The Scientific Journal of Iranian Blood Transfusion
Year:2007 | Volume:3 | Issue:5 (SPECIAL ISSUE)|Papers Count:9

Background and Objectives: Evaluation of the prevalence trend of blood transfusion-transmitted infections is essential in monitoring blood supply safety, determining effectiveness of donor screening, and estimating residual risk of blood transfusion-transmitted infections. Materials and Methods: In this cross-sectional survey, data from blood donors who referred to Shiraz Blood Transfusion Center from 2000 till the end of 2005 were collected. Then, we reviewed the number of HBs cases detected by ELISA test, HIV by Western Blot test, and HCV by ELISA. Then, the demographic status, the incidence of hepatitis B, hepatitis C, and HIV in the population of blood donors during these years were evaluated. Results: During 2000 to 2005, 507531 donors embarked on blood donation in Fars Blood Transfusion Center. The prevalence rate of HIV between 1381 to 1385 were 0.019%, 0.008%, 0.007%, and 0.009%, the prevalence rate of HBs 0.57%, 0.52%, 0.53%, and 0.53%, and prevalence of HCV 0.19%, 0.13%, 0.09%, and 0.16% respectively. The prevalence rate of HIV grew in 2000 (p<0.05); it then decreased and stayed stable afterwards. The prevalence rate of HCV had no significant change over time. The prevalence rate of HBs was lower in 2005 (p<0.05). The prevalence rates of HBs, HCV, and HIV were higher among first-time, male, and married blood donors (p<0.05). The prevalence rates of HBs, HCV, and HIV infection were not significantly correlated with age of blood donors(p>0.05). Conclusions: If we notice the prevalence rate of transfusion transmitted viral infections in blood donors, we understand that the incidence rate of this infection in Shiraz blood donors is less than its rate among normal population and does not change over time; it may be attributed to effective donor screening procedures and the low prevalence rate of transfusion transmitted viral infections in donor population. If we compare the prevalence rate of transfusion transmitted viral infections in our blood donors with that of the other countries, we understand that the prevalence rate of transfusion transmitted viral infections in our country is low. It shows the safety of our blood supply.

Background and Objectives: The incidence of post transfusion hepatitis has been reduced by blood donor screening for HBsAg, but the HBV infection is still responsible for certain cases of post-transfusion hepatitis world-wide. An estimate of the rate of HBV DNA and anti-HBc positive units is important for evaluation of the need for anti-HBc blood donor screening. In this study, the HBsAg negative blood units were evaluated for anti-HBc and all of anti-HBc positive units were tested for HBV DNA by PCR method. Materials and Methods: Extra samples were collected from 2000 HBsAg, anti-HCV, anti-HIV and RPR-negative blood donors. All of the samples were examined by the approved anti-HBc assay. All anti-HBc positive samples were tested by anti-HBs assays and evaluated for HBV DNA (PCR). The sensitivity of the HBV DNA (PCR) assasy was estimated to be 300 geq/ml according to VQC proficiency panels. Results: 230 (11.5%) out of 2000 samples were positive for anti-HBc. 179 (77.8%) out of 230 anti-HBc positive samples were HBsAb positive, and 51(23.2%) HBsAb negative. All 230 samples were assayed for single HBV DNA (PCR) 227 of which came out to be negative for HBV DNA (PCR). Three blood donors were recalled and new samples from two of whom were collected. These new samples were negative for HBV DNA. Conclusions: Further study for evaluation of HBV DNA in anti-HBc positive blood units with full automatic instruments and usage of blood bags with accessories is strongly recommended.

Background and Objectives: Occurrence of new infectious agents threatens access to zero risk in blood transfusion and enhancement of blood safety. Although sensitive methods are available for diagnosis of hepatitis, yet some hepatitis cases do not have a known etiology. In 1997, the novel DNA virus was isolated from post-transfusion serum samples of patients affected by non-A-G hepatitis. Nowadays this novel virus is known as transfusion-transmitted virus. This circular single stranded unenveloped and virucidally resistant virus is the first human circovirus and has universal distribution. It is believed that TTV may cause hepatitis and aplastic anemia. This study was conducted to determine the prevalence of TTV in healthy blood donors in Ahwaz and set up N22 PCR for subsequent first-time viral studies in south region in Iran. Materials and Methods: In 2003, we studied the presence of TTV DNA by using Okamoto primers with PCR in plasma of blood donors in whom serologic tests for hepatitis A-C and HIV-Ab were negative. Results: Our study showed that the virus prevalence in blood donors was 23.7% (60/253) and there were not any significant differences between prevalence of TTV and background variables. Conclusions: Our findings showed the same prevalence rate as in neighboring countries; however, in comparison with thalassemic patients that were studied in parallel with the present research, the difference was significant (143/250; 57.3%). It shows the importance of blood transfusion in transmission of the virus.

Background and Objectives: Investigations have shown that the safest blood is driven from voluntary regular blood donors. Because of the importance of blood safety, the main goal of blood transfusion organizations is to provide the safest blood. Hence, the recruitment of blood donors is of most importance. The aim of this survey is to determine the return rate of first time blood donors both with and without invitation cards mailed following the first blood attempt. Materials and Methods: In a prospective study a questionnaire was handed out to the first time blood donors of Isfahan Blood Transfusion Center. After donation those with negative screening test results (HBsAg, HCV-Ab, HIV-Ab and RPR) were randomly divided into two groups. For one of these groups 3 to 4 months later an invitation card was sent to make an appointment for their next donation session, while the other group (control) did not receive any reminders. At least one year after the first donation attempt, repeat donations of the two groups were recorded. Results: 1500 questionnaires were distributed among first time blood donors out of whom 939 remained in the study (416 in the group for whom invitation card was sent and 523 in the control group). Frequency of blood donation after one year follow up was different in the two groups. Overall 117(28.1%) blood donors receiving the invitation cards and 114 (21.8%) donors in the control group did donate again. The difference came out to be significant by chisquare test (x2=5.002, p=0.013). 25.6% of men and 13.6% of women had repeat donations which indicates a significant difference as analyzed by chi-square test (x2=5.804, p=0.008). There was no significant difference in return rate of married and unmarried blood donors with or without an invitation card (x2=0.067, p=0.21). Pearson's correlation showed no relation between age of the donors and return rate for the subsequent donation (r=0.012, p=0.27). Spearman's rank correlation shows no correlation between education level of the donors and return rate for subsequent donation (r=0.002, p= 0.96). There is no correlation between distance of donor residence from donation center and return rate for subsequent donation by Pearson's correlation test (r=0.021, p=0.53). Conclusions: Regular blood donation is one of the important steps in blood safety, hence retention of regular blood donors, and education and recruitment of sporadic and first time donors can increase the rate of regular donation leading to higher blood safety. This investigation showed that mail of cards three to four months after the first donation attempt to invite first time blood donors for subsequent blood donation is an easy and cost effective method to change them into regular blood donors.      

Background and Objectives: Satisfaction of blood donors plays a critical role in providing safe and adequate blood supply for patients. This study aimed to evaluate the level of satisfaction of blood donors in Iranian Blood Transfusion Organization (IBTO). Materials and Methods: This was a cross-sectional study with the involvement of 2508 blood donors selected in proportion to the average distribution of blood donors in different provinces of Iran. The random sampling method was used. Questionnaires were directly handed over to blood donors. Results: There was a positive relationship between behavior of physicians or other care staff with satisfaction level of blood donors. Physical conditions of donation sites play an important role in satisfaction level of blood donors. There was a negative correlation between education level and satisfaction of blood donors; the higher the education level, the less the rate of satisfaction. There was not any significant difference in satisfaction of blood donors in terms of sex. Satisfaction rate of blood donors was higher among those referring to blood drives than those to blood centers. Satisfaction rate among repeat blood donors was more than twice that among first-time blood donors (PV=0.04). Conclusions: The highest satisfaction value is attributed to the behavior of the personnel involved in phlebotomy and physicians. The lowest satisfaction value pertained to accessibility of blood donor centers. Overall satisfaction rate was more than 50% showing a figure, higher than our previous estimation.

Background and Objectives: High blood pressure is one of the causes of blood donor rejection; therefore, detection and treatment of the mild hypertension in donors have an important role in increasing the health level of blood donors and decreasing their hypertension-attributed mortality and morbidity rate and finally in preventing their rejection from blood donation. Materials and Methods: It is a cross-sectional descriptive study conducted on 1854 donors of Kurdistan Blood Transfusion Center during a 6-month period. Blood pressure of donors is controlled by the physician two times with a 15-minute interval. Demographic data were collected through questionnaire and were analyzed by SPSS and Chi-square test. Results: 80.9% and 19.1% of the donor population were male and female respectively. Age average was 35.53 ± 11.19 years. Averages of systolic and diastolic blood pressures were 123.02 ± 13.23 mmHg and 77.35 ± 8.88 mmHg respectively. Isolated systolic hypertension was detected in 7.5% and isolated diastolic hypertension in 4.5% of blood donors. 3.4% had mild systolic and diastoic hypertension. There was a significant correlation between sex, age, education status, blood donation and systolic hypertension (p<0.05) and also between age, education status and diastolic hypertension (p<0.005) but there was no correlation between donation, sex and diastolic hypertension. Conclusions: There was a low prevalence rate of hypertension in blood donors; it can be attributed to blood donor population being young and middle aged, good attention in donor selection, and careful physical examination.

Background and Objectives: To prevent the transmission of HIV through blood transfusion, blood transfusion centers have embarked on deferring high risk prospected donors by pre-donation consultation and screening blood donors to discard contaminated blood units. Since the deferal of high risk blood donors in consultation sessions in Iranian Blood Transfusion Organization plays a major role in the decrease of HIV risk in donated blood units and considering that high risk behaviours which expose people to HIV are usually deemed taboo making them abstain from speaking about, this study aims to evaluate impact of bar code in gaining the confidence of blood donors to address the questions with a special focus on HIV. Materials and Methods: This study was descriptive. The physicians in blood centers were required to address deferred blood donors with questions about their history of intravenous drug use and unsafe sexual behaviors. Their responses were then reported by a bar-code method as positive or negative. Blood samples of such deferred blood donors were also tested for HIV. SPSS software was finally used for data analysis.Results: Out of 36312 rejected blood donors, 349(1%) deferred had experienced both unsafe sexual behavior and intravenous drug use, 1735(4.8%) unsafe sexual behavior, 267(0.7%) intravenous drug use, and 33961(93.5%) considered themselves free from the both. Out of the 43 contaminated with HIV, 0% fell in the first group, 1(0.58%) in the second, 0% in the third, and 42(1.2%) in the fourth. Conclusions: Since the recognized ways of HIV transmission in Iran are intravenous drug use (in 60.8% of cases) and unsafe sexual behavior (in 7.3% of cases), the high prevalence rate of HIV in rejected blood donors with none of these experiences strengthens the hypothesis that even the use of bar code method can not be effective in assuring them to disclose their confidential information.

Background and Objectives: Infection with cytomegalovirus (CMV) is very common. Contamiated persons can transmit the virus to normal recipients through blood donation. While infection with CMV in normal immunocompetent persons usually has no adverse outcomes, transmission of the virus to immunocompromised patients can lead to serious morbidity and mortality. So we designed a study to determine the prevalence rate of anti-CMV antibodies among the blood donors of Urmia Blood Transfusion Center. Materials and Methods: In this cross-sectional descriptive study, the prevalence rate of anti-CMV antibodies (IgM, IgG) was estimated by ELISA method in serum samples obtained from 180 healthy blood donors in various age and sex groups of Urmia. Results: According to the findings, all (100%) of the sera studied were positive for IgG irrespective of the age and sex of donors while only five persons (2.8%) had anti-CMV IgM at detectable levels. There were four males and one female, all living at urban regions with the age range of 20 to 50 years. Conclusions: The high rate of positive test results among blood donors indicated that nearly all of donated blood units have an infectious nature at least for immunocompromised patients. The findings of this study clearly show that it is time for all blood donations to be screened for CMV infectivity at least for immunocompromised group of recipients such as the patients with malignant diseases receiving chemotherapy and recipients of allograft organs. This group of patients should at least benefit from protective measures in blood transfusion including the use of leukocyte filters which is at the time being limited to thalassemic patients in our country.