Replacement Donor Research Articles

Seroprevalence of Transfusion Transmitted Infection among Blood Donor at a Tertiary Level Hospital of Bangladesh: One Year Retrospective Study

Background: A transfusion transmitted infection (TTI) is an infection that is transmitted from person to person through parental administration of blood and blood products. The magnitude of transfusion transmitted infection (TTI) varies from country to country depending on TTI’s load in that particular population. Measuring their severity their severity WHO (World Health Organization) has recommended pre transfusion blood test for Human Immunodeficiency virus (HIV), Hepatitis B Virus (HBV), Hepatitis C virus (HCV) and Syphilis as mandatory. The aim of the study was to assess the trend and prevalence of TTI among blood donors in BRB Hospitals Limited. Method: A retrospective cross-sectional study was conducted by reviewing the record from 2022 to 2023 at BRB hospitals limited Transfusion Medicine department. All blood donors who presented to the blood bank and screened for TTI during study period were included. Data was collected, entered and analyzed using Microsoft Excel 2007. The descriptive statistics were determined in means of percentage. Chi- square was used for trend analysis and p-value was used to declare the statistical significance between variable. Result: The study included a total of 5074 donors-4,920 (97%) male and 154 (3%) female. Of them 3,840 (76.3%) were directed donor while 1,204 (23.7%) were replacement donor. An overall TTI prevalence rate of 0.95%. The prevalence of HBV, HCV, HIV and Syphilis was 0.5%, 0.1%, 0.07% and 0.2%. Conclusion: Methods to ensure a safety blood supply should be encountered. For that screening with a better selection of donor and used of screening tests including nucleic acid testing technology should be implemented.

Transfusion transmissible malaria: seroprevalence of malaria parasitemia in blood donors in Garhwal region of Uttarakhand, India

Background and Objectives: Malaria was the first ever reported case of transfusion transmitted infection (TTI). Transfusion transmissible malaria (TTM) can result in febrile transfusion reaction in the recipient. TTM can be fatal if the blood transfu- sion recipient is from vulnerable population i.e. pregnant women or young children. Therefore, the present study was done to estimate the seroprevalence of malaria parasitemia among blood donors in Garhwal region. Materials and Methods: Study subjects were healthy blood donors who had passed the screening criteria for blood do- nation. Donors with a history of malaria were temporarily deferred for 3 months following full recovery. Screening of the donated blood units for malaria parasite was done using immunochromatography based rapid diagnostic test. Thin smear examination was performed for malaria parasite species identification. Results: A total of 1984 blood donations were screened for TTI. The seroprevalence of HBV, HCV HIV and syphilis was 0.3% (n=6), 0.25% (n=5), 0% (n=0) and 0% (n=0) respectively. The seroprevalence of malaria parasite was 0.05% (n=1). Plasmodium vivax was identified upon thin smear examination. The donor reactive for malaria parasite was a replacement donor and gave no recent history of fever or any past history of malaria. Conclusion: Meticulous donor screening combined with rapid diagnostic tests for malaria parasite is the most practical strategy to prevent TTM in Garhwal region of India.

Comparison of Volunteer Non-Remunerated Donors and Replacement Donors.

There are mainly two types of blood donor in Nepal i.e., Voluntary Non-Remunerated Donor and Replacement Donor. The main aim of this study is to compare between Voluntary Non-Remunerated Donor and Replacement Donor. This is retrospective and cross-sectional study conducted in the blood transfusion Service, Tribhuvan University Teaching Hospital. The study was conducted on both Voluntary Non-Remunerated Donor and Replacement Donor who came to blood transfusion Service and voluntary blood donation program. All the blood donors donating in blood transfusion Service were considered as the study population. Out of total 25951 donors, there were 15565(60.02%) Voluntary Non-Remunerated Donor and 10386(39.97%) Replacement Donor. On the whole, there were 21938(84.59%) male donors and 3995(15.40%) female donors. The male Replacement Donor was 14273(93.12%) followed by a male Voluntary Non-Remunerated Donor 7582(73.71%). The female Voluntary Non-Remunerated Donor was 2703(67.65 %) followed by female Replacement Donor 1292(32.34 %). This study concludes that the Voluntary Non-Remunerated Donor is quite low, in comparison to Replacement Donor. 100 % Voluntary Non-Remunerated Donor could not be achieved due to lack of awareness about health and voluntary type of blood donation.

Simultaneous Live Donor Liver Transplantation, Aortic Valve Replacement, and Atrial Septal Defect Repair in a Patient With End Stage Liver Disease: A Case Report

Valvular heart disease creates an important barrier for orthotopic liver transplantation in patients with end-stage liver disease and increases mortality. Selection of the appropriate surgical scheme and adequate postoperative management can be lifesaving in these cases. This study presents a 32-year-old man diagnosed with hepatitis C-associated cirrhosis and severe aortic regurgitation due to subacute bacterial endocarditis. Initially, simultaneous aortic valve replacement (AVR) and live donor liver transplantation (LDLT) was planned. However, intraoperative transesophageal echocardiography revealed an additional atrial septal defect (ASD) and AVR, ASD repair, and LDLT surgery were performed. During the 2-year follow-up period, there were no early or late complications. To the best of our knowledge, this is the first patient to have simultaneous AVR, ASD repair, and LDLT surgery. Additionally, the present case is also unique in being the first person in the Republic of Azerbaijan to undergo concomitant cardiac surgery and LDLT.

Impact of Universal Donor History Questionnaire in Pre-Donation Deferrals a Tertiary Care Hospital Experience

Objective: The purpose of this research was to better understand the factors that lead to pre-donation deferral at a tertiary care hospital's Blood bank. Understanding the factors that lead donors to decline can inform more effective selection criteria. Study Design: Cross-sectional/Descriptive study Place and Duration: Diagnostic and research laboratory Liaquat university of Medical and Health Sciences Jamshoro Hyderabad. January 2022-December 2022 Methods: This study comprised of 2200 donors at blood bank of LUMHS. The UDHQ included 25 questions to assess donors' backgrounds in regards to things like injections, medicines, time since last donation, tattoos, general health, dental work, sexual relationships, malaria/T.B., surgery, jaundice, vaccination, positive viral markers, etc. Haemoglobin (Hemacue 50/Diaspect Hb with daily quality control), Heart rate/rhythm, Blood pressure, Body temperature, Weight/Height, and Jaundice were all part of the physical exam. Results: There were majority 1578 (71.7%) males and 622 (28.3%) female donors among all cases. Donors mean age was 26.12±9.88 years and mean weight was 61.3±8.49 kg. 1435 (65.2%) cases were from urban areas. Among all, 1650 (75%) donors were accepted and 550 (25%) donors were deferral. Most common cause of deferral was low hemoglobin followed by anemia, HCV, HBV, inappropriate pulse rate, low BP, jaundice, active infection, malaria, syphilis, allergy, aspirin intake, drugs, last donation, skin/eye colour and sexual relationship. There were 1870 (85%) cases of replacement donors among all cases. Conclusion: The selection of healthy blood and the reduction of donor injury will be made possible by a thorough pre-donation screening interview and physical examination. Our setup has a somewhat higher blood donor deferral rate because to stringent donor sector requirements and extra attention paid to donor selection processes. The increased replacement donor deferral rate is a result of refusals for past injection history and poor hemoglobin levels. Keywords: Donors, Deferrals, Hemoglobin, Infection, HCV

BLOOD DONOR DEFERRAL PATTERN AS A KEY TOOL FOR SAFE BLOOD TRANSFUSION PRACTICE: A RETROSPECTIVE STUDY FROM NORTH EAST INDIA.

Background: Safe blood transfusion practice starts with meticulous selection of blood donors. Recruitment and retention of healthy safe donor is crucial to maintain adequate supply of blood units available for transfusion. The present study was undertaken with the aim to analyze the rate as well as the causes of pre-donation deferral and blood units discarded following screening test for Transfusion Transmitted Infection (TTI). Material and methods: This retrospective hospital-based study was conducted in the Blood Centre, Jorhat Medical College and Hospital, Jorhat, Assam over a period of one year i.e., from 1st October, 2021 to 30th September, 2022. All donors who attended the Blood Centre as well as outdoor voluntary blood donation camps were included in the study. Each and every blood donor was screened as per the guidelines of Drugs and Cosmetics (Second Amendment) Rules, 2020. Transfusion Transmitted Infection (TTI) screening tests were done on the collected blood units and those found to be positive were discarded. The donor records were reviewed and analyzed according to sex, donor type (voluntary or replacement) and reason for deferral. Results: Out of 17030 prospective donors, 14372 (84.39%) donors were accepted for blood donation while 2658 (15.61%) donors were deferred. The deferral rate was higher in females i.e., 35.63% (88 out of 247) compared to males i.e., 15.31% (2570 out of 16783). Deferral percentage of voluntary donors was 19% (2563 out of 13485) and that of replacement donor was 2.68% (95 out of 3545). The rate of temporary and permanent deferral was 99.17% (2636 out of 2658) and 0.83% (22 out of 2658) respectively. The most common cause of temporary deferral was found to be low hemoglobin (41.81%) whereas in case of permanent deferral high risk behaviour (50%) was found to be the leading cause. 3.21% (462 out of 14372) blood units were discarded following screening tests for Transfusion Transmitted Infection (TTI). Hepatitis C was the most common cause of blood units discarded. Conclusion:Asystematic and well organised approach to selection of blood donors is the mainstay of safe blood transfusion practice. Analysis of donor deferral pattern guides us to recruit safe healthy donors and to maintain an adequate pool of blood units available for transfusion

Distribution of ABO And Rh Blood Groups in Blood Donors at the Tertiary Care Centre, Dahod

Introduction When it comes to blood transfusion and transplant medicine, the ABO as well as Rh blood group system are significant. There have been 700 RBC antigens found so far, and they've been divided into 30 blood groups as a result. For example, blood transfusion reaction, paternity testing, legal medicine, as well as associations with different illnesses are all medicolegally relevant when looking at ABO and Rh. Aim: The objective was to find out how much demand there is for a specific blood type compared to how much supply there is in society, to lower death rates caused by a shortage of that kind of blood. Compare the results with those from another comparable research performed in India and across the globe. Material and Methods: Between August 2018 to July 2021, researchers conducted a study on 7820 blood donors who visited the Zydus blood Centre. Tube agglutination testing and the Gel card method were used to find the patient's ABO as well as Rh blood groups. Both reverse as well as forward blood grouping methods are performed and confirmed only if both are identical. The age and sex groups as well as frequency of ABO and Rh blood groups were reported in percentages. Result The male-to-female ratio in our research was 30:1. The greatest number of male and female donors were between the ages of 18 to 30 years. For blood donation, it has been found that "O" blood donors are the most predominant, then those with B>A>AB blood groups. According to voluntary and replacement blood donors, AB & A blood groups are more (%) in replacement blood donors as compare to O and B blood groups. Voluntary donors are 33.67% and replacement donors were 66.64%. Distribution of Rh+ve and Rh-ve blood groups in our study was 98.78% and 1.22% respectively. Conclusion It is essential to have a thorough understanding of the distinct blood groups distribution for ensuring that blood as well as its components are always available to recipients in a particular area. The present work will provide insight on a deficiency of particular blood groups, in a particular area, like A and AB blood group are more in replacement donor showing deficiency of that blood groups in this area in our study.

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

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

Analysis of reasons of blood donor deferral at a tertiary care institute in India and its reflections on community health status.

Safe blood donors form the backbone of safe blood transfusion services.[1] Donor eligibility policies are a critical layer of blood safety designed to ensure selection of healthy donors and to protect recipients from any harm. This study was planned to analyze the pattern of whole blood donor deferrals and its characteristics and reasons at a tertiary care institute in northern India, as the pattern varies according to epidemiology of diseases in different demographic areas. It was a cross-sectional study of 2 years' duration from December 2015 to November 2017. The data of the potential donors who were deferred were recorded on a separate pro forma which included their demographic details, type of donation - voluntary donor and replacement donor; first time and repeat donor; type of deferrals (permanent and temporary); and the reasons of deferrals. A total of 3133 donors (voluntary - 1446 and replacement - 1687) donated and 597 donors were deferred (deferral rate - 16%) during this period. Majority of the deferrals, i.e., 525 (88%) were temporary, while 72 (12%) were permanent. The most common reason of temporary deferral was anemia. The most common reason of permanent deferrals was a medical history of jaundice. Our study results indicate that the blood donor deferral can have subtle variations based on regional aspects that should be considered when national policies are developed as pattern of deferral varies according to the epidemiology of diseases in different demographic areas.

An Insight into the Knowledge, Attitude and Practice towards Blood Donation among the Residents of Hyderabad Sindh

Background and Aim: In developing countries with a high prevalence of bleeding disorders, safe and adequate blood supply has persisted as a major challenge. Blood transfusion and donation in Pakistan are based on replacement donor’s primitive practice whereas voluntary donors worldwide replaced replacement donors. The present study objective was to evaluate the blood donor’s knowledge, attitude, and practice towards blood donation to measure their understanding of blood donation. Materials and Methods: This descriptive cross-sectional study was conducted from November 2020 till June 2021 at the Diagnostic and Research Laboratory, LUMHS Hyderabad. A pre-tested, self-administered survey form was utilized to investigate a total of 350 respondents. Out of the total, 160 were healthcare workers, 90 were medical students, and 100 were general public. Data was analyzed using SPSS version 20. Results: Of the total 350 respondents, the prevalence of blood donors and non-donors were 114 (32.6%) and 236 (67.4%) respectively. Out of 114 blood donors, 87 (76.3%) were male and 27 (23.7%) were female donors. The overall mean age was 37±6.45 years. The prevalence of knowledge, attitude, and practice among health workers was 56%, 64%, and 41% whereas students had 77%, 56%, and 22%, and the general public had 19%, 48%, and 78% respectively. The main reasons for not donating blood were fear of needles or sight of blood, weight loss/gain, lead to anemia, decreased immunity, and no one asked to donate with respective prevalence 11%, 17%, 39%, 21%, and 41%. About 56% of donors donated blood for the first time followed by 37% more than once. Conclusion: The knowledge, attitude, and practice survey concluded that a rational design, voluntary blood donation campaign, targeted strategies, and awareness program could be planned to utilize and increase blood donors on a community level. Keywords: Blood donation, Donors, Knowledge, Attitude, Practice

A study of transfusion transmissible infections in blood donors in blood bank of north Gujarat

One of the main detrimental consequences of blood transfusion is donor-to-recipient infection transfer. Serological tests before transfusion may help to minimise TTIs. The purpose of this research was to establish the prevalence of TTIs among volunteer and blood donors. Records from the blood bank attached to a tertiary care center were analysed. Past of 3 years records were entered and analysed through epi info 7. In present study, the prevalence of blood-borne infection among blood donors was 2.12%. HIV incidence was 0.52% and HBV, HCV and Syphilis 0.68%. 0.11%, respectively, and 0.81%. Replacement donor has a rate of 11.41% relative to voluntary donor of 0.70%. Blood door selection procedure must be comprehensive, utilising traditional procedures. Blood preservation is the recipient's primary concern. Furthermore, community motivation and knowledge campaigns are needed to raise volunteer blood donors.

Emotions and beliefs arising from replacement blood donation may hinder transitioning to exclusive voluntary non‐remunerated blood donation

AbstractBackground and objectivesFor many developing countries, achieving exclusive voluntary non‐remunerated blood donation requires converting an existing pool of family replacement donors consisting of individuals recruited by health professionals and persons they recruited. This study was done to evaluate emotions and beliefs in these two groups and their effect on future blood donor intentions.Materials and methodsCross‐sectional, descriptive, questionnaire‐based surveys were administered by two medical student research groups. Survey 1 assessed persons recruited by health professionals to serve as or recruit replacement donors and Survey 2, individuals recruited by patients or their relatives to be replacement donors.ResultsThe majority of Survey 1 participants experienced negative emotional reactions to being asked to solicit and actually asking persons to serve as family replacement donors (72·3% and 50·2%, respectively). The proportion that would serve as a replacement donor increased from 55·9% to 74·1% (P < 0·001). Among Survey 2 participants, 61% (P < 0·001) would more willingly donate blood if directly approached by the person in need.ConclusionEmotions and beliefs arising from family replacement donation encouraged future replacement donation intention.

Transfusion-Transmitted Infections and associated risk factors at the Northern Zone Blood Transfusion Center in Tanzania: A study of blood donors between 2017 and 2019.

BackgroundBlood transfusion saves many people every year that would otherwise have died. The present study aimed to provide an update and insightful information regarding prevalence of the common Transfusion-Transmitted Infections (TTIs) and associated factors among blood donors in Tanzania.MethodsThis was a cross-sectional study involving retrospectively collected data of blood donors from the Tanzania Northern Zone Blood Transfusion Center between 2017 and 2019. Descriptive statistics were performed to describe characteristics of the blood donors. Univariable and multivariable logistic regression analyses were performed to determine association between prevalence of TTIs and socio-demographic factors. P-value <0.05 was considered statistically significant.ResultsA total of 101, 616 blood donors were included in the present study of which 85,053(83.7%) were males while 16,563 (16.3%) were females. Of all participants, the majority 45,400 (44.7%) were aged between 18 and 25 years; 79,582 (78.3%) were voluntary non-remunerated donors while 22,034 (21.7%) were replacement donors. The vast majority of them 99,626 (98%) were first time blood donors while 1990 (2%) were multiple donors. The overall prevalence of TTIs was 10.1% (10,226 out of 101,616) of which the leading was HBV accounting for 5.1% (5,264 out of 101,616). Being a replacement donor was associated with all the four types of TTIs: HIV (AOR = 1.22, 95% CI = 1.10–1.35), HBV (AOR = 1.35, 95% CI = 1.27–1.44), HCV (AOR = 1.28, 95% CI = 1.12–1.46), and syphilis (AOR = 1.33, 95% CI = 1.20–1.48).ConclusionsOur study has demonstrated that Tanzania has relatively high prevalence of TTIs compared to some countries in Sub-Saharan Africa. HBV infection seems to be the most common infection among blood donors and replacement blood donors are at a higher risk of harboring the commonest TTIs among blood donors.

Free Gastric Flap for Oral Reconstruction-a Feasibility Study in Oral Defects.

Free flap transfer is a standard practice in reconstruction of oral defects. Fasciocutaneous flaps are commonly used for reconstruction of soft tissue defects. Replacement of oral mucosa with skin often causes discomfort, foreign body sensation, dysgeusia, problems with skin hair and morbidity at the donor site. Morbidity at the donor site may interfere with physical activity among manual labourers. We prospectively analysed nine cases of oral cavity defects reconstructed with free gastro-omental flap over 4 months from March to July 2019. A free gastric flap based on right and left gastric artery and vascular arcade was harvested from the body of stomach. Feasibility, technical aspects, advantages and disadvantages of the flap are reviewed. Flap survival was 100%. No re-exploration for salvage was required. Flap was monitored for viability by colour change and capillary refill. All the nine cases healed well. One patient required readmission for bleeding from the raw area exposed at the margins of the flap. Patient satisfaction and quality of life was satisfactory. Long pedicle length, rich submucosal vascular network, dual pedicles available for anastomosis, like to like mucosal tissue replacement and low donor site morbidity make it a reliable option in the armamentarium of oral reconstruction. Free gastro-omental flap is a feasible and reliable tissue available for reconstruction of oral soft tissue defects.

Blood Allocation with Replacement Donors: A Theory of Multi-unit Exchange with Compatibility-based Preferences

In 56 developing and developed countries, blood component donations by volunteer non-remunerated donors can only meet less than 50% of the demand. In these countries, blood banks rely heavily on replacement donor programs that provide blood to patients in return for donations made by their close relatives or friends. These programs appear to be disorganized, non-transparent, and inefficient. We introduce the design of replacement donor programs and blood allocation schemes as a new application of market design. We formulate a general blood allocation and replacement donation model. Within this framework, we introduce optimal blood allocation mechanisms that accommodate fairness, efficiency, and other allocation objectives, together with endogenous exchange rates between received and donated blood units beyond the classical one-for-one exchange. Additionally, the mechanisms provide correct incentives for the patients to bring forward as many replacement donors as possible. This framework and the mechanism class can also apply to general applications of multi-unit exchange of indivisible goods with compatibility-based preferences beyond blood allocation.

Evaluating The Effectiveness Of Donor Recruitment Strategies Towards Improving Availability Of Blood Product In Nigerian Tertiary Health Institution

Abstract Introduction/Objective Over the years, many strategies has been put in place to improve blood donations and overcome socio-cultural myths and fear that has held groups of people from voluntary blood donation in Nigeria and other subsahara africa countries. Among these are adequate education, approaches through religious group leaders, non-monetary incentives like giving them special awards during world blood donor day. The aim of this study is to evaluate the effectiveness and adequacy of our blood donor recruitment and retention strategies in improving availability of blood product in our institution Methods For this cross sectional retrospective study, Data including blood donation and break down of pattern of donations, request for blood products, monthly units of blood issued gotten from our 5 year Transfusion services records were searched, same entered into Microsoft Excel and the were analysed Results Our voluntary non-renumerated blood donation steadily increased from 4.55 in 2015 to 33.3% in 2019, this represent a five fold increase in our voluntary donor recruitment within the period under review. However overall blood donation rate remained steady at approximately 12000 units per annum over this period of time. There is an increase in request rate, on the average the rate of blood request was 1214 units per month in 2015, but in 2018 this has increased to an average of 1738 units per month and by 2019 average rate of request was 2300 units per month. Out of this huge request only 67.9% of them was met, implying a huge deficit in our blood availability despite increasing pool of voluntary blood donor. Conclusion Findings in this study revealed a steady increase in the pool of voluntary blood donor which did not reflect in our overall blood availability. This might be due to concurrent decrease in our family replacement donor. This finding also suggests that even though our current strategy used in donor recruitment and retention might seems effective, they are still not adequat, as there is no commensurate rise in blood donation to match the progressive increase in blood demand. In the face of this inadequacy it might be expedient to also audit the blood ordering pattern in our centre in order to reduce wastage while we continue to work towards increasing the voluntary blood donor base.

Prevalence of transfusion transmissible infection in blood donors at tertiary care centre of Eastern Uttar Pradesh

Microbiological safety is very important aspect of blood transfusion services (BTS). Viral infectious agents possess a great risk of transfusion transmitted disease. On the one hand, blood or component transfusion is a lifesaving modality but on the other hand it can cause great mortality or morbidity in recipient if not used judiciously. The main aim of the study is to evaluate the prevalence of HIV, HBV, HCV, Syphilis and Malaria amongst all types of donors donated at blood bank of Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi during the year 2017. This was a retrospective study. The blood donors included in this study include all donors coming directly to blood bank and blood donation camps organized by blood bank. Total donation during that period was 22255 units. A detailed questionnaire was given to the donors for registration. A total of 226 units (1.01%) were seropositive. The sero-prevalence of HIV, HBV, HCV, and Syphilis were 0.9% (21), 0.79% (177), 0.09% (22), 0.02% (6) respectively. No cases of malaria were detected. TTI can be reduced by motivating maximum voluntary blood donation, reducing replacement donation, public information and donor education awareness programme, stringent donor screening criteria and vigilance of error.

Seroprevalence of hepatitis B and hepatitis C among blood donors in Sierra Leone: A multi-year retrospective study

ObjectivesIn Sierra Leone, very little data are available on hepatitis B virus (HBV) and hepatitis C virus (HCV) prevalence. Blood donor screening permits estimation of the prevalence of transfusion transmissible infections in a general open population. We analyzed blood donor data in Sierra Leone to estimate national viral hepatitis prevalence and identify risk factors for hepatitis infection among the donor population. MethodsWe conducted a retrospective data analysis in five government hospitals. We collected HBV and HCV screening results, donor demographics, and donation type (family replacement or voluntary donor; first-time or repeat). Univariate and multivariate analyses were performed to determine associations between infections and socio-demographic factors. ResultsThe number of donors screened was 29,713. The overall prevalence was: 10.8% (3200) for HBV and 1.2% (357) for HCV. HBV infection was most strongly associated with male sex (p: <0.0001) and younger age (p: <0.0004 for the 22–27 age group). Both HBV and HCV infection were higher in certain locations. ConclusionOur findings stress the presence of viral hepatitis infection throughout the country and the need to invest in safe blood services, vaccination and treatment of viral hepatitis at the national level.

Motivating and deterring factors for repeat blood donation among donors of blood bank

Various factors determine the donor’s frequency of blood donation like lack of awareness, life style barriers, and their present and past experience with blood donation. To determine the motivating and deterring factors for repeat blood donation among donors in blood bank and to analyze how these factors influence their decision for subsequent blood donation. It was a cross sectional study in which both the voluntary and replacement donors visiting the blood bank for blood donation were administered a questionnaire. The questionnaire included the details of the donor’s previous donations, their experience with the present donation and the intention of future blood donation. Out of the total 100 blood donors participated in the study, 63 had a history of previous blood donation and 37 were first time. Most of the donors 96% expressed their willingness for the repeat blood donation and were motivated to encourage their friends and relatives for future blood donation. 75% of the donors suggested that awareness programs can be created in the media to motivate the community for blood donation. Blood banks should adopt strategies to encourage the current donors as a regular blood donor to meet the huge transfusion demand of the nation and current replacement donor should be a voluntary donor in future.

Transfusion in limited infrastructure locations – where to go decades after safe blood initiative by World Health Organization?

Transfusion demand in sub‐Saharan Africa is increasing. Establishment of large national blood services seems to be challenging. Hospital blood services maintain the basic supply. However, they lack effective communication networks. Cell phones/internet provides the infrastructure for establishing such networks and could help in establishing haemovigilance systems. Voluntary non‐remunerated donors are the minority of donors (&lt;20%). It seems more appropriate to develop strategies to increase the safety of replacement donor blood instead of insisting on copying Western‐world models. Red cell serology is usually restricted to ABO/Rh‐D and at best Coombs crossmatch. Introduction of antibody differentiation and additional typing for C,c,E,e and K would prevent 60–70% of delayed haemolytic transfusion reactions. One of the most frequent indications for blood transfusion is major haemorrhage. Why is component therapy still recommended for resource‐limited regions, while whole blood is reintroduced in Europe/US for exactly the same indications? Plasma thawed due to electricity failures is usually discarded anyway. Leuco‐depleted products would be beneficial (multitransfused sickle‐cell patients/neonates/AIDS). An ideal blood product could be whole blood, in‐line leuco reduced by gravity filtration, treated by user‐friendly pathogen‐reduction not requiring irradiation/illumination. The transfusion medicine community should form an alliance to develop an affordable, pathogen‐reduced blood product, to train regional auditors and to bring in external expertise to aid knowledge transfer. However, standards to be reached should be defined by the respective national experts who understand the culture and needs of their country. In respectful collaboration, we could learn from each other to finally improve transfusion in resource‐limited regions.