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Seroprevalence of hepatitis c virus infection among blood donors in Ethiopia: a systematic review and meta-analysis
Lake EA, Fite RO, Gebrekirstos LG, Gebremedhin MH, Obsa MS, Gelaw KA
BMC infectious diseases. 2021;21(1):131
Abstract
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.
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The Order of Draw during Blood Collection: A Systematic Literature Review
Bazzano G, Galazzi A, Giusti GD, Panigada M, Laquintana D
International journal of environmental research and public health. 2021;18(4)
Abstract
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.
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Effect of tourniquet time on whole blood point-of-care lactate concentration: A healthy human volunteer study
Chiew AL, Tran CT, Mackenzie J
Emergency medicine Australasia : EMA. 2021
Abstract
OBJECTIVE Lactate is frequently utilised in clinical practice. Some have concerns that tourniquet application for venous blood collection may falsely elevate venous lactate. The objective of the present study was to determine the effect of tourniquet time on varying venous lactate concentrations. METHODS This is a healthy volunteer study, in which subjects were their own controls. A cannula was inserted into each arm, with a tourniquet remaining on one. Subjects were allocated to one of three groups; rest (no activity), exercise (maximal exertion to elevate lactate concentrations) with immediate tourniquet application or exercise with delayed (5-min post-exercise) tourniquet application. In all blood was drawn simultaneously from both cannulas at 0, 2.5, 5, 10 and 15-min post-tourniquet application and analysed for lactate on a point-of-care device. The primary outcome was a clinically significant difference (>1 mmol/L) in tourniquet versus non-tourniquet arm lactate concentration. RESULTS There were 10 subjects per group; the exercise groups achieved a mean maximum lactate concentration of 10.4 mmol/L (standard deviation [SD] 3.6) (exercise with immediate tourniquet application group) and 8.9 mmol/L (SD 2.5) (exercise with delayed tourniquet application group). There was no clinically significant increase in lactate concentration in the tourniquet compared to non-tourniquet arm in all groups, across all tourniquet application times, and over a range of lactate concentrations. In the rest group after 15-min of tourniquet application the mean lactate concentration of the tourniquet versus non-tourniquet arm was 0.91 mmol/L (SD 0.55) versus 0.89 mmol/L (SD 0.46) (P = 0.99), respectively. CONCLUSION In the present study tourniquet application for blood collection did not significantly increase lactate concentration. Hence, clinically a raised venous lactate concentration should not be attributed to prolonged tourniquet application.
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Seroprevalence and factors associated with hepatitis B virus infection in blood donors in Ethiopia: a systematic review and meta-analysis
Fite RO, Kooti W, Azeze GA, Tesfaye B, Hagisso SN
Arch Virol. 2020
Abstract
Hepatitis B virus (HBV) can be transmitted during blood donation. This study estimated the pooled prevalence of hepatitis B and associated risk factors in blood donors in Ethiopia. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, African Journals Online (AJOL), the Excerpta Medica database (EMBASE), SCOPUS, Web of Science, Google Scholar, and JSTOR were accessed. Articles were searched from the Addis Ababa University research repository. The core search terms and phrases were "Hepatitis", "Hepatitis B", "Blood Donation", "Blood Donor", "Transfusion", "Transfusion Transmissible Infections", "Ethiopia", "Addis Ababa", "Adama", "Bahirdar", "Dire Dawa", "Gondar", "Mekelle", "Hawassa". The data were analyzed based on a DerSimonian-Laird random-effects model using STATA 14 and Review Manager version 5.3. I(2) was used to quantify between-study heterogeneity. Leave-one-out sensitivity analysis was done. Twenty-seven articles with 308,188 samples were included in the meta-analysis. The studies used HBsAg to diagnose hepatitis B. The pooled prevalence of HBV infection among blood donors was 4.91% (95% CI: 4.21-5.60; I(2) = 99%). Male sex (p < 0.001), replacement donors (p = 0.007), history of tooth extraction (p < 0.001), and sharp material sharing (p < 0.001) were associated with increased risk, while being a repetitive blood donor was associated with a decreased risk of being infected with HBV (p = 0.02).
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Cognitive and physical performance are well preserved following standard blood donation: A noninferiority, randomized clinical trial
Nadler R, Tsur AM, Lipsky AM, Lending G, Benov A, Ostffeld I, Shinar E, Yanovich R, Moser A, Levy D, et al
Transfusion. 2020
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Abstract
BACKGROUND A walking blood bank (WBB) refers to the use of fellow combatants for battlefield blood donation. This requires pretesting combatants for infectious diseases and blood type. A fundamental prerequisite for this technique is that the donating soldier will suffer minimal physiological and mental impact. The purpose of the current study is to assess the effect of blood shedding on battlefield performance. METHODS This is a double-blind randomized control trial. Forty Israel Defense Forces combatants volunteered for the study. Participants underwent baseline evaluation, including repeated measurement of vital signs, cognitive evaluation, physical evaluation, and a strenuous shooting test. Three weeks after the baseline evaluation, subjects were randomized to either blood donation or the control group. For blinding purposes, all subjects underwent venous catheterization for the duration of a blood donation. Repeated vital signs and function evaluation were then performed. RESULTS Thirty-six patients were available for randomization. Baseline measurements were similar for both groups. Mean strenuous shooting score was 80.5 +/- 9.5 for the control group and 82 +/- 6.6 for the test group (p = 0.58). No clinically or statistically significant differences were found in tests designed to evaluate cognitive performance or physical functions. Vital signs taken multiple times were also similar between the test and control groups. CONCLUSIONS Executive, cognitive, and physical functions were well preserved after blood donation. This study supports the hypothesis that a WBB does not decrease donor combat performance. The categorical prohibition of physical exercise following blood donation might need to be reconsidered in both military and civilian populations.
PICO Summary
Population
Infantry combatants (n= 36).
Intervention
Blood donation group: 450ml of blood collected after venous catheterisation (n= 18).
Comparison
Control group: venous catheterisation (n= 18).
Outcome
No clinically or statistically significant differences were found in tests designed to evaluate cognitive performance or physical functions. Vital signs taken multiple times were also similar between the test and control groups.
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Overall prevalence of human parvovirus B19 among blood donors in mainland China: A PRISMA-compliant meta-analysis
Li X, Lin Z, Liu J, Tang Y, Yuan X, Li N, Lin Z, Chen Y, Liu A
Medicine (Baltimore). 2020;99(17):e19832
Abstract
BACKGROUND Human parvovirus B19 (B19V) infection exhibits a broad range of clinical outcomes. Blood transfusion is a common route of B19V transmission. However, information about the overall prevalence of B19V infection and B19V genotypes among blood donors in mainland China is lacking. METHODS This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search for studies reporting the B19V prevalence among blood donors in mainland China from 2000 to 2018 was performed. The prevalence of B19V was estimated through a meta-analysis of the relevant literature. A comprehensive meta-analysis program was used for data processing and statistical analysis. RESULTS Twenty-one eligible articles were included, involving 48,923 participants assessed for B19V-DNA, 12,948 participants assessed for anti-B19V immunoglobulin M (IgM), and 8244 participants assessed for anti-B19V immunoglobulin G (IgG). The analysis revealed the pooled estimates of the prevalence rates of B19V-DNA, anti-B19V IgM, and anti-B19V IgG among blood donors to be 0.7% (95% confidence interval [CI] 0.2-2.4%), 2.7% (95% CI 1.7-4.3%), and 33.6% (95% CI 28.2-39.4%), respectively. Moreover, phylogenetic analyses indicated that 142 of 169 (84.0%) B19V isolates belonged to Genotype 1. CONCLUSIONS The overall prevalence of B19V among blood donors is not high in mainland China, and most isolates belong to Genotype 1.
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The benefits of iron supplementation following blood donation vary with baseline iron status
Mast AE, Szabo A, Stone M, Cable RG, Spencer BR, Kiss JE
Am J Hematol. 2020
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Abstract
Whole blood donation rapidly removes approximately 10% of a donor's blood volume and stimulates substantial changes in iron metabolism and erythropoiesis. We sought to identify donors who benefit from iron supplementation, describe the nature of the benefit, and define the time course for recovery from donation. Blood samples were collected over 24 weeks following whole blood donation from 193 participants, with 96 participants randomized to 37.5 mg daily oral iron. Changes in total body, RBC, and storage iron, hepcidin, erythropoietin, and reticulocyte count were modeled using semiparametric curves in a mixed model and compared among six groups defined by baseline ferritin (<12; 12-50; ≥50 ng/mL) and iron supplementation. The effect of oral iron on storage and RBC iron recovery was minimal in donors with baseline ferritin ≥50 ng/mL, but sizeable when ferritin was <50 ng/mL. Iron initially absorbed went to RBC and storage iron pools when ferritin was <12 ng/mL but went mostly to RBCs when ferritin was ≥12 ng/mL. Donors with ferritin ≥12 ng/mL had a "ripple" increase in reticulocytes ~100 days after donation indicating physiological responses occur months following donation. Iron supplements markedly enhance recovery from whole blood donation in donors with ferritin <50 ng/mL. However, full recovery from donation requires over 100 days when taking iron. The findings also highlight the value of the study of blood donors for understanding human hemoglobin and iron metabolism and their usefulness for future studies as additional biomarkers are discovered. This article is protected by copyright. All rights reserved.
PICO Summary
Population
Whole blood donors (n=193).
Intervention
Daily oral iron: 37.5 mg (n=96).
Comparison
No iron (n=97).
Outcome
The effect of oral iron on storage and RBC iron recovery was minimal in donors with baseline ferritin >/=50 ng/mL, but sizeable when ferritin was <50 ng/mL. Iron initially absorbed went to RBC and storage iron pools when ferritin was <12 ng/mL but went mostly to RBCs when ferritin was >/=12 ng/mL. Donors with ferritin >/=12 ng/mL had a "ripple" increase in reticulocytes ~100 days after donation indicating physiological responses occur months following donation.
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Hyperventilation as a Predictor of Blood Donation-Related Vasovagal Symptoms
Mennitto S, Ritz T, Robillard P, France CR, Ditto B
Psychosom Med. 2020
Abstract
OBJECTIVE Most of the research on vasovagal reactions has focused on the contributions of cardiovascular activity to the development of symptoms. However, other research suggests that additional mechanisms like hyperventilation may contribute to the process. The goal of the present investigation was to examine the influences of cardiovascular and respiratory variables on vasovagal symptoms. METHODS This study was part of a randomized controlled trial investigating the effects of behavioral techniques on the prevention of vasovagal reactions in blood donors. Data from the no-treatment control group were analyzed. The final sample was composed of 160 college and university students. Observational and self-report measures of symptoms were obtained. Physiological variables were measured mainly using respiratory capnometry. RESULTS While respiration rate remained stable throughout donation, change in end-tidal CO2 was associated with requiring treatment for a reaction during donation (OR = .57, 95% CI = .41-.79, p = .001) and self-reported symptoms measured in the post-donation period using the Blood Donation Reactions Inventory (beta=-.152, 95% CI= -.28- -.02, t=-2.32, p=.022). Individuals with higher levels of pre-donation anxiety displayed larger decreases in end-tidal CO2 throughout the procedure (F(2,236) = 3.64, p = .043, etap = .030). BDRI scores were related to changes in systolic (beta=-.022, 95% CI= -.04- -.004, t=-2.39, p=.019) and diastolic blood pressure (beta=-.038, 95% CI= -.06- -.02, t=-4.03, p <.001). CONCLUSIONS While the vasovagal reaction has traditionally been viewed as a primarily cardiovascular event, the present results suggest that hyperventilation also plays a role in the development of vasovagal symptoms.
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The Effect of Parenteral or Oral Iron Supplementation on Fatigue, Sleep, Quality of Life and Restless Legs Syndrome in Iron-Deficient Blood Donors: A Secondary Analysis of the IronWoMan RCT
Macher S, Herster C, Holter M, Moritz M, Matzhold EM, Stojakovic T, Pieber TR, Schlenke P, Drexler C, Amrein K
Nutrients. 2020;12(5)
Abstract
Background: Besides anemia, iron deficiency may cause more subtle symptoms, including the restless legs syndrome (RLS), the chronic fatigue syndrome (CFS) or sleeping disorders. Objective: The aim of this pre-planned secondary analysis of the IronWoMan randomized controlled trial (RCT) was to compare the frequency and severity of symptoms associated with iron deficiency before and after (intravenous or oral) iron supplementation in iron deficient blood donors. METHODS/DESIGN Prospective, randomized, controlled, single-centre trial. (ClinicalTrials.gov: NCT01787526). SETTING Tertiary care center in Graz, Austria. PARTICIPANTS 176 (138 female and 38 male) whole-blood and platelet apheresis donors aged ≥ 18 and ≤ 65 years with iron deficiency (ferritin ≤ 30ng/mL at the time of blood donation). INTERVENTIONS Intravenous iron (1 g ferric carboxymaltose, n = 86) or oral iron supplementation (10 g iron fumarate, 100 capsules, n = 90). MEASUREMENTS Clinical symptoms were evaluated by a survey before iron therapy (visit 0, V0) and after 8-12 weeks (visit 1, V1), including questions about symptoms of restless legs syndrome (RLS), chronic fatigue syndrome (CFS), sleeping disorders, quality of life and symptoms like headaches, dyspnoea, dizziness, palpitations, pica and trophic changes in fingernails or hair. RESULTS We found a significant improvement in the severity of symptoms for RLS, fatigue and sleep quality (p < 0.001). Furthermore, a significant decrease in headaches, dyspnoea, dizziness and palpitations was reported (p < 0.05). There was no difference between the type of iron supplementation (intravenous versus oral) and clinical outcome data. CONCLUSION Iron supplementation in iron-deficient blood donors may be an effective strategy to improve symptoms related to iron deficiency and the wellbeing of blood donors.
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The effects of intravenous iron supplementation on fatigue and general health in non-anemic blood donors with iron deficiency: a randomized placebo-controlled superiority trial
Keller P, von Känel R, Hincapié CA, da Costa BR, Jüni P, Erlanger TE, Andina N, Niederhauser C, Lämmle B, Fontana S
Scientific reports. 2020;10(1):14219
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Abstract
We investigated whether intravenous iron supplementation improves fatigue and general health in non-anemic repeat adult blood donors with iron deficiency (ferritin ≤ 50 µg/L). Of 1,487 potentially eligible participants, 203 were randomly assigned to a single intravenous dose of 800 mg iron-carboxymaltose and 202 to placebo; 393 participants completed the trial. At 6 to 8 weeks after intervention, self-rated mean fatigue scores (numeric rating scale from 1-10, primary outcome) were 3.9 ± 1.8 in the iron supplementation group and 4.0 ± 2.2 in the placebo group, showing no group difference (p = 0.819). Pre-specified subgroup analyses of gender, ferritin < 25 µg/L and fatigue ≥ 4 points, as well as exploratory analyses of lower ferritin cut-offs did not reveal any between-group differences. In terms of secondary outcomes, the mean differences were 114.2 µg/L for ferritin (95% CI 103.1-125.3) and 5.7 g/L for hemoglobin (95% CI 4.3-7.2) with significantly higher values in the iron supplementation group. No group differences were observed for different measures of general well-being and other clinical and safety outcomes. Intravenous iron supplementation compared with placebo resulted in increase of ferritin and hemoglobin levels in repeat blood donors with low iron stores, yet had no effect on fatigue and general well-being.
PICO Summary
Population
Non-anaemic blood donors with iron deficiency (n= 405).
Intervention
Single intravenous dose of 800 mg iron-carboxymaltose (n= 203).
Comparison
Placebo (n= 202).
Outcome
At 6 to 8 weeks after intervention, self-rated mean fatigue showed no group difference. Pre-specified subgroup analyses of gender, ferritin < 25 µg/L and fatigue ≥ 4 points, as well as exploratory analyses of lower ferritin cut-offs did not reveal any between-group differences. No group differences were observed for different measures of general well-being and other clinical and safety outcomes. Intravenous iron supplementation compared with placebo resulted in increase of ferritin and hemoglobin levels in repeat blood donors with low iron stores, yet had no effect on fatigue and general well-being.
