Degree of blood safety of voluntary non-remunerated versus replacement blood donations: A multi-centre study of the large cohort of blood donors from two provinces of Pakistan.

BACKGROUND AND OBJECTIVES: Voluntary non-remunerated blood donors (VNRBDs) are recognized as being crucial for the safety and sustainability of national blood supplies. Systems based on replacement donors (RDs) pose high risks of transfusion transmissible infections (TTIs). Currently, only 10%-13% of blood donations are voluntary in Pakistan. No large-scale studies have been conducted to objectively evaluate the impact of the mode of donation on the frequency of TTIs, a gap this study aimed to fill. MATERIALS AND METHODS: The study was conducted at the Indus Hospital, Karachi. Data from a total of 591,820 blood donations were included from 1 October 2017 to 30 May 2021 and evaluated for type of donations and results of TTI testing, primarily performed on Architect i2000SR (Abbott). The TTIs tested include hepatitis B virus, hepatitis C virus, human immunodeficiency virus, syphilis and malaria. RESULTS: A total of 477,938 (80.7%) RDs and 113,882 (19.3%) VNRBDs were screened. Among these, 53,590 (9.06%) were positive for TTIs. There were 10.2% positive RDs (10.08-10.25 95% confidence interval [CI]) while 4.4% in VNRBDs (4.29-4.53 95% CI). Co-infections were observed in 2367 (0.4%) RDs, while 159 (0.02%) in VNRBDs. Geographically, the highest frequency of TTIs was observed in semi-urban areas of Sindh (11.2%) and Punjab (9.6%). A site-wise comparison of TTIs in RD versus VNRBD showed significant differences (p-value 0.00). CONCLUSION: RDs are associated with higher frequencies of TTIs, compared with VNRBD. However, the study was unable to assess whether the significant difference was related to individual risk or repeat/first time status of the donors. Other important variables affecting frequency are the catchment area of the blood donors in Pakistan. Urban areas have less prevalence than semi-urban areas.

Seroprevalence and trends in transfusion transmissible infections among voluntary non-remunerated blood donors at the Malawi Blood Transfusion Service-a time trend study.

Introduction: Collecting blood from voluntary non-remunerated blood donors from low risk populations is a key strategy for blood safety. Identifying such populations involves analysis of population and blood donor data to identify risk factors for transfusion transmissible infections (TTIs). There are no recent seroprevalence statistics for blood donors in Malawi. This study fills this gap by describing characteristics of blood donors, trend of annual prevalence of HIV, HBV, HCV and syphilis and factors associated with each TTI. Methods: Retrospective analysis of blood donors' records in the MBTS database from 2011 to 2015 was undertaken. Summary statistics were performed to describe characteristics of the blood donors. Univariable and multivariable logistic regression analyses were performed to determine association between prevalence of infections and socio-demographic factors. Time trend analysis was done to assess changes in prevalence. P-value <0.05 was considered statistically significant. Results: The number of blood donors screened over the 5 year period was 125,893. The mean number of donors donating blood per year was 39, 289; median age was 19 years; 82% were male, 87% single and 72% students and56% were repeat blood donors. Overall prevalence of each TTI decreased. The 2015 prevalence was: 3.6% for HBV; 1.9% for HIV; 2.6% for Syphilis and 1.0% for HCV while the 2011 prevalence was 4.7% for HBV; 3.5% for HIV 3.2% for syphilis and 2.4% for HCV.Repeat blood donors had significantly lower prevalence of TTIs than first time donors. Females were associated with lower risk for HBV, HCV and syphilis. Age ≥25 years and being out of school were associated with HIV. Age ≥25 years was associated with reduced risk for HCV and being self-employed and married were each associated with syphilis. Conclusion: The typical blood donor is a young single male student. Repeat blood donation improves safety of the blood supply.

[HIV infection status and characteristics of non-remunerated blood donors in Hangzhou, 2008-2017].

Objective: To understand HIV infection status and characteristics of non-remunerated blood donors in Hangzhou. Methods: HIV antibody test were conducted for non-remunerated blood donors in Hangzhou and their demographic and epidemiological information were collected from 2008-2017. χ(2) test for trend (liner by liner association chi square test) was used for the comparison of the HIV infection trends in each year. Results: A total of 1 461 129 non-remunerated blood donors were surveyed in Hangzhou during 2008-2017, and 260 blood donors were HIV positive. Most HIV infected blood donors were males (96.5%, 251/260) and aged 18-34 years (72.7%, 189/260). Among 260 HIV positive blood donors, those reporting repeated non-remunerated blood donation accounted for 36.9% (96/260), those reporting homosexual transmission accounted for 53.5% (139/260) and those reporting heterosexual transmission accounted for 44.6% (116/260). The HIV infected persons reporting homosexual behaviors were mainly aged 18-34 years (82.0%, 114/139) and unmarried (71.2%, 99/139). Most HIV infected students reported homosexual transmission (88.4%, 23/26). The crude HIV positive rate was 0.8/10 000-2.5/10 000, the differences in annual HIV positive rate had no significance (trend χ(2)=2.355, P=0.125). The crude HIV positive rate in male blood donors aged 18-24 years increased from 1.1/10 000 in 2008 to 3.7/10 000 in 2017, the difference was significant (trend χ(2)=5.175, P=0.023). Standardized HIV positive rate was 0.9/10 000-2.4/10 000. Conclusions: HIV infection rate was low in non-remunerated blood donors in Hangzhou during 2008-2017. Most HIV infected persons were males and aged 18-34 years. Heterosexual and homosexual contacts were the major transmission routes. The HIV positive rate in males aged 18-24 years showed an increase trend.

HIV infection status and characteristics of non-remunerated blood donors in Hangzhou, 2008-2017 / 中华流行病学杂志

Objective@#To understand HIV infection status and characteristics of non-remunerated blood donors in Hangzhou.@*Methods@#HIV antibody test were conducted for non-remunerated blood donors in Hangzhou and their demographic and epidemiological information were collected from 2008-2017. χ2 test for trend (liner by liner association chi square test) was used for the comparison of the HIV infection trends in each year.@*Results@#A total of 1 461 129 non-remunerated blood donors were surveyed in Hangzhou during 2008-2017, and 260 blood donors were HIV positive. Most HIV infected blood donors were males (96.5%, 251/260) and aged 18-34 years (72.7%, 189/260). Among 260 HIV positive blood donors, those reporting repeated non-remunerated blood donation accounted for 36.9% (96/260), those reporting homosexual transmission accounted for 53.5% (139/260) and those reporting heterosexual transmission accounted for 44.6% (116/260). The HIV infected persons reporting homosexual behaviors were mainly aged 18-34 years (82.0%, 114/139) and unmarried (71.2%, 99/139). Most HIV infected students reported homosexual transmission (88.4%, 23/26). The crude HIV positive rate was 0.8/10 000-2.5/10 000, the differences in annual HIV positive rate had no significance (trend χ2=2.355, P=0.125). The crude HIV positive rate in male blood donors aged 18-24 years increased from 1.1/10 000 in 2008 to 3.7/10 000 in 2017, the difference was significant (trend χ2=5.175, P=0.023). Standardized HIV positive rate was 0.9/10 000-2.4/10 000.@*Conclusions@#HIV infection rate was low in non-remunerated blood donors in Hangzhou during 2008-2017. Most HIV infected persons were males and aged 18-34 years. Heterosexual and homosexual contacts were the major transmission routes. The HIV positive rate in males aged 18-24 years showed an increase trend.

Should Kiribati continue to aim for 100% voluntary non-remunerated blood donation as recommended by the WHO?

Setting: Tungaru Central Hospital Blood Bank Laboratory, Nawerewere, Tarawa, Kiribati. Objective: To determine characteristics, deferrals and reasons for deferral amongst blood donors from 2011 to 2016. Design: A cross-sectional study using routinely collected data. Results: From January 2011 to March 2016, 8531 potential blood donors were registered. For each full year, the proportion of voluntary non-remunerated blood donors (VNRBD) was below 10%, although it increased to 13% in 2015. The overall proportion of blood donors deferred increased each year over the 5-year period, from 44% to 57%, with similar increases in deferrals in VNRBD and family replacement donors (FRD). Among all blood donors, a higher proportion of females than males (59% vs. 43%) and VNRBD than FRD (56% vs. 44%) were deferred (P < 0.001). Deferrals were due to 1) failing the medical questionnaire (53%), 2) having anaemia and/or high white cell count (26%), or 3) transfusion-transmissible infections (21%). More VNRBD were deferred due to failing the medical questionnaire, while more FRD were deferred due to anaemia and/or high white-cell count; the number of deferrals was similar for transfusion-transmissible infections. Conclusion: This 5-year study showed that the proportion of VNRBD is low and deferrals are higher for this group than for FRD. There is a strong case for encouraging both types of donor in the country.

Contexte : Banque du sang de l'hôpital central de Tungaru, Kiribati.Objectif : Déterminer les caractéristiques, exclusions et motifs d'exclusion parmi les donneurs de sang de 2011 à 2016.Schéma : Etude transversale basée sur des données recueillies en routine.Résultats : Il y avait 8531 donneurs de sang potentiels enregistrés entre janvier 2011 et mars 2016. Pour chaque année, la proportion de donneurs de sang bénévoles non rémunérés (VNRBD) a été inférieure à 10%, en dehors d'une augmentation à 13% en 2015. La proportion de donneurs de sang qui ont été exclus a augmenté chaque année au cours des 5 années de l'étude, de 44% à 57%, avec une augmentation similaire des exclusions chez les VNRBD et les donneurs de remplacement familiaux (FRD). Si l'on considère l'ensemble des donneurs, une plus grande proportion de femmes que d'hommes (59% contre 43%) et de VNRBD comparés aux FRD (56% contre 44%) ont été exclus (P < 0,001). Les exclusions ont été causées par un rejet lié aux réponses au questionnaire médical (53%), une anémie et/ou un nombre élevé de globules blancs (26%) ou une infection transmissible par la transfusion (21%). Davantage de VNRBD ont été refusés à cause du questionnaire médical, plus de FRD ont été rejetés à cause d'une anémie et/ou d'un nombre de globules blanches trop élevé et les exclusions ont été similaires en ce qui concerne les infections transmissibles par transfusion.Conclusion : Cette étude sur 5 ans a montré que la proportion de VNRBD était faible et que les exclusions y étaient plus fréquents que chez les FRD. Il y a là un motif sérieux pour encourager les deux types de donneurs dans le pays.

Marco de referencia: El laboratorio del banco de sangre del Hospital Central de Tungaru, en Kiribati.Objetivo: Determinar las características de los donantes, la frecuencia de los aplazamientos y sus razones en las donaciones de sangre realizadas del 2011 al 2016.Método: Un estudio transversal a partir de los datos recogidos en la práctica corriente.Resultados: Se registraron 8531 posibles donantes de sangre de enero del 2011 a marzo del 2016. En cada año completo, la proporción de donantes de sangre voluntarios no remunerados (VNRDB) fue inferior al 10%, pero en el 2015 aumentó al 13%. La proporción de donantes aplazados aumentó cada año durante los 5 años de 44% a 57% y el aumento de los aplazamientos fue equivalente en los VNRDB y los donantes familiares o de sustitución (FRD). Al considerar todos los donantes de sangre, se observó una mayor proporción de aplazamientos de mujeres que de hombres (59% contra 43%) y de VNRDB que de FRD (56% contra 44%; P < 0,001). Las causas del aplazamiento fueron el resultado del cuestionario médico (53%), la presencia de anemia o leucocitosis (26%) y las infecciones transmisibles mediante transfusión (21%). Los VNRDB se aplazaron con mayor frecuencia por causa del cuestionario médico y los FRD por anemia o leucocitosis; los aplazamientos por riesgo de transmisión de infecciones fueron equivalentes en ambos grupos.Conclusión: El presente estudio de 5 años reveló una baja proporción de VNRDB y puso en evidencia que los aplazamientos son más frecuentes en este grupo que en los FRD. Existen argumentos sólidos que respaldan la promoción de ambos tipos de donantes en el país.

Analysis of efforts to maintain safe donor in main donor pool after completion of temporary deferral period.

BACKGROUND: Voluntary blood donation is not satisfactory all over India. In India, about 55% of donation is through voluntary non-remunerated blood donors (VNRBD). However, about one third already motivated blood donors are deferred due to stringent screening criteria, either temporarily or permanently. The temporarily deferred donors could be a good source of blood donation after deferral period. AIMS: The present study is carried out to know retrieval of blood donors those who are deferred temporarily. DESIGN: The present study is carried out in the Regional Blood Transfusion Centre of Western India. All donors screened as per the guideline and deferred donors are categorized as temporary and permanently deferred donors. MATERIALS AND METHODS: From temporarily deferred donors, reason for deferral is considered. As per reason of deferral, time duration for recalling the donor is defined. Based on this, donor is called back to donate again. STATISTICAL ANALYSIS: Chi-square test is applied. RESULT: A total of 33% donors were deferred either temporarily or permanently. In the repeat donors (5.32%) deferral rate was significantly higher than first time (1.32%) donors. Significant female preponderance was observed (15.05% vs 2.51%). Majority of temporarily deferred donors were less than 40 years of age (80.80%), graduate (82.90%), from low income group (62.90%) and profession was service (48.10%). CONCLUSION: Low hemoglobin (78.30%) was the most common reason of temporary deferral, both in first time and repeat donors (71.00%). Efforts to increase the hemoglobin in the repeat donors will improve the donor retention and overall blood safety can be increased.