An analysis of blood donation barriers experienced by North American and Caribbean university students in Grenada,West Indies

Objectives

To estimate the associations of nationality, university program, donation history and gender, with blood donation barriers experienced by non-donating students on the day of a campus blood drive. This project focused particularly on nationality and the effect of the different blood donation cultures in the students' countries of origin.

Impact of the COVID-19 pandemic on blood donation and transfusions in the United States in 2020

Introduction

Reports have suggested the COVID-19 pandemic resulted in blood donation shortages and adverse impacts on the blood supply. Using data from the National Blood Collection and Utilization Survey (NBCUS), we quantified the pandemic's impact on red blood cell (RBC) and apheresis platelet collections and transfusions in the United States during year 2020.

Methods

The 2021 NBCUS survey instrument was modified to include certain blood collection and utilization variables for 2020. The survey was distributed to all US blood collection centers, all US hospitals performing ≥1000 surgeries annually, and a 40% random sample of hospitals performing 100–999 surgeries annually. Weighting and imputation were used to generate national estimates for whole blood and apheresis platelet donation; RBC and platelet transfusion; and convalescent plasma distribution.

Results

Whole blood collections were stable from 2019 (9,790,000 units; 95% CI: 9,320,000–10,261,000) to 2020 (9,738,000 units; 95% CI: 9,365,000–10,110,000). RBC transfusions decreased by 6.0%, from 10,852,000 units (95% CI: 10,444,000–11,259,000) in 2019 to 10,202,000 units (95% CI: 9,811,000–10,593,000) in 2020. Declines were steepest during March–April 2020, with transfusions subsequently rebounding. Apheresis platelet collections increased from 2,359,000 units (95% CI: 2,240,000–2,477,000) in 2019 to 2,408,000 units (95% CI: 2,288,000–2,528,000) in 2020. Apheresis platelet transfusions increased from 1,996,000 units (95% CI: 1,846,000–2,147,000) in 2019 to 2,057,000 units (95% CI: 1,902,000–2,211,000) in 2020.

Conclusion

The COVID-19 pandemic resulted in reduced blood donations and transfusions in some months during 2020 but only a minimal annualized decline compared with 2019.     

Standing shock index: An alternative to orthostatic vital signs

ObjectiveThe lack of a sensitive, practical bedside test for hypovolemia has rekindled interest in the shock index (heart rate divided by systolic blood pressure). Here, we compare the effect of blood donation on standing shock index values with its effect on values for the supine shock index and orthostatic change in shock indicies (OCSI).

Demographic differences in estimated blood donor eligibility prevalence in the United States

BACKGROUND: The prevalence of blood donor eligibility factors has a major impact on the availability of blood donors and thus the blood supply in the United States. The prevalence of these factors may differ between demographic groups and thus help explain the differences in blood donation rates. STUDY DESIGN AND METHODS: The study population (18‐69 years old who were African American [AA], white, or Hispanic) was 185,073,489. Forty eligibility factors determined by US Food and Drug Administration's Code of Federal Regulations and AABB Standards for Blood Banks and Transfusion Services were used to calculate whole blood donation eligibility rates. Eligibility data were obtained from the 2007 to 2008 National Health and Nutrition Examination Survey, National Ambulatory Medical Care Survey, US Census Bureau, and Centers for Disease Control and Prevention. Eligibility rates were determined by race/ethnicity, sex, and age groups (18‐39 and 40‐69 years). RESULTS: In 2007 to 2008, 122 million Americans (65.9% of the study population and 41.0% of the total US population) were estimated to be eligible to donate blood in the United States. Significant differences in eligibility rates by demographic characterizers were determined (p < 0.001): AAs (36.5%), whites (46.4%), and Hispanics (40.7%); males (45.4%) and females (42.7%); individuals 18 to 39 years old (35.8%); and individuals 40 to 69 years old (32.9%). CONCLUSIONS: AAs were significantly less eligible to donate blood than whites and Hispanics. Disparities in donor eligibility exist by race/ethnicity, sex, and age groups.     

Factors influencing voluntary blood donation practice among university students of Bangladesh

Although voluntary blood donation among young people, particularly university students, is increasing and saving many valued lives, it is unclear which characteristics of the students have the most influence on their willingness to participate in voluntary blood donation. We aimed to identify the correlates that might influence voluntary blood donation practice. In total, 439 students from different universities in Bangladesh participated in this study. Data were collected using an e-questionnaire. To better understand students’ perception regarding voluntary blood donation, exploratory data analysis and the Pearson Chi-square test were performed. The degree of association of the possible risk factors was evaluated using odds ratios (OR) from a backward selection binary logistic regression model. 54 % (237) of the respondents voluntarily donated blood at least once. The odds of male students voluntarily donating blood were 7.28 (95 % CI: 4.14–12.78) times higher than their counterparts. University students who participated in various volunteer organizations were 2.43 [95 % CI: 1.49–3.96], p = 0.005) times and students, who had seen advertisements of blood donation on social media or a part of social media-based blood donation campaign were 4.72 [95 % CI: 2.57–8.65] times more likely to donate blood than their counterparts. The majority of the first-year students were discovered to be first-time blood donors. Moreover, BMI was also found to be significantly associated (positively) with blood donation practice. We found that females, students with lower BMI, and students who are not involved in any voluntary organization are less involved in voluntary blood donation.     

Return of autologous blood donors as homologous blood donors

Autologous blood donors (ABDs) have been reported to have favorable attitudes toward returning as homologous blood donors (HBDs), but the frequency of return has not been well documented. ABDs eligible by history to be HBDs were followed at one blood center: 255 donating for elective surgery and 234 donating during pregnancy were followed for an average of 18 months and 20 months, respectively, from time of eligibility after surgery or postpartum. Male ABDs had a higher rate of return as HBDs, as 34 percent (21/62) returned to donate an average of 3 units, whereas 13 percent (56/427) of female ABDs returned as HBDs to donate an average of 2 units. Although a history of donation was associated with a higher rate of return (30%, 34/113), 11 percent (43/376) of ABDs with no history as HBDs returned to donate homologous units, despite having been recruited less frequently than prior HBDs. Overall, all male ABDs and female ABDs with an HBD history returned most frequently. The extra effort required for an autologous donor program may result in the recruitment of new donors into the HBD pool.     

Feasibility and success of a single-donor red cell program for pediatric elective surgery patients

Although the risks of allogeneic blood transfusions are small, it is wise to limit donor exposure whenever possible. A program has been developed in which one donor provided all red cell (RBC) units for each patient awaiting elective surgery. Patients were mostly children who were ineligible for autologous blood donation. Seventy-three patients and 115 donors (mostly parents) entered the program. Of the 115 donors, 90 (78%) were eligible to participate and 25 (22%) were ineligible; 21 were ineligible because of RBC incompatibility. For each of the 73 patients, one eligible donor was selected to donate all RBC units. Preoperative RBC orders were 1 to 2 units for 41 patients and > or = 3 units for 32 patients. Of the 73 donors, 58 (79%) gave all RBC units ordered; 15 (21%) failed to complete all donations, but only 1 because of anemia (hematocrit < 33% [0.33]). Of 73 patients entered, 46 (63%) underwent transfusion, and 27 (37%) did not. Of 46 patients transfused, 38 (83%) received only single-donor RBCs. Thus, the RBC needs of nearly all pediatric elective surgery patients were provided by a single donor for each patient. Single-donor blood programs should be considered for elective surgery patients who are ineligible for autologous blood donation and who would otherwise be exposed to multiple donors.     

Navigating imperfect policies to donate plasma: Survey on plasma donation and a pilot plasma donation program among men who have sex with men in Canada

Background

In 2021, Canada implemented a pilot plasma program allowing some sexually active men who have sex with men (including but not limited to gay and bisexual men; gbMSM) to donate plasma. Changes to plasma donation policy could help address inequities in access to plasma donation and increase Canada's domestically collected plasma supply if more gbMSM donate as a result. We aimed to (1) examine views regarding plasma donation and the pilot program prior to implementation and (2) identify modifiable theory-informed predictors of gbMSM's intention to donate plasma.

Methods

We developed, piloted, and disseminated a questionnaire informed by the Theoretical Domains Framework (TDF). We recruited gbMSM in London (ON) and Calgary (AB) to an anonymous, online cross-sectional survey.

Results

A total of 246 gbMSM completed the survey. On scales from 1 (strongly disagree) to 5 (strongly agree), general intention to donate was high (mean = 4.24; SD = 0.94). The pilot program itself was mostly acceptable (mean = 3.71, SD = 1.16), but the intention to donate under the unique requirements of the pilot program was lower than general intention (mean = 3.58; SD = 1.26). Two domains from the theoretical domains framework (TDF) (beliefs about consequences of donating plasma and social influences) were independently associated with general intention to donate.

Discussion

The pilot plasma program as an incremental step toward more inclusive policies was mostly viewed as acceptable by the impacted communities. Historical and ongoing exclusions create unique barriers to donation. There are clear opportunities for developing theory-informed interventions to support gbMSM to donate plasma as policies continue to become more inclusive and more become eligible to donate.     

在校本科大学生无偿献血体验的质性研究

目的 了解在校本科大学生参与无偿献血的体验和感受,旨在为高校献血知识教育的开展和相关部门制定更有效的无偿献血规范化流程和服务标准提供依据。方法 通过质性研究中的现象学研究方法,采用面对面半结构式访谈,对18名参与过无偿献血的在校本科大学生进行深度访谈,并利用Colaizzi 7步分析法进行资料整理分析。结果 针对在校大学生无偿献血的体验提炼出4个主题：缺乏无偿献血相关知识;献血体验欠佳;多种因素影响再次献血意愿;期望更完善的献血制度。结论 高校要加大无偿献血的宣传力度,并积极向大学生群体普及献血知识,在提高采血机构服务质量的同时,应注重献血者的心理支持,进而提高在校大学生参与无偿献血的积极性。     

The effect of ferritin-guided iron supplementation among Danish female first-time blood donors

Background

The identification of blood donors at risk of developing low hemoglobin (Hb) and subsequent intervention is expected to reduce donation-induced iron deficiency and low Hb among blood donors. This study explores the effects of ferritin-guided iron supplementation for female first-time donors implemented in four of five administrative regions in Denmark.

Study Design and Methods

We included 45,919 female first-time donors in this study. Hb values were determined in donations of included donors during a 2-year follow-up period. For each region, an intervention group (after implementation) and a control group (before implementation) were defined. The primary outcome was Hb below the donation threshold (7.8 mmol/L ~ 12.5 g/dL) at the time of donation, in the control group, and the intervention group, using logistic regression. The secondary outcome was the number of donations per donor given during the follow-up period.

Results

We observed a statistically significant decrease in the risk of female first-time donors experiencing a donation with low Hb after ferritin-guided iron supplementation was introduced: Odds ratio, 0.82; 95% confidence interval (CI), 0.71–0.95. We found a statistically significant increase in the number of donations per donor during the follow-up period after intervention; rate ratio: 1.05, 95% CI: 1.02–1.08.

Discussion

Ferritin-guided iron supplementation led to a significant reduction in the occurrence of low hemoglobin (Hb) levels among Danish female first-time blood donors. The intervention was additionally associated with an increase in the number of donations per donor.     

Clinical outcomes after peripheral blood stem cell donation by related donors: a Dutch single‐center cohort study

BACKGROUND: Relatives donating peripheral blood stem cells (PBSCs) may be accepted for donation on less strict criteria than unrelated donors. We evaluated the occurrence of adverse events during procedure and follow‐up, with a special focus on donors who would have been deferred as unrelated donors. STUDY DESIGN AND METHODS: All 268 related PBSC donors at our center (1996‐2006) were included. Data were retrospectively collected from medical reports and standard follow‐up. Health questionnaires were sent from 2007. Medical outcomes of donors, deferrable or eligible according to international criteria for unrelated donation, were compared. RESULTS: Forty donors (15%) would have been deferred for unrelated donation. Short‐term adverse events occurred in 2% of procedures. Questionnaires were returned by 162 (60%) donors on average 7.5 years after donation, bringing total person‐years of follow‐up to 1278 (177 in deferrable donors). Nine malignancies and 14 cardiovascular events were reported. The incidence rate of cardiovascular events in eligible donors was 6.5 (95% confidence interval [CI], 2.5‐12.3) per 1000 person‐years compared to 44.9 (95% CI, 17.4‐85.2) in deferrable donors; incidence rates of malignancies were 4.6 (1.4‐9.6) and 24.0 (6.0‐53.9) per 1000 person‐years, respectively, in eligible and deferrable donors. All incidence rates were within the range of age‐ and sex‐matched general population. No autoimmune disorders were reported. CONCLUSION: In both the eligible and the deferrable related donors treated with granulocyte–colony‐stimulating factor there are few short‐term and long‐term problems. The occurrence of post‐PBSC cardiovascular events and malignant disease in related donors appears to be within the range of the general population.     

The United States' potential blood donor pool: estimating the prevalence of donor-exclusion factors on the pool of potential donors

BACKGROUND: Efforts to ensure donor and recipient safety have reduced the population of eligible voluntary blood donors. The current method for determining eligible blood donors in a population using only age as the criterion for excluding donors poorly reflects the large constellation of factors known to cause donor deferrals. An epidemiologic model has been developed to determine the prevalence of donor exclusions and thus improve the estimate of total eligible blood donors in the nation. STUDY DESIGN AND METHODS: Epidemiologic databases were selected to enumerate the population prevalence of 31 donor exclusionary factors which correspond to the AABB standards. Prevalence data were adjusted for age, duration of exclusion, and comorbidities. This method yields the number of excluded individuals to calculate the number of eligible blood donors. RESULTS: The conventional method of calculating eligible donors indicates that there are approximately 177 million eligible blood donors in the US population. This study indicates that this method erroneously includes 66 million individuals who are ineligible due to known exclusionary factors. Only 111 million individuals in the US population are eligible to donate blood. CONCLUSION: The conventional method of determining eligible blood donors overestimates eligible donor prevalence by approximately 59 percent (111 million eligible individual blood donors rather than 177 million eligible individuals). It is recommended that a method similar to the one described in this study be utilized to additionally exclude potential donors not meeting AABB donation standards to improve accuracy of eligible blood donor estimations.     

Transfusion-associated adverse events incidence and severity after the implementation of an active hemovigilance program with 24 h follow-up. A prospective cohort study

Background

Hemovigilance (HV) is usually based on voluntary reports (passive HV). Our aim is to ascertain credible incidence, severity, and mortality of transfusion-associated adverse events (TAAEs) using an active HV program.

Study Design and Methods

Prospective cohort study to estimate transfusion risk after 46,488 transfusions in 5830 patients, using an active HV program with follow-up within the first 24 h after transfusion. We compared these results to those with the previously established passive HV program during the same 30 months of the study. We explored factors associated with the occurrence of TAAEs using generalized estimating equations models.

Results

With the active HV program TAAEs incidence was 57.3 (95% CI, 50.5–64.2) and mortality 1.1 (95% CI, 0.13–2.01) per 10,000 transfusions. Incidence with the new surveillance model was 14.0 times higher than with the passive. Most events occurred when transfusions had already finished (60.2%); especially pulmonary events (80.4%). Three out of five deaths and 50.3% of severe TAAEs were pulmonary. In the multivariate analysis surgical patients had half TAAEs risk when compared to medical patients (OR, 0.53; 95% CI, 0.34–0.78) and women had nearly twice the risk of a pulmonary event compared to men (OR, 1.84; 95% CI, 1.03–3.32). Patient's age, blood component type, or blood component shelf-life were unrelated to TAAEs risk.

Discussion

Active hemovigilance programs provide additional data which may lead to better recognition and understanding of TAAEs and their frequency and severity.     

Estimating the risk of blood donation associated with HIV risk behaviours

summary .  A blood donor questionnaire and declaration, with deferral of potential donors at a higher risk of blood-borne infections, was introduced in Australia in the mid-1980s to reduce the risk of donation of HIV-infected blood. However, the absolute risk of HIV transmission through blood donation from high-HIV-risk donors has not been estimated. This study presents a new method of assessing the risk posed to the blood supply by selected HIV risk behaviours. A model was developed to estimate the probability of blood donation during the window period for HIV infection. Five scenarios for blood donors were considered: (1) men who have sex with men (MSM), (2) men who have sex with women in Australia, (3) women who have sex with partners from countries with a high HIV prevalence, (4) men who have sex with commercial sex workers in Australia and (5) people injecting drugs used once in a year. Those estimated to be at highest risk of becoming infected and donating in the window period were MSM. Women who have sex with men from countries of high HIV prevalence are at greater risk than men who have sex with female sex workers from Australia. These three groups under current Australian guidelines are deferred from donating blood for 12 months. In Australia, a single episode of injecting drug use is associated with very low risk of HIV transmission. The model presented in this study can be used to assess the impact of selected individual risk behaviours on the safety of the blood supply.     

佛山市民献血动机及献血行为影响因素调查分析

目的了解佛山市民献血动机及献血行为的主要影响因素,针对性制定招募策略。方法采取分层整群抽样法,抽取佛山市583例非献血者和554例献血者分别进行无偿献血影响因素的问卷调查。采用χ~2检验与Logistic回归等方法进行分析。结果献血人群特征为男性较多,年龄20~30岁,高中/中专学历,月收入1 000~3 000元;献血的主要动机是"奉献爱心和社会责任";献血行为受"奉献爱心和社会责任""给多次献血者颁发证书和勋章""害怕献血会感染疾病和影响健康""怕痛""献血地点交通不方便"等因素影响。结论激励措施、阻碍措施、心理因素、献血服务等因素都会影响市民献血,应针对不同人群,制订不同的招募策略。     

Determinants of return behavior: a comparison of current and lapsed donors

BACKGROUND: There is a need to identify factors explaining why some people stop donating blood. STUDY DESIGN AND METHODS: A random mail survey of first-time (FT) and repeat (RPT) current (donating within 6 months before survey) and lapsed (donating >2 years prior) donors was conducted. The self-administered questionnaire included questions on personal, social, and behavioral characteristics. RESULTS: Among 1280 current and 1672 lapsed donors with valid addresses, the participation rate was 66.8 and 39.2 percent, respectively. In FT donors, the odds of lapsing increased with education (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.34-3.55 for college or higher vs. Grade 12 or less education). Lapsed FT donors were more often asked to donate (OR, 1.89; 95% CI, 1.32-2.70) and had less interest in incentives (p < 0.001) than current FT donors. In RPT donors, lapsed status was associated with being younger (p < 0.001) and female (OR, 1.19; 95% CI, 1.00-1.42). Lapsed status was inversely associated with satisfaction with the last donation experience in both FT (p = 0.043) and RPT (p < 0.001) donors. Lapsed and current donors did not differ in perceived need for blood, personal transfusion experience, or mean reported altruistic behavior score. CONCLUSION: A positive donation experience appears to be a major determinant of donor return behavior. Lapsed donors do not appear, on average, to engage in fewer altruistic behaviors than currently active donors. Retention marketing strategies that appeal solely to altruistic values need to be further evaluated for their effectiveness.     

Factors Associated with Intention to Donate Hematopoietic Stem Cells among Blood Donors

IntroductionPast studies pay little attention to the intention to donate hematopoietic stem cells (HSC) among blood donors. This study investigated the level of and the influence of socio-demographic characteristics, knowledge, attitude, subjective norm and self-efficacy on the intention to donate HSC among blood donors.MethodsThis cross-sectional study recruited blood donors at selected public hospitals in the Malaysian State of Sarawak in 2019. A structured questionnaire was developed based on the review of relevant literature. It gathered information on socio-demographic characteristics, knowledge, attitude, subjective norm and self-efficacy on the intention to donate HSC. Variables with a p value <0.200 in bivariate analysis were included in the variable selection for regression modeling to examine their associations with the intention to donate HSC.ResultsA total of 569 blood donors participated (94.5% response rate). Overall, 87.1% reported a positive intention to donate HSC. In the regression model, the factor with the greatest association with intention to donate HSC was subjective norms about HSC donation (β = 0.35, 95% CI 0.27–0.42), followed by attitude about regulations of HSC donation (β= 0.21, 95% CI 0.13–0.35), self-efficacy on HSC donation (β = 0.15, 95% CI 0.09–0.32), attitude about the potential side effects of HSC donation (β = 0.14, 95% CI 0.02–0.10) and highest education level (β = 0.10, 95% CI 0.03–0.44).ConclusionsThe findings can be used to formulate a better strategy in promoting HSC donation among blood donors in the region.