ABSTRACT
In April 2020, in light of COVID-19-related blood shortages, the US Food and Drug Administration (FDA) reduced the deferral period for men who have sex with men (MSM) from its previous duration of 1 year to 3 months.Although originally born out of necessity, the decades-old restrictions on MSM donors have been mitigated by significant advancements in HIV screening, treatment, and public education. The severity of the ongoing COVID-19 pandemic-and the urgent need for safe blood products to respond to such crises-demands an immediate reconsideration of the 3-month deferral policy for MSM.We review historical HIV testing and transmission evidence, discuss the ethical ramifications of the current deferral period, and examine the issue of noncompliance with donor deferral rules. We also propose an eligibility screening format that involves an individual risk-based screening protocol and, unlike current FDA guidelines, does not effectively exclude donors on the basis of gender identity or sexual orientation. Our policy proposal would allow historically marginalized community members to participate with dignity in the blood donation process without compromising blood donation and transfusion safety outcomes.
Subject(s)
Blood Donors/ethics , Blood Safety/standards , Blood Transfusion/standards , COVID-19/epidemiology , Donor Selection/standards , Sexual and Gender Minorities/statistics & numerical data , COVID-19/therapy , COVID-19/transmission , HIV Infections/transmission , Health Policy , Homosexuality, Male/statistics & numerical data , Humans , Male , Transgender Persons/statistics & numerical data , United StatesABSTRACT
BACKGROUND: Biobanks are highly organized infrastructures that allow the storage of human biological specimens associated with donors' personal and clinical data. These infrastructures play a key role in the development of translational medical research. In this context, we launched, in November 2015, the first biobank in Morocco (BRO Biobank) in order to promote biomedical research and provide opportunities to include Moroccan and North African ethnic groups in international biomedical studies. Here, we present the setup and the sample characteristics of BRO Biobank. METHODS: Patients were recruited at several departments of two major health-care centers in the city of Oujda. Healthy donors were enrolled during blood donation campaigns all over Eastern Morocco. From each participant, personal, clinical, and biomedical data were collected, and several biospecimens were stored. Standard operating procedures have been established in accordance with international guidelines on human biobanks. RESULTS: Between November 2015 and July 2020, 2446 participants were recruited into the BRO Biobank, of whom 2013 were healthy donors, and 433 were patients. For healthy donors, the median age was 35 years with a range between 18 and 65 years and the consanguinity rate was 28.96%. For patients, the median age was 11 years with a range between 1 day and 83 years. Among these patients, 55% had rare diseases (hemoglobinopathies, intellectual disabilities, disorders of sex differentiation, myopathies, etc.), 13% had lung cancer, 4% suffered from hematological neoplasms, 3% were from the kidney transplantation project, and 25% had unknown diagnoses. The BRO Biobank has collected 5092 biospecimens, including blood, white blood cells, plasma, serum, urine, frozen tissue, FFPE tissue, and nucleic acids. A sample quality control has been implemented and suggested that samples of the BRO Biobank are of high quality and therefore suitable for high-throughput nucleic acid analysis. CONCLUSIONS: The BRO Biobank is the largest sample collection in Morocco, and it is ready to provide samples to national and international research projects. Therefore, the BRO Biobank is a valuable resource for advancing translational medical research.
Subject(s)
Biological Specimen Banks/ethics , Biological Specimen Banks/standards , Biomedical Research/standards , Specimen Handling/ethics , Specimen Handling/standards , Adolescent , Adult , Aged , Aged, 80 and over , Blood Donors/ethics , Child , Child, Preschool , Consanguinity , Ethnicity , Female , Geography , Humans , Infant , Infant, Newborn , Male , Middle Aged , Morocco , Quality Control , Translational Research, Biomedical , Young AdultABSTRACT
INTRODUCCIÓN: La metodología de aprendizaje-servicio se presenta como una herramienta educativa que permite respon-der integradamente a tres dimensiones: una académica, que posibilita mayores y mejores aprendizajes en los estudiantes; otra, la contribución real a la solución de problemas comunitarios, y finalmente, generar un espacio de formación en valores para los estudiantes. OBJETIVO: El objetivo de la estrategia metodológica de aprendizaje-servicio fue fortalecer los aprendizajes declarados en las trayectorias relacionados con la donación altruista de sangre, junto con instaurar en los estudiantes la responsabilidad social de hacerse donantes y promotores de la donación como futuros profesionales de la salud, en coordinación con un socio comunitario. Sujetos y métodos: La actividad se desarrolló a través de charlas a comunidades objetivo. Los estudiantes contactaron con las comunidades, prepararon el material y desarrollaron la actividad. Se hizo evaluación a través de una encuesta a los estudiantes, con aseveraciones que debían responder de acuerdo con una escala de 1 a 4, siendo 4 el mayor nivel de acuerdo. RESULTADOS: La actividad de aprendizaje-servicio fue evaluada por los estudiantes con un promedio global de 3,69. El criterio mejor evaluado fue la actividad de aprendizaje-servicio potencia el desarrollo de responsabilidad profesional y social', con una media de 3,86. CONCLUSIÓN: Esta metodología de enseñanza mejora la adquisición de saberes pertenecientes a módulos disciplinares y fortalece el compromiso social en los estudiantes
INTRODUCTION: The service-learning methodology is presented as an educational tool that allows to respond integrally to three dimensions: an academic one, which enables greater and better learning in students; another to the real contribution to the solution a community problem; and finally, to generate a space for values training for students. AIM: The objective of the service-learning methodological strategy was to strengthen the declared learning in the trajectories related to altruistic blood donation, along with establishing in students the social responsibility of becoming donors and promoters of donation as future health professionals, in coordination with a community partner. Subjects and methods: The activity was developed through talks to target communities. The students contacted the communities, prepared the material, and developed the activity. Evaluation was made through a survey of students, with statements that they had to answer according to a scale of 1 to 4, with 4 being the highest level of agreement. RESULTS: The service-learning activity was evaluated by the students with a global average of 3.69. The best evaluated criterion was 'the service-learning activity enhances the development of professional and social responsibility', with a 3.86 grade point average. CONCLUSION: This teaching methodology improves the acquisition of knowledge belonging to disciplinary modules, and strengthens social commitment in students
Subject(s)
Humans , Learning , Health Strategies , Biomedical Technology/statistics & numerical data , Social Responsibility , Biomedical Technology/education , Social Values , Educational Measurement , Surveys and Questionnaires , Liability, Legal , Blood Donors/ethics , Blood Banks/standardsABSTRACT
Introducción: La donación de sangre salva vidas, por lo que la seguridad de la sangre es lo más importante de todo el proceso. La localización demográfica conduce a tener causas específicas de diferimiento. Vivir en zonas altoandinas produciría cambios adaptativos hematológicos. Es por esta razón que resulta importante conocer las causas de rechazo y así poder reorientar los programas de promoción de donación de sangre. Objetivo: Determinar las causas de rechazo de donantes de sangre de un hospital del sur peruano a 3825 m. s. n. m. Métodos: Se realizó un estudio transversal, de corte retrospectivo, sobre las causas de rechazo de posibles donantes de sangre del Hospital III EsSalud, Juliaca. Se analizaron los registros de predonantes que fueron rechazados, desde enero del 2014 a diciembre del 2018. Los datos se analizaron en el programa STATA v.14. Resultados: De los posibles predonantes seleccionados (4057), 1699 (41,87 por ciento) fueron mujeres y 2358 (58,13 por ciento) fueron varones. Fueron diferidos 1458 (41,87 por ciento), los varones tuvieron la tasa de rechazo más alta 882 (60,49 por ciento) en comparación con las mujeres 576 (39,51 por ciento). La polieritrocitemia fue la causa más frecuente de rechazo 669 (45,8 por ciento). Conclusiones: La tasa de rechazo fue moderada (35,93 por ciento) y la principal causa, fue el hematocrito alto (68,4 por ciento), seguido por el bajo (6,8 por ciento).
Introduction: Blood donation saves lives. Blood safety is thus the most important factor throughout the whole process. Demographic location accounts for specific reasons for deferral. Living in high Andean areas causes adaptive hematological changes. Therefore, it is important to be aware of the reasons for deferral with a view to reorienting blood donation promotion programs. Objective: Determine the reasons for blood donor deferral in a Southern Peruvian hospital 3 935 m amsl. Methods: A retrospective cross-sectional study was conducted of the reasons for deferral of potential blood donors in EsSalud III Hospital in Juliaca. An analysis was performed of the records of pre-donors deferred from January 2014 to December 2018. The data were processed with the software STATA version 14. Results: Of the potential pre-donors selected (4 057), 1 699 (41.87 percent) were women and 2 358 (58.13 percent) were men. A total 1 458 (41.87 percent) were deferred. Men had the highest deferral rate with 882 (60.49 percent), whereas the rate for women was 576 (39.51 percent). Polyerythrocythemia was the most common reason for deferral with 669 (45.8 percent). Conclusions: The deferral rate was moderate (35.93 percent) and the main reason was high hematocrit (68.4 percent), followed by low hematocrit (6.8 percent)(AU)
Subject(s)
Humans , Male , Female , Blood Donors/ethics , Blood Safety/methods , Cross-Sectional Studies , Blood Safety/ethicsABSTRACT
Voluntary, non-remunerated donations are fundamental principles with anonymity regarding donations of elements and products of the human body in France. Blood donation was a model to organize donation of organs, hematopoietic stem cell or gamete. These principles, which at first glance appear to be intangible, commonly accepted and transposable between the different types of donation, though reveal singularities regarding to a collective imagination, a biological reality, evolution of society, medicine and science. Through the study of these different principles applied to donated human body parts, this article aims to highlight the ethical limitations of a single principlist approach. The notions of anonymity, consent, voluntariness, non for profit, under their universal aknowledge, reveal variability of interpretation and scope due to the heterogeneous characteristics, implications and purposes between these donations of different elements and the uses made of them.
Subject(s)
Ethical Theory , Human Body , Tissue and Organ Procurement/ethics , Altruism , Blood Donors/ethics , Blood Donors/legislation & jurisprudence , Confidentiality , France , Humans , Informed Consent , Male , Milk, Human , Motivation , Oocytes , Organ Transplantation , Personal Autonomy , Plasma , Remuneration , Social Justice , Spermatozoa , Tissue and Organ Procurement/legislation & jurisprudence , VolunteersABSTRACT
RESUMEN La terapia transfusional demanda de sólidos conocimientos para lograr planear y ejecutar un plan de trabajo integral para el logro del bienestar de la persona que lo requiera. El personal que desarrolla su profesión en aspectos relacionados con las transfusiones sanguíneas debe estar en una actualización continua de conocimientos, orientados a desarrollar nuevas técnicas así como medidas de seguridad. El objetivo de este trabajo fue abordar acerca de la importancia del uso de la sangre como recurso terapéutico, y el valor hermanado de la donación voluntaria y generoso de sangre lo que vincula al individuo a una nueva conducta y actitud hacia el mundo exterior natural, socia. La sangre constituye la materia prima esencial para los bancos de sangre, de ella se obtiene el plasma, glóbulos rojos, glóbulos blancos, plaquetas, hemoderivados y otros productos biológicos para terapias en la medicina transfusional. La donación voluntaria es una acción desprendida por el solo hecho de ayudar a otros a los que no se conoce, no sólo es la más generosa y la más ética, es el pilar de los servicios modernos de donación y transfusión sanguínea (AU).
SUMMARY Transfusion therapy demands solid knowledge to plan and perform a comprehensive work plan to achieve the wellbeing of persons needing it. The staff whose profession is related with blood transfusions should be continuously updating their knowledge, trying to develop new techniques and secure practices. The aim of this article was approaching the importance of using blood as therapeutic resource and the associated value of generous and voluntary donation, linking individuals to a new behavior and attitude to the natural and social outside world. Blood is the essential raw material for blood banks, obtaining from it plasma, red blood cells, white blood cells, platelets, blood products and other biological products for therapies in transfusion medicine. Voluntary donation is a disinterested action just for the fact of helping unknown persons. It is not only the most generous and the most ethical action, but it is also the support of the modern blood donation and transfusion services (AU).
Subject(s)
Humans , Blood , Blood Donors/ethics , Blood-Derivative Drugs , Blood Banks/methods , Blood Banks/supply & distribution , Blood Platelets , Therapeutic Uses , Transfusion MedicineABSTRACT
OBJECTIVES: In this study, the conformity of blood donation services performed by Turkish Red Crescent Mobile Medical Team in a Basic Military Training Centre to quality standards was researched and the results were discussed by taking the principles of biomedical ethics into consideration. MATERIALS AND METHODS: This descriptive study was conducted at the Basic Military Training Centre, Canakkale, Turkey. In total, 269 voluntary non-remunerated blood donors who made blood donation between 10 and 12 August 2015 formed the population of the study. All of the donors were recruits who had joined the army to carry out their military service. A questionnaire for assessing the quality of the blood donation services was administered to the participants after the blood donation. SPSS 15.0 software package was used for data analysis. RESULTS: In the study, 232 voluntary non-remunerated blood donors were reached with a response rate of 86.2%. It was seen that the phlebotomists in the mobile medical team followed the quality standards in the blood donation process with the rate of 91.8% to 100%. However, outstanding omissions were found in informing the donors about blood donation process. CONCLUSION: In blood donation campaigns conducted in the institutions such as military units, the quality standards developed in line with the principles of biomedical ethics should not be neglected citing some reasons such as excessive numbers of donors, time limitations and organisational deficiencies. Increasing the quality in blood donation services will increase both donor satisfaction and their motivation to donate blood again in the future.
Subject(s)
Blood Donors , Military Personnel , Adult , Blood Donors/ethics , Blood Donors/psychology , Decision Making , Educational Status , Humans , Informed Consent , Male , Military Personnel/psychology , Motivation , Pilot Projects , Quality Assurance, Health Care , Surveys and Questionnaires , Turkey , Volunteers , Young AdultABSTRACT
BACKGROUND AND OBJECTIVES: The perception of transfusion-transmitted infections (TTIs) is sensitive to various concerns besides the probability and impact of infection, and some of these concerns may be ethically relevant. This paper aims to advance thinking about blood safety policies by exploring and explaining stakeholders' reasons to consider TTI risks tolerable or intolerable. MATERIALS AND METHODS: Inspired by critical empirical ethics and phenomenological hermeneutics, we held interviews and focus group discussions to explore the moral experience of policymakers, hematologists, blood donors and recipients. Respondents were invited to discuss general concerns about the blood supply, to address the tolerability of TTI risks compared with other hazards and to comment on the costs of blood safety. Arguments for tolerance or intolerance towards TTI risks were analysed qualitatively. RESULTS: Stakeholders' views could be clustered into seven categories: (1) clinical impact; (2) probability of infection; (3) avoidability of infection; (4) cost and health benefits; (5) other consequences of safety measures; (6) non-consequentialist ethical arguments; and (7) stakeholders' interests. Various arguments were offered that resonate with current ethical thinking about blood safety. Assuming that resources spent on inefficient blood safety measures could be applied more beneficially elsewhere, for example, responders typically expressed tolerance towards TTI risks. Some other arguments seem novel, for instance arguments for risk intolerance based on the low probability of infection and arguments for risk tolerance if patients have a poor prognosis. CONCLUSION: Understanding the moral experience of stakeholders enriches ethical debate about blood safety and prepares developing more widely acceptable policies.
Subject(s)
Blood Donors/ethics , Blood Safety/ethics , Blood Transfusion/ethics , Transfusion Reaction/psychology , Adult , Aged , Female , Humans , Male , Middle Aged , Transfusion Reaction/epidemiologyABSTRACT
Modern biomedical and genetic studies require large study cohorts; blood donors have been suggested to represent an appropriate group for recruiting healthy cohorts. The Blood Service Biobank (BSB) in Finland was recently established to recruit blood donors willing to give broad biobank consent. The aim of the present study is to understand how the blood bank context influences views on donating samples and health data. We organised 61 interviews and 10 group discussions with current and potential blood donors. Using qualitative content analysis, we identified three discussion frameworks that summarise the results. We found that frequent blood donors associated the voluntary act of donation with caring for patients. The blood donation experience was considered to accommodate biobank participation, but also allowed critical observations on the integration of research data collection into blood donation. Research participants identified an important difference between the blood bank and biobank contexts. In the biobank context, the focus shifts from donating blood to patients into donating personal and genetic data for research use. Blood donors' anxiety over data use was balanced with their experience of the trustworthiness of the Blood Service. These experiences indicated that the new biobanking activity could be trusted to a familiar organisation. To build donors' trust, biobanks should invest in their institutional reputation, donor experience and dialogue with donors. These findings can be applied to other institutions that are considering setting up biobanks with broad consent for personal data use.
Subject(s)
Biological Specimen Banks/ethics , Blood Donors/ethics , Health Knowledge, Attitudes, Practice , Behavior , Biomedical Research/ethics , Finland , Humans , Informed Consent/ethics , Patient Rights/ethics , Surveys and QuestionnairesABSTRACT
En este artículo, expongo los pros y contras éticos de cuatro políticas públicas diferentes de provisión de sangre para los bancos de sangre con el fin de satisfacer la demanda de productos sanguíneos y hemoderivados destinados a atender a los enfermos que los necesitan. Esas cuatro políticas se basan, respectivamente, en la donación altruista, la remuneración a los donantes, los estímulos no monetarios o nudging, y la obligatoriedad equitativa. En la última parte del artículo, y tras comparar las cuatro políticas, muestro la deseabilidad ética de la última de ellas junto a algunos de sus principales problemas
In this article, I expose the ethical pros and cons of four different public blood supply policies for blood banks in order to meet the demand for blood products intended to care for the patients who need them. These four policies are based, respectively, on altruistic donation, remuneration to donors, non-monetary or nudging stimuli, and equitable obligatoriness. In the last part of the article, and after comparing the four policies, I show the ethical desirability of the last one and some of its main problems
En aquest article, exposo els pros i contres ètics de quatre polítiques públiques diferents de provisió de sang per als bancs de sang amb la finalitat de satisfer la demanda de productes sanguinis i hemoderivats destinats a atendre els malalts que els necessiten. Aquestes quatre polítiques es basen, respectivament, en la donació altruista, la remuneració als donants, els estímuls no monetaris o nudging, i l'obligatorietat equitativa. En l'última part de l'article, i després de comparar les quatre polítiques, mostro la desitjabilitat ètica de l'última d'elles al costat d'alguns dels seus principals problemas
Subject(s)
Humans , Blood Donors/ethics , Public Policy , Blood Banks/ethics , Bioethics , Altruism , Tissue Donors/ethics , Blood Donors/legislation & jurisprudenceABSTRACT
In recent years, there has been a considerable increase in the degree of philosophical attention devoted to the question of the morality of offering financial compensation in an attempt to increase the medical supply of human body parts and products, such as plasma. This paper will argue not only that donor compensation is ethically acceptable, but that plasma donors should not be prohibited from being offered compensation if they are to give their informed consent to donate. (While this paper will focus on the ethics of compensating plasma donors, its arguments are also applicable to the ethics of offering compensation for other body parts, such as kidneys.) Regulatory regimes that prohibit donor compensation thus unethically prevent the typical donor from being able to give her informed consent to donate.
Subject(s)
Blood Donors/ethics , Informed Consent/ethics , Plasma , Remuneration , Blood Donors/psychology , Humans , Philosophy, MedicalABSTRACT
In 2015, the United States Food and Drug Administration (FDA) changed their indefinite deferral policy towards donors who were men who had sex with men (MSM). I develop an empirical case for the current, revised MSM deferral policy and show that rights-based objections fail. This empirical case, however, misleadingly accounts for an elevated risk for MSM donors because it lumps two distinct kinds of MSM donors into the same category. Building on some recent work that has been published since the revision, I introduce and defend a distinction between MSM donors who have what I call 'exact justification' and those who have what I call 'ordinary justification'. MSM donors with exact justification present no risk with respect to the deferral and should be allowed to donate. I conclude by addressing a practical issue about how primary partner testimony is not enough to create exact justification, but it is enough to sustain it.
Subject(s)
Blood Donors/ethics , HIV Infections , Health Policy , Homosexuality, Male , Sexual Partners , Sexual and Gender Minorities , Bioethical Issues , HIV Infections/prevention & control , Human Rights , Humans , Male , Risk , Social Discrimination , United States , United States Food and Drug AdministrationABSTRACT
Some screening tests for donor blood that are used by blood services to prevent transfusion-transmission of infectious diseases offer relatively few health benefits for the resources spent on them. Can good ethical arguments be provided for employing these tests nonetheless? This paper discusses-and ultimately rejects-three such arguments. According to the 'rule of rescue' argument, general standards for cost-effectiveness in healthcare may be ignored when rescuing identifiable individuals. The argument fails in this context, however, because we cannot identify beforehand who will benefit from additional blood screening tests. On the 'imposed risk' argument, general cost-effectiveness standards do not apply when healthcare interventions impose risks on patients. This argument ignores the fact that imposing risks on patients is inevitable in healthcare and that these risks can be countered only within reasonable limits. Finally, the 'manufacturing standard' argument premises that general cost-effectiveness standards do not apply to procedures preventing the contamination of manufactured medical products. We contend that while this argument seems reasonable insofar as commercially manufactured medical products are concerned, publicly funded blood screening tests should respect the standards for general healthcare. We conclude that these particular arguments are unpersuasive, and we offer directions to advance the debate.
Subject(s)
Blood Donors/ethics , Blood Safety/ethics , Delivery of Health Care/ethics , Donor Selection/ethics , Mass Screening/ethics , Morals , Communicable Disease Control , Cost-Benefit Analysis , Humans , Mass Screening/economics , Social ResponsibilityABSTRACT
Este texto trata sobre la legislación española en materia de donación de sangre. Lo que nos proponemos en él es sostener que, dado que en nuestro país se prohíbe la donación remunerada de sangre pero se permite la importación de sangre y derivados de la misma, especialmente de plasma, proveniente de donaciones remuneradas, dicha legislación tiene problemas de coherencia. Paradójicamente, el establecimiento de un deber cívico de donar sangre sería más coherente con la legislación vigente, y con los principios que la inspiran, que la situación actual
This text focus on the Spanish regulation of Blood donation. Our aim is to defend that, given the fact that in our state paid blood donations are forbidden while the importation of blood and its products -especially plasma- coming from remunerated donations is permitted, the aforementioned legislation entails several consistency issues. Paradoxically, establishing a civic duty to donate blood would be more congruent with the legislation in force and its underlying principles than the present situation
Subject(s)
Humans , Blood Donors/ethics , Blood Donors/legislation & jurisprudence , Public Health/ethics , Public Health Administration/ethics , Human Rights/legislation & jurisprudenceABSTRACT
A hepatite B oculta é caracterizada pela presença do ácido desoxiribonucleíco (ADN) do VHB no soro, plasma ou tecido hepático em indivíduos com serologia negativa para o antígeno de superfície (HBsAg). Os mecanismos que conduzem à infecção oculta pelo VHB não são claros, embora as mutações virais sejam provavelmente um factor significativo. O objectivo deste estudo foi determinar a frequência, presença de marcadores serológicos e caracteríticas moleculares dos casos com Hepatite B Oculta em dadores de sangue no banco de sangue do Hospital Central de Maputo. Para tal, 1500 dadores de sangue foram recrutados e testados para HBsAg. As amostras HBsAg negativas foram testadas para identificar à presença de ADN do VHB. Amostras com o ADN do VHB detectado foram submetidas ao nested PCR para amplificação das regiões S e P do genoma de VHB, de seguida foram sequenciadas. A frequência de hepatite B oculta foi de 1,2% (17/1436). Os resultados das análises filogenéticas realizadas em 10 dos 17 casos com hepatite B oculta revelaram que 9 isolados pertenciam ao genótipo A e um isolado pertencia ao genótipo E. Foi encontrada uma mutação de escape em uma das amostras e várias substituições de aminoácidos na região S e P. O marcador Anti-HBc foi encontrado na maior parte casos com Hepatite B oculta 76,4% (13/17) e não foi registada a reactividade para HBeAg. Os dados mostram uma urgência de introdução de testes complementares para a exclusão de Hepatite B Oculta e necessidade de maior entendimento dos factores relacionados com a não expressão de HBsAg (Hepatite Oculta).
Occult hepatitis B is characterized by the presence of HBV DNA in serum, plasma or hepatic tissue in subjects with negative serology for the surface antigen (HBsAg). The mechanisms leading to occult HBV infection are unclear, although viral mutations are likely a significant factor. The aim of this study was to determine the presence of HBV serological markers other than HBsAg (anti-HBc, anti-HBs and HBeAg), frequence of OBI and to characterize viral genotypes and mutations among blood donors at the Hospital Central de Maputo. A total of 1500 blood donors were recruited and tested for HBsAg. Serum samples HBsAg negative were tested for presence of HBV DNA. Serum samples HBV DNA detected were submitted to nested PCR for amplifications of S and P regions in HBV genome and sequencing. The frequency of hepatitis B was 4.3% (64/1500) and the frequency of occult hepatitis B was 1.2% (17/1436). The results of the phylogenetic analysis in 10 of 17 cases of occult hepatitis B sequences obtained in this study revealed that 9 isolates belonged to genotype A and only one isolate belonged to genotype E. An escape mutation was found in one of the samples and several amino acid substitutions in the S and P regions in HBV genoma. Anti-HBc marker was found in most OBI cases (76.4%) and no sample was reactive for HBeAg. The data show an urgency to introduce complementary tests for the exclusion of Occult Hepatitis B and need for a better understanding the factors related to non-expression of HBsAg (Occult Hepatitis B)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Hepatitis B/blood , Hepatitis B Antibodies/immunology , Blood Donors/ethics , Sexual Partners/psychology , Sexual and Gender Minorities , Sexual and Gender Minorities/legislation & jurisprudence , MozambiqueABSTRACT
The not-for-profit issue has been debated in November 2016 in Paris; this issue is one of the four canonical pillars of ethical blood donation. It is intimately bound to benevolence though it is distinct, as not-for-profit calls for institutions while benevolence calls for individuals. It is indeed intended that voluntary blood donors do not benefit from their donation and are thus non-remunerated. Not-for-profit is essential since it refers to the public character of blood as a putative public resource aimed at being shared as a tribute of solidarity. A central question however is linked to the capacity- or not -of public sectors to ensure that blood components are universally available, with special mention to plasma derived drugs, without the contribution of the for profit, private sector.