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1.
What influences decisions to donate plasma? A rapid review of the literature
Berger, M., Easterbrook, A., Holloway, K., Devine, D., Bansback, N.
Vox sanguinis. 2023
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Editor's Choice
Abstract
BACKGROUND AND OBJECTIVES Plasma has become an essential ingredient for various medical treatments. Many blood collection agencies rely on voluntary non-remunerated donation when collecting plasma, but at present many do not collect sufficient plasma to meet domestic demands. This rapid review sought to explore the factors that have been found to influence people's decisions to donate plasma to inform future research. METHODS Searches were conducted in PubMed, PsycINFO, Social Sciences Citation Index and CINAHL for peer-reviewed journal articles that discussed plasma donation and the factors associated with donor behaviour. Pertinent information from included articles was extracted and arranged in themes. RESULTS In total, 33 articles were included in this review. Three main themes were identified by the authors. The first focused on site-level factors related to blood collection agencies' engagement with plasma donors and their influence on plasma donation experiences. The second theme considered how individual characteristics and experiences influence willingness to donate plasma. The third theme examined social and cultural-level factors, such as how social networks and community shape perceptions and experiences with donation. CONCLUSION Our findings suggest that the current understanding of plasma donation is focused mainly on converting whole blood donors and also centres on individual-level factors to donation. Further research must examine what factors attract non-whole blood donors to become plasma donors, focusing on broader social-level influences. This review will inform policies and interventions for blood collection agencies to increase plasma donors.
PICO Summary
Population
Plasma donors (33 studies).
Intervention
Rapid review exploring the factors influencing people's decisions to donate plasma.
Comparison
Outcome
Three main themes were identified by the authors. The first focused on site-level factors related to blood collection agencies' engagement with plasma donors and their influence on plasma donation experiences. The second theme considered how individual characteristics and experiences influence willingness to donate plasma. The third theme examined social and cultural-level factors, such as how social networks and community shape perceptions and experiences with donation.
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The health impacts of blood donation: a systematic review of donor and non-donor perceptions
Thorpe, R., Masser, B., Coundouris, S. P., Hyde, M. K., Kruse, S. P., Davison, T. E.
Blood transfusion = Trasfusione del sangue. 2023
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Editor's Choice
Abstract
BACKGROUND The health and well-being of volunteer donors is of critical concern for blood collection agencies responsible for ensuring a stable supply of blood products. However, lay understandings of the impact of donating blood on health remain poorly understood. As lay perceptions are likely to influence critical decisions about donation, understanding these perceptions is key for informing evidence-based approaches to donor retention and recruitment. As such, we conducted a systematic review of the blood donation literature to identify donors' and non-donors' perceptions of the short and longer-term physiological health effects of whole-blood and/or blood product donation. MATERIALS AND METHODS This review was conducted in line with PRISMA guidelines. Studies published from January 1995 to February 2021 were included. Perceptions were defined as both experiences and beliefs. Psychological effects were considered outside the scope of the review. RESULTS A total of 247 studies were included. Most studies (89.5%) had donation-related health perceptions as a background rather than a central (10.5%) focus, and they were only assessed in relation to whole blood donation. More results focused on health-related beliefs than experiences (82 vs 18%), specific rather than general beliefs and experiences (80 vs 20%) and more frequently examined negative than positive beliefs and experiences (83 vs 17%). The most commonly studied and reported specific negative beliefs related to increased risk of infectious disease, reduced vitality, vasovagal reactions and low iron. Most studies examining specific negative beliefs were conducted in Asian countries. DISCUSSION Findings reinforce that lay perspectives on how donation impacts health are under-researched, and it is difficult to know how important these are in informing critical decisions about donation for donors and non-donors. We suggest that further research with donation-related health beliefs and experiences as the central focus is needed to provide insights to inform communications with donors and the public.
PICO Summary
Population
Blood donors and non-donors (247 studies, comprising: 27 qualitative, 204 quantitative, and 16 mixed-design methods).
Intervention
Systematic review of the blood donation literature to identify donors' and non-donors' perceptions of the short and longer-term physiological health effects of whole-blood and/or blood product donation.
Comparison
Outcome
From the included studies, there were 568 reports of beliefs and/or experiences. Perceptions were defined as both experiences and beliefs. Most studies (89.5%) had donation-related health perceptions as a background rather than a central (10.5%) focus, and they were only assessed in relation to whole blood donation. More results focused on health-related beliefs than experiences (82 vs. 18%), specific rather than general beliefs and experiences (80 vs. 20%) and more frequently examined negative than positive beliefs and experiences (83 vs. 17%). The most commonly studied and reported specific negative beliefs related to increased risk of infectious disease, reduced vitality, vasovagal reactions and low iron. Most studies examining specific negative beliefs were conducted in Asian countries.
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3.
Men who have sex with men and risk for transfusion-transmissible infections in blood donors in Western countries: A systematic review update
Schroyens, N., Borra, V., Compernolle, V., Vandekerckhove, P., De Buck, E.
Vox sanguinis. 2023
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Editor's Choice
Abstract
BACKGROUND AND OBJECTIVES This systematic review update summarizes evidence concerning transfusion-transmissible infections (TTIs) in male blood donors reporting sex with another man (MSM) or after easing the MSM deferral period. MATERIALS AND METHODS We searched five databases, including studies comparing MSM versus non-MSM donors (Type I), MSM deferral periods (Type II) or infected versus non-infected donors (Type III) in Western countries, and used GRADE to determine evidence certainty. RESULTS Twenty-five observational studies were included. Four Type I studies suggest that there may be an increased risk for overall TTIs, human immunodeficiency virus (HIV), hepatitis B virus (HBV) and syphilis in MSM donors, but the evidence is very uncertain. There was insufficient evidence of MSM with low-risk sexual behaviour. A Type II study indicates that easing the MSM deferral period to 1 year may have little to no effect on TTI risk. TTI prevalence in blood donors under 5-year, 1-year, 3-month or risk-based deferral in eight other Type II studies was too low to provide clear conclusions on the effect of easing the deferral. Three Type III studies reported that MSM may be a risk factor for HIV. Increased risk of HBV, hepatitis C virus and HTLV-I/II could not be shown. The evidence from Type III studies is very uncertain. CONCLUSION There may be an increased risk of HIV in MSM blood donors. Shortening the deferral from permanent to 1 year may have little to no effect on TTI risk. However, there is limited, unclear evidence from observational studies concerning the impact of introducing 3-month or risk-based deferrals.
PICO Summary
Population
Blood donors or people eligible to give blood, living in Australia, Canada, Europe, New Zealand and USA (25 observational studies).
Intervention
Systematic review summarizing published studies on the relation between men who have had sex with another man (MSM) or an MSM deferral policy and the risk of transfusion-transmissible infections (TTI) markers in donated blood.
Comparison
Outcome
The three types of included studies compared: MSM vs. non-MSM donors (Type I); MSM deferral periods (Type II); and infected vs. non-infected donors (Type III). Four Type I studies suggested that there may be an increased risk for overall TTIs, human immunodeficiency virus (HIV), hepatitis B virus (HBV) and syphilis in MSM donors, but the evidence was very uncertain. There was insufficient evidence of MSM with low-risk sexual behaviour. A Type II study indicated that easing the MSM deferral period to 1 year may have little to no effect on TTI risk. TTI prevalence in blood donors under 5-year, 1-year, 3-month or risk-based deferral in eight other Type II studies was too low to provide clear conclusions on the effect of easing the deferral. Three Type III studies reported that MSM may be a risk factor for HIV. Increased risk of HBV, hepatitis C virus and HTLV-I/II could not be shown. The evidence from Type III studies was very uncertain.
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The effect of motivational strategy on voluntary plasma donation, a field trial
Hajinasrollah G, Maghsudlu M, Nazemi AM, Teimourpour A, Tabatabai M, Sedaghat A, Beigi BH, Sohrabi MR
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis. 2022;:103518
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Editor's Choice
Abstract
BACKGROUND Plasma protein therapies (PPTs) are a group of medicines extracted from human plasma through fractionation. The manufacture of adequate amounts of PPTs requires a large volume of human plasma. WHO emphasized that whole blood and blood component donations should be voluntary and non-remunerated. So, motivating people to donate plasma is crucial. In this study, we evaluated the impact of social media on motivating blood donors to donate plasma without any compensation and the moderating effects of blood donation history on plasma donation. METHODS AND MATERIALS we allocated blood donors (n = 501) to intervention and control groups randomly. Participants in the intervention group got educational and motivational messages through a WhatsApp channel. Then, we followed up all participants for six months and registered the information of the plasma donation during this period. RESULT In the intervention group, 6.8% had returned to donate plasma, while this was 2% in the control group (p = 0.016, OR:3.59, 95%CI:1.3-9.89). Among regular blood donors in the intervention group, 17.86% had returned to donate plasma but, no regular donor returned to donate plasma in the control group (p = 0.055). In addition, 10.8% of donors who had academic education in the intervention group returned to donate plasma, although this was 2.54% in the control group (P = 0.0485). CONCLUSION Our findings suggest that the educational interventions have more effects on academically educated donors to motivate them to donate plasma.
PICO Summary
Population
Blood donors (n= 501).
Intervention
Educational and motivational messages (e.g., texts, pictures, videos) sent via social media (n= 250).
Comparison
No social media (n= 251).
Outcome
In the intervention group, 6.8% had returned to donate plasma, vs. 2% in the control group (Odds Ratio: 3.59, 95% Confidence Interval: 1.3-9.89). Among regular blood donors in the intervention group, 17.86% had returned to donate plasma but, no regular donor returned to donate plasma in the control group. More donors who had academic education in the intervention group returned to donate plasma, compared to the control group (10.8% vs. 2.54%).
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Assessing unintentional creation of bias against men who have sex with men as a function of exposure to blood donor screening questionnaire: A national randomized controlled trial
Hofkirchner A, Kohut T, O'Brien SF, Fisher WA
Transfusion. 2022
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Editor's Choice
Abstract
BACKGROUND Canadian Blood Services (CBS) screens donors based on group status (e.g., men who have sex with men, MSM) instead of specific, high-risk sexual practices (e.g., occurrence of condomless sex). The MSM screening question is embedded in a cluster of questions about stigmatized attributes such as history of imprisonment and illicit substance use. This juxtaposition of the "MSM question" and stigmatized attributes may unintentionally cause blood donors to perceive MSM more negatively. The aim of this research is to determine whether the CBS donor eligibility questionnaire generates negative bias against MSM. STUDY DESIGN AND METHODS A national, randomized online study of 903 CBS donors was conducted. Participants completed either the existing blood donor eligibility questionnaire or a modified donor questionnaire that repositioned the MSM question among neutral questions. After completing the existing or modified questionnaire, bias against MSM was measured using the sexuality implicit association test (IAT) and Modern Homonegativity Scale - Gay Men (MHS-G). Lastly, participants estimated prevalence rates among MSM of certain stigmatized behaviors. RESULTS Participants who completed the existing donor eligibility questionnaire more strongly associated gay men with negative attributes on the IAT (p(one-tailed) = .045), suggesting question position generated implicit negative bias toward MSM. Responses to the MHS-G (p(one-tailed) = .506) and prevalence estimation task (p = .443) indicated that question order had no significant impact on explicit bias. DISCUSSION Positioning the MSM screening question among stigmatizing questions creates implicit negative bias against MSM. Policy makers should be mindful of question positioning when designing donor questionnaires.
PICO Summary
Population
Blood donors registered in the Canadian Blood Services (n= 903).
Intervention
Modified donor questionnaire that repositioned the men who have sex with men (MSM) question among neutral questions (n= 457).
Comparison
Existing blood donor eligibility questionnaire (n= 446).
Outcome
Participants who completed the existing donor eligibility questionnaire more strongly associated gay men with negative attributes on the sexuality implicit association test (IAT), suggesting question position generated implicit negative bias toward MSM. Responses to the Modern Homonegativity Scale - Gay Men (MHS-G) and prevalence estimation task indicated that question order had no significant impact on explicit bias.
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6.
Improving donor retention following a temporary deferral: A cluster randomized controlled trial of deferral educational materials
Gemelli CN, Kruse SP, Thijsen A, Van Dyke N, Karki S, Davison TE
Transfusion. 2022
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Editor's Choice
Abstract
BACKGROUND Providing educational materials to deferred donors has been shown to increase their understanding about their deferral and knowledge about their return. The aim of this study was to determine the effectiveness of educational materials in increasing the retention of deferred donors. STUDY DESIGN AND METHODS A three-arm cluster randomized controlled trial was conducted, with the following conditions: (a) Incenter Brochure plus Email; (b) Email Only; (c) Control. The Incenter Brochure plus Email condition also included a guided conversation led by staff at the point of deferral. Donors were followed up for 3 months after their deferral had ended to determine if they had attempted to donate. RESULTS Compared with the Control condition, donors in the Incenter Brochure plus Email condition had increased odds of return at 3 months after their deferral ended (OR: 1.16; 95% CI 1.00-1.33). Subgroup analysis highlighted that novice (OR: 1.38; 95% CI 1.04-1.83) and established donors (OR: 1.36; 95% CI 1.13-1.64) had increased odds of return if they received the incenter materials. Donors who were deferred to maintain their well-being (OR: 1.28; 95% CI 1.03-1.60) and donors with a prior deferral history (OR: 1.55; 95% CI 1.15-1.55) had increased odds of return if they received the incenter materials. No significant differences were found between the Email Only and Control conditions. DISCUSSION This trial demonstrates the benefits of providing onsite educational materials to donors at the point of deferral. This is a simple, effective strategy to increase the return behavior of donors within 3 months of their deferral ending.
PICO Summary
Population
Deferred blood donors from 30 Australian Lifeblood donor centres (n= 6,039).
Intervention
In-centre educational materials consisting of a brochure about referral and a ‘conversation guide’ prompting staff to be empathetic, plus a follow up e-mail (In-centre brochure plus e-mail group, n= 2,022).
Comparison
Business-as-usual in-centre process and a follow up e-mail (E-mail only group, n= 2,028); business-as-usual deferral process (Control group, n= 1,989).
Outcome
Compared with donors in the Control group, donors in the In-centre brochure plus e-mail group had increased odds of return at 3 months after their deferral ended (odds ratio (OR), 1.16, 95% CI [1.00, 1.33]). Subgroup analysis highlighted that novice (OR, 1.38, 95% CI [1.04, 1.83]) and established donors (OR, 1.36, 95% CI [1.13, 1.64]) had increased odds of return if they received the in-centre materials. Donors who were deferred to maintain their well-being (OR, 1.28, 95% CI [1.03, 1.60]) and donors with a prior deferral history (OR, 1.55, 95% CI [1.15, 1.55]) had increased odds of return if they received the in-centre materials. No significant differences were found between the E-mail only and Control conditions.
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7.
Web-Based Short Video Intervention and Short Message Comparison of Repeat Blood Donation Behavior Based on an Extended Theory of Planned Behavior: Prospective Randomized Controlled Trial Study
Hu Q, Hu W, Han W, Pan L
Journal of medical Internet research. 2022
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Editor's Choice
Abstract
Background: Although blood is an indispensable and important resource for clinical treatment, an imbalance between supply and demand may occur as the population ages and diversifies. Studies indicate that repeat blood donors are safe blood sources because of their voluntary blood donation education and frequent blood screening. However, the high rate of reduction in the number of first-time voluntary blood donors and low rate of repeated blood donation are common problems worldwide. Objective: This study aimed to evaluate the effect of an intervention in nonregular blood donors using web-based videos and SMS text messages, in which the former was guided by the extended theory of planned behavior, to discover effective intervention methods to improve repeat blood donation rates among nonregular blood donors. Methods: A total of 692 nonregular blood donors in Zhejiang province were randomly divided into intervention and control groups. The control group received regular, short reminder messages for a 6-month period, whereas the intervention group received web-based videos on the WeChat platform. The intervention group was guided by an extended theory of planned behavior, which included 9 factors: the respondents' attitude, subjective behavioral norms, perceived behavioral control, the willingness to donate blood, outcome expectations, self-identity, blood donation-related anxiety, cognition of the blood donation environment, and previous blood donation experience. The intervention group was divided into 2 stages: those with an intervention at 3 months and those with a follow-up 3 months later. After 6 months, the redonation rate was evaluated for the 2 groups, and the scale in the intervention group was determined both before and after the intervention. A t test, chi-square test, logistic stepwise regression, and ANOVA were performed. Results: The intervention group's redonation rate was 16.14%, which was significantly higher than the control group's redonation rate of 5.16%; P<.001. Men who were aged 31 to 45 years and had donated blood twice had a higher redonation rate after the web-based video intervention than after the SMS text messages; P<.05. The repeat donors' improved blood donation anxiety (P=.01), outcome expectations (P=.008), and cognition of the blood donation environment (P=.005) after the intervention were significantly higher than those of the nonrepeat donors. Conclusions: The web-based short video intervention based on the extended theory of planned behavior can effectively improve redonation rates. Outcome expectations, blood donation anxiety, and cognition of the blood donation environment can directly influence irregular blood donors to redonate blood.
PICO Summary
Population
Non-regular blood donors (n= 692).
Intervention
Web-based videos sent via WeChat, and guided by an extended theory of planned behavior (Intervention group), (n= 285).
Comparison
Regular, short text reminder SMS messages (Control group), (n= 407).
Outcome
The Intervention group re-donation rate was significantly higher (16.14%), than the Control group rate (5.16%). Men aged 31 to 45, who had donated blood twice had a higher re-donation rate after the web-based video intervention than after the text messages. After the web-based intervention, repeat donors' improved blood anxiety, outcome expectations, and cognition of the blood donation environment were significantly higher than those of the non-repeat donors.
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8.
The effectiveness of iron education through a mobile application on donor return after deferral for low hemoglobin
Hasan MI, Noordin SS, Hami R, Ishak N, Achuthan A
Blood transfusion = Trasfusione del sangue. 2022
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Editor's Choice
Abstract
BACKGROUND Low hemoglobin level is a common cause of donor deferral and results in a huge loss of the donor pool. This study aimed to evaluate the effectiveness of a mobile application as an educational tool to enhance donor return and improve hemoglobin levels after deferral. MATERIALS AND METHODS This was an interventional study involving 382 blood donors who were deferred for low hemoglobin. The donors were divided equally into two groups: a control group and the intervention group. The control group received standard management for low hemoglobin deferral, which includes a short counseling session and a 1-month course of oral iron therapy. The intervention group used a mobile application in addition to standard management. The primary endpoint was the number of blood donors who returned during the 7 months of follow-up. The secondary endpoints were the hemoglobin increment at the first visit after the donors' deferral. RESULTS The return rate was higher in the intervention group, with 81.2% of the donors returning in the 7 months of follow-up compared to 66% of the control group (p<0.001). Male and female donors had mean hemoglobin increments of 1.0 g/dL and 0.7 g/dL, respectively, in the intervention group, compared to decrements of 0.2 g/dL and 0.4 g/dL, respectively, in the control group (p<0.001). Multivariable analysis showed a significant association between intervention method, education level and donation status on donor return (p=0.015, p<0.001, and p<0.001, respectively). DISCUSSION Higher return rate and greater hemoglobin increase in the interventional group could be attributed to features in the mobile application. Repeat donors had the highest odds of returning to donate, followed by those with a tertiary level of education, and those given the mobile application. This study showed that a mobile application was effective in enhancing donor return and increasing hemoglobin level among deferred blood donors on their first return.
PICO Summary
Population
Blood donors deferred for low haemoglobin levels (n= 382).
Intervention
Mobile phone application with three education areas (anaemia, iron absorption, and a list of foods rich in iron), a link to the donation campaign location, a daily reminder to take an iron tablet, plus standard management for low haemoglobin deferral (Intervention group, n= 191).
Comparison
Standard management for low haemoglobin deferral, which included a short counseling session and a one-month course of oral iron therapy (Control group, n= 191).
Outcome
The return rate was higher in the Intervention group, with 81.2% of the donors returning in the 7 months of follow-up compared to 66% of the Control group. Male and female donors had mean haemoglobin increments of 1.0 g/dL and 0.7 g/dL, respectively, in the Intervention group, compared to decrements of 0.2 g/dL and 0.4 g/dL, respectively, in the Control group. Multivariable analysis showed a significant association between intervention method, education level and donation status on donor return.
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9.
A Systematic Review of Interventions Used to Increase Blood Donor Compliance with Deferral Criteria
Cutts JC, Quinn B, Seed CR, Kotsiou G, Pearson R, Scott N, Wilson DP, Harrod ME, Maher L, Caris S, et al
Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie. 2021;48(2):118-129
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Editor's Choice
Abstract
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.
PICO Summary
Population
Blood donation settings undertaking pre-donation screening (10 studies).
Intervention
Systematic review to identify interventions to improve blood donor compliance with deferral criteria.
Comparison
Outcome
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.
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10.
Knowledge of blood donation and associated factors in Ethiopia: a systematic review and meta-analysis
Getie A, Wondmieneh A, Bimerew M, Gedefaw G, Demis A
BMJ open. 2021;11(7):e044343
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Editor's Choice
Abstract
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.
PICO Summary
Population
Men and women living in Ethiopia (20 studies, n= 8,338).
Intervention
Systematic review to assess the level of knowledge about blood donation and associated factors in Ethiopia.
Comparison
Outcome
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.