The impact of COVID-19 pandemic on blood supplies and transfusion services in Eastern Mediterranean Region

BackgroundSevere Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spurred a global health crisis. The safety and supply of blood during this pandemic has been a concern of blood banks and transfusion services as it is expected to adversely affect blood system activities. We aim to assess the situation in the Eastern Mediterranean Region (EMR) during the first months of the pandemic.Materials and methodsA survey was designed to address blood supply, transfusion demand, and donor management during the coronavirus disease-19 (COVID-19) pandemic. Medical directors of different blood banks were invited to participate.ResultsA total of 16 centers participated with representation from 15/19 countries in the region. In total, 75% were from national blood banks. Most centres had a decrease in the blood supply, ranging from 26–50%. Representatives from 14 countries (93.3%) believed that public fear has contributed to a decrease in donations. Most centres (n = 12, 75%) had a reduction in transfusion demand, while those who did not, reported heavy involvement in treating patients with underlying haemoglobinopathies and haematological malignancies. Half of the centres activated their contingency plans. Four centres had to alter the blood donor eligibility criteria to meet demands. All centres implemented donor deferral criteria in relation to SARS-CoV-2, but were variable in measures to mitigate the risk of donor and staff exposure.ConclusionBlood services in the region faced variable degrees of blood shortages. We summarize lessons learnt during this pandemic for the blood banks to consider to plan, assess, and respond proportionately to future similar pandemics.     

Evaluation of blood donors questionnaire in a developing country: The case of Gabon

BackgroundBlood transfusion is a life-saving therapeutic act without alternative. Each blood transfusion carries the risk of blood-borne pathogens transmission. The present study, is the first establishing the usefulness of blood donors screening questionnaire in the setting of the Gabonese National Blood Transfusion Center.Study designNine hundred and thirty-four blood donors aged between 18 and 48 years old were initially enrolled and submitted to physical examination (body-mass index and blood pressure). After physical examination 854 donors were judged fit for blood donation and were randomly distributed in two groups. The first group of donors did not take the screening questionnaire; whereas the second group went through the screening questionnaire. Both groups were then tested for human immunodeficiency virus, hepatitis B, hepatitis C and syphilis.ResultsData revealed a seroprevalence among the donors of 2.5%, 2.5%, 1.1%, and 3.3% for the human immunodeficiency virus, hepatitis B, hepatitis C and syphilis markers respectively. In the Gabonese setting, blood donors’ screening questionnaire reduced respectively by 0.6%, 0.35% and 1.3% the proportion of hepatitis B, hepatitis C and treponema pallidum seroreactive donors being selected for donation. The questionnaire had no positive effect on discriminating human immunodeficiency virus positive donors.ConclusionBlood donors’ seroprevalence of blood-borne pathogens is relatively important in our setting. Blood donors’ screening questionnaire reduced the proportion of hepatitis B, hepatitis C and syphilis seropositive blood donors. The questionnaire did not effectively discriminate human immunodeficiency virus-infected donor candidates.     

Post-donation information and haemovigilance reporting for COVID-19 in Greece: Information supporting the absence of SARS-CoV-2 possible transmission through blood components

BackgroundAlthough the SARS-CoV-2 virus is transmitted mainly through the respiratory tract, possible transmission by transfusion from asymptomatic carriers should be explored. As yet there are no reports of transfusion transmission of COVID-19. Haemovigilance findings within a three-month surveillance period during the new coronavirus pandemic are presented.Materials and methodsDue to great demand and shortage, blood sessions in outpatient facilities were organized during the high prevalence period of COVID-19, alongside a national plan to monitor the evolving public health situation by random molecular screening of high-risk groups of the population. Haemovigilance protocols were implemented as well as surveillance for any COVID-19 case reported post-transfusion. A 14-day quarantine and follow-up molecular and antibody testing of any COVID-19 positive case was obligatory.ResultsPost-donation, post-transfusion information and molecular testing of swab samples collected from three asymptomatic donors at risk for COVID-19, revealed the case of an immunosupressed patient who had been transfused with whole blood derived platelets from a donor subsequently diagnosed with COVID-19. The recipient exhibited no symptoms of the disease. Molecular and antibody testing results were negative.ConclusionHaemovigilance provided information supporting the absence of transfusion transmission of COVID-19, thus strengthening the hypothesis that, even if it cannot yet be definitively ruled out, COVID-19 is not transmitted through blood transfusion. As of early June 2020, a perfect test does not exist, therefore haemovigilance along with the implementation of strict proactive measures is crucial to identify eluding asymptomatic individuals and ensure blood safety during the pandemic.     

SARS-CoV-2 neutralizing capacity among blood donors without prior COVID-19 symptomatic history vs. blood donors with prior COVID-19 symptomatic history: A comparative study

IntroductionThough moderate to severely ill COVID-19 patients are being treated using COVID Convalescent plasma across the world, there is a lack of standardization or information about the relative neutralizing capacity of antibodies from convalescent plasma donors. The current study aimed to compare the neutralizing antibody inhibition levels between COVID-Convalescent plasma from apheresis donors who had symptomatic COVID-19 history and asymptomatic blood donors, i.e., whole blood donors without prior any COVID-19 positive diagnosis nor symptoms/contact history related to COVID-19.MethodsObservational study conducted at the Blood Centre, Tertiary Care Hospital, South India on blood donor samples during the period July–December 2020. A total of 90 samples (43 convalescent plasma donors and 47 whole blood donors) were tested for SARS-CoV-2-IgG and Neutralising antibodies.ResultsNo significant difference in neutralization capacity was observed between these symptomatic vs. asymptomatic donors. Also, inhibition % appeared similar in the two groups with respect to age, gender, blood group, donation status, or type of donation without any statistical significance. On analyzing the correlation between the SARS-CoV-2-IgG levels and neutralizing antibodies among the WBD and CCP, both the groups showed a positive correlation, while neutralizing antibodies showed a significant correlation with SARS-CoV-2-IgG levels among the whole blood donors (Pearson correlation P = 0.000).ConclusionNo significant difference in neutralizing antibody capacity was observed in asymptomatic whole blood donors and convalescent plasma donors. Therefore, donors having adequate levels of SARS-CoV-2-IgG antibody levels on screening can be considered for convalescent plasma donation irrespective of prior COVID-19 diagnosis or COVID-related symptoms.     

SARS COV-2- IgG antibodies in blood donors in pandemic – A game changer for policy makers

BackgroundA novel beta coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), has been identified as the causative pathogen for the present pandemic. The objective of the study was to measure the levels of IgG antibodies targeting the SARS-CoV-2 during the peak period of the COVID-19 pandemic in Odisha State, India to know the magnitude of SARS-CoV-2 exposure, the prevalence of herd immunity in the population, the distribution of IgG-positive cases examined according to ABO blood groups and the number of blood donors with higher neutralizing IgG antibody titre who later on were converted into Plasma Donors donating Convalescent Plasma (CP).MethodThis observational prospective study was conducted for a duration of three months on 1032 number of Blood donors consisting of 1025 number of males and 07 number of females. The samples of donors were subjected to Electro- chemiluminescence immunoassay (ECLIA) to detect SARS-CoV-2 IgG antibodies.ResultOut of 1032 Donors, 370(35.9%) were SARS-COV-2 IgG positive which included 303 donors (29.36%) with neutralizing antibody titre of SARS-COV2 IgG antibodies above 1:80. SARS-COV-2 IgG positive cases consisted of 367(35.8%) male and 3(42.9%) female donors. The number of IgG positive cases were highest in 21–40 years’ age group i.e. 323 out of 869(37.2%). In terms of Blood group, 145(42.4%) out of 342 were from B RhD positive group. Out of 22 donors who were positive with COVID 19 in the past with neutralizing IgG antibody titre more than 1:80, 6(27.3%) persons came for voluntary convalescent plasma(CP) donation.ConclusionA high prevalence of SARS-CoV-2 antibodies was detected among blood donors which indicated a high level of exposure to the virus within the population and development of innate immunity against the virus. Policy makers can add the protocol of antibody testing in the screening of blood donors to enhance the number of Plasma Donation cases for the treatment of serious COVID patients.     

The impact of COVID-19 on transfusion-dependent thalassemia patients of Karachi,Pakistan: A single-center experience

ObjectivesWith the advent of COVID-19 in Pakistan, the already fragmented blood transfusion services (BTS) received a severe blow, putting the lives of transfusion-dependent thalassemia children on stake. This study aimed to assess the impact of the COVID-19 on blood transfusion therapy (BTT) of thalassemia patients and suggest ways to ensure safe and reliable blood supplies amid such health crises.Material and methodsA retrospective, cross-sectional study was conducted from October 2019 (before COVID-19) to July 2020 (during COVID-19) based on the data provided by a thalassemia center, named Help International Welfare Trust, Karachi, Pakistan. SPSS version 24.0 was used for the data analysis. Data were described in the form of means and percentages.ResultsThere was a significant reduction in the consumption of PRBCs bags after the emergence of COVID-19 (P = 0.002). Moreover, the number of thalassemia patients receiving BTT was dropped by 10.56% during the pandemic. There was a strong negative correlation observed between the rising cases of COVID-19 in Pakistan and the number of patients missing their therapy sessions (r = ?0.914, P = 0.030). A considerable decline in the reserves of all Rhesus-negative blood groups amid the COVID-19 outbreak was also observed.ConclusionThe COVID-19 pandemic adversely affected the already suboptimal care catered to thalassemia patients in Karachi, Pakistan. The fear of the virus contraction coupled with the lockdown and restricted mobility has disrupted the entire transfusion chain from donor to the recipient. Collaborated efforts by the government and healthcare authorities are essential to ensure sufficient blood for thalassemia patients amid the pandemic.     

Motivation et sociologie des donneurs de sang en Tunisie : réalités et perspectives

In Tunisia, blood donation is voluntary, anonymous and non-remunerated. The aim of the study is to analyze donor motivation and sociology in the regional center of transfusion of Sfax. Between 14 May 2007 and 23 June 2007, a total of 903 Tunisian blood donors filled a questionnaire. Among the donors, 81.8% were men and have a mean age of 34.2 years and the majority of them have an age between 18 and 29 years. The middle social class was majority (77.8%) as well as the liberal profession (65.1%). Primary and secondary education were dominant (79.3%). Among the blood donors, 41.6% were new donors and 28.6% had a history of a single donation, 50.3% were voluntary and 49.7% replacement donors. The reasons motivating the voluntary donation were solidarity (69.9%), religion (21.2%), health benefit (3.6%) and insurance for the family (5.2%). The replacement donors refuse the voluntary donation for not obvious reasons (51%), lack of availability (13.3%), difficulties of accessibility of the sites of collection (7.6%), phobia of the blood and the stings (4.02%) or by refusal of blood donation (1.79%). The information and the raising awareness of the replacement donors could change in a near future their attitudes to become voluntary and regular donors. The implication of donor associations in the organization of the collections and the promotion of the blood donation would be of considerable contribution.     

Seroprevalency of transfusion-transmitted infections in first-time volunteer and replacement donors in Tunisia

BackgroundReplacement donors are considered as having a major risk of transmission of infections to recipients mainly by the World Health Organisation.Study design and methodsSeroprevalency of HBV, HCV, HIV and syphilis were determined in 19,783 whole blood donations collected in the Tunisian National Blood Transfusion Centre during the year 2010 (12,968 [65.55%] replacement donations and 6815 [34.44%] voluntary blood donations). For HBV, HCV and syphilis, we performed a univariate analysis to determine whether age, sex and type of donation were risk factors, then multivariate logistic regression, to see if these factors were independent.ResultsMean age of donors was 30.1 years (replacement donors 34.5 years, first time non-remunerated donors 34.5 years, P < 0.001). The predominant age group was 30–39 years (35.51%) in replacement donors and 20–29 years (54.15%) in first time non-remunerated donors. Male gender was significantly predominant (73.00% men vs 27.00% women, P < 10^?6). There were significantly more men among replacement donors (82.27% vs 55.38%, P < 10^?3). There were more women in the age groups 18–19 and 20–29 years. Only one HIV seropositive donation was noted in a male first time non-remunerated donor aged 18. Replacement type of donation, male sex and age were three independent risk factors for the HBs Ag carriage. For anti-HCV antibodies and TPHA, only replacement type of donation and age were found out to be risk factors and only age was independent.ConclusionIn Tunisia, replacement blood donors were at higher risk of infection transmission, but only for hepatitis B.     

Status analysis and evaluation of the blood scrap rate from 2015–2017 for a blood center in China

ObjectivesThe objective of this study was to ascertain the current conditions and development in the past three years of clinical transfusion practice in Nanjing, Jiangsu province, China.Materials and methodsBlood quality control practices and the blood production scrap rate from 2015–2017 were monitored and measured using different quality statistics and management tools.ResultsThe causes of unqualified and scrapped blood during blood collection and supply were analyzed and evaluated. The analysis of the key indices for blood component quality control showed that the qualified rate of FVIII activity (from fresh frozen plasma) was 54.55%, which failed to meet the threshold of 75%. Retrospective analysis of conventional blood scrapping factors showed that laboratory scraps accounted for the majority. The composition ratio of TTI screening results included ALT (31.91%), HBV (21.92%), TP (12.15%), NAT (10.78%), HCV (8.45%), and HIV (7.43%). Retrospective analysis of unconventional blood scrapping factors showed that the total unconventional blood depletion rate was 0.565%. Insufficient or small quantities of collected blood was the most important factor related to unconventional scrapping. The blood donor and blood hospital service satisfaction rates were over 95% and 90%, respectively, which achieved the quality target.ConclusionsNonconforming product control was proposed and determined as the urgent theme of the first QCC. It is necessary for blood stations to effectively control blood scrapping, which can reduce the cost of blood collection, protect the blood donation of unpaid blood donors, increase the rate of repeated blood donation, and improve blood safety.     

Seroprevalence of SARS-CoV-2 among potential convalescent plasma donors and analysis of their deferral pattern: Experience from tertiary care hospital in western India

Background and objectivesSeroprevalence estimation of COVID-19 is quite necessary for controlling the transmission of SARS-CoV-2 infection. Seroprevalence rate in recovered COVID-19 patients help us to identify individual with anti-SARS-CoV-2 antibodies and its protective nature. The objective of present study was to evaluate seroprevalence of SARS-CoV-2 among potential convalescent plasma donors and analysis of their deferral reasons.Materials and methodsA total 400 potential convalescent plasma donors were enrolled over five-month period for this prospective study. Inclusion criteria were lab confirmed COVID-19 recovered patients and 14 days of symptoms free period. All prospective plasmapheresis donors were tested for IgG SARS-CoV-2 antibody through chemiluminescent microparticle immunoassay, CBC, serum protein, blood grouping along with other required test for normal blood donation as per Drugs & Cosmetics Act. After pre donation testing and medical examination if donor was found to be ineligible for plasmapheresis was deferred. Seroprevalence rate was calculated by positive IgG antibody test results among the potential plasma donors.ResultsSeroprevalence rate was 87% for IgG SARS-CoV-2 antibodies in prospective convalescent plasma donors (recovered COVID-19 patients). There was no significant difference in seroprevalence rate between different sub-groups with respect to gender, age, blood groups, Rh factor, mode of treatment, day of Ab testing and repeat plasma donation. Most common reason for their deferral was absent IgG SARS-CoV-2 antibodies (13%) followed by absenteeism of eligible screen donors (6.7%), low Hb (1.7%) and poor veins for plasmapheresis (1.7%). Till five-month study period none of the plasmapheresis develop symptoms of reinfection with COVID-19.ConclusionIn all, 13% recovered patients did not develop IgG antibodies after SARS-CoV-2 infection. SARS-CoV-2 IgG antibodies persist for quite some time and are protective against reinfection. More long-term serology studies are needed to understand better antibody response kinetics and duration of persistence of IgG antibodies.     

Delayed adverse reaction in donors after whole blood donation: Is it a matter of concern?

BackgroundBlood donation has a remarkable safety record and most of the donors have a good experience or only mild symptoms after blood donation were noted. Although even a very low rate of reactions may have gloomy effect diminishing their fondness to donate again. The main aim of our study was to determine the incidence and to analyze how various donor demographic factors tend to be associated with delayed adverse donor reactions (ADR).Material and methodsThe prospective observational study was conducted in Department of Immuno-hematology and Blood Transfusion of tertiary care hospital. All the whole blood donors, who gave consent to participate in the study were contacted telephonically after 24 hours and day 7 after donation. The donor who couldn’t be contacted telephonically, was tried again at an interval of four hours in a day for two consecutive days before declaring the participant to be non-responder.ResultsA total of 2495 (92.4%) blood donors experienced delayed ADRs. The commonest delayed ADRs reported were generalized weakness (24.6%), bruises (24.2%) followed by painful arm (14.5%). Females, first-time blood donors, donors with low BMI and donors engaged in manual labor were more vulnerable to develop any adverse reactions.ConclusionBlood donors can experience delayed ADRs. It is important to prevent these reactions especially in susceptible donors. Proper awareness and training to the staff was provided to minimize the incidence of ADR.     

Measuring public awareness about blood donation in Assir,South-Western Saudi Arabia

ObjectivesBlood transfusion is a life-saving measure in many acute and chronic conditions. Voluntary blood donation by healthy donors has been promoted by the World Health Organization (WHO) to ensure the availability of safe blood. Difficulty in the recruitment of donors and their retention is a problem faced in most populations. A paucity of research to identify barriers to blood donation in the Southwestern region of Saudi Arabia prompted us to explore this important public health issue.Materials and methodsA cross-sectional survey was performed using a pre-tested, structured, self-administered questionnaire comprising of questions on demographical details, awareness regarding blood donations, perceived barriers to blood donations, attitude towards blood donation, etc. was distributed to the general population in Assir region through one to one contact in big malls, hospital area as well as electronically through social media. The data thus collected was statistically analysed using appropriate tests.ResultsA total of 844 subjects were surveyed. Most of the respondents (65.0%) reported not having donated blood in the past. The blood donation was found to have a significant relationship (≤ 0.05) with age, gender, occupation, and education status. Roughly, 40.0% of the respondents suggested that blood donation could be promoted by raising public awareness.ConclusionGaps were identified in the awareness of the studied population regarding blood donation. Specific awareness drives may help overcome these barriers to voluntary blood donation.     

Positive anti-SARS-CoV-2 rapid serological test results among asymptomatic blood donors

ObjectivesThe world is fighting with a COVID-19 pandemic, some of the uncertainties have been revealed. To figure out an estimation of asymptomatic patients and seropositive SARS-COV-2 blood donors in Iran, a national survey was conducted to find the prevalence of asymptomatic blood donors with positive SARS-COV-2 IgM/IgG test results at the end of May 2020.Material and methodsFrom all 31 provinces, 1339 blood donors were included. At first, data was collected with an interview containing demographic data, risk factors and possible signs and symptoms held for each donor by a trained medical expert. Then, SARS-COV-2 serologic rapid tests were conducted. Subsequently, the test results were observed and recorded; all of their photos were checked by one single expert. We corrected the prevalence rates for sensitivity and weighted them by the last year rate of blood donation of each province.ResultsThe corrected prevalence rates of positive serological test results for sensitivity in provinces were between zero and 38.24%. The national prevalence was calculated 14.45% after weighting. Out of 161 positive donors, only 43 cases reported related signs or symptoms during the defined period of time, while 118 (73.29%) seropositive cases had not reported any related signs or symptoms. Some signs or symptoms were reported more frequent in the SARS-COV-2 serologic rapid test positives. The highest OR (10.19) was linked to ageusia.ConclusionsThis study has shown the prevalence of seropositive results to be around 14% in target population in which around ¾ had not reported any signs or symptoms.     

Voluntary donors-need for a second look

Voluntary non-remunerated blood donation is the source of the safest blood supply to the transfusion service. In the Indian set up where voluntary donations are fewer and poorly structured, safety of blood could still be compromised. This study was carried out to find out the seroprevalence of transfusion transmitted diseases among replacement and voluntary donors. A retrospective study of replacement and voluntary donors over a three and a half year period was carried out and the seroprevalence for human immunodeficiency virus (HIV), hepatitis B, hepatitis C, syphilis and malaria was noted. A total of 41122 donors were studied comprising of 94.7% replacement and 5.3% voluntary donors. The prevalence of transfusion transmitted diseases was marginally higher among voluntary donors (3.3%) as compared to replacement donors (2.9%). All cases of HIV were seen in the replacement donors while the figures for hepatitis B and C were marginally higher in the voluntary donors (p>0.05). Voluntary donations in our study were not voluntary in the real sense. There is a need to work on building a stronger voluntary donor base and to create awareness among the populace in order to gradually abolish the replacement donations; thereby ensuring the safety of blood and its products.     

Self-ignored onsite adverse donor reaction among whole blood donors: A single center experience from India

ObjectivesAdverse donor reactions (ADR) may often go unreported due to donor related or blood center related factors. Possible donor related factors are self-ignorance of the adverse reaction, inertia to notify blood centre and non-compliance to follow-up. A better understanding of the self-ignored adverse donor reaction (SIADR) helps in early detection, avoidance of complications, adoption of mitigation strategies, and retention of donors. In the current study, we aim to identify the incidence and reasons for onsite SIADR among whole blood donors.Materials and methodsProspective single-center observational study where 501 participants who completed whole blood donation were recruited. They were interviewed twice by an experienced investigator to identify any onsite SIADR occurred. First interview was conducted just before leaving the premise and second two days after donation using a peer reviewed and validated questionnaire. Cross-tabulation and Chi-square test were used for bivariate analysis.ResultsTwelve participants out of 501 (2.39%) were found to have onsite SIADR which was twice the frequency of reported onsite ADR (1.20%) during the study period in our center. A majority (75%) of them experienced grade I vaso-vagal reactions (VVR). Around 58.3% of the SIADR donors ignored the reaction as they perceived it as mild, while 25% perceived the symptoms but failed to interpret them as a reaction.ConclusionIn our center, incidence of onsite SIADR was double the incidence of ADR and majority were VVR grade I. Commonest reason for SIADR was interpretation of reaction as mild. Blood center team shall be proactive and vigilant to identify and report SIADR.     

Profile of transfusion transmissible infections and associated risk factors among blood donors of Kerala

Blood transfusion is an important mode of transmission of infections to the recipient. The aim of the study was to assess the prevalence of transfusion transmissible infections and the possible risk factors among blood donors. During the study period (1994-99) donor samples were screened for HBsAg, HIV, HCV and Syphilis. The relevant donor history was examined to identify the risk factors leading to transfusion transmissible infections. The prevalence of infection was 3.1% among donors, with HBsAg constituting 1.3%, HCV 1.4%, HIV 0.2% and RPR 0.2%. In a classification based on occupation, class III donors (drivers, Businessmen & men in uniform) showed a significantly higher incidence of transfusion transmissible infections for HIV (0.38%) and Syphilis (0.36%). Health care workers constituted only a small fraction of the study; prevalence of infections was low among them. History of jaundice or hospitalization was not associated with higher incidence of seropositivity. Seropositivity for HIV is relatively low compared to similar studies conducted in other regions of the country. This finding is attributed to the pre donation counseling in donor selection. An important outcome of the study is that Class III donors form a high-risk group for transfusion transmissible infections.     

Les hépatites B et C chez les donneurs bénévoles de sang et non rémunérés de l’Est de la République démocratique du Congo

ObjectiveWe aimed to evaluate the global prevalence of hepatitis B and C among voluntary blood donor.MethodsIn the study, 1079 blood donors were included. The investigation was carried out from 1 January till 31 December 2010 in the central Blood Bank of Bukavu in DRC. The median age of sample was 26 years. In total, 72.4% among them were male sex and 54.5% of new blood donors.ResultsThe prevalence of hepatitis B was 4.2% and hepatitis C was found in 3.8% case the coinfection VHB and VHC with 2.2%. VHB was prevalent in blood donor group of less than 30 years (5.0%), new blood donor (5.1%), in medical profession (7.1%) and in the male sex group (5.1%) and was significantly according to the sex (P = 0.01) and the place of residence (P = 0.002). A strong association was showed between the rural medium and hepatitis B OR 3,1 (1.4–6.5) and VHC OR 2.9 (1.3–6.5). After estimation with logistic regression a higher risk of seropositivity of VHB found in blood donor sex male group, married group, blood donor coming from the rural middle and having less than 30 years.ConclusionFor blood safety, a particular attention must be laid in the selection of donor before a blood donation and in donation in reagent.     

Review of blood donor deferral with emphasis on donor and patient safety

IntroductionBlood donor deferral is a part and parcel of the commitment of the blood transfusion services to assure the safety and health of the blood donor as well as the recipient. Periodic review of blood donor deferral is to incorporate or revoke deferral reasons based on the evidence generated in the process of review. Therefore, emphasis must be laid on preparing strategies to only judiciously defer blood donors, recruit and retain first time blood donors, which needs critical appraisal of the existing deferral policies, so that the evidence based changes can be done.Material and methodsA retrospective analysis of deferral in blood donors who presented at the blood donation centre of an institute of national importance over a span of nine years (2011–2019). Donors were screened as per the Drugs and Cosmetics Act 1940 and Rules 1945 given by the Ministry of Health and Family Welfare, Govt of India.ResultsThere were 1,37,935 donors attempts, out of which 20,167 (14.6%) donors were deferred from donating blood. Most of the deferred donors were male (88.5%), first time (86.1%) and temporarily deferred (87.6%). Almost comparable number of donors (49.1 % & 48.5%) were deferred for donor safety and patient safety reasons respectively. Overall the three most common reasons for deferral were low hemoglobin (21.6%), hypertension (11.4%) and history of jaundice (9%). In donor safety reasons, low hemoglobin (43.4%), hypertension (22.9%) and low blood pressure (4.5%), and in patient safety, a history of jaundice (18.6%), common cold (15.8%), and high-risk behavior (8.8%) emerged as the three most common reasons for deferral respectively.ConclusionBlood donor deferral is an essential quality indicator of the blood donor selection process. Initiatives like fortification of dietary ingredients with iron, optimizing protein in diet served in schools under mid-day meal program, screening for iron deficiency, hypertension and education about high-risk behavior in schools and colleges may have long term effects of promotion of better health.     

Marseillevirus prevalence in multitransfused patients suggests blood transmission

BackgroundEmerging viral infections in humans are appearing at an increasing rate. Recently, we identified a new Marseillevirus, named Giant Blood Marseillevirus (GBM), by performing viral metagenomics on asymptomatic blood donors.ObjectivesTo study and compare the prevalence of Marseillevirus between asymptomatic blood donors and thalassemia patients.DesignHere, we present a combined molecular and serological study on 174 asymptomatic blood donors and 22 patients with thalassemia who receive repeated blood transfusions to estimate the prevalence of Marseillevirus in these two populations.ResultsWe identified Marseillevirus genomic DNA in 4% of donors, whereas 9.1% of the thalassemia patients were positive for this virus. Moreover, IgG seropositivity was detected in 22.7% of patients in the thalassemia group, whereas this seropositivity was observed in 12.6% of the blood donor population.ConclusionThese results suggest that Marseillevirus infection is not rare in healthy persons and may be transmitted by transfusion, thus raising speculation regarding the long-term consequences of this viral infection, particularly in patients requiring repeated blood transfusions.     

Incidence and risk predictors analysis of adverse donor reactions in whole blood donation

ObjectiveAdverse donor reactions in normal healthy blood donors is not unusual. However, these unpleasant effects have a negative impact on donor retention. Adverse event due to blood donation is multifactorial in origin. Therefore, the objective of this study was to determine the frequency and type of adverse donor reactions during or after blood donation. More importantly, this study also aimed at analyzing important risk predictors of adverse donor reaction.Material and methodsThis was a retrospective study conducted from May 2017 to April 2019 in the department of Transfusion Medicine at a tertiary care center in eastern India. Data were stored in Microsoft excel 2016 by using a standardized format as per ISBT criteria and analyzed with software “R, version 3.5.3” to find out the various independent precipitating factor.ResultsOverall, 107 donors (0.98%) experienced adverse events with 10,814 whole blood donations. The first time, females, younger age donors (18–30 years), and donors with a mean arterial blood pressure of less than 90 mm of Hg were the most important independent risk factors predicting the possibility of adverse donor reaction. Donors’ weight, hemoglobin, and the type of donation had not affected the frequency of adverse events.ConclusionAnalysis of adverse donor reactions helps in selecting the blood donors who are at risk of donor reactions. Our study highlights the importance of proper predonation screening especially in terms of assessment of mean blood pressure, along with identification of first time and female blood donors in order to reduce untoward donor reaction.