A survey of the incidence of Miltenberger antibodies among Hong Kong Chinese blood donors

BACKGROUND: The ready availability of red cells of the Miltenberger (Mi) class III phenotype (6.28%) prompted the study of Mi antibodies among Chinese blood donors in Hong Kong, 98 percent of whom are descended from inhabitants of Guangdong Province in southern China. STUDY DESIGN AND METHODS: Red cells of the Mi class III phenotype were used to conduct a survey of the frequency of Miltenberger antibodies in 56,161 random Chinese blood donors, over a period of 12 months, using a microplate technique. RESULTS: Sera from 32 donors (0.057%) were found to contain Mi antibodies: sera from 22 contained anti-Mur + Hut; sera from 4 contained anti-Vw + Mur + Hut; sera from 4 had monospecific anti- Mur; and sera from 2 had monospecific anti-Hil. The immunoglobulin isotypes of 24 sera were mixtures of IgM and IgG, 4 were pure IgM, and 4 were pure IgG. CONCLUSION: The majority of Mi antibodies detected were naturally occurring. This survey proved useful for mass screening of random donors for the procurement of valuable Mi antisera.     

Risk factor analysis of hepatitis C virus infection among Chinese blood donors in Hong Kong

Background: Hepatitis C virus (HCV) infection can result in serious hepatic complications and hence potentially significant burden to the society. Despite advances in technology, transfusion‐transmitted HCV infection still exists. To further minimise the risk, a review on the epidemiology of HCV infection among Chinese blood donors in Hong Kong was conducted. Methods: All donations associated with HCV infection confirmed by positive serologic diagnosis with or without molecular confirmation during the period from 2003 to 2010 were studied. Demographic data were retrieved and risk factors were identified. Results: HCV infection was more commonly seen in first time donors and donors with blood transfusion history before the availability of HCV testing, whereas its association with intravenous drug use was noted to be decreasing. Interestingly, half of the HCV positive donors in 2008–2010 were young donors aged below 21, which was also the group with the highest rate of no known source of infection. Conclusion: A subgroup of younger age donors was found to have no known risk factor. To develop better screening strategy, it is recommended that a more detailed analysis of this group of donors is required.     

The MiIII phenotype among Chinese donors in Hong Kong: immunochemical and serological studies

Summary. The incidence of the MiIII phenotype among Chinese blood donors in Hong Kong was found to be 6·28%. Eleven individuals apparently homozygous for the MiIII gene were detected by immunoblotting with monoclonal antibodies Rl.3 and R18. Rl.3 detects an identical epitope on both glycophorins A and B and Rl 8 detects a different epitope on glycophorin A. Immunoblotting with R1.3 showed an absence of bands corresponding to normal glycophorin B. Immunoblotting with R18 showed an absence of a 58 K band, which corresponds to a heterodimer of normal glycophorin B complexing with the MiIII component, found in MiIII heterozygotes. In two families with apparent MiIII homozygous individuals, both parents of the propositi had the MiIII phenotype which implies normal autosomal inheritance of the MiIII gene. In another family, only one parent had the MiIII phenotype and the presence of an S^u gene is postulated to explain the immunochemical and serological findings.     

Bv: a distinct category of B sub-group among Chinese blood donors in Hong Kong

During the period 1984-1989, a total of 46 examples of Bv phenotype were encountered out of a total of 567,210 donors, giving an incidence of 1 in 12,330 among the Chinese in Hong Kong. The Bv determinant corresponds to the portion of the B antigen that is present on rabbit red cells, and gives a negative reaction with polyclonal anti-B reagents absorbed with rabbit red cells that still react with B3. Some potent monoclonal anti-B reagents confirm the absence of a B epitope from Bv red cells even by adsorption and elution techniques. The failure of some monoclonal anti-B reagents to detect Bv demonstrates the need to select or blend monoclonal anti-B reagents for use in typing Oriental bloods. Cell-conversion techniques failed to convert O cells to B cells using Bv serum with the appropriate substrate, whereas sera from most of the other B variants were capable of doing so. The Bv phenotype, therefore, represents a distinct category of B subgroups that is easily distinguishable from B3 and other B variants.     

A qualitative study of cough medicine abuse among Chinese young people in Hong Kong

Drug abuse has been a social problem for many years and is often complicated by the emergence of new types of abused drugs or new forms of abuse. Abuse of cough medicine has been a focus of concern in Hong Kong since the late 1980s. This paper describes the findings of a qualitative study of the phenomenon of cough medicine abuse in Hong Kong. Focus group interviews were conducted to explore the perceived causes and effects of cough medicine abuse among Chinese young people in Hong Kong. The results from focus group interviews with cough medicine abusers, their family members, and service providers reveal that the primary factors accounting for adolescent cough medicine abuse are social pressure (peer and environmental influences), personal problems (evasion and avoidance), family (difficult relationships or harmful incidents), availability (ease of access), and ignorance. The research participants reported that their cough medicine dependence had serious side effects that threatened their physical and psychological wellbeing, as well as their interpersonal and family relationships. Based on the findings, several recommendations for the prevention of cough medicine abuse are proposed.     

A prospective study evaluating the lowering of hemoglobin standards for blood donors

Strict regulations exist for the selection of blood donors. These include minimum hemoglobin (Hb) standards of 13.5 and 12.5 g/dL for males and females respectively. In Canada 2% of all blood donors, or approximately 25,000 individuals annually attempt to make a blood donation but are deferred because their Hb level does not meet these minimum accepted standards. In a previous study we provided a biostatistical approach to ascertain objectively the optimal minimum Hb standards for blood donors to best discriminate between iron deficient and non iron deficient individuals. The derived values were lower than the existing minimum Hb standards and because of concern that blood donors accepted using these lower Hb standards might have asymptomatic disease, the proposed new levels were not adopted. This present prospective study was undertaken to assess the impact on the blood donors of the new Hb standards. Over 26 months we evaluated 1,558 donors (695 males and 863 females). On entry into the study they were screened for a variety of medical conditions which could result in asymptomatic anemia and 6 months later they answered a health questionnaire. Blood donors were entered into 1 of 3 groups. Group I were donors accepted by the existing criteria. Group II were donors who did not meet the existing Hb criteria but satisfied the newly derived standards. Group III were donors deferred even by the new Hb standards.(ABSTRACT TRUNCATED AT 250 WORDS)     

Rh phenotypes of Chinese blood donors in Hong Kong, with special reference to weak D antigens

Among Hong Kong Chinese blood donors, 99.71 percent were found to be D+. Of these, 55.02 percent were of the phenotype CCDee. The Du phenotype was found to be present in 0.016 percent. Among the 0.27 percent who were apparently D-, 0.079 percent were of the Del phenotype, while the remaining 0.19 percent were "true D-," as defined by a nonreactive eluate obtained by an adsorption and elution procedure using anti-D. The ccdee phenotype constitutes 56.77 percent of the "apparent D-" and 80.24 percent of the true D-. Data show that anti-D rarely occurs in Hong Kong Chinese, and it is postulated that this could be due to the presence of a very weak form of the D antigen among many of those who appear to be D-.     

Cognitive functions among Hong Kong Chinese people with schizophrenia

Persons with schizophrenia show deficits in a variety of cognitive domains including executive function, attention, memory and language. Similar interest in studying the impact of cognitive deficits on the everyday functioning of people with schizophrenia has been documented. This study examined the cognitive functioning among Hong Kong Chinese schizophrenic patients compared with other patient groups, and its relationship with functional outcome, especially in the social aspect. Results indicated that schizophrenic patients presented with mild cognitive problems compared with neurosurgical and demented patients. Initial support was found in relating cognitive functions, as measured by Neurobehavioral Cognitive Status Examination, with functional outcome as measured by Functional Independence Measures. The implication for community rehabilitation is also discussed.     

Individual empowerment among Chinese cancer patients in Hong Kong

Among the various chronic diseases, cancer is the leading cause of death in Hong Kong. This article presents the process of how cancer patients are being enabled and strengthened to overcome powerlessness based on the interview findings of 12 participants. Interviews were analyzed using constant comparison. The basic social process of empowerment included finding meaning in life, seeking mastery over illness, and acceptance of illness. This study's unique findings suggest that the process of empowering cancer patients consists of more than giving patients control, choice, or resources, such as knowledge and skills. Nurses have an important role in facilitating patients to find meaning in life, as well as in the transformation of thoughts and attitudes. Nurses' personal qualities and skills embedded in the nurse-patient relationship constitute an important source of empowerment for patients.     

Donation frequency of blood donors participating in a prospective cohort study of iron status

BACKGROUND: Blood centers are interested in understanding determinants of frequent blood donation. We hypothesized that participation in uncompensated research could result in higher donation rates. STUDY DESIGN AND METHODS: Donation rates for 2425 subjects from six US blood centers enrolled in the Retrovirus Epidemiology Donor Study‐II Donor Iron Status Evaluation Study were compared to those of nonenrolled donors (n = 202,383). Over 15 months, we compared mean donation rates and adjusted rate ratios (RRs) between enrolled and nonenrolled for three subgroups, first‐time, reactivated, and frequent donors, and donation rates before and after the study enrollment period for frequent donors only. RESULTS: Enrolled donors had higher 15‐month mean donation rates than nonenrolled donors (first‐time, 1.21 [RR = 1.91]; reactivated, 1.68 [RR = 1.83]; frequent, 3.40 [RR = 1.12]). However, frequent donors donated at approximately the same rate after enrollment as they did before enrollment in the study (3.62 per 15 months [RR = 1.12]). CONCLUSION: Donors enrolled in the study donated at a higher rate than nonenrolled donors, but frequent donors remained consistent in their donation frequency both before and after enrollment. Although increased donation rates could have been causally related to study enrollment, we cannot rule out an enrollment bias whereby more committed donors were more likely to enroll in the study.     

A case study of the effectiveness of nurse-led screening programmes for cervical cancer among Hong Kong Chinese women

Cervical cancer remains a cause of morbidity and mortality among women despite the efficacy of Pap smear screening. Uptake rates for Papanicolaou (Pap) smears among Hong Kong Chinese women remain low and evidence suggests that both intrinsic and extrinsic factors influence women's attendance for Pap smear screening, particularly the practitioner taking the smear. This study examined the experiences and perceptions of Hong Kong Chinese women of having a Pap smear taken by a female doctor or a female nurse using a case study design. A convenience sample of 50 women was selected from the two case study settings. Data collection involved a confidential structured interview, followed by focus group interviews with a sample of women participating in the structured interview. The findings relating to the technical quality and outcome of care provide the focus for this paper. Although women were highly satisfied with the care provided by both practitioners, women were more satisfied with the information given about the procedure by the nurse (P = 0.0130) and had more confidence in the nurse (P = 0.024). One of the five criteria used to assess the quality of smears demonstrated the doctor achieved a statistically significant higher number of smears containing the required percentage of endocervical cells (P = 0. 0180). Nevertheless, none of the smears taken by the nurse required repeating due to an inadequate specimen. These findings suggest, despite the need for audit of Pap smears, that appropriately qualified nurses can make an important contribution to the uptake of Pap smears among this population.     

Demographic correlates of low hemoglobin deferral among prospective whole blood donors

BACKGROUND: Approximately 10% of attempted blood donations are not allowed because of low hemoglobin (Hb) deferral. STUDY DESIGN AND METHODS: Low Hb deferrals were tracked in more 715,000 whole blood donors at six blood centers across the United States. A multivariable logistic regression model was developed to comprehensively assess demographic correlates for low Hb deferral. RESULTS: Demographic factors significantly associated with low Hb deferral include female sex (11 times greater odds than males), increasing age in men (men over 80 have 29 times greater odds than men under 20), African American race (2‐2.5 times greater odds than Caucasians), Hispanic ethnicity in women (1.29 times greater odds than Caucasian women), and weight in men (men under 124 pounds have 2.5 times greater odds than men over 200 pounds). Interestingly, increasing donation frequency is associated with decreased odds for low Hb deferral (women with one donation in the previous 12 months have two times greater odds than those with six donations). CONCLUSIONS: Low Hb deferral is associated with female sex, older age, African American race/ethnicity, and lower body weight in men. An inverse association with donation frequency suggests a selection bias in favor of donors able to give more frequently. These data provide useful information that can be utilized to manage blood donors to limit low Hb deferrals and assist in policy decisions such as changing the Hb cutoff or permissible frequency of donation. They also generate hypotheses for new research of the causes of anemia in defined groups of donors.     

Association between raised blood pressure and dysglycemia in Hong Kong Chinese

OBJECTIVE—To investigate the association between raised blood pressure and dysglycemia.RESEARCH DESIGN AND METHODS—We studied the association between raised blood pressure and dysglycemia in 1,862 subjects in the Hong Kong Cardiovascular Risk Factor Prevalence Study cohort. We determined the factors predicting the development of diabetes and hypertension in 1,496 subjects who did not have either condition at baseline.RESULTS—Diabetes and hypertension were both related to age, obesity indexes, blood pressure, glucose, HDL cholesterol, and triglycerides. Of subjects with diabetes, 58% had raised blood pressure. Of subjects with hypertension, 56% had dysglycemia. BMI and blood glucose 2 h after a 75-g oral glucose load were independent predictors of new-onset diabetes. Age, systolic blood pressure, and 2-h glucose were independent predictors of new-onset hypertension. BMI, systolic blood pressure, and 2-h glucose were independent predictors of the development of diabetes and hypertension together.CONCLUSIONS—Diabetes and hypertension share common etiological factors. Patients with diabetes or hypertension should be screened and managed for the precursor of the other condition.In the U.S., ∼29.3 and 7.8% of the general population have hypertension or diabetes, respectively (1). In Hong Kong, ∼20 and 9.6% of adults have hypertension and diabetes, respectively (2,3). Obesity is as an important precursor of both hypertension and diabetes in Hong Kong (2,3). Therefore, we investigated the association between raised blood pressure and dysglycemia in the Hong Kong Cardiovascular Risk Factor Prevalence Study cohort.