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Background: Syphilis infections among volunteer blood donors increased rapidly in recent years. It is important to analyze the demographics of seropositive donor groups and help to recruit donors from low-risk population. Objective: The aim of this study was to analyze the syphilis prevalence among volunteer blood donors in Jinan Blood Center and give direction to blood recruitment. Methods and Materials: A cross-sectional study was conducted among blood donors in Jinan, China. Socio-demographic data and blood donation testing data from January 2007 to December 2021 were extracted from the database of blood management software of Jinan Blood Center for analysis. All blood samples were screened by ELISA, and those anti-TP-positive samples were counted and analyzed by sex, age, educational background, occupation and blood donation times. Logistic regression was used to explore risk factors associated with syphilis infection. Results: Totally 700,757 blood samples were collected in the study during 2007 to 2021, 2290 cases were detected anti- TP positive with a positive rate of 0.33%. Female, 35-44 years old, with a lower education degree, farmers and first-time donors were the high-risk subgroups. Conclusion: Consultation and identification of high-risk population groups should be improved. Measures should be taken to make the donor recruitment more professional and detailed. Keywords: transfusion-transmitted infections, volunteer blood donors, syphilis, China

The blood transfusion (BT) system in Pakistan is fragmented, demand-driven and depends on weakly regulated transfusion practices. There is a considerable possibility that transfusion-transmissible infections (TTIs) are contributing to the current epidemic of hepatitis B virus (HBV) and hepatitis C virus (HCV) (affecting 7.4% of the general population) in the country. To study this issue, we conducted a systematic review to identify articles related to TTIs and transfusion safety in Pakistan from January 1, 2010 to January 31, 2020. A review of 33 articles met the final criteria for qualitative synthesis. Analysis of these studies showed a cumulative frequency of HBV 2.04%, HCV 2.44%, HIV 0.038%, syphilis 1.1% and malaria 0.11%. The frequency of coinfections among blood donors varied from 0.0099% to 0.35%. The highest number of coinfections were HCV and syphilis, followed by HCV and HBV infections. Syphilis and malaria were tested in only 38% and 46% of all the blood donations in one study. The rate of voluntary non-remunerated donations (VNRDs) was less than 13%, and male donors were 95% to 100% in these studies. There was a significant difference in the frequency of HBV and HCV in VNRDs (0.48%) as compared to replacement donors (RDs) (4.15%). In short, this review shows a high frequency of TTIs, especially HBV, HCV and syphilis in the blood donor population in Pakistan. There is a high dependency on RDs, minimal use of healthy voluntary blood donation practices, inadequate screening of high-risk donors, repeated collections of the blood from RDs, poor quality of screening methods and limited knowledge of donor health. Without standardized safe transfusion practices, there will be an ongoing increase in transmission of TTIs, especially HBV, HCV, syphilis, and HIV leading to a significant adverse public health impact. Keywords: transfusion-transmitted infections, hepatitis B, hepatitis C, HIV, syphilis, malaria

Background New and emerging transfusion–transmitted infections remain a threat to the blood supply. Blood donors are currently screened for less than half of known agents, primarily by individual tests. A screening platform that could simultaneously detect all known transfusion–transmitted pathogens and allow rapid addition of new targets would significantly increase blood safety and could improve the response to new agents. We describe the early stage development and validation of a microarray-based platform (pathogen chip) for simultaneous molecular detection of transfusion–transmitted RNA viruses. Methods Sixteen RNA viruses that pose a significant risk for transfusion–transmission were selected for inclusion on the pathogen chip. Viruses were targeted for detection by 1769 oligonucleotide probes selected by Agilent eArray software. Differentially concentrated positive plasma samples were used to evaluate performance and limits of detection in the context of individual pathogens or combinations to simulate coinfection. RNA-viruses detection and concentration were validated by RT-qPCR. Results Hepatitis A, B and C, Chikungunya, dengue 1–4, HIV 1–2, HTLV I–II, West Nile and Zika viruses were all correctly identified by the pathogen chip within the range of 10 5 to 10 2  copies/mL; hepatitis E virus from 10 5 to 10 4 . In mixtures of 3–8 different viruses, all were correctly identified between 10 5 and 10 3 copies/mL. Conclusions This microarray-based multi-pathogen screening platform accurately and reproducibly detected individual and mixed RNA viruses in one test from single samples with limits of detection as low as 10 2 copies mL.

Screening of blood and blood products is important to reduce the risk of transfusion transmitted infections (TTIs). The transfusion of unscreened or inadequately screened blood and blood products are the major source of TTIs. The aim of this paper is to find out the prevalence of TTIs in ABO blood groups and Rh type system. A total of 4128 blood donors were screened from January 2010 to April 2014. Serological tests were performed for hepatitis B surface antigen (HBsAg), anti hepatitis C virus (Anti-HCV), anti HIV-1 and 2, venereal disease research laboratory test (VDRL) and malaria parasite (MP) antigen. In seroreactive donors, HBsAg, Anti-HCV, VDRL, MP antigen and anti HIV were positive in 40 cases, 26 cases, 19 cases, 6 cases and 2 cases, respectively. Highest percentage of HBsAg, Anti HCV, VDRL, MP antigen and anti HIV was observed in blood group A negative (2/50), O negative (1/66), B negative (1/91), AB positive (2/377) blood group respectively. In the present study, the total number of Rh-negative donors is lower when compared to Rh-positive blood donors, but Rh-negative blood donors show higher percentages of seroreactivity for TTIs. Larger scale studies at molecular level are required to improve the knowledge of this aspect.

The establishment of systems to ensure that all donated blood is screened for transfusion-transmissible infections is a core component of every national blood program. Globally, however, there are significant variations in the extent to which donated blood is screened, the screening strategies adopted and the overall quality and effectiveness of the blood screening process. As a result, in many countries the recipients of blood and blood products remain at unacceptable risk of acquiring life-threatening infections that could easily be prevented.These recommendations are designed to support countries in establishing effective national programs to ensure 100% quality-assured screening of donated blood for transfusion-transmissible infections. In countries where systems are not yet fully in place, the recommendations will be helpful in instituting a step-wise process to implement them.

Background: Hepatitis E is a fecal orally transmitted disease and an emerging transfusion transmissible infection with potential transfusion safety implications. Hepatitis E Virus screening among blood donors is not routinely done despite the fact that it is endemic in India. As there are very few reports and evidence, the justification for mandating HEV screening among blood donors is still only marginally convincing. Therefore, the present study was carried out to determine the incidence and prevalence of HEV infection among blood donors in Coastal Karnataka, India. Methods: This cross-sectional study was conducted in a tertiary care hospital in Udupi district of Karnataka, India. A total of 1939 blood donors were randomly selected between June 2020 to June 2022 to participate in the study, where anti-HEV IgM antibody screening was performed using HEV IgM ELISA test kit (DiaPro, Italy). Further, a randomly selected 588 and 1620 pooled donor samples were screened for anti-HEV IgG antibodies and HEV RNA, respectively. Results: The overall prevalence of HEV IgM antibodies among study application is found to be 1.39%, with a statistically significant difference between males and females (n=20, 1.18% vs. n=7, 3.07 %; p=0.027). The prevalence of HEV IgG antibodies was 11.39%. Exposure to agriculture, animal husbandry, and poor hand hygiene were significant risk factors for HEV IgG reactivity. Conclusions: Given the high prevalence of HEV viral markers in the study population, routine screening of blood donors for risk factors and implementation of serologic testing in endemic areas may be considered.

This study was aimed at determining the prevalence estimate and association of transfusion-transmitted infections (TTIs) with ABO and Rh blood groups among blood donors at the King Faisal Specialist Hospital and Research Center (KFSH & RC) in the western region of Saudi Arabia. A retrospective study was conducted at the blood bank center of KFSH and RC from 1 January 2013 to 31 December 2019. Data on ABO and Rh blood group testing, serological testing, molecular investigations, serological assays, nucleic acid testing (NATs), and socio-demographic information were gathered. During the study period, there were 959,431 blood donors at the KFSH and RC. The overall 7-year cumulative prevalence estimate of blood transfusion-transmitted infections among blood donors was low at 7.93%, with an average prevalence estimate of 0.66%. Donors with the O blood group, the O RhD +ve blood group, in particular, were more at risk of developing TTIs, whereas donors with the AB blood group, the AB RhD −ve blood group, in particular, were at the lowest risk of developing TTIs. In total, 96.9% of the blood donors were males (n = 916,567). Almost half of the blood donors belong to the O blood group (49.4%). A total of 861,279 (91.0%) donors were found to be RhD positive. The percentages of TTIs were found to be higher in RhD +ve donors compared with RhD −ve donors. The prevalence estimate of the hemoglobin C (HbC) infection was the most common TTI among the blood donors being 3.97%, followed by malaria being 2.21%. The least prevalence estimate of TTI in the present study was for NAT HIV being 0.02%. Significant associations were observed between RhD +ve and RhD −ve among the malaria-infected donors (A: χ2 = 26.618, p = 0.001; AB: χ2 = 23.540, p = 0.001; B: χ2 = 5.419, p = 0.020; O: χ2 = 68.701, p = 0.001). The current 7-year retrospective study showed a low level of TTIs among blood donors. However, we urge that more research encompassing the entire country be conducted in order to obtain more representative results in terms of the prevalence estimate and association of transfusion-transmitted infections with ABO and Rh blood groups in communities.

Background and Objectives: Transfusion-transmitted infections (TTIs) impose a considerable healthcare burden globally. Despite rigorous screening protocols, these infections can still be present among apparently healthy blood donors, potentially compromising the safety of transfusion recipients. Understanding the frequency of TTIs among blood donors is crucial for ensuring a healthy blood supply and gaining insights into the epidemiology of these infections within a community. Materials and Methods: The main objective of this study is to determine the frequency of TTIs among healthy blood donors, aged 18 to 60 years, at King Abdulaziz Hospital in Makkah City, Saudi Arabia. Data was collected retrospectively at the blood bank center from 1 January 2023, to 31 December 2023. Results: There were 8831 blood donors included. Saudi participants emerged as the dominant nationality, comprising 57% of the total sample (5036 out of 8831 donors). The prevalence of TTIs among blood donors varied according to the individual markers used. The overall TTI reactivity rates were low. Anti-HBc was the most common TTI-positive marker (7.5%), followed by syphilis (0.5%), HBV NAT (0.3%), HBsAg, and anti-HCV (0.3%). On the other hand, the lowest TTI-positive markers were HIV-1/-P2 and HTLV-1/-2 (0.04%). In Saudi participants, the most prevalent TTI marker was anti-HBc with a rate of 5.8% (293 out of 5036), followed by HBsAg (0.3%), syphilis (0.3%), and HBV NAT (0.2%). Conclusions: The present study found that HBV outperformed other TTI markers compared to the regional reports. However, in our research and the earlier reports, the rates of seropositive patients were noticeably low for HIV, HTLV, and malaria, while the rate for syphilis was higher, particularly among non-Saudi donors. NAT assays are crucial for screening blood donations for TTIs, which can help the early detection of infections and significantly reduce serological window periods. For a precise estimation of the frequency of TTIs, large prospective multicenter studies from various regions of the KSA are required.

Background Transfusion-transmitted infections (TTI) are among the most critical challenges of blood transfusion. Patients with lower health literacy can have adverse consequences for blood transfusion and due to the lack of standard tools for measuring health literacy related to TTI, this study was conducted to develop a standardized tool for assessing Health literacy associated with TTI. Aim This study aimed to develop a standardized tool for assessing Health literacy related to TTI. Material and Methods This study was a cross-sectional analytical study of the tool development and validation type, according to the definitions provided for health literacy, questions were designed in the five areas of search, understanding, evaluation, decision-making, and application. The questionnaire was provided to relevant experts to evaluate the content validity with a qualitative and quantitative approach. After making corrections according to the experts’ opinions, the Content Validity Index (CVI) and the Content Validity Ratio (CVR) were checked. It was given to people who were at least literate in reading and writing levels to check the quantitative and qualitative face validity. Finally, the structural validity of the tool was checked by performing a confirmatory factor analysis and its reliability by calculating Cronbach's Alpha. Results The CVR and CVI had an average of 0.86 and 0.93 respectively. The reliability of the questionnaire was calculated using Cronbach's alpha coefficient of 0.744. In examining the structural validity of the tool, the root mean squared error (RMSE) index was less than 0.0001, the Goodness of Fit Index (GFI) was 0.975, the Adjusted Goodness of Fit Index (AGFI) was 0.957, Bentler and Bonnet's Normed Fit Index (NFI) was 1 and Comparative Fit Index (CFI) was 0.856. Conclusion The tool developed is reliable and valid, and can be used to measure the level of health literacy related to transfusion-transmitted infections.

Background Red blood cell (RBC) transfusion is a critical supportive therapy in cardiovascular surgery (CVS). Donor selection and testing have reduced the risk of transfusion-transmitted infections; however, risks remain from bacteria, emerging viruses, pathogens for which testing is not performed and from residual donor leukocytes. Amustaline (S-303)/glutathione (GSH) treatment pathogen reduction technology is designed to inactivate a broad spectrum of infectious agents and leukocytes in RBC concentrates. The ReCePI study is a Phase 3 clinical trial designed to evaluate the efficacy and safety of pathogen-reduced RBCs transfused for acute anemia in CVS compared to conventional RBCs, and to assess the clinical significance of treatment-emergent RBC antibodies. Methods ReCePI is a prospective, multicenter, randomized, double-blinded, active-controlled, parallel-design, non-inferiority study. Eligible subjects will be randomized up to 7 days before surgery to receive either leukoreduced Test (pathogen reduced) or Control (conventional) RBCs from surgery up to day 7 post-surgery. The primary efficacy endpoint is the proportion of patients transfused with at least one study transfusion with an acute kidney injury (AKI) diagnosis defined as any increased serum creatinine (sCr) level ≥ 0.3 mg/dL (or 26.5 µmol/L) from pre-surgery baseline within 48 ± 4 h of the end of surgery. The primary safety endpoints are the proportion of patients with any treatment-emergent adverse events (TEAEs) related to study RBC transfusion through 28 days, and the proportion of patients with treatment-emergent antibodies with confirmed specificity to pathogen-reduced RBCs through 75 days after the last study transfusion. With ≥ 292 evaluable, transfused patients (> 146 per arm), the study has 80% power to demonstrate non-inferiority, defined as a Test group AKI incidence increase of no more than 50% of the Control group rate, assuming a Control incidence of 30%. Discussion RBCs are transfused to prevent tissue hypoxia caused by surgery-induced bleeding and anemia. AKI is a sensitive indicator of renal hypoxia and a novel endpoint for assessing RBC efficacy. The ReCePI study is intended to demonstrate the non-inferiority of pathogen-reduced RBCs to conventional RBCs in the support of renal tissue oxygenation due to acute anemia and to characterize the incidence of treatment-related antibodies to RBCs.