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Little is known about the motivations and outcomes of sellers in remunerated markets for human materials. We exploit dramatic growth in the U.S. blood plasma industry to shed light on the sellers of plasma. Sellers tend to be young and liquidity-constrained with low incomes and limited access to traditional credit. Plasma centers absorb demand for nontraditional credit. After a plasma center opens nearby, demand for payday loans falls by over 13% among young borrowers. Meanwhile, foot traffic increases by over 4% at nearby stores, suggesting that constrained households use plasma markets to smooth consumption without appealing to high-cost debt. [ABSTRACT FROM AUTHOR]

Background: Platelet-rich fibrin (PRF) is used to prepare "sticky bone" by combining it with bone graft material. The present study investigated the ability of different bone grafts to absorb growth factors from the PRF and release them over time. Materials and Methods: Human blood was collected from 10 healthy volunteers for liquid PRF preparation. Bovine bone, allograft (mineralized and demineralized), and synthetic bone were each mixed with the PRF to prepare a sticky bone. All sticky bone samples were incubated for up to 4 days. The absorption and release pattern kinetics of two selective growth factors within the PRF--platelet-derived growth factor (PDGF) and bone morphogenetic protein-2 (BMP-2)--were quantified with immunofluorescence staining and enzyme-linked immunoassay (ELISA) testing. Results: All bone graft materials adsorbed the examined growth factors from the PRF. ß-TCP showed the highest adsorption levels, followed by the xenograft, and the allografts showed the lowest adsorption levels. Furthermore, PDGF showed a fast-release pattern from the grafts, whereas BMP-2 was released at a later stage. Similar to the adsorption pattern, the ß-TCP and xenograft were better able to sustain the release of the PRF growth factors from the graft than the allografts. Conclusions: The adsorption of PDGF and BMP-2 differ between graft materials, with superior results for ß-TCP, followed by xenograft, then allograft materials. [ABSTRACT FROM AUTHOR]

Nucleocapsid antibody assays can be used to estimate SARS-CoV-2 infection prevalence in regions implementing spike-based COVID-19 vaccines. However, poor sensitivity of nucleocapsid antibody assays in detecting infection after vaccination has been reported. We derived a lower cutoff for identifying previous infections in a large blood donor cohort (N = 142,599) by using the Ortho VITROS Anti-SARS-CoV-2 Total-N Antibody assay, improving sensitivity while maintaining specificity >98%. We validated sensitivity in samples donated after self-reported swab-confirmed infections diagnoses. Sensitivity for first infections in unvaccinated donors was 98.1% (95% CI 98.0-98.2) and for infection after vaccination was 95.6% (95% CI 95.6-95.7) based on the standard cutoff. Regression analysis showed sensitivity was reduced in the Delta compared with Omicron period, in older donors, in asymptomatic infections,

BACKGROUND: Monitoring genotypes of HIV infections in blood donors may provide insights into infection trends in the general population. METHODS: HIV RNA was extracted from plasma samples of blood donors confirmed as HIV positive by blood screening nucleic acid and antibody tests. HIV genome target regions were amplified using nested real time-polymerase chain reaction followed by next-generation sequencing. Sequences were compared to those in the Los Alamos National Laboratory (LANL) database. Sequences were also assessed for drug resistance mutations (DRM) using the Stanford HIV DRM Database. RESULTS: From available HIV-positive donations collected between 1 September 2015 and 31 December 2020, 563 of 743 (75.8%) were successfully sequenced; 4 were subtype A, 543 subtype B, 5 subtype C, 1 subtype G, 5 circulating recombinant forms (CRF), and 2 were subtype B and D recombinants. Overall, no significant differences between blood donor and available LANL genotypes were found, and the genotypes of newly acquired versus prevalent HIV infections in donors were similar. The proportion of non-B subtypes and CRF remained a small fraction, with no other subtype or CRF representing more than 1% of the total. DRM were identified in 122 (21.6%) samples with protease inhibitor, nucleoside reverse transcriptase inhibitor and non-nucleoside reverse transcriptase inhibitor DRMs identified in 4.9%, 4.6% and 14.0% of samples, respectively. CONCLUSIONS: HIV genetic diversity and DRM in blood donors appear representative of circulating HIV infections in the US general population and may provide more information on infection diversity than sequences reported to LANL, particularly for recently transmitted infections.

OBJECTIVES: Hepatitis B virus (HBV) infection remains a global health problem. Risk factors for HBV infection are usually assessed in prevalent rather than incident infections. To identify demographic and behavioral risks associated with incident HBV among South African blood donors. METHODS: A case-control study was performed between November 2014 and January 2018. Cases were blood donors testing positive for HBV DNA with or without hepatitis B surface antigen but negative for antibody to hepatitis B core antigen. Participants completed an audio computer-assisted structured interview on exposures during the previous 6 months. Sex-specific multivariable logistic regression yielded independent associations between risks and HBV infection. RESULTS: 56 females and 37 males with incident HBV were compared to 438 female and 439 male controls, respectively. For females, risk factors were accepting money or goods for sex, using agents to prepare ones anus prior to anal sex, penetrating injury, non-Black race, and lower educational status. Men reporting homosexual or bisexual orientation or sex with other men, previous injury, referral for HBV testing, or lack of medical insurance were at increased risk. For both sexes, having more than two male sexual partners increased risk. CONCLUSIONS: Sexual behaviors predominated over parenteral exposures as risks for incident HBV in both female and male blood donors.

BACKGROUNDCOVID-19 convalescent plasma (CCP) virus-specific antibody levels that translate into recipient posttransfusion antibody levels sufficient to prevent disease progression are not defined.METHODSThis secondary analysis correlated donor and recipient antibody levels to hospitalization risk among unvaccinated, seronegative CCP recipients within the outpatient, double-blind, randomized clinical trial that compared CCP to control plasma. The majority of COVID-19 CCP arm hospitalizations (15/17, 88%) occurred in this unvaccinated, seronegative subgroup. A functional cutoff to delineate recipient high versus low posttransfusion antibody levels was established by 2 methods: (i) analyzing virus neutralization-equivalent anti-Spike receptor-binding domain immunoglobulin G (anti-S-RBD IgG) responses in donors or (ii) receiver operating characteristic (ROC) curve analysis.RESULTSSARS-CoV-2 anti-S-RBD IgG antibody was volume diluted 21.3-fold into posttransfusion seronegative recipients from matched donor units. Virus-specific antibody delivered was approximately 1.2 mg. The high-antibody recipients transfused early (symptom onset within 5 days) had no hospitalizations. A CCP-recipient analysis for antibody thresholds correlated to reduced hospitalizations found a statistical significant association between early transfusion and high antibodies versus all other CCP recipients (or control plasma), with antibody cutoffs established by both methods-donor-based virus neutralization cutoffs in posttransfusion recipients (0/85 [0%] versus 15/276 [5.6%]; P = 0.03) or ROC-based cutoff (0/94 [0%] versus 15/267 [5.4%]; P = 0.01).CONCLUSIONIn unvaccinated, seronegative CCP recipients, early transfusion of plasma units in the upper 30% of study donors antibody levels reduced outpatient hospitalizations. High antibody level plasma units, given early, should be reserved for therapeutic use.TRIAL REGISTRATIONClinicalTrials.gov NCT04373460.FUNDINGDepartment of Defense (W911QY2090012); Defense Health Agency; Bloomberg Philanthropies; the State of Maryland; NIH (3R01AI152078-01S1, U24TR001609-S3, 1K23HL151826NIH); the Mental Wellness Foundation; the Moriah Fund; Octapharma; the Healthnetwork Foundation; the Shear Family Foundation; the NorthShore Research Institute; and the Rice Foundation.

Background: The safety of blood donation requires screening for transfusion-transmitted infections, including human immunodeficiency virus (HIV), syphilis, hepatitis B virus (HBV) and hepatitis C virus (HCV). This study aimed to determine the seroprevalence of HIV, HBV, HCV and syphilis in blood donors of Mogadishu Tertiary Care Hospital, Somalia from 2020 to 2022. Methods: The records of 109,385 blood donors who attended our blood center in Mogadishu-Somalia between 2020 and 2022 were examined retrospectively. Serum samples of donors; HBsAg, anti-HCV, anti-HIV and syphilisscreening tests were studied using the microparticleEnzyme-Linked ImmunoSorbent Assay (ELISA)(Vitros, Ortho-Clinical Diagnostics, U.S) method.The distribution of HBsAg, anti-HCV, anti-HIV and syphilis positivity rates of 109,385 blood donors according to years, gender and age were examined. Kolmogorov Smirnov, Skewness, Kurtosis tests and histogram were used for normality analysis. Chi-squared test (χ2) and Fisher Exact test were used to analyze categorical data. Categorical variables were expressed as frequency (percentage). Analysis of continuous data was performed with the Mann Whitney U test. P < 0.05 value was considered statistically significant. Results: HBsAg positivity was found in 0.6% of the donors, anti-HCV positivity in 0.01%, anti-HIV positivity in 0.03% and syphilispositivity in 0.3%. The results showed that among the blood donors, the prevalence of syphilis, HIV, Hepatitis B, and Hepatitis Cwas notably low. Conclusion: The prevalence of HBV, HCV, HIV, and syphilis among blood donors in Somalia was found to be quite low. Even if our found seroprevalence rates are low, to guarantee the safety of blood for recipients, strict selection of blood donors and thorough screening of donors' blood using accepted procedures are strongly advised. [ABSTRACT FROM AUTHOR]

Background: Blood transfusion services play a very key role in modern health care service delivery. About 118.5 million blood donations were collected globally in 2022. However, about 1.6 million units of blood are destroyed annually due to transfusion-transmissible infections (TTIs). There is a very high risk of TTIs through donated blood to recipients if safe transfusion practices are not observed. This study determined the prevalence and factors associated with TTIs among blood donors in Arua regional blood bank, Uganda. Methods: This study was a retrospective cross-sectional design that involved a review of a random sample of 1370 blood donors registered between January 1st, 2018 and December 31st, 2019 at Arua regional blood bank, Uganda. Descriptive statistics were used to describe the characteristics of the blood donors. The binary logistic regression was used to determine the factors associated with TTIs. Results: The majority of the blood donors were male (80.1%), and the median donor age was 23 years (IQR = 8 years). The overall prevalence of TTIs was found to be 13.8% (95%CI: 12.0-15.6%), with specific prevalences of 1.9% for HIV, 4.1% for HBV, 6.6% for HCV and 2.8% for treponema pallidum. Male sex (AOR = 2.10, 95%CI: 1.32–3.36, p-value = 0.002) and lapsed donor type compared to new donor type (AOR = 0.34, 95%CI: 0.13–0.87, p-value = 0.025) were found to be associated with TTIs. Conclusion: The prevalence of TTIs among blood donors of West Nile region, Uganda was found to be significantly high, which implies a high burden of TTIs in the general population. Hence, there is need to implement a more stringent donor screening process to ensure selection of risk-free donors, with extra emphasis on male and new blood donors. Additionally, sensitization of blood donors on risky behaviors and self-deferral will reduce the risk of donating infected blood to the recipients. [ABSTRACT FROM AUTHOR]

Background and Objectives Materials and Methods Results Conclusions Blood establishments strive to ensure the safety and comfort of blood donors while minimizing adverse events. This review aims to assess the efficacy and effectiveness of eating and/or drinking interventions before, during and/or after blood donation in reducing vasovagal reactions (VVRs).We analysed randomized and non‐randomized controlled trials comparing eating and/or drinking interventions to no intervention, placebo or usual practice on (pre‐)syncopal VVRs and related symptoms. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to assess the risk of bias and overall certainty of the evidence.Pre‐donation water ingestion likely results in reduced on‐site VVRs, compared to no water (2 fewer per 100 donors, moderate‐certainty evidence). A pre‐donation isotonic drink likely results in reduced VVRs, compared to usual practice (2 fewer per 100 donors, moderate‐certainty evidence). Pre‐donation salt‐loaded sweetened lemon water may result in fewer off‐site VVRs, compared to sweetened lemon water only (1 fewer per 100 donors, low‐certainty evidence). Pre‐donation water and a gel cap containing sucrose with 250 mg caffeine may result in fewer blood donor reaction ratings, compared to pre‐donation water only (low‐certainty evidence).Pre‐donation plain water ingestion or isotonic drink probably results in a large reduction in on‐site and off‐site VVRs. Pre‐donation water ingestion with caffeine consumption or salt supplementation may result in a VVR reduction, compared to water ingestion only. Future large trials are required to increase the certainty of the effect of these and other interventions in the prevention of VVRs. [ABSTRACT FROM AUTHOR]

A core component of every blood program is the supply of safe blood and blood products. The elevated risk of transmission through these products is due to parvovirus B19 (B19V) resistance to the virus inactivation procedures. Our study aimed to screen asymptomatic blood donors for B19V at a tertiary care hospital in Chennai, Tamil Nadu, between September 2020 and June 2021. Sera from 106 healthy blood donors who tested negative for Human immunodeficiency virus (HIV), Hepatitis B surface antigen (HBsAg), Hepatitis C virus (HCV), syphilis, and malaria were tested for anti-B19V IgM and IgG using a qualitative indirect enzyme-linked immunosorbent assay (ELISA). In the study population, 23.5% (n = 25) of donors tested IgM positive, 38.6% (n = 41) tested IgG positive, and 7.5% (n = 8) tested positive for both IgM and IgG. A proportion of 61.3% (n = 65) of the blood donors tested IgG negative, suggesting they had no past B19V infection. B19V DNA was not detected in any of the subjects. The high seroprevalence of IgM indicates that blood donors may have been recently exposed to B19V, potentially posing a risk to immunocompromised individuals and those with hematological stress. Further longitudinal studies with a larger sample size are recommended to better understand the risk of B19V transfusion transmission. [ABSTRACT FROM AUTHOR]

Background: Surveillance of HIV-1 pre-treatment drug resistance (PDR) is essential for ensuring the success of first-line antiretroviral therapy (ART). Beside population-based surveys, sentinel surveillance of PDR and circulating HIV-1 clades in specific populations such as blood donors could efficiently inform decision-making on ART program. We therefore sought to ascertain HIV-1 residual infection, the threshold of PDR and viral diversity among recently-diagnosed blood donors in Gabon. Methods: A sentinel surveillance was conducted among 381 consenting blood donors at the National Blood Transfusion Center (NBTC) in Gabon from August 3,2020 to August, 31, 2021. In order to determine the residual risk of HIV transmission, viral load and HIV-1 Sanger-sequencing were performed at the Chantal BIYA International Reference Center (CIRCB)-Cameroon on HIV samples previously tested seronegative with ELISA in Gabon. Phylogeny was performed using MEGA X, PDR threshold>10% was considered high and data were analysed using p≤0.05 for statistical significance. Results: Five HIV-negative blood donors had a detectable viral load indicating a high residual risk of HIV transmission. Among the samples successfully sequenced, four participants had major drug resistance mutations (DRMs), giving a threshold of PDR of 25% (4/16). By drug class, major DRMs targeting NNRTI (K103N, E138G), NRTIs (L210W) and PI/r (M46L). The most representative viral clades were CRF02_AG and subtype A1. The genetic diversity of HIV-1 had no significant effect on the residual risk in blood transfusion (CRF02_AG, P = 0.3 and Recombinants, P = 0.5). Conclusion: This sentinel surveillance indicates a high residual risk of HIV-1 transfusion in Gabon, thereby underscoring the need for optimal screening strategy for blood safety. Moreover, HIV-1 transmission goes with high-risk of PDR, suggesting suboptimal efficacy of ART. Nonetheless, the genetic diversity has limited (if any effect) on the residual risk of infection and PDR in blood donors. [ABSTRACT FROM AUTHOR]

Background and Objectives Materials and Methods Results Conclusion Homophily represents the extent to which people feel others are like them and encourages the uptake of activities they feel people like them do. Currently, there are no data on blood donor homophily with respect to (i) people's representation of the average prototypical UK blood donor and (ii) the degree of homophily with this prototype for current donors, non‐donors, groups blood services wish to encourage (ethnic minorities), those who are now eligible following policy changes (e.g., men‐who‐have‐sex‐with‐men: MSM) and recipients. We aim to fill these gaps in knowledge.We surveyed the UK general population MSM, long‐term blood recipients, current donors, non‐donors and ethnic minorities (n = 785) to assess perceptions of the prototypical donor in terms of ethnicity, age, gender, social class, educational level and political ideology. Homophily was indexed with respect to age, gender and ethnicity.The prototypical UK blood donor is perceived as White, middle‐aged, middle‐class, college‐level educated and left‐wing. Current donors and MSM are more homophilous with this prototype, whereas recipients and ethnic minorities have the lowest homophily. Higher levels of homophily are associated with an increased likelihood of committing to donate.The prototype of the UK donor defined this as a White activity. This, in part, may explain why ethnic minorities are less likely to be donors. As well as traditional recruitment strategies, blood services need to consider broader structural changes such as the ethnic diversity of staff and co‐designing donor spaces with local communities. [ABSTRACT FROM AUTHOR]

Background and Objectives Materials and Methods Results Conclusion In 2016, France allowed men who have sex with men (MSM) to donate blood if they had not had sex with men in the previous 12 months. In April 2020, this restriction was relaxed to 4 months due to the lack of negative impact observed on blood safety. This study assesses the impact of reducing this deferral period on epidemiological surveillance indicators.This study compares infection surveillance indicators between two 30‐month periods before (P1) and after (P2) this second deferral change.Overall, 79 donations tested positive for human immunodeficiency virus (HIV) (49 in P1 and 30 in P2), 322 for hepatitis C virus (HCV) (185 and 137), 622 for hepatitis B virus (HBV) (355 and 267) and 1684 for syphilis (799 and 885). Positive donation rates decreased between P1 and P2, except for syphilis: HIV (0.07/10,000 donations vs. 0.04; p > 0.5), HCV (0.25 vs. 0.20; p < 0.05), HBV (0.49 vs. 0.39; p < 0.01) and syphilis (1.10 vs. 1.29; p < 0.001). For all three viruses, residual risks of transmission by transfusion did not increase: HIV (1/7,800,000 donations vs. 1/10,500,000), HCV (1/25,200,000 vs. 1/47,300,000) and HBV (1/6,400,000 vs. 1/6,000,000).Reducing the deferral period for MSM in April 2020 did not negatively impact residual risks, which remained very low, or the rate of positive donations, except for syphilis, which requires careful monitoring. To ensure equal access to blood donation, MSM have been allowed to donate blood under the same conditions as other donors since March 2022 (i.e., no more than one sexual partner in the last 4 months). [ABSTRACT FROM AUTHOR]

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Background and Objectives Materials and Methods Results Conclusion Blood donor questionnaires are tools used to screen prospective blood donors to determine their eligibility. There are limited data regarding blood donor questionnaires and infectious disease screening of the blood supply in Latin American countries. This study aimed to survey donor centres in Latin American countries to learn more about blood donor screening and infection assessment.An international team of transfusion medicine professionals including medical directors and supervisors who work or collaborate with Latin American donor centres, called ‘Comité de Investigación en Medicina Transfusional’, designed a survey (16 questions) to characterize blood donor eligibility in Latin America.Eighty‐two institutions from 14 Latin American countries responded to the survey. Most donor centres (66%; 54 of 82) had a donor deferral percentage between 5% and 25%, and the most common causes of deferrals were low haemoglobin and high‐risk behaviour. Most donors in blood centres were directed family donors compared with voluntary donors. Infection evaluation included mostly serologic assessment (81%; 30 of 37) for human immunodeficiency virus (HIV), Hepatitis B, Hepatitis C, Treponema pallidum and Trypanosoma cruzi rather than nucleic acid tests (5%; 2 of 37).Heterogeneity exists in donor selection and infectious disease screening in Latin American countries. This survey provides valuable information to understand Latin American blood centre practices. [ABSTRACT FROM AUTHOR]

Background Study Design and Methods Results Discussion Currently in Australia, men are deferred from donating blood if they have had sex with another man within the past 3  months. However, a proposed gender‐neutral assessment (GNA) process will ask all donors questions about sex with new or multiple recent partners, with deferral based on responses to a question about anal sex. Understanding the acceptability of such questions among existing and potential blood donors is paramount for successful implementation of GNA.We used data from a nationally representative survey to estimate the levels of comfort with the proposed GNA questions among the Australian population and subgroups, defined by self‐reported ethnicity and religion. Respondents were aged over 18 and living in Australia. Results were weighted to represent the population.Most of the 5178 respondents described themselves as comfortable with answering questions about new partners (73.1%) or anal sex (64.0%) to donate blood. However, 2.2% and 4.5% indicated that questions about new sex partners and anal sex, respectively, would stop them from donating, and 4.4% and 7.7% respectively, said they were “completely uncomfortable.” By religion, the least comfortable were Muslim or Eastern Orthodox respondents, and by country of birth, the least comfortable were those born in the Middle East, followed by those born in Southern Europe and Asia.GNA appears to be broadly acceptable in the Australian context, but our findings suggest that key GNA questions are less acceptable in some population subgroups, indicating a need for targeted campaigns that consider cultural sensitivities. [ABSTRACT FROM AUTHOR]

Background and Objectives Materials and Methods Results Conclusion Facemasks represent an essential measure of prevention against the spread of infectious diseases; however, they lessen the ability to convey and understand emotions through facial expressions. In blood donation settings, facemask wearing could interfere with professionals' tasks, reduce the satisfaction of blood donors and affect their future blood donation behaviour. This preliminary cross‐sectional study explored the association of mandatory facemask wearing with the quality of the blood donation process at the end of the coronavirus 2019 (COVID‐19) pandemic.A sample of 615 voluntary unpaid Italian blood and plasma donors completed an online survey assessing their attitude towards facemask wearing, the perceived distress due to facemasks in the different steps of the donation process, self‐reported vasovagal reactions after donation and the intention to donate again.Nearly 24% of donors reported a worsened quality of the donation process due to facemask wearing, and 36% reported moderate to severe distress during the donation itself. Donors with a more negative attitude towards facemasks reported a worse donation experience, mainly related to the interactions and the communication with physicians and nurses, and a higher probability of experiencing vasovagal reactions at their last donation. No significant correlations were observed between negative facemask attitudes towards facemask wearing, distress or future intention to donate blood/plasma.Facemasks have worsened the quality of blood and plasma donations for one fourth of donors, confirming the interference with the quality of communications and relationships with healthcare professionals. [ABSTRACT FROM AUTHOR]

The World Health Organization recommends that all blood donations be screened for transfusion transmissible infections; these data are currently not incorporated into national disease surveillance efforts. We set out to use routinely collected data from blood donors in Blantyre district, Malawi to explore HIV and syphilis prevalence and identify sero-conversions among repeat donors. We conducted a retrospective cohort analysis of blood donation data collected by the Malawi Blood Transfusion Service from 2015 to 2021. All blood donations were routinely screened for HIV and syphilis. We characterized donor demographics as well as screening outcomes, including identifying sero-conversions among repeat donors who previously tested negative on their last donation. A total of 23,280 donations from 5,051 donors were recorded, with a median frequency of donations of 3 (IQR:2–6). Most donors were male (4,294; 85%) and students (3,262; 64.6%). Prevalence of HIV at first donation was 1.0% (52/5,051) and prevalence of syphilis was 1.6% (80/5,051); 52 HIV sero-conversions and 126 syphilis sero-conversions were identified, indicating an incidence rate per 1,000 person-years of 5.9 (95% CI: 4.7, 7.4) and 13.3 (95% CI:11.4, 15.4) respectively. Students had a lower prevalence of HIV and syphilis but higher risk of syphilis seroconversion. While blood donors are generally considered a low-risk population for HIV and syphilis, we were able to identify relatively high rates of undiagnosed HIV and syphilis infections among donors. Routinely collected data from national blood donation services may be used to better understand local HIV and syphilis epidemiology, with the potential to enhance disease surveillance systems. These findings may be used to identify priority prevention areas and populations in Blantyre district that can inform targeted interventions for improved disease prevention, testing and treatment. [ABSTRACT FROM AUTHOR]

Objective Background Methods Results Conclusions To propose a rational basis for donor testing in cases of suspected antibody‐mediated transfusion‐related lung injury (AMT).Anti‐leukocyte antibodies in donated blood are established causes of transfusion‐related lung injury (TRALI). However, the question of whether to test donors for antibodies is not identical to whether the case meets definition criteria for TRALI. There is a balance between the potential benefits of testing and the costs of donor deferral and investigation. We propose that a decision‐making process based on optimising the balance between risk and benefit requires a subjective choice of the relative value of different outcomes of testing.We have developed a formal decision model to illustrate how these choices affect testing decisions.Using a Bayesian probability model, we show that the diagnostic benefit and TRALI prevention benefit of testing donors have a complex interrelationship with the number of implicated donors and clinical suspicion of antibody‐mediated TRALI (AMT) and that rational testing choices vary according to value assigned to outcomes.The challenges to the use of a formal decision model for clinical testing are discussed and conclude that a formal model is a useful consensus‐building tool for improving consistency and openness in decision making. [ABSTRACT FROM AUTHOR]

Background and Objectives Materials and Methods Results Conclusion Iron deficiency (ID) poses a prevalent concern among blood donors, especially impacting young donors, premenopausal females and frequent donors. In alignment with recommendations to address ID, routine ferritin testing was implemented in a hospital‐based donor centre.Data set, encompassing 26 164 ferritin values from 16 464 blood donors over 33 months, were analysed retrospectively. Ferritin levels were assessed concerning donor characteristics such as sex, age, ethnicity and donation frequency.Ferritin testing revealed age, sex and ethnicity variations, emphasising the heightened risk of ID in young females meeting all donation criteria under 23 year of age who demonstrated the lowest mean baseline ferritin (41% [CI: 34%–48%] < 26 ng/mL; 20% [CI: 14%–25%] < 15 ng/mL). Postmenopausal females exhibited ferritin levels similar to similarly aged males. Irrespective of sex, donors showcased mean ferritin recovery within 6 months. Analysis of ferritin recovery post‐donation showed a five‐fold increase in risk (compared with first visit) of ID when donors return at a 2‐month interval. ‘Regular’ donors (≥10 visits) approach a median steady ferritin level (~30–35 ng/mL) by the sixth visit.As reliance on regular blood donors increases, donation policies must strike a balance between blood centre resources and the risks posed to both regular and at‐risk donors. Frequent blood donation led to donors attaining a mean steady state ferritin level above the threshold for ID. At‐risk groups, particularly premenopausal females, were several times more likely to experience ID after donation but demonstrated recovery rates similar to their group's baseline levels. This valuable information informed the development of new donor deferral policies. [ABSTRACT FROM AUTHOR]

Background: Transfusion-transmissible infections (TTIs) remain a major public health problem in countries with limited resources, particularly in Gabon. Complete information on the prevalence in Gabon of the main TTIs among blood donors is still lacking in the national context. The purpose of this systematic review and meta-analysis was to determine the prevalence and factors associated with TTIs among blood donors in Gabon. Methods: This systematic review and meta-analysis was reported in accordance with the PRISMA 2020 guidelines. It was the result of data from several comprehensive studies published between 2014 and 2022, the purpose of which focused on the prevalence and factors associated with TTIs among blood donors in Gabon. The quality of the articles was assessed using the Joanna Briggs Institute critical appraisal checklist for studies reporting prevalence data. The overall prevalence of TTIs among blood donors was determined using the random effects model. Heterogeneity between studies was assessed using I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics. Results: A total of 175,140 blood donors from the nine eligible studies were admitted to this study. The combined prevalence of HIV, HBV, HCV and syphilis obtained in the random effects model was 3.0%, 6.0%, 4.0% and 3.0%, respectively. Moreover, being a male blood donor and aged between 25 and 44 years was significantly associated with HBV infection and being a female blood donor and aged 35 years and over was significantly associated with HIV infection. Family or replacement blood donors had a high infection burden for all four TTIs of study. Conclusion: The overall prevalence of transfusion-transmissible infections remains high in the country's blood banks. Improving current prevention (selection criteria) and screening strategies may be necessary in a global approach. [ABSTRACT FROM AUTHOR]

Background: This study determined the trends of transfusion-transmissible infections (TTIs) among blood donors in a regional hospital in Ghana from 2017 to 2022. Methods: A retrospective analysis was conducted on 6339 blood donor records. Data were analyzed using STATA version 17.0 at the 0.05 significance level. Results: The prevalence of TTIs was 31.4% in 2017, 13.8% in 2018, 20.4% in 2019, 9.5% in 2020, 9.6% in 2021, and 11.7% in 2022. There were significant associations between hepatitis C virus (HCV), Syphilis, and sex (OR = 2.06; 95% CI [1.29-3.30]; P =.003) and (OR = 2.28; 95% CI [1.48-3.54]; P <.001), respectively. Blood donors aged 20-29 were more likely to be infected with hepatitis B virus (OR = 1.96; 95% CI [1.28-2.99]; P =.002). Blood donors aged 40-49 had higher odds of infection with HCV (OR = 3.36; 95% CI [2.02-5.57]; P <.001) and Syphilis (OR = 3.79; 95% CI [2.45-5.87]; P <.001). Conclusion: The study highlights the need to implement targeted prevention strategies for donors with a higher TTI prevalence. Plain Language Summary: Trends in transfusion-transmissible infections among blood donors in a Regional Hospital in Ghana: 2017 to 2022 Background: Despite efforts to enhance the safety of the blood supply, transfusion-transmissible infections (TTIs) continue to pose a significant problem. This study determined the trends of TTIs among blood donors in a Regional Hospital in Ghana from 2017 to 2022. Methods: A retrospective analysis was conducted on the records of 6,339 blood donors to determine the presence of anti- human immunodeficiency virus 1/2 IgG/IgM, hepatitis B virus (HBV), anti-hepatitis C virus (HCV) IgG/IgM, and anti- Treponema pallidum IgG/IgM/IgA. Data were analyzed using STATA version 17.0. Both descriptive and inferential statistics were employed at a significance level of 0.05. Results: Of the 6339 blood donors, 16.1% showed serological evidence of at least one TTI. The trend analysis showed that the prevalence rates of TTIs were 31.4% in 2017, 13.8% in 2018, 20.4% in 2019, decreased to 9.5% in 2020, 9.6% in 2021 and increased to 11.7% in 2022. TTIs were dominant among male blood donors compared to female blood donors. There was a significant association between HCV, Syphilis, and sex (aOR = 2.06; 95% CI [0.59-1.73]; P =.003) and (aOR = 2.28; 95% CI [0.15-0.69]; P <.001) respectively. Donors aged 20 to 29 were more likely to be infected with HBV (aOR = 1.96; 95%CI [1.28-2.99]; P =.002). Also, donors aged 40 to 49 years were more likely to be infected with HCV and Syphilis (aOR = 3.36; 95% CI [2.02-5.57]; P <.001) and (aOR = 3.79; 95% CI [2.45-5.87]; P <.001) respectively. Conclusion: The study identified a high overall prevalence of TTIs, highlighting the need to encourage female donor participation, raise awareness among young adults about safe practices, and implement targeted prevention strategies for males with a higher TTI prevalence. [ABSTRACT FROM AUTHOR]

Severe alpha-1 antitrypsin deficiency (AATD) is associated with an increased risk of emphysema. However, the clinical manifestations are very heterogeneous, and an individual prognosis is very difficult to establish. Intravenous augmentation therapy with alpha-1 antitrypsin (AAT) from pooled blood donors is the only specific treatment available, but it requires weekly or biweekly administration for life. Several guidelines provide the indication criteria for the initiation of AAT augmentation therapy. However, in clinical practice, there are situations in which the decision as to when to start treatment becomes uncertain and some studies have shown great variability in the indication of this treatment even among specialists. The usual dilemma is between initiating augmentation therapy in individuals who may not develop significant lung disease or in whom disease will not progress or delaying it in patients who may otherwise rapidly and irreversibly progress. We illustrate this dilemma with five clinical cases: from the case of a patient with normal lung function who requests initiation of therapy to a moderately stable patient without augmentation or a mild patient who, after several years of remaining stable without treatment, deterioration in lung function initiated and, consequently, augmentation therapy was begun. All the nuances associated with the indication of augmentation justify a personalised approach and the decision about initiating augmentation therapy must be made after careful consideration of the pros and cons with the patient in reference centres with experience in treatment. These reference centres can work in collaboration with local hospitals where patients can be closely followed and augmentation therapy can be administered to avoid unnecessary travelling, making periodical administrations more comfortable for the patient. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) uses sophisticated algorithms to “learn” from large volumes of data. This could be used to optimise recruitment of blood donors through predictive modelling of future blood supply, based on previous donation and transfusion demand. We sought to assess utilisation of predictive modelling and AI blood establishments (BE) and conducted predictive modelling to illustrate its use. A BE survey of data modelling and AI was disseminated to the International Society of Blood transfusion members. Additional anonymzed data were obtained from Italy, Singapore and the United States (US) to build predictive models for each region, using January 2018 through August 2019 data to determine likelihood of donation within a prescribed number of months. Donations were from March 2020 to June 2021. Ninety ISBT members responded to the survey. Predictive modelling was used by 33 (36.7%) respondents and 12 (13.3%) reported AI use. Forty‐four (48.9%) indicated their institutions do not utilise predictive modelling nor AI to predict transfusion demand or optimise donor recruitment. In the predictive modelling case study involving three sites, the most important variable for predicting donor return was number of previous donations for Italy and the US, and donation frequency for Singapore. Donation rates declined in each region during COVID‐19. Throughout the observation period the predictive model was able to consistently identify those individuals who were most likely to return to donate blood. The majority of BE do not use predictive modelling and AI. The effectiveness of predictive model in determining likelihood of donor return was validated; implementation of this method could prove useful for BE operations. [ABSTRACT FROM AUTHOR]

ABSTRACT Hepatitis B Virus (HBV) infectivity data were reviewed and the 50% infectious dose (ID50) was reassessed in different HBsAg‐positive infection stages enabling modelling of transfusion‐transmitted (TT)‐HBV infection risk if HBsAg donor screening was replaced by individual donation nucleic acid amplification technology (ID‐NAT). Quantitative HBsAg and HBV‐DNA assays were performed against international standards to compare the ratio between potential infectious HBV virions and subviral HBsAg particles in Egyptian HBsAg‐positive blood donors as well as in Japanese chimpanzee samples of known infectivity. HBV‐DNA load below the quantification limit of detection was estimated against a reference standard by replicate NAT testing (n = 25). Infectivity of chimpanzee samples collected during ramp‐up and declining viremic phase were tested in a human liver chimeric mice (HLCM) model and compared with published infectivity data from different HBsAg‐positive infection stages. Lowest estimates of ID50 in HBsAg‐positive plasma were 3–6 HBV virions in chimpanzee studies. Infectivity decreased approximately 10‐100‐fold in the declining viremic phase using HLCM. In acute phase samples, HBV to HBsAg particle ratios varied between 1:102–104 but in HBsAg‐positive blood donors this particle ratio reached 1:106–1012 when viral load was below 100 HBV‐DNA copies/mL. Modelled TT‐HBV risk of an HBsAg‐positive/ID‐NAT nonreactive blood transfusion was estimated at 5.5%–27% for components containing 20–200 mL of plasma when assuming an ID50 of 316 (point estimate between 100 and 1000) virions. It cannot be ensured that discontinuation of HBsAg donor screening and reliance on ID‐NAT alone is safe. [ABSTRACT FROM AUTHOR]

Babesia ovis, transmitted by Rhipicephalus bursa ticks, is the causative agent of ovine babesiosis, a disease characterized by fever, anemia, hemoglobinuria, and high mortality in sheep. This study investigates whether sheep that survived babesiosis without treatment can serve as a source of infection for B. ovis-free host-seeking R. bursa larvae in a later season. Three donor sheep were experimentally infected with B. ovis, and after six months, persistence of B. ovis was assessed through blood and tick transmission experiments. Blood from donor sheep was intravenously injected into three recipient sheep, while donor sheep were also infested with B. ovis-free R. bursa larvae. Engorged nymphs molted to adults, and new recipient sheep were infested with these ticks. All recipient sheep were monitored for B. ovis for 100 days using microscopic, serological, and molecular approaches. The presence of B. ovis was confirmed in the recipient sheep that received blood, leading to clinical infection in two. However, no B. ovis was detected in recipient sheep infested with ticks. These results suggest that sheep recovering from B. ovis infection do not serve as a source of infection for R. bursa larvae in subsequent seasons. [ABSTRACT FROM AUTHOR]

Objective: To detect any possible illnesses, such as syphilis, and stop them from spreading through transfusion, screening blood donors is crucial. Study Design: Cross-sectional Retrospective Research study. Setting: Four RBCs and the sixteen associated hospital-based blood banks (HBBBs) that are spread over Sindh's various areas. Period: January 2022 to December 2022. Methods: Employing non-probability convenience sampling was carried out. We collected data from Sindh province's Regional Blood Centers (RBCs) and Hospital Based Blood Banks (HBBBs), dispersed throughout the province. Sindh Blood Transfusion Authority (SBTA)'s ethical committee approved the study. To screen selected blood donors for Syphilis, the Chemiluminescence Immunoassay Analyzer (CLIA) was used. Data from the study were summarized using simple percentages after they were statistically examined. Results: With 171,725 male donors and 1,460 female donors, men comprised the bulk of the 173,185 blood donors. Syphilis turned up in 2.5% of the male donors, resulting in an additional 4,311 cases. On the other hand, just 18 (1.2%) of the female donors had a positive syphilis test. The gender distribution of cases with positive Syphilis indicates a notable difference in its frequency between people of both sexes. The age group of 25 to 40 years old accounted for the largest proportion of syphilis cases among blood donors. Conclusion: One of Sindh's biggest public health concerns is the high incidence of syphilis among blood donors. Additionally, the results show that the incidence of syphilis varies by gender. Furthermore, there are considerable age range differences in the distribution of syphilis cases. These results highlight the need for increased screening and preventive programmes, especially in areas with higher incidence rates. Given the high frequency of syphilis among Sindhi red blood cell donors, this could point to a greater number of cases in the overall community. [ABSTRACT FROM AUTHOR]

INTRODUCTION: There is substantial variability in patient outcomes for gastrointestinal bleeding (GIB) across hospitals. This study aimed to identify hospital factors associated with GIB outcomes. METHODS: This was a retrospective cohort study of Medicare fee-for-service beneficiaries hospitalized for GIB from 2016 to 2018. These data were merged with the American Hospital Association Annual Survey data to incorporate hospital characteristics. We used generalized linear mixed-effect models to estimate the effect of hospital-level characteristics on patient outcomes after adjusting for patient risk factors including anticoagulant and antiplatelet use, recent GIB, and comorbidities. The primary outcome was 30-day mortality, and secondary outcomes included length of stay and a composite outcome of 30-day readmission or mortality. RESULTS: Factors associated with improved GIB 30-day mortality included large hospital size (defined as beds >400, odds ratio [OR] 0.93, 95% confidence interval [CI] 0.90-0.97), greater case volume (OR 0.97, 95% CI 0.96-0.98), increased resident and nurse staffing (OR 0.88, 95% CI 0.83-0.94), and blood donor center designation (OR 0.93, 95% CI 0.88-0.99). Patients treated at a hospital with multiple advanced capabilities, such as availability of advanced endoscopy, advanced intensive care unit (ICU) capabilities (both a medical-surgical ICU and cardiac ICU), blood donor center, and liver transplant center, had a 22% reduction in 30-day mortality risk, compared with those hospitalized in a hospital with none of these services (OR 0.78, 95% CI 0.68-0.91). However, length of stay increased with additional services. DISCUSSION: Patients hospitalized for GIB at hospitals with multiple advanced specialized capabilities have lower mortality but longer lengths of stay. Further research should examine the processes of care linked to these services that contribute to improved mortality in GIB. [ABSTRACT FROM AUTHOR]

Introduction: To prevent blood donors from developing iron deficiency (ferritin <15 μg/L) and subsequent anemia (hemoglobin <120 g/L), blood services rely on information about known risk factors, including the donor's sex and age. For example, while Finnish women are able to donate whole blood with a minimum donation interval of 91 days, women in the 18 to 25‐year‐old age group are recommended to donate no more than once per year. Menstrual blood loss is not accounted for in blood donation interval recommendations, despite being a known risk factor of iron deficiency. We aim to investigate to what extent menstrual bleeding is associated with ferritin and hemoglobin levels in female blood donors, and quantify the association of other menstruation‐related variables not currently accounted for by blood services (i.e., use of hormonal contraception, heavy menstrual bleeding) with iron deficiency or anemia. Material and Methods: The study population consisted of 473 premenopausal and 491 postmenopausal Dutch whole blood donors. Exclusion criteria were current pregnancy, BMI ≥50, ferritin ≥200, pictorial blood assessment chart (PBAC) ≥400, and age <18 or ≥70 years. Menstrual blood loss was quantified using a PBAC, a semiquantitative method to evaluate the number of used menstrual products and the degree of staining. We identified predictors of log(ferritin)/hemoglobin and iron deficiency/anemia using Bayesian linear and logistic regression models and quantified the average percentage of variance in log(ferritin) and hemoglobin explained by the covariates. Results: Menstrual blood loss accounted for most of the explained variance in hemoglobin (8%) and second only to the number of days since last donation for ferritin (8%). Heavy menstrual bleeding (PBAC ≥150, OR = 3.56 [1.45–8.85], prevalence 13%) was associated with anemia, and use of levonorgestrel‐releasing intrauterine device was negatively associated with iron deficiency (OR = 0.06 [0.01–0.44]). After statistical control for menstrual blood loss, age was not associated with iron status. Conclusions: Menstrual blood loss and blood donation were the most important determinants of iron status in premenopausal women. Thus, results suggest that accounting for menstrual blood loss in donation interval guidelines may benefit blood donors. [ABSTRACT FROM AUTHOR]

Background: Studies preceding the COVID‐19 pandemic found that slower time‐to‐return was associated with first‐time, deferred, and mobile drive blood donors. How donor return dynamics changed during the COVID‐19 pandemic is not well understood. Methods: We analyzed visits by whole blood donors from 2017 to 2022 in South Africa (SA) and the United States (US) stratified by mobile and fixed environment, first‐time and repeat donor status, and pre‐COVID19 (before March 2020) and intra‐COVID19. We used Kaplan–Meier curves to characterize time‐to‐return, cumulative incidence functions to analyze switching between donation environments, and Cox proportional hazards models to analyze factors influencing time‐to‐return. Results: Overall time‐to‐return was shorter in SA. Pre‐COVID19, the proportion of donors returning within a year of becoming eligible was lower for deferred donors in both countries regardless of donation environment and deferral type. Intra‐COVID19, the gap between deferred and non‐deferred donors widened in the US but narrowed in SA, where efforts to schedule return visits from deferred donors were intensified, particularly for non‐hemoglobin‐related deferrals. Intra‐COVID19, the proportion of donors returning within a year in SA was higher for deferred first‐time donors (>81%) than for successful first‐time donors (80% at fixed sites; 69% at mobile drives). Conclusions: The pandemic complicated efforts to recruit new donors and schedule returning visits after completed donations. Concerted efforts to improve time‐to‐return for deferred donors helped mitigate donation loss in SA during the public health emergency. [ABSTRACT FROM AUTHOR]

Background: Blood collection from donors on testosterone therapy (TT) is restricted to red blood cell (RBC) concentrates to avoid patient exposure to supraphysiological testosterone (T). The objective of this study was to identify TT‐related changes in RBC characteristics relevant to transfusion effectiveness in patients. Study Design: This was a two‐part study with cohorts of patients and blood donors on TT. In part 1, we conducted longitudinal evaluation of RBCs collected before and at three time points after initiation of T. RBC assays included storage and oxidative hemolysis, membrane deformability (elongation index), and oximetry. In part 2, we evaluated the fate of transfused RBCs from TT donors in immunodeficient mice and by retrospective analyses of NIH's vein‐to‐vein databases. Results: TT increased oxidative hemolysis (1.45‐fold change) and decreased RBC membrane deformability. Plasma free testosterone was positively correlated with oxidative hemolysis (r =.552) and negatively correlated with the elongation index (r = −.472). Stored and gamma‐irradiated RBCs from TT donors had lower posttransfusion recovery in mice compared to controls (41.6 ± 12 vs. 55.3 ± 20.5%). Recipients of RBCs from male donors taking T had 25% lower hemoglobin increments compared to recipients of RBCs from non‐TT male donors, and had increased incidence (OR, 1.80) of requiring additional RBC transfusions within 48 h of the index transfusion event. Conclusions: TT is associated with altered RBC characteristics and transfusion effectiveness. These results suggest that clinical utilization of TT RBCs may be less effective in recipients who benefit from longer RBC survival, such as chronically transfused patients. [ABSTRACT FROM AUTHOR]

Background: In May 2023, the Food and Drug Administration (FDA) released final guidance for blood donor eligibility that recommended the elimination of 3‐month deferral for men who have sex with men (MSM) and the related deferral for women who have sex with MSM. In its place, FDA introduced an individual risk assessment policy of asking all presenting blood donors, regardless of sex or gender, if they have had a new partner or more than one sexual partner in the last 3 months and deferring those who also report anal sex (penile–anal intercourse) during this period. We modeled the possible impact of this policy on the US blood donor base. Study Design and Methods: We developed a computational model to estimate the percentage of blood donors who would be deferred under a policy of individual HIV risk assessment. The model incorporated demographic information about donors and national survey data on HIV risk behaviors and included age and sex distributions and dependencies. Results: Our model estimates that approximately 1.2% of US blood donors would be deferred under the individual HIV risk assessment paradigm. Discussion: The model predicts a relatively minor effect of replacing the time‐based deferral for MSM with individual risk‐based deferral for sexual behavior. As US blood centers implement this new policy, the effect may be mitigated by donor gains, which warrant further study. The new policy is unlikely to adversely affect the availability of blood and blood components. [ABSTRACT FROM AUTHOR]

• Temporary deferral results in a substantial decrease in the return rate. • The adverse impact of deferral on the return rate is more pronounced among women, less educated donors, and first-time volunteers. • Providing clear and effective counseling that elucidates the purpose of deferral is crucial, particularly for first-time blood donors. The process of selecting blood donors is crucial for keeping the health of donors and ensuring the safety of the blood supply. However, it may create unpleasant feeling in those who are deferred. In this study, we aim to explore the return rates of Iranian deferred donors in comparison with eligible donors. The study included all whole blood donors referred between March 2017 and March 2018, who experienced temporary deferral for any reason. Donors who successfully donated blood during this period were also part of the study. Participants were followed up until their next donation attempt, spanning 4.8 years after initial inclusion. Then odds of return and median return time for both deferred and eligible donors were calculated. From 993,824 volunteers, 733,153 (73.77%) were eligible and 192,332 (19.35%) temporary deferred. The return rate in the eligible and deferred donors was 74.77% vs. 51.77%, respectively (OR:2.78; 99%CI: 2.71–2.81). Odds of return among deferred regular (OR = 7.02, 99%CI:6.64–7.42), men (OR: 2.57, 99%CI:2.45–2.69), and over 45 years (OR: 1.15, 99% CI: 1.09–1.20), was higher than first-time, women, and younger donors. The median return time for eligible and deferred donors was 315 (99%CI: 313–316) and 1,467(99%CI: 1,412–1,524) days, respectively. This study revealed the negative effect of deferral on the return rate, that led to a 23% reduction in the return of deferred donors. Avoiding unnecessary deferral through adherence to the standard operating procedure of donor selection and effective counselling which clarifies the purpose of deferral and encourages them to return after the deferral period ends are recommended. [ABSTRACT FROM AUTHOR]

• Approximately two-thirds of donors in Lebanon have adequate knowledge of blood donation; nevertheless, they exhibit reluctance to donate owing to apathy. • Merely 22.2% of donors are voluntary non-remunerated donors (VNRDs), with the remaining 77.8% being replacement donors. • The fragmented blood transfusion system, compounded by the continuous financial and socioeconomic turmoil, political inertia, and geopolitical disruptions, collectively impede the achievement of the World Health Organization's goal of achieving 100% VNRDs. • The active engagement of public authorities combined with the implementation of strategies gleaned from successful experiences in culturally akin neighboring countries, such as Morocco, are crucial for enhancing blood donation rates in Lebanon. The World Health Organization advocates for the achievement of 100% voluntary non-remunerated blood donation (VNRD) globally by the year 2020. However, until today, little was known in Lebanon regarding its actual rate or influencing factors, particularly donor motivations and behaviors. Therefore, the aim of this study was to assess the knowledge, attitudes, and practices of blood donors in Lebanon. The ultimate goals were to retain first-time donors, encourage them to become regular ones, and facilitate the transition from replacement donation to VNRD. A multi-centric cross-sectional study was carried across the five governorates in Lebanon. A self-administered and structured questionnaire was used in this survey. Results were presented in terms of odds ratios, with statistical significance defined at a P value of 0.05 and a 95% confidence interval. Additionally, a benchmarking analysis of the situation of blood donation in Lebanon was also conducted, identifying several areas for improvement. A total of 620 blood donors participated in this study, with 21.3% being first-time donors and 78.7% repeat donors. While the latter were primarily motivated by self-esteem, solidarity or returning a favor (89%, 77.9% and 78.1%), the main obstacle for becoming regular donors was a lack of initiative (34.6%). Female donors (9.9% of the total) exhibited better knowledge (OR = 2.20, p = 0.011) and were more inclined to donate voluntarily (OR = 1.52, p = 0.048). Conversely, male donors were more likely to be repeat donors, often through replacement donation (OR = 2.95, p = 0.001). There is a significant disparity between the low rate of voluntary donation in Lebanon (22.2%) and the relatively high proportion of donors with adequate knowledge of the donation process (60.5%). Therefore, urgent action by public authorities, based on the evidence based strategies outlined in this article, is crucial to enhancing the voluntary donation rate in Lebanon. [ABSTRACT FROM AUTHOR]

Background and Objectives: The RHCE gene plays an important role in the complex and polymorphic Rh blood group system. RHCE genotyping holds significant clinical and transfusion‐related implications. The objective of this study was to evaluate the accuracy of RHC/c genotyping in the Chinese Han population. Materials and Methods: Blood samples were obtained from 653 Chinese Han blood donors. The serological RhD and RhCcEe types were determined using monoclonal antibodies. Subsequently, multiplex real‐time polymerase chain reaction (PCR) analysis was performed for RHC and RHc genotyping. Additionally, exon 2 of RHCE and exon 1 of RHD were sequenced. Results: The analysis in this study found 443 RhD‐positive donors and 210 RhD‐negative donors. Among the 653 total donors, discrepancies between the RHC genotyping results and the serological results were found in 37 individuals. Specifically, 6 false‐positive RhC results in RhD‐positive donors and 28 false‐positive RhC results in RhD‐negative donors were identified based on c.48C in RHCE exon 1. Additionally, 3 false‐negative RhC results were observed in the RhD‐positive donors due to a 109 bp insertion in RHCE intron 2. RHc typing demonstrated complete consistency between the real‐time PCR and the serological results. Conclusion: In the Chinese Han population, RHC genotyping was reliable when consistent results were achieved by both c.48C‐based and 109 bp insertion‐based genotyping. Moreover, RHc genotyping based on c.203A and c.307C polymorphic loci demonstrated dependable performance. [ABSTRACT FROM AUTHOR]

This article presents a study on the distribution of cytochrome P450 (CYP450) alleles in the Danish population. CYP450 enzymes are important for drug metabolism, and genetic variations in the genes encoding these enzymes can impact drug response. The study compared genotype data from different genotyping platforms and found that the CYP2C19*17 and CYP2C9*2 alleles were more common than the CYP2C19*2 and CYP2C9*3 alleles. The results provide valuable insights into the genetic variability of these enzymes in the Danish population and suggest that the Illumina GSA platform could be useful for identifying drug-gene interactions. [Extracted from the article]

Background: Patient safety is seriously threatened by bacterial infections that spread through blood transfusions (TTBI). It has been noticed that a number of infectious viral, bacterial, and parasitic pathogens are involved as barriers to the patient's blood safety. This study aimed to determine the antibiotic resistance pattern of bacteria in the donors’ blood attending Federal Medical Centre, Birnin Kebbi, Kebbi State, Nigeria. Methods: The study adopted a cross-sectional research design. A structured questionnaire was administered to 120 blood donors to obtain bio-demographic information and their blood was collected accordingly. The blood samples were processed using standard bacteriological analysis. The isolated bacteria was confirmed using standard biochemical tests. The identified bacteria were subjected to antibiotic testing using the Kirby-Bauer disc diffusion method. Results: Twenty-four 24(20.0%) blood samples were found contaminated with bacteria. The main bacteria isolates were Gram-negative organisms namely- Klebsiella oxytoca (20.8%), Citrobacter diversus (16.7%), Enterobacter aerogene (16.7%), Shigella sonnei (12.5%), Shigella dysentrae (4.2%), Morganella morganii (4.2%), Escherichia coli (4.2%) with only Staphylococcus aureus (20.8%) as Gram-positive bacteria. The prevalence rate of TTBIs was high within the age group 36-49 years 12(50.0%). Morganella morganii was (100%) resistance to all the antibiotics used in this study. Conclusions: the study revealed that, donors’ blood was contaminated with Gram-negative bacteria which are capable of causing sepsis and which may result in death. Therefore, it is recommended that screening for bacterial infections should be done routinely because of the threat it posed as seen in Federal Medical Centre, Birnin Kebbi, Kebbi state, Nigeria. [ABSTRACT FROM AUTHOR]

Blood donation services seek new strategies to improve donor relationships and increase donor retention. In this study, we propose a novel strategy that employs appeals with feedback on the use of blood donors' past donations. We theorize that this feedback increases the perceived relationship investment and, subsequently, the quality of the relationship with the blood donation service, thereby increasing redonations. An online experiment shows the positive effect of past donation use appeals on donation intention and transmission through perceived relationship investment and relationship quality. Three field studies with Red Cross Blood Donation Services confirm the effectiveness of past donation use appeals on redonation behavior compared with thank-you appeals and with a future donation use appeal. Past donation use appeals are effective for retention purposes, especially for more experienced donors and when sent shortly after the donation. Such appeals also lead to higher reactivation rates of inactive donors. In addition to having practical implications, the study contributes to the relationship and nonprofit service literature. [ABSTRACT FROM AUTHOR]

Objective: To describe coronavirus disease 2019 (COVID‐19) mitigation measures in workplaces of employed US blood donors by industry and work arrangement. Methods: During May–December 2021, blood donors responded to a survey; we describe the distribution of reported workplace mitigation measures by industry and work arrangement, organized using the hierarchy of controls. Results.: Of 53,433 respondents representing 21 industries, ventilation upgrades were reported by 4%–38% of respondents (overall: 20%); telework access ranged from 14%–80% (53% overall). Requiring masks (overall: 84%; range: 40%–94%), physical distancing (77%; 51%–86%), paid leave for illness (70%; 38%–87%), and encouraging vaccination (61%; 33%–80%) were common. Independent workers reported fewer mitigation measures than those in traditional employment settings. Conclusions: Mitigation measures varied by industry and work arrangement. Some mitigation measures may be challenging to implement or irrelevant in certain industries, supporting the idea that mitigation is not a one‐size‐fits‐all strategy. Policy Implications: Tailored strategies to mitigate workplace risks of disease transmission are vital. Strategies should rely on effective methods for identifying workplace controls (e.g., through the hierarchy of controls) and account for industry‐specific characteristics and workplace environments. [ABSTRACT FROM AUTHOR]

Anti‐Spike IgG antibodies against SARS‐CoV‐2, which are elicited by vaccination and infection, are correlates of protection against infection with pre‐Omicron variants. Whether this association can be generalized to infections with Omicron variants is unclear. We conducted a retrospective cohort study with 8457 blood donors in Tyrol, Austria, analyzing 15,340 anti‐Spike IgG antibody measurements from March 2021 to December 2022 assessed by Abbott SARS‐CoV‐2 IgG II chemiluminescent microparticle immunoassay. Using a Bayesian joint model, we estimated antibody trajectories and adjusted hazard ratios for incident SARS‐CoV‐2 infection ascertained by self‐report or seroconversion of anti‐Nucleocapsid antibodies. At the time of their earliest available anti‐Spike IgG antibody measurement (median November 23, 2021), participants had a median age of 46.0 years (IQR 32.8–55.2), with 45.3% being female, 41.3% having a prior SARS‐CoV‐2 infection, and 75.5% having received at least one dose of a COVID‐19 vaccine. Among 6159 participants with endpoint data, 3700 incident SARS‐CoV‐2 infections with predominantly Omicron sublineages were recorded over a median of 8.8 months (IQR 5.7–12.4). The age‐ and sex‐adjusted hazard ratio for SARS‐CoV‐2 associated with having twice the anti‐Spike IgG antibody titer was 0.875 (95% credible interval 0.868–0.881) overall, 0.842 (0.827–0.856) during 2021, and 0.884 (0.877–0.891) during 2022 (all p < 0.001). The associations were similar in females and males (Pinteraction = 0.673) and across age (Pinteraction = 0.590). Higher anti‐Spike IgG antibody titers were associated with reduced risk of incident SARS‐CoV‐2 infection across the entire observation period. While the magnitude of association was slightly weakened in the Omicron era, anti‐Spike IgG antibody continues to be a suitable correlate of protection against newer SARS‐CoV‐2 variants. [ABSTRACT FROM AUTHOR]

Background: Blood donation is an essential and most important part of the health care system across the world. It becomes necessary to know the root cause of individuals who are willing to donate the blood but deferred on some grounds. Aim and Objectives: The aim of this study is analysis of such deferrals so as to promote voluntary blood donation practice in our health-care system. The objectives of this study are to promote voluntary blood donation, provide safe blood and blood components/products to the recipients, ensure the safety and well-being of blood donors and make strategies to retain already motivated but deferred donors. Materials and Methods: A prospective observational study was done during the period January 2021-December 2021 at blood center of S.B.K.S. MI & RC, Dhiraj Hospital, Vadodara. All individuals willing for whole blood donation were subjected to detailed history taking and general physical examination and were either accepted or denied for blood donation using the standard blood donor guidelines. Pre-donation deferred individuals and their data were then thoroughly analyzed. Results: A total of 2168 individuals reported at blood center for whole blood donation out of which 311 donors (14.34%) were deferred. Of all deferred donors, male-to-female ratio of deferral found out to be 4.02:1. Two hundred and forty-nine deferrals (80.06%) were males while 62 deferrals (19.94%) were females. Two hundred and seventy-two deferrals (12.54%) were deferred temporarily while 39 deferrals (1.79%) were permanent. Youngest deferred donor was aged 18 years while the eldest was 59 years. Low hemoglobin cases were 134 making it 43.09% of all reasons of deferring a pre-donation whole blood donor. Conclusion: Low hemoglobin (<12.5 gm%) was the leading cause of deferrals accounting for 43.09%. The majority of the deferrals were temporary where the cause can be treated or eliminated. Such donors need to be remotivated and bring them back to the donor pool so that maximum blood donation which indeed is a life-saving measure can be promoted. Furthermore, the analysis done by doing such study can help to promote the blood donation on a large scale and not only saving many lives but also create awareness among the society. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) remains a public health concern. Blood donors screened for HBV surface antigen (HBsAg) along with aspartate transaminase (AST)/alanine aminotransferase (ALT) could play a key in providing safe blood products. We investigated the features related to HBV infection among rejected blood donors in Luanda, Angola. Methods: This was a cross‐sectional study conducted with 164 rejected donors. Donors were screened for HBsAg from March to May 2022. Overall, 63.4% tested positive for HBV. Results: The mean age of the HBV‐positive (29.2 ± 8.02) was lower than the HBV‐negative (33.9 ± 10.0) (p < 0.001). Donors between 20 and 40 years (odds ratio [OR]: 2.34, p = 0.045), females (OR: 1.40, p = 0.516), residents in urbanized areas (OR: 1.23, p = 0.530), low educational (OR: 1.54, p = 0.458), unemployed (OR: 1.65, p = 0.271), and unmarried (OR:1.41, p = 0.616) might be likely to contract HBV. AST/ALT ratio was higher in HBV‐infected (2.07 ± 1.42) than in HBV‐uninfected (1.90 ± 1.14). About 20% of HBV‐positive were classified as having acute liver disease, while 80% with chronic liver disease, based on AST/ALT ratio. Age ranged from 20 to 40 years (OR: 1.97, p = 0.305), females (OR: 1.61, p = 0.557), donors from non‐urbanized (OR: 1.69, p = 0.557), a low educational (OR: 1.64, p = 0.571), and unemployed donors (OR: 1.81, p = 0.289) were likely to develop chronic liver disease. Conclusions: Our findings indicated the failure of viral hepatitis control measures. Authorities should consider including HBV nucleic acid testing to ensure early identification of HBV in Angola. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic has had significant health and socioeconomic impacts worldwide. Extensive measures, including contact restrictions, were implemented to control the spread of the virus. This study aims to examine the factors that influenced private and professional contact behaviour during the COVID-19 pandemic. Results: We used baseline data (January–April 2021) from the SeMaCo study (Serologische Untersuchungen bei Blutspendern des Großraums Magdeburg auf Antikörper gegen SARS-CoV-2), a longitudinal, regional cohort study assessing COVID-19 seroprevalence in blood donors from Magdeburg and surrounding areas in Germany. In the blood donor cohort (n = 2,195), there was a general reduction in private contacts (by 78.9%) and professional contacts (by 54.4%) after March 18, 2020. Individuals with higher education reduced both private (by 84.1%) and professional (by 70.1%) contacts more than those with lower education levels (private contacts 59.5%; professional contacts 37%). Younger age groups (18–30 years) reduced private contacts more frequently (by 85.4%) than older individuals (61–83 years, by 68.6%) and demonstrated a higher likelihood of private contact reduction compared to older age groups (51–60 years: odds ratio (OR) 0.45 [95% [CI] 0.32–0.65]; 61–83 years: OR 0.33 [95% [CI] 0.22–0.48]). [ABSTRACT FROM AUTHOR]

Background and Objectives Materials and Methods Results Conclusion There is a growing infectious syphilis outbreak in Western Canada. Although blood donors are screened for syphilis risks, some blood donors will still be confirmed test‐positive for syphilis. This study compares the characteristics of confirmed test‐positive syphilis donations in both Western Canada and Eastern Canada, November 2022–August 2023.Donors were defined as Western or Eastern Canadian. Blood donations were tested for syphilis using the PK‐TP assay (Beckman Coulter PK7300 Automated Microplate System). Confirmatory Treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR) assays were performed by one of two reference laboratories. An RPR titre ≥1:8 was used as a proxy for possible infectious syphilis.Rates of laboratory‐confirmed syphilis were higher in Western (n = 43, 13.4/100,000 donations) versus Eastern donors (n = 19, 4.7/100,000 donations; Fisher's exact test, two‐sided, p ≤ 0.0001). Most syphilis confirmations were in first‐time donors (Western Canada n = 31/43, 72.1%, Eastern Canada 12/19, 63.2%).Although rates of laboratory‐confirmed syphilis were higher in Western versus Eastern donors, Western donors did not have higher rates of infectious syphilis. Further studies might assess whether donors with laboratory‐confirmed syphilis understood pre‐donation screening questions or were completely unaware of a past infection. [ABSTRACT FROM AUTHOR]

Background and Objectives Materials and Methods Results Conclusion The risk of transfusion‐transmitted malaria (TTM) infections is extremely low in Australia, and the cost‐effectiveness of the current screening strategy has not been assessed. This study aims to conduct a cost‐effectiveness analysis of different malaria screening strategies in blood donors as part of the risk‐based decision‐making framework.A decision tree model was developed to assess the cost‐effectiveness of five alternative malaria screening strategies from a healthcare sector perspective. Screening strategies combining total or partial removal of malaria testing with different deferral periods were considered. The probabilities of developing severe and uncomplicated TTM were based on a literature review of cases in non‐endemic areas since 2000. The health outcomes were quantified using disability‐adjusted life years. The costs of non‐returning donors due to deferral were also included. Deterministic and probabilistic sensitivity analyses were conducted to account for data uncertainty.The residual risks for all strategies were so low that the costs, mortality and morbidity associated with TTM are almost negligible. The overall costs were predominantly influenced by the costs of non‐returning blood donors. As a result, removal of malaria testing and applying a 28‐day deferral for at‐risk donors were the least costly and most cost‐effective of all the options considered.The current screening strategy for malaria in blood donors in Australia is not an efficient use of healthcare resources. Partial or total removal of malaria testing would bring significant cost savings without significantly compromising blood safety. [ABSTRACT FROM AUTHOR]

Background and Objectives Materials and Methods Results Conclusion To reduce the risk of transfusion‐transmitted malaria (TTM) from transfusible components, Australia tests for malaria antibodies in both travellers returning from and former residents of malaria‐endemic areas. The testing is performed a minimum of 120 days after last potential exposure. TTM is an extremely rare event and managing the risk adds considerable complexity. The objectives of this study were to analyse various testing and deferral strategies, considering the risk, donation numbers and operational complexities.A residual risk model was developed to calculate the risk of TTM in five testing/deferral strategies. Australian blood donor data from 2020 and 2021 were used and incorporated the incidence of parasitaemia, Plasmodium species and the malaria enzyme immunoassay test's failure rate. Donor and donation loss or gain and an operational assessment were performed.The current model's estimated risk of TTM is 1 in 67.9 million transfused units. Testing residents with a 120‐day plasma restriction for visitors without testing was found to have the same estimated risk, with an expected increase of 342 donations per year, significant cost savings and a 62% reduction in the number of donors requiring assessment.A strategy that involves testing residents of malaria areas only and a 120‐day plasma travel restriction would not significantly increase the risk of TTM, is operationally simpler, costs less and results in a small increase in donations. [ABSTRACT FROM AUTHOR]