Prevalence of selected viral infections among temporarily deferred donors who returned to donate blood: American Red Cross blood donor study

BACKGROUND: Health history questions are introduced into the predonation interview to identify blood donors believed to pose a higher risk of infectious diseases to recipients. This study assesses the current impact of some of those questions. STUDY DESIGN AND METHODS: Donor deferral and donation data were extracted from a research database of the American Red Cross. The prevalence of hepatitis B surface antigen or antibodies to human immunodeficiency virus, hepatitis C virus, or human T-lymphotropic virus was obtained for different groups of donors who were temporarily deferred in 2000 through 2001 and later returned to donate blood in 2000 through 2003. The results were compared with either first-time or repeat donors in 2000 through 2003, while controlling for differences in sex, age, and year of donation. RESULTS: Of donors temporarily deferred in 2000 through 2001 who had had no donation or deferral during the previous 2 years, only 22.08 percent subsequently returned to donate blood in 2000 through 2003. Donations from returning donors who had been deferred for potential infectious disease risk did not show a higher prevalence for any of the viral markers when those with no donation or deferral during the previous two years were compared with first-time donations, and those with prior donation were compared with repeat donations. CONCLUSION: Blood donors temporarily deferred in 2000 through 2001 for potential risk of viral infection who later returned to donate blood did not appear to pose a higher risk compared to first-time or repeat donors. The effectiveness of some of the currently used deferral questions in reducing viral risks warrants further study.     

Prevalence of anti-dengue immunoglobulin G antibodies among American Red Cross blood donors in Puerto Rico, 2006

BACKGROUND: Dengue is endemic in Puerto Rico and causes periodic outbreaks involving thousands of persons. Seroprevalence studies among blood donors can provide useful data on the immune status of the adult population. The objective of this study was to determine the prevalence of anti‐dengue immunoglobulin (Ig)G antibodies in a random sample of blood donors to the American Red Cross (ARC) in Puerto Rico. STUDY DESIGN AND METHODS: Three‐hundred randomly selected blood donations collected by the ARC from February 1 to March 31, 2006, were tested using an anti‐dengue IgG enzyme‐linked immunosorbent assay. One‐third of the positive specimens were randomly selected and tested by a microneutralization test (MNT) to determine the serotypes of previous dengue infections. RESULTS: Most (84%) blood donors were male, and the mean age was 44.6 years (range, 18‐80 years). The prevalence (95% confidence interval) of anti‐dengue IgG antibodies was 92% (89%‐95%). Of the 92 specimens tested by the MNT, reactivity to all four dengue serotypes was observed and 96% were secondary infections. The predominant serotype with the highest neutralization titers, as identified by at least a fourfold higher titer compared to any other serotype tested, was identified in 32 specimens; the most common predominant serotypes identified by the MNT were DENV‐3 and DENV‐2 (63%). Recent infection with DENV‐1 was detected but, in 2005, routine surveillance did not detect any cases of this serotype. CONCLUSION: Supplementary serologic testing of donated blood can potentially provide information on the silent circulation or introduction of dengue serotypes.     

The American Red Cross donor hemovigilance program: complications of blood donation reported in 2006

BACKGROUND: The American Red Cross (ARC) initiated a comprehensive donor hemovigilance program in 2003. We provide an overview of reported complications after whole blood (WB), apheresis platelet (PLT), or automated red cell (R2) donation and analyze factors contributing to the variability in reported complication rates in our national program. STUDY DESIGN AND METHODS: Complications recorded at the collection site or reported after allogeneic WB, apheresis PLT, and R2 donation procedures in 36 regional blood centers in 2006 were analyzed by univariate and multivariate logistic regression. RESULTS: Complications after 6,014,472 WB, 449,594 PLT, and 228,183 R2 procedures totaled 209,815, 25,966, and 12,282 (348.9, 577.5, and 538.3 per 10,000 donations), respectively, the vast majority of which were minor presyncopal reactions and small hematomas. Regional center, donor age, sex, and donation status were independently associated with complication rates after WB, PLT, and R2 donation. Seasonal variability in complications rates after WB and R2 donation correlated with the proportion of donors under 20 years old. Excluding large hematomas, the overall rate of major complications was 7.4, 5.2, and 3.3 per 10,000 collections for WB, PLT, and R2 procedures, respectively. Outside medical care was recorded at similar rates for both WB and automated collections (3.2 vs. 2.9 per 10,000 donations, respectively). CONCLUSION: The ARC data describe the current risks of blood donation in a model multicenter hemovigilance system using standardized definitions and reporting protocols. Reported reaction rates varied by regional center independently of donor demographics, limiting direct comparison of different regional blood centers.     

Determinants of repeated blood donation among new and experienced blood donors

BACKGROUND: The maintenance of a safe level of blood supply is provided by a small number of volunteers, and their retention is difficult. The aim of this study was to identify factors predicting repeated blood donation among experienced and new donors. STUDY DESIGN AND METHODS: A random sample of 2,231 donors (2,070 experienced and 161 new) completed a questionnaire assessing psychosocial factors as defined by the most prominent social cognitive theories. Six months later, an objective measure of frequency of registrations to give blood was obtained from the database of the local official agency for blood donation. RESULTS: Logistic regression analysis indicated that for experienced donors, the predictors were intention, perceived control, anticipated regret, moral norm, age, and frequency of blood donation in the past. For new donors, intention and age were the only determinants of behavior. Important differences in the determinants of intention were also noted between experienced and new donors. CONCLUSION: In summary, the results of this study support the idea that distinct promotion strategies should be adopted to increase repeated blood donation among experienced versus new donors.     

有效回访对于不愉快献血经历献血者保留的探索

目的分析衢州市中心血站2016—2017年不愉快献血经历献血者的回访结果,为提高献血者保留工作寻找方法。方法将发生献血不良反应、不满意的644例不愉快经历献血者按照路径回访后的再次献血情况进行统计,并按类型进行分析、归纳和总结。结果 644例不愉快献血经历献血者中有222例再次参加献血,再次献血率34.47%。其中不满意献血者再次献血率最高达39.80%。结论对不愉快经历献血者进行及时有效的回访,既保留了献血者,也提升了无偿献血服务质量。     

Interdonation intervals and patterns of return among blood donors in Brazil

BACKGROUND: In Brazil, most donations come from repeat donors, but there are little data on return behavior of donors. STUDY DESIGN AND METHODS: Donors who made at least one whole blood donation in 2007 were followed for 2 years using a large multicenter research database. Donation frequency, interdonation intervals, and their association with donor demographics, status, and type of donation were examined among three large blood centers in Brazil, two in the southeast and one in the northeast. RESULTS: In 2007, of 306,770 allogeneic donations, 38.9% came from 95,127 first‐time donors and 61.1% from 149,664 repeat donors. Through December 31, 2009, a total of 28.1% of first‐time donors and 56.5% of repeat donors had donated again. Overall, the median interdonation interval was approximately 6 months. Among men it was 182 and 171 days for first‐time and repeat donors, and among women, 212 and 200 days. Predictors of return behavior among first‐time donors were male sex (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.13‐1.20), community donation (OR, 2.26; 95% CI, 2.20‐2.33), and age 24 years or less (OR, 0.62‐0.89 for donors ≥25 years). Among repeat donors predictors were male sex (OR, 1.35; 95% CI, 1.32‐1.39), age 35 years or more (OR, 1.08‐1.18 vs. ≤24 years), and community donation (OR, 2.39; 95% CI, 2.33‐2.44). Differences in return by geographic region were evident with higher return rates in the northeast of Brazil. CONCLUSION: These data highlight the need to develop improved communication strategies for first‐time and replacement donors to convert them into repeat community donors.     

音乐对初次无偿献血者的干预效果观察

目的:探讨音乐对初次无偿献血者静脉穿刺疼痛、一次自愿采集400m l献血量及降低献血反应的影响。方法:将初次无偿献血者随机分为对照组与实验组各240名,两组采血程序相同,实验组加用音乐进行干预,观察每组静脉穿刺疼痛及一次自愿采集400m l献血量的比例。结果:实验组献血者疼痛献血反应发生率明显低于对照组,一次自愿献血400m l采集率明显高于对照组(P<0.01)。结论:音乐能分散无偿献血者的注意力,减轻疼痛,降低献血反应,提高400m l采集率,对保留、招募献血者,促进无偿献血事业顺利发展有重要意义。     

Human immunodeficiency virus type 1-infected blood donors: behavioral characteristics and reasons for donation. The HIV Blood Donor Study Group

Between May 1988 and September 1989, 829 human immunodeficiency virus type 1 (HIV-1)-seropositive donors were identified from 3,919,000 units of blood donated at 20 United States (US) blood centers. Of the 829,512 (62%) were interviewed to assess behavioral characteristics of the largest subgroup, men reporting sex with men, use of the confidential unit exclusion (CUE) and reasons for donation among all donors. Among 216 men reporting sex with men, 97 percent had male and 72 percent had female sexual contact since 1978. The majority identified themselves as bisexual (29%) or heterosexual (26%). Although 61 percent of 512 donors were aware of their risk behavior at donation, including 57 percent of those infected through heterosexual transmission, only 5 percent used the CUE. Reasons for donation included failure to read carefully (46%) or comprehend (15%) the deferral materials, pressure to donate (27%), a desire to be tested for HIV-1 (15%), and a reliance on screening to identify infected blood (10%). Reasons given for a perception of being at low risk included no recent risk behaviors, infrequent risk behaviors, or modification of risk behaviors. To reach high-risk donors, centers should assess whether referral materials provide necessary medical information and are clearly written for persons with diverse cultural and language backgrounds. Staff should be encouraged to avoid the use of culturally stigmatized terms and behaviors that may be perceived as high pressure.     

Minority and foreign-born representation among US blood donors: demographics and donation frequency for 2006

BACKGROUND: Historically, minority populations have represented only a small proportion of US blood donors, but recent trends in immigration and potential blood shortages emphasize the need for recruitment strategies to increase minority donations.
STUDY DESIGN AND METHODS: Donation data from a network of six US blood centers for 2006 were analyzed. Race/ethnicity, country of birth, and educational attainment data were collected specifically for the study and assessed for their influence on donation behavior. Logistic regression was used to determine independent associations with repeat donors status and annual donation frequency.
RESULTS: A total of 1,288,998 donations from 729,068 donors were studied; most donors had data on race/ethnicity (97.1%) and country of birth (93.1%). The proportion of minority donors differed by blood center, with African American donors (16%) most common at the Southeastern blood center and Asian (12%), Hispanic (13%), and foreign-born donors (13%) most common at the Northern California blood center. Minority donors and those born in Mexico or Latin America were younger than white donors. Minority and non–US-born donors were less likely than white and US-born donors to be repeat donors (odds ratio [OR], 0.60-0.78), and most were less likely to give two or more annual donations (OR, 0.82-1.11).
CONCLUSION: Minority and Mexico/Latin America–born donors represent a younger and often first-time donor population compared to white and US-born donors, but their annual donation frequency was only slightly lower than white and US-born donors. Increasing the retention and donation frequency of minorities will be important for supplementing the blood supply.     

Motivating factors and deterrents for blood donation among donors at a university campus-based collection center

BACKGROUND: Insight into motivating factors and barriers for blood donation, especially for young people and underrepresented minorities, is important to donor recruitment and retention. We surveyed donors at a new blood collection facility based on a large, ethnically diverse university campus. STUDY DESIGN AND METHODS: Individuals who had donated or attempted to donate at the facility during the first 17 months of its operation were invited by e‐mail to respond to an anonymous, Web‐based questionnaire. Respondents were asked to provide demographic characteristics, rate the importance of various motivating and deterring factors for blood donation, and indicate how they prefer to be contacted by the blood center. RESULTS: More than 30% of the 1619 invitees responded, 95.6% (n = 479) of whom gave complete responses. The respondents were ethnically diverse, and 79.1% were between 18 and 28 years of age. Altruism was by far the most important motivating factor for donation. However, incentives were also rated as important or very important by 72.2% of the respondents. Inconvenience due to time or location constraints was the most important deterrent. E‐mailing was the most preferred contact method and chosen by 80.3% of those surveyed. Some differences were noted in the responses from members of different age, sex, and ethnic groups. CONCLUSION: Although overall altruism and inconvenience were the major motivating factor and deterrent for blood, some demographic differences existed in donor attitude toward incentive programs and preference for the method of contact used by blood centers for recruitment purposes.     

Bruising following blood donation, its management and the response and subsequent return rates of affected donors

A study was undertaken to determine the incidence of bruising among blood donors and to analyse their response to the management of this complication. A total of 52 510 donors were bled at 476 consecutive donor sessions held by the Brentwood Centre during a 4-month period. Of these, 344 donors (0.66%) were found to have developed bruises following venepuncture. The incidence of bruising among males was 0. 35% and that among females was 0.98%. All bruised donors were managed by the Centre nursing and medical staff. One hundred and sixty-one donors informed the Centre that they were fully satisfied with the way their bruising was managed. Of 329 bruised donors who remained in the panel, 249 (75.7%) attended subsequent blood donor sessions in response to routine invitations, showing that the majority of bruised donors continued to donate blood. This response was compared with that of a control group of donors who did not develop any complications and there was no significant difference in the return rates between the two groups.     

Evaluation of hemoglobin of blood donors deferred by the copper sulphate method for hemoglobin estimation.

INTRODUCTION: The copper sulphate (CuSO4) specific gravity test for Hb screening tends to give inappropriate failures. This prompted us to compare it with alternate screening methods. AIM: To study the impact of inaccuracy of CuSO4 method on donor deferral. METHODS: Capillary and venous blood samples of 400 potential blood donors failing the primary Hb screening using appropriately standardized CuSO4 test (specific gravity 1.053) were tested by Hemocue photometer, the Hb colour scale, Cyanmethemoglobin method as well as the automated hematology analyser, which was considered as the standard reference method. RESULTS: One hundred and sixteen donors (29%) who failed the CuSO4 test had true Hb levels >12.5 g/dl. The Hb levels of 131 (32.8%) deferred donors were between 12 and 12.5 g/dl. The sensitivity of Hemocue, Hb colour scale and Cyanmethemoglobin was 99%, 97% and 96% and their specificity was 45%, 93% and 46%, respectively. The positive predictive values (PPV) of Hemocue and Cyanmethemoglobin methods were low (43% and 44%, respectively) but their negative predictive values (NPV) were high (99%, and 97%, respectively). The Hb colour scale had an overall best performance with a PPV of 96% and NPV of 95%. CONCLUSION: The Hemoglobin colour scale which is inexpensive, convenient for field testing and has the overall best performance, is the most suitable for donor Hb screening. Since its readability is 12 g/dl, lowering the donor Hb threshold to 12 g/dl should be actively considered.     

影响公民自愿无偿献血的因素调查分析

目的了解影响公民无偿献血的各种因素以及公民决定献血的重点因素,以制定有针对性的招募策略。方法依照知、信、行(KAP)理论设计调查表,对成都市2385名献血与未献血的公民做现场问卷调查,通过对其无偿献血的知识、态度、行为的研究来做相关分析。结果①对无偿献血的认知:成都地区公民对我国实行无偿献血制度的知晓率较高(87.5%),但对无偿献血常识和危险行为方式总的知晓率较低(分别为29.4%、32.5%),其中献血者(1349名)对无偿献血常识和危险行为方式总的知晓率(分别为33.4%、38.1%)均高于未献血者(1036名)(分别为24.2%、25.1%)(P<0.05);文化程度越低,对献血常识和危险行为的知晓率越低,职业分布以医生的知晓率最高,农民的最低。②了解渠道:献血者通过人际传播的渠道了解的比例高于未献血者(P<0.05)。③献血动机:未献血者、初次献血者和重复献血者愿意献血的主要原因是“献爱心”,但献血动机比较多样,街头献血的行为受各种环境因素的影响;“人道主义”、“同伴招募”和“健康检查”是促使公民初次献血的因素,而影响初次献血的重点因素是“便利和勇气”;再次献血的公民主要是“献爱心、没什么特别原因和享受用血优惠”。④关注信息:未献血者如果打算献血,最希望了解的依次为“献血后是否影响身体”、“是否会感染疾病”、“血液相关知识”、“相关疾病知识”、“献血后优惠”、“献血时间地点”和“其他“。⑤对待献血的态度和行为:认为献血不影响身体的公民占73.5%,献血者(76.3%)的比例高于未献血者(70%)(P<0.05);献血者愿意继续献血的占93.3%,重复献血者(97.1%)高于初次献血者(91.1%)(P<0.05);77.3%的献血者表示“如有危险行为时选择放弃献血”。结论动机、认知、态度、个性及职业与文化程度等自身因素,献血法律法规、献血宣传方式、献血服务过程等环境因素亦都会影响公民献血。献血者招募的策略,首先应研究不同人群对献血不同的需求,采取针对性的措施,促使公民献血;其次,应为献血者提供安全、舒适和方便的服务。     

The effects of a phone call prompt on subsequent blood donation among first-time donors

BACKGROUND: A strategy used by blood centers to retain donors is to place phone call reminders. However, among first‐time donors, no studies have tested the effect of this strategy. This was the aim of this study among individuals who had recently given their first lifetime blood donation. STUDY DESIGN AND METHODS: A quasi‐experimental study using a nonequivalent control group was adopted; participants in the control group were donors with blood types B+ and AB+, since these individuals are not phoned by the blood agency. A total of 1604 first‐time donors aged 18 to 70 years from the province of Quebec, Canada, were assigned to the experimental (n = 870) or the control (n = 734) group. Participants in the experimental group were phoned a few days before they had a new opportunity to give blood while those in the control condition were not phoned. RESULTS: In the experimental condition, 48.3% of the donors attempted to give blood during the 12‐month follow‐up period compared to 38.0% in the control condition. The hazards of the first blood donation attempt among donors who were phoned were 32% higher compared to the hazards of those who were not phoned (p = 0.0004). CONCLUSION: The results of this study indicate that a first phone call reminder about the upcoming opportunity to give blood again has a significant positive effect on return rates among first‐time donors.     

Seroprevalence of SARS-Coronavirus 2 among asymptomatic healthy blood donors from healthcare and non-healthcare settings: Implications for safety of blood donors and blood collection staff during blood donation

IntroductionSARS-Coronavirus-2 pandemic has adversely affected blood supply as potential blood donors were afraid of acquiring infection in hospital settings. We aimed to compare COVID-19 seroprevalence among asymptomatic blood donors from healthcare and non-healthcare setting to analyse the difference in exposure level of each group as well as the risk of acquiring infection during the process of blood donation.Material and MethodsAnalysis of whole blood donors tested for SARS-CoV-2 IgG antibodies was carried out after categorizing them into healthcare workers (HCW) and non-healthcare workers (NHCW). NHCW were further categorized into residents of containment and non-containment zones and seroprevalence analyzed. Seroprevalence among different ABO blood groups was also analyzed.Results1191 blood donors were tested for SARS-CoV-2 antibodies with 9.5 % seropositivity. Significantly lower seropositivity of 3.2 % (p < 0.001) was observed among HCW as compared to 10.9 % seropositivity in NHCW. Among NHCW no difference in seropositivity was observed based on residence in containment or non-containment zone. Significantly higher (p = 0.012) seroprevalence was observed among A blood group donors (12.5 %) as compared to O blood group donors (6.8 %).ConclusionResults suggests that a blood donor, in a hospital setting is less likely to be exposed to COVID-19 disease than when participating in activities of daily living. It is postulated that the lower seroprevalence among HCW as compared to NHCW reflects differences in knowledge and practice of preventive measures among these groups. The findings should instil confidence among blood donors and motivate them to donate blood without fear.     

Human T-lymphotropic virus (HTLV) types I and II infection in sexual contacts and family members of blood donors who are seropositive for HTLV type I or II. American Red Cross HTLV-I/II Collaborative Study Group

Interviews and laboratory testing were conducted for 168 contacts referred by former blood donors identified as seropositive for antibody to human T-lymphotropic virus type I (HTLV-I) or type II (HTLV-II). Thirty-two (28%) of 114 heterosexual contacts of seropositive donors, including 12 women and 20 men, were found to be antibody positive. None of 40 offspring (except one adult man who reported sexual contact in Puerto Rico) or 14 other (nonspousal) family members were seropositive. Thirty-one of the seropositive contacts were typeable as having either HTLV-I (52%) or HTLV-II (48%). Assessment of couples found that the median duration of the sexual relationship was significantly longer (p = 0.03) for those in which both partners were infected than in discordant pairs. Analysis of risk history data for 22 infected couples revealed that, in three cases, risk factors (Japanese ancestry or sexual contact with an injecting drug user) could be identified in the women, but not in their male partners. Among couples in which the male had the greater risk history, the risk factor was either a history of transfusion, birth or sexual exposure in an endemic area, or injected drug use. Counseling strategies for individuals with HTLV-I or HTLV-II infection should take into account the relatively high seroprevalence in their partners and should address the potential for sexual transmission in both directions.