Το σύστημα αιμοδοσίας στην Ελλάδα – Στρατηγική και οργάνωση της εθελοντικής αιμοδοσίας – Οι ανάγκες αίματος των πασχόντων από συγγενείς αιμοσφαιρινοπάθειες

Viral attacks on the blood supply: the impact of severe acute respiratory syndrome in Beijing.

Optimal blood donation screening annotation.

Haemovigilance is an organised scheme of monitoring, identifying, reporting, investigating and analysing adverse events and reactions pertinent to transfusion and manufacturing blood products. This system is also an elemental part of quality control in a blood system, bringing about corrective and preventive measures, and for the perpetual advancement of the quality and safety of blood products and the transfusion process. Nowadays haemovigilance setups have been enforced throughout the globe in most developed countries, to monitor the adverse reactions and episodes associated with blood donations and transfusions. Indian Pharmacopoeia Commission has started a Haemovigilance Program of India (HvPI) in 2012 under its Pharmacovigilance Program of India (PvPI) in collaboration with National Institute of Biologicals, Noida, Uttar Pradesh, under Ministry of Health and Family welfare, Government of India with a primary objective to track adverse reactions/events and incidences associated with blood transfusion and blood product administration and to identify trends, recommend best practices and interventions required to improve patient care and safety. This review article is a detail update of current scenario of haemovigilance in India.

Background: Blood transfusion having some risks of transfusion transmissible infections (TTIs) in the recipients especially when blood is collected during window period. In Africa, about 10-15% of human immunodeficiency virus (HIV) transmission had been related to blood transfusions. Aims: The aim of this study is to present the prevalence of TTIs among the apparently healthy donors, both voluntary as well as replacement donors. Settings and Design: This was a prospective study, carried out in a blood bank attached to a tertiary care hospital, Central India. Materials and Methods: All blood bags collected from these blood donors during the study period were screened for TTIs like hepatitis B surface antigen (HBsAg; Hepalisa, J. Mitra), anti-HIV antibodies (HIV Ab; HIV 3rd generation kit for detection of antibodies to HIV1 and HIV2, J. Mitra), anti-hepatitis C virus antibodies (HCV Ab; MicroELISA 3rd generation, J. Mitra), and Venereal Diseases Research Laboratory (VDRL) reactivity (Carbogen kit, Tulip Diagnostics). Serum were separated from all blood bags and serological test was performed according to the instructions provided by the manufacturers of respective kit. All seroreactive blood bags were considered as positive for TTIs and the blood bags were discarded. Statistical Analysis: A total of 10,582 blood donors were selected for blood donation after clinical history and brief medical examination by medical officer. Blood bags collected from them were screened for TTIs. Among the total blood bags screened, 273 (2.57%) were found positive for transfusion transmissible infectious diseases. Results: Among TTIs, the most common infection was hepatitis B followed by HIV infection in our study. Prevalence of coinfection in our study was very low (0.01%). Voluntary donations have low seroreactivity (2.40%) for TTIs as compared to replacement donations (3.20%). Conclusions: Multiple infections have a very small but definite risk to the recipients, recieving blood and blood products. Hepatitis B was the most common infection in our study. The incidence of coinfection was very low in our study. Prevalence of TTIs was more among replacement donors as compared to the voluntary donors. So, it is possible to improve the safety of blood and blood product by the promotion of voluntary donation, selection of low-risk donors, and use of highly sensitive laboratory screening test.

BackgroundThe availability of safe blood and blood products is a critical factor in improving health care. In Ethiopia, lack of voluntary blood donors is a major challenge. This could be due to low community knowledge, unfavorable attitude, and poor donation practice regarding voluntary blood donation. Thus, the aim of this study was to assess community knowledge, attitude, and practice regarding voluntary blood donation among adults in Harar town, Ethiopia.Materials and methodsA community-based cross-sectional study was conducted from July 1 to July 31, 2015. A total of 845 adults were randomly selected and interviewed using a pretested, structured questionnaire. Six trained data collectors conducted a face-to-face interview. Data were entered into EpiData Version 3 and analyzed using STATA Version 11.ResultsComprehensive knowledge of the study participants toward voluntary blood donation was 43.5%. Multivariable logistic regression demonstrated that male sex (adjusted odds ratio [AOR] = 1.69, 95% confidence interval [CI]: 1.19–2.39), age (31–45 years; AOR = 0.50, 95% CI: 0.34–0.74) and >45 years (AOR = 0.60, 95% CI: 0.38–0.95), and higher education (AOR = 15.34, 95% CI: 5.01–46.91) were significantly associated with comprehensive knowledge about voluntary blood donation. A total of 278 (32.9%) study participants had positive attitude toward voluntary blood donation. College graduates (AOR = 13.05, 95% CI: 4.12–41.29) were significantly associated with positive attitude toward voluntary blood donation. Only 191 (22.6%) subjects had ever donated blood. However, the proportion of study participants who donated blood voluntarily with good knowledge about voluntary blood donation was significantly lower than the study participants who donated blood voluntarily with low knowledge (X2 = 6.1746, P = 0.013).ConclusionThis study showed an inauspicious attitude toward blood donation and poor blood donation practices. Subjects with good comprehensive knowledge about voluntary blood donation were less likely to donate blood voluntarily compared to those with lower comprehensive knowledge about voluntary blood donation.

Blood transfusion is a critical component of modern healthcare system, which is ensured the availability of safe and compatible blood products for patients as when need. This review article explores the entire journey of blood from donor to patient, emphasizing the importance of voluntary non-remunerated repeat blood donation, rigorous donor selection, and advanced laboratory techniques to ensure transfusion safety. It excavates into the challenges of maintaining an adequate blood supply, the ethical considerations in transfusion practices, and the latest advancements in transfusion medicine. In this article, we discuss the indications for blood transfusion, liberal versus restricted transfusion policies, and the management of transfusion reactions. Through comprehensive analysis and practical insights, main aims of this article to enhance the understanding and implementation of blood transfusion services, ultimately improving patient outcomes.

Background & objectives:Safe blood and blood products should be offered to all patients in need for blood transfusion. The objectives of the present study were to establish prevalence estimates for hepatitis B and hepatitis C virus infections as a foundation for safe blood transfusion in rural Vietnam, and to check the accuracy of the laboratory analysis used for hepatitis testing of blood donors in Vietnam.Methods:A cross-sectional study was conducted in two rural communities in Quang Tri, Vietnam. A total of 1,200 blood samples collected from potential blood donors were tested by an enzyme immunoassay technique (EIA) for detection of hepatitis surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), and antibodies to hepatitis C antigen (anti-HCV). The EIA test outcome was validated by a chemiluminescent micro particle immunoassay technique (CMIA).Results:The prevalence of HBsAg and anti-HBc in the study population was 11.4 per cent (95% CI 9.6 - 13.2) and 51.7 per cent (95% CI 48.8 - 54.5), respectively, the prevalences being higher in males than females. The prevalence of anti-HCV was 0.17 per cent. The test agreement between the EIA and CMIA techniques was high both for HBsAg detection (κ = 0.91; 95% CI: 0.83 - 0.99) and for anti-HBc detection (κ = 0.89; 95% CI 0.81 - 0.97). Compared to CMIA results, the positive and negative predictive values of the EIA tests were found to be 94.9 per cent (95% CI 87.5 - 98.6) and 97.5 per cent (95% CI 86.8 - 99.9) for HBsAg, and 92.4 per cent (95% CI 84.2 - 97.2) and 100 per cent (95% CI 91.2 - 100) for anti-HBc.Interpretation & conclusions:The study shows that hepatitis B virus infection is endemic in rural areas of Vietnam and that almost half of the population is or has been infected. Hepatitis C infection is rare, but false negative test results cannot be ruled out. Also, the results indicate that the EIA performance in blood donor screening in Vietnam may be sub-optimal, missing 2.5 per cent of hepatitis B virus carriers and falsely excluding more than 7 per cent of blood donors. As the prevalence of hepatitis B infection is high, occult hepatitis B infection may represent a threat to safe blood transfusion. Therefore, nucleic acid amplification testing for HBV should be considered for blood donor screening in Vietnam.

Introduction: Blood transfusion is a medical procedure that is designed to provide patients who need Blood or blood products to correct a defect .Secure supply of safe blood components; Based on voluntary, non-remunerated blood donation is an important national goal to Prevent blood shortages. Now a day, in many low and middle income countries, blood Supply is critically inadequate. We therefore set out to determine knowledge regarding Blood donation among non-medical students. Design: A Descriptive Survey research design. Participants: 100 Non Medical Students were selected using Probability Simple random sampling technique in selected colleges of Mount Abu, Rajasthan. Tool: Self Structured Questionnaire was used to assess the level of Knowledge of Non Medical Students regarding Blood Donation. Results: In this study overall the highest percentage in the demographic data including the Age group 50% (20- 22), Gender 54% (Female), Religion 90% (Hindu), Residence 46% (Rural), Monthly Income 644% (less than 10000), father education 36% (primary education), mother’s education 64% (no formal education), father occupation 50% (others), mothers occupation 88% (house wife). Majority of students (46%) of non-medical students were having poor knowledge regarding blood donation, (32%) having average knowledge, (18%) having good knowledge and only 4% having excellent knowledge. Findings revealed that there was significant association between age and level of knowledge at 0.05.Conclusion: The result of study clearly shows that there is poor knowledge regarding blood donation among Non-Medical Students. Further research and multi centric studies required to assess the real problem behind their lacking knowledge.

Ensuring the safety of blood and blood products is a vital aspect of healthcare. The potential for transmission of pathogens through blood and blood products makes transfusion safety a significant concern. Despite advancements in testing methodologies, donated blood products still pose a risk for infection transmission. Human parvovirus B19 (B19V) is a small, single-stranded, non-enveloped DNA virus transmissible parenterally by blood transfusion. B19V causes a wide range of clinical manifestations, which is generally harmless in healthy individuals. B19V infection may cause severe complications, such as aplastic crises, as it affects erythrocyte progenitor cells in individuals with increased erythrocyte turnover. Additionally, B19V can be transmitted from pregnant women to their foetus, potentially causing hydrops fetalis and foetal death. The potential for transmission through blood and blood products makes B19V a significant concern for transfusion safety. In response to the growing recognition of B19V's impact on transfusion safety, various international health organisations have introduced guidelines to minimise its transmission through blood and plasma products. However, the implementation of these guidelines varies globally, with some regions, such as India, still lacking formal protocols for B19V monitoring. This review article explores the existing methodologies for screening blood donors for B19V, assesses the associated transfusion risks, and considers the implications for public health and clinical practice. By emphasising advancements in diagnostic techniques and the challenges of their implementation, this article provides a comprehensive overview of efforts to reduce the transmission of B19V through blood transfusions, thereby ensuring safer blood supplies and improved patient outcomes.

Background: Nepal is categorized as a country with ‘concentrated' epidemic of HIV Nepal Red Cross Society, Blood Transfusion Service has implemented considerable efforts to supply the safe blood and blood products according to the increasing demand. A trend analysis might prove valuable to understand the outcome and appropriately plan for further improvements in providing safe blood supply. The study aimed to assess the trends of HIV seroprevalence over the six years in nationwide and in urbanized setting of Kathmandu Valley.Methods: This is a retrospective study conducted among Nepalese blood donors through the years 2001-2007. Serum samples were tested using third generation ELISA tests, strictly following the instructions of manufacturers. The donors' information was collected through the donor record register through the respective Blood Transfusion Services.Results: The overall seroprevalence of HIV among the total blood donors in nation wide and in Central Blood Transfusion Service (CBTS), Kathmandu through the six years of review (from 2001-2007) was 0.33% and 0.4% respectively. A significant decreasing trend in HIV seroprevalence was observed both in nationwide and in Central Blood Transfusion Service, Kathmandu (P< 0.001).Conclusion: The analysis of trends in HIV seroprevalence among blood donors through the year 2001- 2007 showed a significantly decreasing trend, probably due to the cumulative effect of increasing awareness of HIV and improved screening system for safe blood donation. However, an abrupt increase in demand of blood supply was associated with significant increase in seroprevalence in the year 2005/2006. Key words: Nepalese blood donors; Seroprevalence; Trends.doi: 10.3126/jnhrc.v6i2.2203Journal of Nepal Health Research Council 2008 Oct;6(13): Page: 93-97

Blood and blood products are precious commodity which gives life to another person. Though we have immense discoveries and invention in science and technology, yet we cannot make blood hence, human blood has no substitute. The availability of safe blood and blood products is essential for diverse modern healthcare services including some surgeries, treatments for cancer, chronic medical conditions, trauma care, organ transplantation, and childbirths that ultimately improve life for millions of patients who are need of transfusion annually. We do not have yet well-defined and stringent regulatory framework for blood products regulation. Frailty may arise from the inability of governments to enforce laws, regulations, and policies and personnel who may not aware or cannot follow quality assurance and/ or good manufacturing practices. While the health sector in developed nation has made outstanding accomplishments in the past few decades. The study sheds on the overview of blood transfusion system in India and other developed nations. There were a mix of methodologies, including literature review (government documents), interviews with key officials in Indian Red Cross Society and analysis of data was used. Results of analysis showed that there are several areas that need to be addressed as it potentially affect the timely availability of safe blood products, which calls for strengthening the planning and monitoring of blood transfusion services.

To investigate the hepatitis C virus (HCV) infection rate among general population in Jiangsu province and to analyze the main risk factors for HCV infection. Subjects in 3 counties were surveyed by stratified cluster random sampling in the National Major Science and Technology Projects demonstration area in Jiangsu province. Interview was carried out with uniformly- designed questionnaires. Blood samples were collected and anti-HCV tested. Data were analysed under SPSS 13.0. Case-control study was conducted on two groups with subjects under 1:4 matching by sex, age, village of residence and status of HCV infection. Cox's proportional hazards regression analysis was then performed to analyze the risk factors for HCV infection. The positive rate of anti-HCV was higher in females (0.965%, 95%CI:0.899%-1.035%) than in males (0.572%, 95%CI:0.517%-0.632%). Significant differences were noticed among the positive rates of anti-HCV in the three counties (0.131%, 95%CI:0.103%-0.164%;0.316%, 95%CI: 0.268%-0.370%; 2.173% , 95% CI:2.039%-2.315% , respectively). Peak prevalence of anti-HCV (1.577%, 95%CI:1.425%-1.740%) was observed among persons at 50-59 years of age. Bottom rate (0.161%, 95%CI:0.125%-0.204%) was observed below 30 years of age. High anti-HCV positive rate was detected in people with lower education background or belonged to 'floating population'. Factors as having histories of hospitalization (OR = 3.049, 95% CI:1.322-7.036), blood transfusion (OR = 14.319, 95%CI:2.318-88.459) or sharing razor (OR = 3.604, 95%CI:1.096-11.851) were risk factors of HCV infection in the area with the lowest anti-HCV positive rate. In another county, factor as having histories of 'blood products transfusion' (OR = 7.202, 95% CI:1.170-44.310) appeared important while in the third county, having history of 'blood donation' (OR = 7.496, 95%CI:6.121- 9.180); 'blood transfusion' (OR = 2.305, 95%CI:1.578-3.369) and 'invasive physical examination' (OR = 1.258, 95% CI:1.021-1.549) appeared to be important. Age seemed a risk factor for HCV infection. "Sharing razor" was a specifically important risk factor among the 30- year-olds. "Having received acupuncture" was noticed a risk factor only among people at 50-59 years of age while "Having received invasive physical examination" was important in the 50-59 and 60-69 year-olds. High anti-HCV positive rate was observed in people at middle of aged population, as well as in those with poor education or under 'floating'. Unsafe blood donation or having received blood-product transfusion might be the risk factors in the last decades. Factors as sharing razor, having received acupuncture or invasive examination might be specifically risky in different populations.

The demand for blood products in Ireland is constantly rising due to population growth and population ageing. It is believed that within the next decade these two factors will present challenges to blood donor recruitment and the availability of blood supplies. Improving the retention of blood donors will have a positive impact on the availability of blood products. Identification of suitable donors with the potential for long-term donating can potentially enhance the predictability of blood supply levels. This research proposes that the patterns of blood donation behaviours of donors can be isolated from blood donor databases held by blood collecting institutions. These databases typically include only basic information such as age, gender, dates of donations and deferrals from donating. Additionally, the analysis might be enriched with factors related to motivational factors such as intention and attitudes towards blood donation, perceived risks, and personality traits. Machine learning is the fundamental tool used to analyse these blood donation datasets in an attempt to isolate patterns of donor behaviour and characteristics. It is hypothesised that the patterns discovered can be used to predict an individual’s propensity for blood donation and as a consequence forecast future donations. This analysis attempts to create profiles of different types of donors such as short-term and regular donors, which may help predict the likelihood for individuals to become long-term blood donors. The experiments completed in this thesis include the application of machine learning algorithms for the purpose of donor classification and the prediction of blood donation behaviours. The datasets used in this study has been kindly provided by the Irish Blood Transfusion Service. Identification of suitable algorithms for profiling of blood donors may aid the forecasting of long-term blood donations and the efficient management of blood stocks. Furthermore, the results of this research may assist policy makers in creating policies to retain future regular donors.

Haemovigilance: Giving it our best SHOT!

ObjectiveThe relationship among blood donation, cognition in blood donation and health condition of blood donors remains unclear. Based on our hypothesis, this study aimed to explore the mediating effect of cognition in blood donation on the relationship between blood donation and blood donors’ health status.MethodsA total of 837 participants who had prior experience in donating whole blood were recruited into a cross-sectional survey. The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Questionnaire on Cognition in Non-remunerated Blood Donation were used to evaluate the health status and the level of cognition in blood donation, respectively. Blood donation referred to the cumulative times of blood donation. The mediating effect of cognition in blood donation was analyzed by applying a path model.ResultsThe results revealed that blood donation was positively related to the physical component summary (PCS) and mental component summary (MCS) of SF-36, and cognition in blood donation was shown to have a partial mediating effect on the relationship between blood donation and both PCS and MCS. The effect size of cognition in blood donation was 24.63% in PCS and 26.72% in MCS.ConclusionsBlood donation is positively correlated with SF-36 outcomes (PCS and MCS) of blood donors, and cognition in blood donation plays a partial mediating effect in the relationship between blood donation and PCS and MCS.