Object-Oriented Programming for Beginners - Certificate of Completion from UDEMY – 2018, Online Cambridge Certified Web Publisher from Cambridge Intercontinental University-2010, and a Diploma in Advanced Web Development from ECAND Nig. Ltd-2009. He is currently working with Kampala international University as a Web Administrator.Email address: oluwole.afolabi@kiu.ac.ug ORCID: 0000-0002-4007-6363Putu Hadi received his M.Sc degree in ICT in Business and the Public Sector from Leiden University, the Netherlands, in 2021. He is a PhD student with the Leiden University Medical Center (LUMC). He is now an ICT expert in Central Bureau of Statistics, Indonesia. His research interests include data governance and principles such as FAIR and open data. He is a technical team lead in VODAN-Africa on implementation in health facilities.Email address: putu.hadi.purnama.jati@umail.leidenuniv.nl ORCID: 0000-0002-6533-3709Reginald Nalugala is a postgraduate tutor at Tangaza University, specializing in social transformation. He trains research students in the PhD and Masters programme to draw on the SDGs to foster social transformation. At VODAN Africa and Asia, he is the country lead for Kenya where he coordinates the VODAN activities in Kenya. SDG 3 highlights the importance of health and wellbeing. This situation has been made worse by the COVID-19 pandemic. Reginald and the team are studying different methodologies on how to improve livelihoods of households affected by COVID-19 pandemic.Email address: reg.nanales@gmail.com ORCID: 0000-0002-3737-9777Ruduan Plug is an associated researcher with the Leiden University Medical Center and a scientist in machine learning and artificial intelligence at monitoring &amp; control services of TNO. Previously he has been named a Google Scholar for his work on OpenAI's scalable meta-learning algorithm and he has worked with CEDAR at the Stanford Center for Biomedical Informatics Research. In addition, he has acted as a technical coordinator for VODAN, is active within the interdisciplinary GAIC research group of Tilburg University and is an ambassador for FAIR data and the European Open Science Cloud (EOSC) at the GO FAIR foundation. His research primarily focuses on the application and adaptation of machine learning, artificial intelligence and the architecture of interoperable, federated and distributed computational ecosystems for data-driven applications.Email address: ruudplug@gmail.com ORCID: 0000-0001-5146-6116Samson Yohannes Amare is a lecture in the department of Software Engineering, Mekelle University (MU). He is an active member of digital health research and development center at MU doing research, teaching and software development. Samson has been involved in most of the digital health activities done in MU. He has also been working on a couple of software development projects and implementation researches. He is actively working on the project Virus Outbreak Data Network Africa and Asia (VODANA), which is a Global Open Findable, Accessible, Interoperable, and Reusable (GO FAIR) Implementation Network set up to help fight COVID-19. He has also experience on software architecture and enterprise architecture development working closely with OpenHIE and the ministry of health. He has contributed during digital health blueprint development by the ministry of health. His research interests include digital health and data science. He holds a master's degree in Informatics Engineering from University of Algarve, Portugal.Email address: samsonya@gmail.com; samson.yohannes@mu.edu.et (Official email)Sara Nodehi received her MSc degree in ICT in Business and the Public Sector from Leiden University, the Netherlands, in 2021. Immediately after graduation, she started her work as a Ph.D. candidate at the Open University, the Netherlands. Her research interests include IT governance, Business/IT alignment, Information security management, and digital transformation.Email address: sara.nodehi95@gmail.com (preferred); s.nodehi@umail. leidenuniv.nl (work address) ORCID: 0000-0002-2919-1336Sakinat Folorunso is a computer science lecturer and researcher at Olabisi Onabanjo University, Ago Iwoye, Ogun State, Nigeria. She had a B. Tech in Computer Science from the Federal University of Technology, Akure, Ondo State, Nigeria. She also had an M. Sc and PhD in Computer science for the University of Ibadan, Ibadan, Oyo State, Nigeria. She has authored many journals and conference articles in Data mining, Machine Learning and Data Science.Email address: sakinat.folorunso@oouagoiwoye.edu.ng ORCID: 0000-0002-7058-8618Tesfit Gebremeskel Gebreslassie is a lecturer of Health Informatics at the school of public health, Mekelle University (MU). He has eight years of experience in electronic Health Management Information Systems as a program implementer and consultant to the Ministry of Health in the area of eHealth and health informatics initiatives. He has been engaged in the development and implementation of different health-related electronic health system. He has been working in the areas of eHealth Architecture and interoperability in collaboration with OpenHIE. He spends most of his time in reading and practising health information and innovation related trending ideas and developments. Tesfit is head of the digital health research and development center at Mekelle University. He holds a master's degree in Biostatistics and Health Informatics.Email address: tesfitgebremeskel@gmail.com ORCID: 0000-0001-9389-5584Tigist Abtamu is an Information Science expert with a multi-disciplinary orientation and qualifications. She worked in the field of information science for more than 10 years in the Ethiopian Public Health Institute. Currently she is working as e-health coordinator at Addis Ababa University, School of Public Health, Capacity Building and Mentorship Program to support the Ministry of health initiative in the area of Health Information System development in the country by strengthening the Health information system aiming to build local capacity to transform health data quality and information use for evidence-based decision making.Email address: tigist.habtamu@aau.edu.et; tigist12@yahoo.com ORCID: 0000-0001-6082-1060William Muhadi Nandwa holds a BSc. Microbiology and Biotechnology and an MSc. Epidemiology. He has worked at Pumwani Maternity Hospital in Kenya as a data steward under USAID Afya Jijini. Currently, he is the lead data steward and Country Coordinator for the VODAN-Kenya team. He also brings together the forum of all Country Coordinators of VODAN-Africa. He has undertaken further training in data management technology under the Phillips Foundation. His research experiences has been fundamental in the development of this paper.Email address: wmnandwa77@gmail.com ORCID: 0000-0002-2994-4916Wondimu Ayele is Assistant Professor Biostatistics and Health Informatics at School of Public Health, Addis Ababa University. Assistant Professor and Director Health Information Capacity Building and Mentorship Project (Preventive medicine). He is a coordinator in the Virus Outbreak data Network - Africa. He studied at the Institute of Medicine, Epidemiology, Health Informatics and Biometer, Martin Luther University, Halle (Saale), Germany. Data manager for Ebola Response (Diseases Surveillance).Email address: wondimu.ayele@aau.edu.et; wondaay@gmail.com ORCID: 0000-0001-5899-347XWhitney Atieno Otieno is an Highway Engineering student at Kenya Institute of Highways and Building Technology. She is a community worker at Majengo, Pumwani, in Nairobi, Kenya and a leader in the Kamukunji Community Empowerment Initiative (KCEI). She developed an interest with community work for she grew up in slums. She is a women's rights activist. In 2018, she joined Kenya Women in Justice Centres group. She is a community leader and associated with the Tangaza University College initiative with the community organization KACPEN on social transformation.Email address: atienowhitney6@gmail.comYan Liang has received a double BA from University of Minnesota Morris in Economics and Statistics and a MSc in Computer Science from Leiden University. Her interests are in cloud computing and big data management and she has contributed to the core architecture of VODAN. Yan is currently active as a data engineer at KPMG in Digital Assurance &amp; Innovation and is a chair at the KPMG Dani Young Board.Email address: y.liang.2@umail.leidenuniv.nl; liangyan12138@gmail.com ORCID: 0000-0002-3860-725XYi Lin received his M.Sc degree in ICT in Business and Public Sectior from Leiden University, Netherlands, in 2021. He is now a research assistant at Leiden Institute of Advanced Computer Science (LIACS), Leiden University. His research interests focus on data analysis for business insight.Email address: y.lin@liacs.leidenuniv.nl ORCID: 0000-0002-9833-3457Zohra Touati received her Professional Master's Degree in Information and Communication Technology in 2008. She is now a Professor in Computer Science at the Faculty of Medicine of Sousse, University of Sousse, Tunisia.Email address: zohra.touati@live.fr ORCID: 0000-0002-8329-706X

Effect of SARS-CoV-2 pandemic on blood product usage at the University of Pécs

The impact of COVID-19 pandemic on patient care is pronounced also in Hungary. Blood supply was hindered by the reduction of public blood donation events, the reduced willingness to donate, and the difficult predictability of blood product demand as a result of the epidemiological regulations. The wider application of Patient Blood Management guidelines in the medical practice will promote optimal blood product utilization by avoiding transfusions where possible. The aim of our study was to assess the changes in the usage of blood products in the first five months of 2020 at the Clinical Center of the University of Pécs, Janus Pannonius Clinical Building. In the period following the epidemiological measures, we found reduction in the number of hospitalized patients (34.08%), in the number of patients requiring transfusion (39.69%) and in the number of red blood cell products used (46.41%). The number of transfused red blood cell concentrates per patient was also significantly reduced (from 2.61 to 1.97) in this period. The number of transfused fresh frozen plasma units and platelet concentrates also decreased by approximately 30%. After the implementation of the strict restrictions, despite the difficulties, it was possible to provide patients with sufficient blood products. Due to the efforts of both the Regional Blood Transfusion Center of Pécs of the Hungarian National Blood Transfusion Service and of the clinicians, a new balance was established between the demand and the supply of blood products, which provided adequate care for the necessary transfusions. Orv Hetil. 2021; 162(43): 1717-1723.

Impacts of COVID-19 on essential health services in Tigray, Northern Ethiopia: A pre-post study.

BackgroundCOVID-19 has proved to have an indirect impact on essential health services in several parts of the world which could lead to increased morbidity and mortality and loss of the gains made in the past decades. There were no synthesized scientific evidences which could show the impact of COVID-19 epidemics/pandemic on essential health services in Tigray, Northern Ethiopia. Therefore, this study aimed to assess the impacts of COVID-19 epidemics/pandemic on essential health services provision in Tigray, Northern Ethiopia.MethodsA pre-post study design was used to assess the impacts of COVID-19 on essential health services delivery in Tigray, Northern Ethiopia in the second quarter of 2020 (Post COVID-19) compared to similar quarter in 2019 (Pre COVID-19). The study focuses on five categories; namely; maternal, neonatal and child health care; communicable diseases with a focus on HIV and TB-HIV co-infection; prevention of mother to child transmission of HIV; basic emergency, outpatient, inpatient and blood bank services, non-communicable diseases and road traffic accidents (RTAs). Analysis was done using Stata version 14.0 software package. The effects of COVID-19 epidemics/pandemic were calculated taking the differences between post COVID -19 and pre COVID-19 periods and the levels of service disruptions presented using proportions. Wilcoxon sign rank test was done and a significance level of ≤0.05 was considered as having significant difference among the two quarters.ResultsThere were significant increase in institutional delivery, delivery by Caesarian Section (CS), still birth, postnatal care within 7 days of delivery, the number of children who received all vaccine doses before 1st birthday, the number of under 5 children screened and had moderate acute malnutrition, the number of under 5 children screened and had severe acute malnutrition and children with SAM admitted for management. However, there were significant decrease in HIV testing and detection along with enrolment to antiretroviral therapy (ART) care, number of patients with cardiovascular disease (CVD) risk ≥ 30% received treatment, RTAs, total units of blood received from national blood transfusion service (NBTS) and regional blood banks, total number of units of blood transfused and emergency referral. There were no significant changes in outpatient visits and admissions.ConclusionDespite commendable achievements in maintaining several of the essential health services, COVID-19 has led to an increase in under nutrition in under five children, decline in HIV detection and care, CVD, cervical cancer screening and blood bank services. Therefore, governments, local and international agencies need to introduce innovative ways to rapidly expand and deliver services in the context of COVID-19. Moreover, lower income countries have to customize comprehensive and coordinated community-based health care approaches, including outreach and campaigns. In addition, countries should ensure that NCDs are incorporated in their national COVID-19 response plans to provide essential health care services to people living with NCDs and HIV or HIV-TB co-infection during the COVID-19 pandemic period.