Teaching Hospital Blood Bank Research Articles

Assessing the implications of using RDTS in donor blood screening for transfusion-transmissible infections (TTIs): analysis of trans-in donor blood at a Tertiary Hospital in Ghana

BackgroundBlood transfusion is a critical hemotherapeutic intervention. However, the widespread utilization of Rapid Diagnostic Test (RDT) methods in screening potential donors for TTIs poses a serious public health challenge. We investigated the prevalence of TTIs in donor blood units that were transported from external health facilities (Trans-in blood) to Ho Teaching Hospital for critical care. MethodWe adopted a cross-sectional design to investigate 727 units of Trans-in blood at the Ho Teaching Hospital's blood bank between January 1, 2021, to December 31, 2022. An apriori-developed data capture form was used to collect the data for this study. The chi-square test and Cramer's V or Phi were used to assess the association between variables of interest. Binary logistic regression analysis was used to determine the association between TTIs and donor's blood groups whereas spatial visualization was employed to present the distribution of missed TTIs. ResultsThe overall prevalence of missed TTIs was 6.19 % (95 % CI: 4.66–8.18), comprising missed HIV, HBV, and Syphilis infection rates of 1.79 % (95 % CI: 1.72–1.86), 1.24 % (95 % CI: 1.17–1.31), and 3.16 % (95 % CI: 3.09–3.23), respectively. There was a higher rate of missed HIV infections in 2022 (2.04 %, 95 % CI: 1.04–3.97) compared to 2021 (1.49 %, 95 % CI: 0.64–3.45), and a decline in the rates of missed HBV and Syphilis infection within the period. The prevalence of TTI was highest among donors with ABO blood group 'O' (68.89 %, 95 % CI: 54.34–80.47) and Rh 'D' Positive blood group (95.56 %, 95 % CI: 85.17–98.77). Compared to donors with blood group O, non-O donors had 4.53 times the odds (95 % CI: 1.12–18.27; p-value=0.034) of missed HBV infection. ConclusionThe observed prevalence of missed TTIs highlights potential gaps in current screening practices, posing a significant public health concern. Efforts made to clamp down on the spread of these infections within the population may be impeded if the current trend of missed TTIs continues. Further studies on a larger scale with more comprehensive data are advised to better appreciate the public health implications of missed TTIs in Ghana.

Evaluation of Blood Transfusion Request form: The Experience in a Tertiary Health Facility in Jos, Nigeria

Background: There is a thin line between a safe blood transfusion and transfusion-related fatality hence the need to be diligent in every aspect of the blood transfusion process. Appropriate and complete documentation on a blood transfusion request form is one of the most important preanalytic activities serving as a communication tool between the clinician and the blood transfusion laboratory personnel. Aims: To evaluate compliance with appropriate and complete documentation of information on our blood transfusion request forms for a reliable preanalytic process towards an efficient blood transfusion service. Study Design: It is a retrospective study. Place and Duration of Study: Blood Bank of the Jos University Teaching Hospital between January to December 2023. Methodology: Six thousand, three hundred and sixty (6360) blood transfusion request forms from the Jos University Teaching Hospital Blood bank were evaluated for complete or incomplete documentation retrospectively and results were presented in frequencies and percentages. Results: There was 100% compliance in filling in the patients' surnames and other names as well as the laboratory number and blood groups of the patients while only 4779 (75.14%) filled in the patients' ages with 1416(22.26%) using the prefix of adult(ad) while 165(2.59%) fail to document the patients' age. There were 2829 (44.48%) males with 3522 (55.38%) females while no sex was indicated in 9 of the reviewed forms. Obstetrics history has the least cumulated documented response of 0.38% while a significant 1008 (15.85%) did not indicate either blood grouping or blood grouping with cross-match request. Conclusion: Appropriate and complete documentation of information on blood transfusion request forms is a problem among clinicians and will require continuous education on its importance, periodic auditing, provision of electronic data system and attitudinal change for a better blood transfusion compatibility service.

Transfusion transmitted infections among blood donors of Kamenge Teaching Hospital blood bank in Burundi.

The current risk of contracting a transfusion transmitted infections (TTIs) is unknown in Burundi. The aim of this study was to assess sociodemographic profiles of blood bank donors at Kamenge Teaching Hospital, the prevalence and associated risk factors of HIV, syphilis, HBV and HCV from 2015 to 2020. We conducted a cross-sectional study including all blood donors of Kamenge Teaching Hospital blood bank. During this study, 1370 blood samples were screened for HIV, Syphilis, HBV and HCV. We calculated prevalence of TTIs and performed logistic regression to know associated risk factors. Blood donors were males at 77% and 23% females. They were mostly students (54.2%). On screening, 83 blood samples (6.06%) were seropositive for at least one TTI. The overall prevalence rate of HIV, Syphilis, HBV and HCV among blood donors was 1.3%, 0.2% ,1.6%, 2.9% respectively. There was difference in distribution of the four TTIs among blood donors which is statistically significant (x2=33.997, ϱ-value<0.001). Private donors were associated with a high risk of syphilis and being a first-time donor was associated with a high HBV risk factor. The prevalence of TTIs found still to be high; mandatory and continuous screening is necessary.

An Assessment of the Viability of Haematological and Haemostatic Parameters of Blood under certain Storage Conditions at the Rivers State University Teaching Hospital Blood Bank in Port Harcourt, Nigeria

Introduction: Despite significant advances in transfusion medicine, concerns about the inherent risks of blood transfusion persist, even under optimal temperature and duration of storage. This makes the evaluation of blood viability a global task (1). Maintenance of adequate temperature is considered a key factor in the viability and quality of stored blood in healthcare institutions. Evaluating the haematological and haemostatic functionality of blood elements at different storage temperature and duration is therefore imperative for improving patient care and resource utilization in Rivers State University Teaching Hospital (RSUTH) blood bank in Port Harcourt.&#x0D; Methods: In this cohort study design, a total of sixteen (16) male and female blood donors in equal proportion of sex and ABO blood groups were randomly selected from the Port Harcourt blood donors' population and recruited as study subjects for this research. A well-structured questionnaire and the immunoassays were used to assess the donors' health and serological status respectively. Also the sample obtained were analayzed by automation and data statistically analyzed using ANOVA.&#x0D; Results: The results of this study shows a statistically significant decrease in white blood cell count from 4.93×109/L ± 0.33 to 2.79×109/L ± 1.68 (p=0.00) and platelet count from 227.38×109/L ± 32.17 to 153.75×109/L ± 58.39 (p=0.00) at day 7. Also, a significant decrease in platelet count from 227.38×109/L ± 32.17 to 141.50±60.92 at day 14. A significant decrease in Fibrinogen from 340.75mg/L±18.69 to 281.2575 mg/L ±46.41 at day 1 and day 14 respectively, and rise in PT and aPTT from 17.02s ±1.28 to 24.31s ±6.67 and 41.25s±3.23 to 46.63s±6.28 at day 14th to day 21 respectively (p=0.00).&#x0D; Conclusion and Implications for Translation: Pooled plasma at 4-60C contain clinically significant amount of coagulation factors up to day 21 in storage. The WBC and platelet is lost within seven day of storage at 4-60C. Lower temperatures, especially freezing at -60°C accelerate the loss of haematological viability of blood especially the depletion of white blood cells and platelets (p=0.00). Antihaemophilic factor and fibrinogen is maintained in FFP at 180 day in storage at -600C.

Blood Transfusion Request and Utilization: The Trend in a Tertiary Health Care Centre in North Central Nigeria

Background: An effective blood transfusion service is anchored on an adequate supply of safe blood and its components as well as its accessibility and appropriate clinical use. There is a contrast in blood supplies and utilization between the high, middle and low-income countries necessitating the formulation of appropriate modalities to ensure judicious use of blood while minimizing wastage.&#x0D; Aims: This study was aimed at assessing the blood transfusion request trend in our institution and its utilization with the intent of curtailing the wastage of safe blood for transfusion.&#x0D; Study Design: It is a retrospective study.&#x0D; Place and Duration of Study: Jos University Teaching Hospital Blood Bank from January 2022 to December 2022.&#x0D; Methodology: Appropriately filled blood transfusion request forms of the Jos University Teaching Hospital compared with the blood bank In-house records from January 2022 to December 2022 were reviewed. Request dates, requesting Department, Unit or Specialty, indications for request, Number of units requested, and number eventually utilized were used to determine blood transfusion indices which are indicative of efficient and significant blood use.&#x0D; Results: Eight thousand, five hundred forty-eight (8,548) blood transfusion request forms from the blood bank and patients' folders were reviewed and compared with the Blood Bank's in-house records. Requests for blood transfusion for over 460 indications were received from twenty-six (26) departments and units. There was a general Crossmatch: Transfusion ratio (C: T) of 1.7 with a transfusion index (TI) of 1.2 and transfusion probability (TP) of 48.0%.&#x0D; Conclusion: Transfusion requests were characterized by low utilization across departments and units. This calls for the establishment of a transfusion protocol for the determination of blood volume required for every indication so that this limited commodity will be made available and accessible when needed.

Study of reasons for discarding whole blood and its components in a blood bank in a rural tertiary care teaching hospital in Maharashtra

Abstract Introduction: Each unit of blood is valuable; thus, it must be used as efficiently as possible with the least amount of waste. Supply of blood in an emergency requires stringent storage conditions with quality checked and should be available at the time of demand to the needy. So blood banks play a vital role in this demand-supply process. On the other hand, because of the biological nature of blood, it is very vulnerable to contamination by infections, early expiry and hemolysis. The purpose of this study was to determine the reasons for the wastage of blood and blood components. Materials and Methods: At our tertiary care teaching hospital blood bank we conducted a retrospective analysis of data of all whole blood and blood component samples collected from January 2013 to December 2020. Results: 391 (9%) of the 4022 entire blood bags collected were discarded 132 (32%) of them were eliminated due to hemolysis and lipolysis and the same 32% expired due to completion of the life span of RBC. Sero-reactivity for TTI or transfusion-transmitted diseases was 22.4% and only 13% were rejected for use because of some leakage or inadequate quantity of blood in the bag. Conclusion: An adequately conducted donor screening, notification and counseling of permanently deferred donors will help in discarding less number of bags that are positive for different TTI. Properly implemented blood transfusion policies will help to utilize the blood components in a proper way resulting in discarding the number of blood bags due to expiry.

W262 Proportion of different ABO and Rh phenotypes in voluntary blood donors at Tribhuvan university teaching hospital blood bank

W262 Proportion of different ABO and Rh phenotypes in voluntary blood donors at Tribhuvan university teaching hospital blood bank

Pattern of blood procurement and utilization in a university hospital in Southeast Nigeria

Background: Blood is a scarce commodity and every effort needs to be made to use it judiciously and avoid wastage. This study reviewed the pattern of blood procurement, ordering, and utilization at a hospital-based blood bank. Materials and Methods: This was a retrospective study in which data on blood procurement methods, pattern of requisition of blood, and outcome of issued blood were obtained from blood bank registers over a 2-year period at the Nnamdi Azikiwe University Teaching Hospital blood bank. Results: Approximately, 99% of donors were family replacement donors. In 2014, total blood donated was 4003 which exceeded the request for red blood cell (RBC) transfusion by 921 units. The highest request for blood was from the accident and emergency and 90% of blood issued were used. Overall percentage wasted of RBCs was 19.8% and the major contributors to these were antenatal clinic and labor ward both having 80% and 55.8% issued blood returned to blood bank unused. Conclusion: The proportion of wasted units of RBC is high. Designing and adhering to maximum blood ordering schedule and blood transfusion guidelines with efforts toward converting family replacement donors to voluntary blood donors will help in maintaining a steady supply of safe blood.

Evaluation of Reasons for Blood Donor Deferral in A Tertiary Care Teaching Hospital Blood Bank Unit, Tumkur, Karnataka, India

Evaluation of Reasons for Blood Donor Deferral in A Tertiary Care Teaching Hospital Blood Bank Unit, Tumkur, Karnataka, India

Whole Blood Donor Deferral Causes in a Tertiary Care Teaching Hospital Blood Bank from South India

Whole Blood Donor Deferral Causes in a Tertiary Care Teaching Hospital Blood Bank from South India

Prevalence of HIV among Blood Donors at RIMS, Teaching Hospital Blood Bank, Raichur: A Retrospective Study

Prevalence of HIV among Blood Donors at RIMS, Teaching Hospital Blood Bank, Raichur: A Retrospective Study

Distribution of ABO and rhesus (D) blood group antigens among blood donors at a tertiary care teaching hospital blood bank in south India

Background: The ABO and Rhesus (Rh) blood group systems are important for transfusion of blood and its components, organ transplantation, genetic studies and in medico-legal issues. Despite the long list of several other blood groups discovered so far, the knowledge and distribution of ABO and Rh-D blood group are essential for effective management of blood bank inventory. Methods: We retrospectively studied the distribution of ABO and Rh blood group antigens in donors presenting to our tertiary care teaching hospital blood bank in south India during the period January 2007 to August 2014. Blood group was determined by commercially available standard monoclonal antisera by test tube agglutination technique. Results: A total of 49,110 donor samples were tested during the study period for ABO grouping and Rh-D typing. Out of these 96.9% were males. The frequency of O, B, A, AB and Bombay blood groups were 41.7%, 32.2% 20%, 6.1% and 0.03% respectively. Rh (D) positive and negative blood groups were seen in 92.8% and 7.2% respectively. The allele frequencies of the IA, IB and IO alleles were 0.1398, 0.2148 and 0.6454 respectively. In case of Rh-D group, the calculated gene frequencies for ID and Id were 0.7321 and 0.2679 respectively. Conclusion: Knowledge of blood group systems as documented in the present study helps in efficient manage- ment of blood bank and transfusion services in emergencies.

Reasons for discarding whole blood and its components in a tertiary care teaching hospital blood bank in South India

Introduction: Each unit of blood is precious and has to be utilized properly with minimal discards. The aim of thisstudy was to find out the reasons for discarding blood and blood components. Materials and Methods: We retrospectively studied all whole blood and blood components collected during January 2013 to June 2014 at our tertiary care teaching hospital blood bank in South India. Results: Of the 5261 whole blood bags, 298 (5.7%) were discarded. Of these, 146 (49%) were discarded because of seroreactivity for transfusion transmitted infections (TTI). Of the 19586 blood components prepared, 1449 (7.4%) were discarded. Among blood components discarded, most common units were platelets (16.3%). The most common cause of discarding the blood components was due to expired date (36.9%). Conclusion: A properly conducted donor screening, notification and counselling of permanently deferred donors will help in discarding less number of bags which are positive for different TTI. Properly implemented blood transfusion policies will help to utilize the blood components in a proper way resulting in discarding the less number of blood bags due to expiry.

An ex vivo evaluation of efficacy of refrigerated canine plasma.

To determine thawing times of fresh frozen plasma (FFP), and to evaluate the activity of hemostatic proteins (coagulation factors V, VII, VIII, IX, X, and fibrinogen), clotting times (prothrombin time and activated partial thromboplastin time), and sterility of canine plasma stored refrigerated. Prospective laboratory-based study. Veterinary teaching hospital blood bank. Phase 1: Six units of canine FFP were retrieved from the blood bank and thawed individually in a warm water bath. Time for thaw was recorded in minutes and reported as mean ± SD. Phase 2: One unit of fresh whole blood was collected from 9 dogs and processed routinely. Resulting plasma was divided into 2 aliquots, 1 stored as refrigerated plasma (RP) and 1 as frozen plasma. Samples from the RP were taken at 0, 1, 5, 7, and 14 days and from the FFP at days 0 and 14 for determination of clotting factor activity (V, VII, VIII, IX, and X and fibrinogen) and clotting times. Coagulation factors and clotting times were analyzed using a mixed effects linear model for ANOVA, comparing changes over time as well as differences between groups. For all comparisons, a P value of <0.05 was considered significant. Batch bacterial aerobic and anaerobic cultures of the RP samples were submitted on days 7 and 14 and from the frozen plasma on day 14. Time to thaw for FFP units was 34.7 ± 1.38 minutes. Refrigerated storage resulted in significant decreases in the activity of all clotting factors and a subsequent prolongation in clotting times. However, no values were outside of the reference interval. All bacterial cultures yielded no growth. Refrigerated storage results in only minor loss of coagulation factor activity in canine plasma. The use of RP, therefore, may be a viable option in high-volume veterinary hospitals for rapid correction of coagulopathy in critical care patients.

Screening for hepatitis C virus infection in a high prevalence country by an antigen/antibody combination assay versus a rapid test

In low-income-countries, screening for hepatitis C virus (HCV) infection is often based on rapid tests (RT). Their lower sensitivity compared to enzyme immunoassay (EIA) suggests that newer HCV Antigen/Antibody (Ag/Ab) combination assays might have a role in such countries. To test this idea, 1998 blood donors were tested at the University Teaching Hospital blood bank in Yaoundé, Cameroon simultaneously with a RT (HCV rapid test, Human Diagnostics, Berlin, Germany) according to standard practice (S1) and with an Ag/Ab assay (Monolisa HCV Ag/Ab Ultra, Biorad, France) (S2). All discordant, borderline and reactive samples were submitted to confirmatory testing by immunoblot and/or HCV-RNA. Of the 86 (4.3%) samples positive with one or both strategies, 29 were confirmed negative, 37 positive and 20 were false positive or resolved infection. There was a significant difference in test sensitivity (p=0.01) between S1 (70.3%) and S2 (91.9%) but not in test specificity (99.4% and 98.6%, respectively). The benefit of the Ag/Ab assay in the detection of recent HCV seronegative infections could not be evaluated since no Antigen-only donations were identified. However, better Ag/Ab test sensitivity compared to RT supports the implementation of these newer immunoassays for HCV screening in the African blood bank setting.

Pattern of blood donor deferral in a tertiary hospital, South-south, Nigeria: A three-year study review

Aims: Provision of safe and adequate supply of blood and blood products is a major public health issue globally. Safe blood is ensured through proper donor selection and testing of donated blood. However, a large number of apparently healthy donors are unable to donate blood for various reasons. To determine the proportions and reasons for donor deferral in University of Uyo Teaching Hospital (UUTH) Blood Bank. Methods: A three-year retrospective review of records of blood donors from January 2009 to December 2012 was analyzed to determine the proportions and reasons for donor deferral in University of Uyo Teaching Hospital blood bank. Results: There were 5,636 donors of which 902 donors representing 16% of the entire donor population were deferred for various reasons. Large proportions (89.1%) of the donors were family replacement donors. Female donors constitute 16% of the entire donor population and were more frequently deferred than male donors 34.4% versus 12.4%, respectively. Transfusion transmissible infections (TTIs) positivity and anemia were the major reasons for permanent (50.4%) and temporary (39%) deferral of donors. The TTIs rates were higher among male donors than female donors. Conversely, more female donors were anemic (25.6%) compared to male (12.7%). Other reasons identified for donor deferral were underage (6.8%), underweight (2.4%), and hypertension (3.1%). Conclusion: A donor deferral rate of 16% in this study is similar to that reported in other studies. However, the reasons for deferral differ reflecting differences in donor selection criteria.

Prevalence of hepatitis B surface antigen seropositivity among HIV-infected and non-infected individuals in Nnewi, Nigeria

Background:Co-infection of human immunodeficiency virus (HIV) and hepatitis B virus (HBV) is common as both viruses share common routes of transmission. HIV significantly affects the natural history of HBV, hence the need to determine the prevalence of co-infection.Materials and Methods:This was a retrospective study between 2005 and 2009, in which is a total of 2018 subjects who reported at our University Teaching Hospital blood bank and human immunodeficiency virus clinic were studied. Hepatitis B surface antigen (HBsAg) was tested for using a one step lateral flow rapid chromatographic immunoassay (Acumen labs and diagnostic centre, Bangalore, India) and HIV 1/2 was tested using two kits, Determine (made by Abbot, Japan for Inverness Medical, Japan).Results:A total of 2018 subjects were studied out of which 1176 were HIV positive (964 males and 212 females) and 842 (334 males and 508 females) were negative. The prevalence of HBsAg positivity in the study population was 5.9%. It was 6.3% and 5.6% in the HIV-infected and un-infected population, respectively. Although the prevalence was higher in those who are HIV infected, the difference was not statistically significant (P=0.52). Males who were HIV positive were found to be more likely to have co-infection than females (8.7% vs. 4.2%, P=0.02, OR=1.917).Conclusion:This study showed that in south-eastern Nigeria, infection with HBV is relatively common in both HIV-infected and un-infected individuals. Routine screening for HBV should be done for all HIV positive individuals.

The prevalence of A2 and A2B subgroups in blood donors at a tertiary care teaching hospital blood bank of Rayalaseema region: A pilot study

The prevalence of A₂ and A₂B subgroups in blood donors at a tertiary care teaching hospital blood bank of Rayalaseema region: A pilot study

Effet de la déleucocytation des concentrés érythrocytaires sur les réactions transfusionnelles

In order to assess the impact of leukocyte reduction, all transfusion reactions reported at Liege Teaching Hospital's Blood Bank 2 years before and after the implementation of universal leukocyte reduction of red blood cells concentrates which started-up on 1 January 2005 were evaluated. A retrospective analysis of transfusion reactions from 1 January 2003 to 31st December 2006 was undertaken. Data were collected from computerized reports, which were entered as soon as a transfusion reaction was reported. Symptoms were classified in different reaction's categories. Blood cultures, antibody screening and direct antiglobulin test were performed. Differences between the two time periods, before (2003-2004) and after (2005-2006) universal leukoreduction were determined by the Chi-square test and significance was defined as a p value less than 0.05. During period before the implementation of systematic leukoreduction, 68.7% of red blood cells transfused were leukoreduced. A total of 365 transfusion reactions in 91,996 red blood cells units transfused (0.4%) were reported, of which 266 were classified as febrile non-hemolytic transfusion reactions (72.9%), followed by allergic reactions (7.1%) and miscellaneous reactions (3.8%). When comparing the two-time periods, the rate of all transfusion reactions in general significantly decreased from 0.49 to 0.31% (p<0.001). Therefore, universal leukocyte reduction significantly reduced the rates of febrile non-hemolytic transfusion reactions (0.35% versus 0.24%; p=0.002) and allergic reactions (0.05% versus 0.01%; p<0.001). Universal leukocyte reduction significantly reduced the rate of transfusion reactions.

Sero-epidemiology of transfusion-transmissible infectious diseases among blood donors in Osogbo, south-west Nigeria.

Transfusion-transmissible infectious agents such as hepatitis B virus (HBV), human immunodeficiency virus (HIV), hepatitis C virus (HCV) and syphilis are among the greatest threats to blood safety for transfusion recipients and pose a serious public health problem. This cross-sectional study was undertaken with the aim of determining the seroprevalence of HIV, HCV, hepatitis B surface antigen (HBsAg) and syphilis and correlates the findings with sex and age to ascertain the associations, if any, in the occurrence of the pathogens. HBsAg, antibodies to Treponema pallidum and HCV were determined using Clinotech test strips. Antibodies to HIV types 1 and 2 were screened with Determine and Immunocomb. All the reactive samples were confirmed using enzyme-linked immunosorbent assays. Antibodies to Treponema pallidum were confirmed with a Treponema pallidum haemagglutination test. A total of 1,410 apparently healthy prospective blood donors aged between 18 and 64 years (mean+/-SD, 32.58 +/- 10.24 years) who presented for blood donation at the Ladoke Akintola University of Technology Teaching Hospital Blood Bank, Osogbo were studied. The male:female ratio was 6:1. Of the prospective blood donors, 406 (28.8%) had serological evidence of infection with at least one infectious marker and 36 (2.6%) had dual infections. The overall seroprevalence of HBsAg, HIV, HCV and syphilis was found to be 18.6%, 3.1%, 6.0% and 1.1%, respectively. The highest prevalences of HBsAg, HIV, HCV and syphilis infections occurred among commercial blood donors and those aged 18 to 47 years old, the most sexually active age group. There were no significant associations between pathogens except for syphilis and HIV (p > 0.001). The high seroprevalence of blood-borne pathogens among prospective blood donors in Osogbo, Nigeria calls for mandatory routine screening of blood donors for HBV, HIV, HCV and syphilis.