Back to base pairs: What is the genetic risk for red bloodcell alloimmunization?
Blood reviews. 2021;:100794
Red blood cell (RBC) alloimmunization is a serious complication of blood transfusions, challenging selection of compatible units for future transfusions. Genetic characteristics may be associated with the risk of RBC alloimmunization and may therefore serve to identify high-risk patients. The aim of this systematic review was to summarize the available evidence on genetic risk factors for RBC alloimmunization. Electronic databases were searched up to April 2020 for studies (Search terms included transfusion, alloimmunization and genetic). A total of 2581 alloimmunized cases and 26,558 controls were derived from 24 studies. The alleles that were most frequently studied and that demonstrated significant associations in a meta-analysis with alloimmunization to the Duffy(a) antigen were HLA-DRB1*04 (Odds Ratio 7.80 (95%CI 4.57-13.33)), HLA-DRB1*15 (OR 3.76 (95%CI 2.14-6.59)), and HLA-DRB1*03 (OR 0.12 (95%CI 0.05-0.29)). Furthermore, significant associations with anti-K formation was found for the alleles HLA-DRB1*10 (OR 2.64 (95%CI 1.41-4.95)), HLA*DRB1*11 (OR 2.11, (95%CI 1.34-3.32)), and HLA-DRB1*13 (OR 1.71 (95%CI 1.26-2.33)). Overall, the available evidence was of moderate to low quality, hampering interpretation of reported results. There is an urgent need for high quality evidence on genetic risk factors for RBC alloimmunization.
Sero-epidemiology and associated factors of HIV, HBV, HCV and syphilis among blood donors in Ethiopia: a systematic review and meta-analysis
BMC infectious diseases. 2021;21(1):778
BACKGROUND Transfusion transmissible infections (TTIs) remain a major public health problem in developing countries including Ethiopia. In Ethiopia, comprehensive information about sero-epidemiology of major TTIs is lacking at the national level. Therefore, this systematic review and meta-analysis was aimed at providing the pooled estimate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among blood donors in Ethiopia. METHODS Relevant studies published until May 31, 2019 were searched through PubMed/Medline, EMBASE, SCOPUS, HINARI, Cochrane database library, Web of Science, Google Scholar and Google. The methodological quality of articles was assessed using Joanna Brigg's Institute critical appraisal checklist for prevalence and analytical studies. The pooled sero-epidemiology of HIV, HBV, HCV and syphilis were determined using the random-effects model. Heterogeneity between the studies was assessed using the I(2) statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics. RESULTS A total of 7921 articles were retrieved, and 7798 were screened for eligibility after duplicates removed. Forty-nine full-text articles were assessed for eligibility; of which 45 were eligible for qualitative and quantitative synthesis: categorized as 36, 34, 31 and 23 studies for estimations of HBV, HIV, HCV and syphilis, respectively. In the random-effects model, the pooled sero-epidemiology of HBV, HIV, HCV and syphilis was 5.20, 2.83, 0.93 and 1.50%, respectively. Moreover, being a male blood donor was significantly associated with HBV and syphilis infection, whereas being a replacement blood donor was significantly associated with a high burden of HIV, HBV and HCV infections. CONCLUSION The pooled sero-epidemiology of major TTIs among blood donors was high. Therefore, there is a need to design prevention and control strategies in a comprehensive approach to reduce the burden.
Pathologic Blood Samples Tolerate Exposure to Vibration and High Turbulence in Simulated Drone Flights, but Plasma Samples Should be Centrifuged After Flight
IEEE journal of translational engineering in health and medicine. 2021;9:4000110
OBJECTIVE Most of the previous studies of drone transport of blood samples examined normal blood samples transported under tranquil air conditions. We studied the effects of 1- and 2-hour drone flights using random vibration and turbulence simulation (10-30 g-force) on blood samples from 16 healthy volunteers and 74 patients with varying diseased. METHODS Thirty-two of the most common analytes were tested. For biochemical analytes, we used plasma collected in lithium heparin tubes with and without separator gel. Gel samples were analyzed for the effect of separation by centrifugation before or after turbulence. Turbulence was simulated in an LDS V8900 high-force shaker using random vibration (range, 5-200 Hz), with samples randomly allocated to 1- or 2-hour flights with 25 or 50 episodes of turbulence from 10 to 30 G. RESULTS For all hematologic and most biochemical analytes, test results before and after turbulence exposure were similar (bias < 12%, intercepts < 10%). However, aspartate aminotransferase, folate, lactate dehydrogenase and lipid index increased significantly in samples separated by gel and centrifugation prior to vibration and turbulence test. These changes increased form 10 G to 30 G, but were not observed when the samples were separated after vibration and turbulence. CONCLUSIONS Whole blood showed little vulnerability to turbulence, whereas plasma samples separated from blood cells by gel may be significantly influenced by turbulence when separated by spinning before the exposure. Centrifugation of plasma samples collected in tubes with separator gel should be avoided before drone flights that could be subject to turbulence.
The Order of Draw during Blood Collection: A Systematic Literature Review
International journal of environmental research and public health. 2021;18(4)
Blood collection is one of the most common nursing procedures and is not devoid of complications. The order of draw during blood collection is a controversial theme. We aimed to define the efficacy of the order of draw during blood collection to guarantee an exact biochemical result. We carried out a systematic literature review on PubMed, Scopus, Web of Science, CINAHL, Embase, Joanna Briggs Institute, Cochrane Library, and Google Scholar. Articles written in English and published from 2000 to 2020 were considered suitable. The analysis of the 11 articles included highlighted different opinions; however, the most recent evidence declares that the cross-contamination caused by the incorrect order of draw is a trait only in the open system of drawing. The most recent evidence affirms the negligible effect of the order of draw during blood collection when using the closed blood collection system, while it is recommended when using the open collection system.
Personalized Collection of Plasma from Healthy Donors: A Randomized Controlled Trial of a Novel Technology-Enabled Nomogram
BACKGROUND Source plasma is essential to support the growing demand for plasma-derived medicinal products. Supply is short, with donor availability further limited by the COVID-19 pandemic. This study examined whether a novel, personalized, technology-based nomogram was non-inferior with regard to significant hypotensive adverse events (AEs) in healthy donors. STUDY DESIGN AND METHODS IMPACT (IMproving PlasmA CollecTion) was a prospective, multi-center, double-blinded, randomized, controlled trial carried out between January 6 and March 26, 2020 in three U.S. plasma collection centers. Donors were randomized to the current simplified 1992 nomogram (control) or a novel Percent Plasma Nomogram (PPN) with personalized target volume calculation (experimental). Primary endpoint was the rate of significant hypotensive AEs. Non-inferiority (NI) was tested with a margin of 0.15%. Collected plasma volume was a secondary endpoint. RESULTS 3,443 donors (Mean [SD] BMI: 32 (7.74) kg/m(2) ; 65% male) underwent 23,137 donations (Median [range]: 6 [1-22] per subject). Ten significant hypotensive AEs were observed (6 control; 4 experimental), with model-based AE incidence rate estimates (95% CI) of 0.051% (0.020%, 0.114%) and 0.035% (0.010%, 0.094%), respectively (p=0.58). NI was met at an upper limit of 0.043% versus the predefined margin of 0.15%. There was no statistical difference between total AE (all AE types: p=0.32). Mean plasma volume collected was 777.8 mL (control) versus 841.7 mL (experimental); an increase of 63.9 mL per donation (8.2%; p<0.0001). CONCLUSION This trial showed that a novel personalized nomogram approach in healthy donors allowed approximately 8% more plasma per donation to be collected without impairing donor safety. This article is protected by copyright. All rights reserved.
Seroprevalence of hepatitis c virus infection among blood donors in Ethiopia: a systematic review and meta-analysis
BMC infectious diseases. 2021;21(1):131
BACKGROUND Blood transfusion is one of the routine therapeutic interventions in hospitals that can be lifesaving. However, this intervention is related to several transfusion-related infections. Hepatitis C viral infection is one of the most common causes of transfusion-related hepatitis. Subsequently, this systematic review and meta-analysis was aimed to estimate the seroprevalence of hepatitis C virus infection among blood donors in Ethiopia. METHODS PubMed, Google Scholar, Health InterNetwork Access to Research Initiative (HINARI), Excerpta Medica database (EMBASE), and Cochrane library, the web of science, African journal of online (AJOL), and Google Scholar was searched. The data were extracted using Microsoft Excel and analyzed by using STATA version 14. Publication bias was checked by funnel plot, contour-enhanced funnel plots, trim and fill analysis and more objectively through Egger's regression test, with P < 0.05 considered to indicate potential publication bias. The heterogeneity of studies was checked using I2 statistics. Pooled analysis was conducted using a weighted inverse variance random-effects model. Subgroup analysis was done by region and study period. A sensitivity analysis was employed. RESULT A total of 25 studies with 197,172 study participants were used to estimate the seroprevalence of hepatitis c virus among blood donors. The overall seroprevalence of hepatitis C virus was 0.819% (95% CI: 0.67-0.969; I2 = 92.3%). Regional sub-group analysis showed that the pooled prevalence of hepatitis c virus infection among blood donors found to be 0.563% in Somali, 1.08% in Oromia, 0.847% in Amhara, and 0.908% in south nations nationalities and peoples region. CONCLUSION The pooled seroprevalence of hepatitis C virus infection among blood donors in Ethiopia found to be low. Moreover, there should be systematic strategies that enhance donor screening and retention of safe regular donors.
A Systematic Review of Interventions Used to Increase Blood Donor Compliance with Deferral Criteria
Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie. 2021;48(2):118-129
BACKGROUND AND OBJECTIVES Pre-donation screening of potential blood donors is critical for ensuring the safety of the donor blood supply, and donor deferral as a result of risk factors is practised worldwide. This systematic review was conducted in the context of an expert review convened by the Australian Red Cross Lifeblood in 2013 to consider Lifeblood's injecting drug use (IDU)-related policies and aimed to identify studies assessing interventions to improve compliance with deferral criteria in blood donation settings. MATERIALS AND METHODS MEDLINE/PubMed, OVID Medline, OVID Embase, LILACS, and the Cochrane Library (CENTRAL and DARE) databases were searched for studies conducted within blood donation settings that examined interventions to increase blood donor compliance with deferral criteria. Observational and experimental studies from all geographical areas were considered. RESULTS Ten studies were identified that tested at least one intervention to improve blood donor compliance with deferral criteria, including computerized interviews or questionnaires, direct and indirect oral questioning, educational materials, and a combination of a tickbox questionnaire and a personal donor interview. High-quality evidence from a single study was provided for the effectiveness of a computerized interview in improving detection of HIV risk behaviour. Low-quality evidence for the effectiveness of computerized interviews was provided by 3 additional studies. Two studies reported a moderate effect of direct questioning in increasing donor deferral, but the quality of the evidence was low. CONCLUSION This review identified several interventions to improve donor compliance that have been tested in blood donation settings and provided evidence for the effectiveness of computerized interviews in improving detection of risk factors.
Blood donation settings undertaking pre-donation screening (10 studies).
Systematic review to identify interventions to improve blood donor compliance with deferral criteria.
Ten studies were identified that tested at least one intervention to improve blood donor compliance with deferral criteria, including computerized interviews or questionnaires, direct and indirect oral questioning, educational materials, and a combination of a tick-box questionnaire and a personal donor interview. High-quality evidence from a single study was provided for the effectiveness of a computerized interview in improving detection of HIV risk behaviour. Low-quality evidence for the effectiveness of computerized interviews was provided by 3 additional studies. Two studies reported a moderate effect of direct questioning in increasing donor deferral, but the quality of the evidence was low.
Evaluation of efficacy of Valsalva for attenuating needle puncture pain in first time nonremunerated voluntary plateletpheresis donors: A prospective, randomized controlled trial
Asian journal of transfusion science. 2021;15(1):68-74
BACKGROUND Plateletpheresis is generally safe but may have adverse reactions. Adverse reactions can negatively influence donor recruitment and retention. Valsalva is a proven method of attenuating pain caused by venipuncture. AIMS The aim was to evaluate the efficacy of the Valsalva maneuver on the attenuation of needle pain and donor anxiety. SETTINGS AND DESIGN This prospective randomized controlled trial was conducted between November 2015 and April 2016 at the Department of Transfusion Medicine. SUBJECTS AND METHODS One-hundred and sixty consecutive donors were grouped into control group (C) and Valsalva group (V) each of sample size 80. The Valsalva group performed a Valsalva maneuver and control did nothing before the venipuncture. Anxiety and pain were scored using a 10 cm visual analog scale (VAS). Severity was graded as VAS = 0 defines no pain and anxiety, VAS = 1-3 as mild pain and anxiety, VAS = 4-6 as moderate pain and anxiety, VAS = 7-9 as severe pain and anxiety, whereas VAS = 10 denotes extreme pain and anxiety. STATISTICAL ANALYSIS Statistical Package for Social Sciences, version 23 was used for analysis. Independent samples t-test/Mann-Whitney U-test was used to compare between treatment and control group, whereas the Wilcoxon signed-rank test was used to test the difference between pre- and postobservations. RESULTS In the Valsalva group, post-Valsalva anxiety levels were significantly reduced to (1 [0-2]) from their pre-Valsalva values of (2 [0-3]); (P < 0.001). Pain was significantly lower (2[1-2]) in Valsalva group compared to control (4[2-5]); (P < 0.001). CONCLUSIONS Valsalva reduced both severity of venipuncture pain and anxiety. Valsalva can be performed by donors as it is an easy, painless, and nonpharmacological method of pain and anxiety attenuation.
Knowledge of blood donation and associated factors in Ethiopia: a systematic review and meta-analysis
BMJ open. 2021;11(7):e044343
OBJECTIVE To assess the level of knowledge about blood donation and associated factors in Ethiopia. DESIGN Systematic review and meta-analysis. METHODS Both published and unpublished cross-sectional studies on the level of knowledge about blood donation in Ethiopia were included. Articles from different databases such as PubMed/MEDLINE, HINARI, EMBASE, Scopus, Google Scholar and African Journals Online were searched. Cochrane I(2) statistics were used to check for heterogeneity. Subgroup and sensitivity analyses of evidence of heterogeneity were carried out. Egger's test with funnel plot was conducted to investigate publication bias. RESULT Twenty cross-sectional studies with a total of 8338 study participants (4712 men and 3626 women) were included. The overall nationwide level of knowledge about blood donation was 56.57% (95% CI 50.30 to 62.84). Being in secondary school and above (adjusted OR=3.12; 95% CI 2.34 to 4.16) and being male (adjusted OR=1.81; 95% CI 1.44 to 2.28) were the factors associated with level of knowledge about blood donation. CONCLUSION More than half of the study participants were knowledgeable about blood donation. Sex and educational status were the factors significantly associated with level of knowledge about blood donation in Ethiopia. Therefore, there is a need for education and dissemination of information about blood donation among the general population to build adequate knowledge and maintain regular blood supply.
Men and women living in Ethiopia (20 studies, n= 8,338).
Systematic review to assess the level of knowledge about blood donation and associated factors in Ethiopia.
The overall nationwide level of knowledge about blood donation was 56.57%. Being in secondary school and above and being male were the factors associated with level of knowledge about blood donation.
Prevalence of Chikungunya, Dengue and Zika viruses in blood donors: a systematic literature review and meta-analysis
Blood transfusion = Trasfusione del sangue. 2021
BACKGROUND Blood transfusion centres should understand the epidemiology of emerging diseases that are transmissible through the transfusion of blood components. The risk of transmission of arboviruses through this route has become apparent in recent years. The aim of our study is to summarise the reported prevalence (viraemic rate, seroprevalence and/or antigen detection) of Chikungunya (CHIKV), Dengue (DENV) and Zika (ZIKV) viruses in blood donors according to screening test used and world region. MATERIALS AND METHODS We conducted a systematic literature review and meta-analysis having searched for information in the main bibliographic databases (MEDLINE, Embase, and Scopus). The prevalence for each of the viruses was calculated according to the screening test used and geographic location. RESULTS We included 18 records on CHIKV, 71 on DENV, and 27 on ZIKV. The highest prevalences of RNA for CHIKV were 1.9% in Puerto Rico (2014), 1.0% in Thailand (2009), and 1.0% in French Polynesia (2014-15). The highest prevalences of RNA for DENV were 5.5% in Saudi Arabia (2015-16), 2.3% in Madeira, Portugal (2012-13), and 0.6% in Brazil (2012). The highest prevalences of RNA for ZIKV were 2.8% in French Polynesia (2013-14), 2.7% in Brazil (2015-16), and 1.8% in Martinique (2016). Overall seroprevalence, as assessed by IgG antibodies, was 21.6% for CHIKV, 24.0% for DENV, and 5.1% for ZIKV. DISCUSSION Our study shows a high proportion of donors who are viraemic and asymptomatic, especially during outbreaks, with prevalences surpassing 5% for DENV, 1% for CHIKV, and 2% for ZIKV. These data confirm a clear threat to blood transfusion safety. The elevated seroprevalence for these three arboviruses is also indicative of their wide circulation in populations, correlating with an increased risk of infected but asymptomatic donors. Health centres and institutions must address this threat, especially in tropical regions where the biggest outbreaks occur.