THE SCIENTIFIC JOURNAL OF IRANIAN BLOOD TRANSFUSION ORGANIZATION (KHOON)
Year:2006 | Volume:2 | Issue:7 (Special Issue)|Papers Count:19

Background and ObjectivesDue to frequent tranfusion of blood components, hemophiliac patients have been exposed to a wide range of blood-borne viruses, among which the human immune deficiency virus (HIV) and the hepatitis C virus (HCV) have had a considerable impact on their life. Prior to the introduction of virus- inactivation methods in 1985, almost all treated hemophiliacs had been infected with HCV transmited by factor concentrates, and in most countries almost 50% of hemophiliacs had also been infected with HIV.Materials and Methods162 patients with inherited coagulation disorders including 113 hemophilia A and 17 hemophilia B patients living in East Azarbaijan participated in this observational study.The patients started to be tested for anti-HCV, anti-HIV, and HBs-Ag in 2003. Demographic information were gathered through questionnaires and some other information was taken from patient's medical records.ResultsAmong 113 hemophilia A and 17 hemophilia B patients, 63 (56%) and 9 (53%) were seropoitive for HCV-Ab respectively. The youngest patient who was seropositive for HCV-Ab was eleven years old, and his first blood tranfusion occurred in 1993. No child under the age of 10 was HCV positive; in other words, there was no case of HCV in 1995 (P<0.001). In hemophilia A group one patient (0.9%) was seropositive for HIV and 3 (2.7%) were seropositive for HBs-Ag. HCV status was also related to baseline factor activity level. In more severely affected patients of both group A and B (< 1% factor activity) , the prevalence of HCV was 75%. ConclusionsHemophiliac patients born after 1995 have no evidence of HIV infection. Only one patient (0.9%) was seropositive for HIV and in this respect our province as compared with other countries is in a good condition.

Background and ObjectivesIn recent years there have been special interet in the donor selection strategies in blood banks in order to provide safer blood supply. Important steps are exclusion of paid and replacement donation and increase in the number of regular donors. In this survey the seroprevalence of blood-borne infections among regular, sporadic (lapsed) and first-time blood donors were compared (from August 2002 to March 2003).Materials and MethodsIn a retrospective study the prevalence of transfusion transmitted infections were compared among regular, sporadic (lapsed) and first-time blood donors of Isfahan city. The total of 29458 blood donors donated blood during August 2002 to March 2003 in Isfahan; out of this number, 16620 were regular donors (56.42%), 5742 sporadic donors (19.49%), and  7096  first-time donors (24.09%). Data were collected from the computerized data source of Isfahan Blood Transfusion Center and were then compared by the χ2test.ResultsOut of 16620 regular donors, 64 (0.385%) were HBsAg positive, 32 (0.192%) were HCV-Ab reactive, and all were HIV-Ab negative. Whereas, from 5742 sporadic donors 55(0.958%) were HBsAg positive, 18 (0.313%) HCV-Ab reactive, and one (0.017%) was HIV-Ab reactive. Out of 7096  first-time  blood donors, 42 (0.592%) were HBsAg positive, and 22 (0.31%) HCV-Ab reactive. No HIV-Ab reactive donors were detected. The prevalence of blood-borne infections (hepatitis B, hepatitis C and HIV) was less in regular than sporadic and first-time blood donors. The difference was significant (p=0.000 for regular and sporadic donors and p=0.005 for regular and first-time donors).ConclusionsRegular blood donation is one of the important steps in blood safety; hence, retention of regular donors, and awareness-raising and recruitment of sporadic and first-time donors can increase the rate of regular donation leading in turn to higher blood safety.

Background and ObjectivesThe use of blood and blood products is one of the necessities of clinics. Blood donation should comply with international criteria because of the probability of transmission of infections following blood transfusion. One of the priorities in reliable blood transfusion centers in the world and in our country will be the improvement of the donor recruitment methods. It seems that recent methods are useful in non-emergencies.The use of such methods in emergency cases like what happened in Bam earthquake is practically impossible. This study aims to if this would endanger blood safety.Materials and MethodsIn this cross-sectional study, 4188 blood units including 2094 blood units collected (as case group) immediately after Bam earthquake and 2094 units collected (as control group) before Bam earthquake were studied. In this process all blood units in the case and control groups were tested for HBV, HCV and HIV by Elisa method. We repeated positive results by Elisa. If test results were positive again, we would use confirmation tests (western blot and RIBA).ResultsThe results show that there is a significant difference in Binomial test between control and case group (PV<0.001) for HBV and HCV before and after Bam earthquake; however, no difference was observed for HIV between two groups.ConclusionsHigher rate of serologically positive results in case group shows that there is a higher risk in emergencies for transmission of viral infections. To decrease this risk, it is proposed that blood donation is managed by implementing control mechanisms in emergency conditions.

Background and ObjectivesAs hemophilia and thalassemia patients are in regular need of blood or blood products, they are exposed to blood units of hundreds or even thousands of blood donors; therefore, they are at a high risk of acquiring blood transmissible infections. Different prevalent rates of hepatitis B, C and HIV infection in hemophilia and thalassemia populations have been reported in various regions of Iran and the world. The present study was conducted to determine the prevalence of hepatitis B, C and HIV infection in hemophilia and thalassemia population of Yazd province of Iran.Materials and MethodsIn this descriptive study, 85 thalassemia major and 74 hemophilia patients were included.The necessary information was gathered from the patients, blood samples were tested for serum markers of anti-HIV, anti-HCV and HBsAg by the ELISA method, and positive cases were confirmed by Western blot, RIBA and neutralization methods.The data were analyzed by Chi square and Fischer exact tests.ResultsNone of the thalassemia patients was positive for HIV Ab or HBsAg, while 9.4% were anti-HCV positive. In hemophilia patients, the prevalence of HIV Ab and HBsAg was 1.4%, while that of anti-HCV was 48.6%. The prevalence of anti-HCV in those patients who had received blood or blood products after implementation of the screening program in the country was significantly lower (P=0.02, P<0.000).Overall, the prevalence of hepatitis C as compared to hepatitis B and HIV was more in both the hemophilia and thalassemia populations and higher in hemophiliacs.ConclusionsHepatitis C is the main problem of these patients, especially hemophiliacs. The screening program in the country has led to a significant reduction in the incidence of hepatitis C. In order to reduce the risks of transmissible infections by blood and blood products in the future, it is proposed tests that are more sensitive be used, especially for reduction of the window period of hepatitis C. For hemophiliacs, virally inactivated factor concentrates should be used; in case such concentrates are not adequately available, donor retested quarantined plasma should be used.

Background and objectivesDemographic profiles of blood donors and prevalence of major viral markers in them are important as for as blood supply and donor retention are concerned. In this study, profiles of blood donors and prevalence of viral markers were studied in first-time donors and were then compared with those of repeat donors. Materials and MethodsThis study was carried out with census method in Esfahan Blood Transfusion Center in 2003. All samples were tested with ELISA method and reactive samples were confirmed. The findings were compared with those of repeat blood donors byχ 2 and t- test. ResultsThe age average and marital status rate in first time blood donors were less than the repeat donors (CI: 95%, P<0.05). The frequency of first- time female blood donors was very low. Most of first-time blood donors were businessmen and the second larger group belonged to employees (CI: 95%, P<0.05). Frequency of HBs Ag and HCV Ab reactive results in first-time blood donors was 1.4% and 0.5% respectively, and HIV Ab was negative for all of them. These values for repeat donors were 0.5% and 0.2% respectively, and HIV Ab was positive in 0.004%.ConclusionsIranian demographic data were different form developed country. However, low frequency of female blood donors and lower prevalence of HBs Ag and HCV Ab in repeat blood donors were significant.

Background and ObjectivesHepatitis C virus (HCV) is one of the most prevalent causes of viral hepatitis in haemodialysis (HD) and kidney transplant patients. In average, 20% of HD patients are infected with HCV. But this prevalence differs in various areas of the world.The aim of this study is to assess prevalence and risk factors of HCV infection in HD patients.Materials and MethodsThis descriptive cross-sectional study was performed on 89 HD patients in Ghazvin in 1383. Risk factors were assessed for each patient.Then, blood samples of these subjects were evaluated for Anti-HCV Ab by ELISA and RIBA. In analysis of t-test, Chi2 and Fisher exact were used. Logistic regression was also done to predict infection with HC.ResultsThere were 45 (50.6%) female and 44 (49.4%) male subjects. Age average was 50.97 (SD=14.94). Anti-HCV Ab in 9 (10.3%) patients was positive by ELISA. Along risk factors, marital status, date of first blood transfusion (before 1375 according to Iranian calendar), frequency of blood transfusion (above 20 times), and HD duration had significant correlation with hepatitis C infection (p=0.002, p=0.003, p=0.032, and p= 0.00 respectively).ConclusionsAccording to this study, the prevalence of hepatitis C in HD patients in Ghazvin was 6.4% that shows decrease in rate of infection in comparison to 23.9% in 1380. Because of various side effects and restricted efficacy of available drugs, prevention considering risk factors is necessary.

Background and ObjectivesBlood transmitted infections have always made problems in the use of blood and blood products. In this study, the prevalence of hepatitis B,C and HIV and relevant factors were evaluated among regular and non regular donors in Arak Blood Center in the first six months of the year 1383 (2004).Materials and Methods11615 donors of Arak Blood center were selected. The required data were gathered by reviewing donor forms. Finaly, the subjects divided into regular and non-reguler donors according to demographic properties were compared. Results were analyzed based on Fisher Exact Test and Logistic Regression in spss software.Results40% of donors were regular and 60% non-regular. According to confirmed tests, prevalence of HBV, HCV and HIV were 0.68% , 0.2% and 0% in donors. These fiqures were 0.1%, 0.02% and 0% in regular donors and 0.05%, 0.45% and 0% in non-regular donors respectively. 1.4% of all blood donations were discarded for being positive in Elisa tests; this rate is  111 times higher among non-regular donors. In this study viral infections in non-regular donors had more prevalence (p<0.0001); prevalence of these infections in regular donors was higher among men and lower in employees (p<0.05) as tested by Elisa. The results for both groups of subjects were higher in mobile units (p<0.05). Prevalence of infections was lower among non-regular donors as appeared in confirmed tests in subjects with bachelor degree or higher (p<0.05). ConclusionsPrevalence of viral infections among regular donors was much lower than non-regular donors. Proper awareness-raising of donors about viral diseases, criteria for blood donation, appropriate behavior for blood donation in order to promote regular donation is the solution to decrease viral infections.

Background and objectives Blood transfusion Organizations screen blood donors by interview, and serological tests for blood safety. This study was conducted to describe the of donor deferral and the blood borne infections and related variables in Tehran Blood Transfusion Center (TBTC), during 8 month period of 2003.Materials and MethodsIn this cross sectional study, 34823 volunteers of blood donation were selected randomly from all clients of Tehran Blood Transfusion Center, over a period of 8 months, (from June 2003 to January 2004).The prevalence of HBV, HCV and HIV were studied in 26645 accepted blood donors. Correlation of donor deferral and blood borne infections with demographic (gender, ages, marital status, job, educational level) and donation related variables (continuous donation) was studied.ResultsDeferral rate was 22.5% in the study period. Risk of blood born disease, disease/ exposure, medications, and other causes were the cause of blood deferral in 43.36%, 34.02%, 13.91% and 15.42%. The age less than 40, female gender, single, less educational level, non continous donation and some jobs were correlated with lower deferral rate.The prevalence rates of HBV, HCV and HIV were 0.6%, 0.2%, and 0.003%, respectively. Higher prevalence of HBV was significantly correlated with the age of over 40 year old (p=0.000), lower educational levels (p=0.002), to be married (p=0.001). HCV was not significantly correlated with any of these factors (p>0.05).ConclusionsThis study highlights that the attraction of males, those with age less than 40, singles, those with higher educational level, and continuous donors in Tehran will bring the increase in blood products, and attraction of those with age less than 40, those with higher educational levels, continuous donors will provide the safer blood products. Such studies are recommended for the blood transfusion organization in all provinces of Iran.

Background and ObjectivesTo ensure safe and adequate blood supply to meet patients' needs is the main goal of blood centers. To this end, regular blood donors play an important role; especially recruitment of female teachers and students is very significant. In this study, we aimed to study reasons why females as compared with males are less motivated to embark on blood donation.Materials and MethodsThis survey was a cross-sectional research.A questionnaire was used to gather data on the knowledge and attitude of 280 female teachers and 280 female students about blood donation . SPSS statistical software was used for data analysis. ResultsThe age average of students and teachers were 17/9±1/39 and 33.7±6.74 respectively. 10% of female students and 21% of female teachers had the experience of blood donation. The main positive motivation for blood donation in both groups came out of altruistic causes. 35% of students and 21% of teachers were afraid of blood donation, 40% of students and 57% of  teachers were afraid of anemia, and finally 32.2% of students and 17% of teachers were not allowed by their parents and hubands to donate blood.ConclusionsIn this study, three main negative motivation causes for females to embark on blood donation came out to be fear of donation, fear of getting anemia, and lack of permission by their parents and husbands.

Background and ObjectivesEvaluation of demography and prevalence of HBsAG, HCV and HIV in blood donors in Jahrom was the goal of this study.Materials and MethodsData includeing age, sex, job, education level, underlying diseases, serologic tests (HBsAg, HCV, HIV) were obtained from files of blood donors who referred to blood center in Jahrom during 2001-2003.ResultsThe average age of blood donors was 32.52±5.6; 92.2% of them were male. Most of the blood donors (71.9%) were rural inhabitants.Having free jobs (43.5%) and being government employees (14.5%) were the most frequent job categories.The prevalence of HBsAg and HCV was 0.4 and 0.3% respectively. No case of HIV was detected. ConclusionsAge and sex distribution of blood donors in present study was similar to other studies, but job and education frequency was different. The prevalence of HBV, HCV and HIV was lower than others parts of the world.

 Background and Objectives After many blood donors being rejected cause of anaemia detected by WHO haemoglobin colour scale, we thought that the first blood drops may have been mixed with the extra cellular fluid leading to the lower range of Hb concentration. Then, we decided to assess the 2nd blood drops so as to compare the results of both 1st and 2nd drops with those of the automated blood cell counter. Materials and Methods A descriptive study was conducted. WHO haemoglobin colour scale and automated blood cell counter were used to test 100 blood donor samples. In this study, we considered 12.5g/dl as the cut off point. ResultsThe study indicated that there are 26% false readings in the assessment of the 1st drop by WHO haemoglobin colour scale; this figure includes 26% false rejection and 0% false acceptance. Test sensitivity and its specificity are 100 and 72.9% respectively. In the assessment of the 2nd drop, we faced 8% false reading including 5% false rejection and 3% false acceptance. Its sensitivity and specificity were 25 and 94.7% respectively. Conclusions Our research has shown that cause of 26% false rejection in the 1st drop and the low test sensitivity of 25% in the 2nd drop, none of the 1st and 2nd drops are the favorite scale test for screening anaemia among blood donors.  

Background and ObjectivesDistinguishing two common hypochromic microcytic anemias (i.e. iron deficiency anemia and minor thalassemia) needs expensive laboratory tests not readily available everywhere. A number of indices derived from original cell counter parameters were tried to screen patients; these indices are compared in this study.Materials and MethodsFour indices of England, Mentzer, Shine and MDHL were calculated for 110 cases of known thalassemia minors and 61 iron deficients. The best cut-off point for each index was selected by receiver operator characteristic (ROC) analysis reaching the highest sensitivity to separate thalassemics from iron deficients. Sensitivity and specificity of indices were compared.ResultsMentzer’s index(sensitivity:90.9, specificity:80.3) had the best results.ConclusionsIt seems Mentzer’s index can be used widely to screen hypochromic microcytic anemic patients.Tests like hemoglobin electrophoresis, genetic studies, serum iron, TIBC and ferritin measurement should be reserved for selected patients in refferal centers. In this way we reduce public health costs significantly.