Evaluation Of The Reasons For Pre- Donation Deferral Of Prospective Blood Donors In A Tertiary Teaching Hospital In North India
S Awasthi, S Dutta, A Haritwal, M Ansari, N Arathi, D Agarwal
S Awasthi, S Dutta, A Haritwal, M Ansari, N Arathi, D Agarwal. Evaluation Of The Reasons For Pre- Donation Deferral Of Prospective Blood Donors In A Tertiary Teaching Hospital In North India. The Internet Journal of Public Health. 2009 Volume 1 Number 1.
Whole blood donors deferral, either temporarily or permanently is an important step in improving the safety of blood transfusion. This retrospective study quantifies and analyzes the rate and reasons of donor deferral in a tertiary teaching hospital. All pre-donation deferral of prospective blood donors (n= 352) over a period of two years (1 June 2008 to 31 May 2010) were analyzed. Of these 10.4% were deferred from donation and among these deferrals, majority (83%) were temporarily deferred and only few (17%) were permanently deferred. The most common reason for deferral was low hemoglobin count (33.5%), closely followed by hypertension (11.1%) and alcohol intake in last 24 hours (10.8%). The three most common reasons for temporarily deferral (anemia 33.5%, alcohol intake in last 24 hrs 10.8% and low weight 8.81%) accounted for more than half of the total deferrals. More than 50% of female donor deferrals were due to low hemoglobin count (n=28).
Blood banking is one of the pillars of modern medicine but simultaneously it carries the potential risk of transmitting lethal infectious diseases. Hence the proper pre-screening of the blood donors is essential to ensure quality of donors and to avoid risk of transfusion transmitted diseases to the recipient. Various efforts have been made for ensuring a safe blood donor selection through screening and education. By the process of screening donors are deferred for several reasons related to the donor as well as recipient safety. It is very essential to study and analyze the reasons for such deferral among prospective donors in order to categorize them into temporary and permanent deferrals. The objective of this study is to assess the current rate and reasons for donor deferral so that temporarily deferred donors with corrective reasons can be identified, properly informed and guided to improve their quality and thus later on continuous blood supply can be maintained.
Material And Method
A retrospective study of pre-donation deferral of prospective blood donors at a blood bank in tertiary teaching hospital in North India (U.P.) is conducted. Based on the history and physical examination findings, all blood donors coming to the blood bank were classified in to fit for donation or as a deferred donor. Records of all pre-donation deferral over a period of two years (1 June 2008 to 31 May 2010) were analyzed to quantify the deferral rate and reasons. Deferred donors were also analyzed according to gender.
Total 3388 pre-donation screening interviews were conducted over the period of two years out of which 3036 (89.6%) were found fit for donation. Total 352 (10.4%) donors were found unfit for various reasons and were deferred. Among the deferred donors, 297 (84.4 %) were males and 55 (15.6 %) were females (male-female ratio 5.4:1). Majority of deferral was due to temporary reasons (n=292, 83%) and very few (n=60, 17%) donors were permanently deferred. The causes of deferral in the temporary and permanent groups are shown in the Table -1. The most common reason for overall deferral was low hemoglobin count (33.5%), closely followed by hypertension (11.1%) and alcohol intake in last 24 hours (10.8%); accounting for more than half of the total deferrals. The four leading causes of deferral among males and females are given in Table-2
Discussion And Conclusion
One of the most important steps in improving the safety of blood and blood products is donor selection. Insight into the reasons of donor deferral is very important to avoid the permanent loss of the donor as blood donation programme is the life-force of any blood bank and hospital.
Most of the donors in our study were males 84.4% and females accounted for only 15.6% of donors. The donor deferral rate in our study was 10.4% and 7.1% were deferred for more than one reasons. Zou
The most common cause for deferral in our study was anemia 33.5%, closely followed by hypertension 11.1%, alcohol (intake in last 24 hrs) 10.8 % and low weight 8.8%. Arsalan
The second common cause of temporary deferral in our study was alcohol intake in last 24 hrs (10.8%). Such high percentage has not been shown by any other study and this probably reflects the regional life-style.
A very important and different observation in our study was that a significant number of donors (6.3%) were deferred due to receiving anti-tubercular treatment or recent history of tuberculosis. Such a high percentage of deferral due to tuberculosis possibly reflects the high prevalence of tuberculosis infection in the Indian population (WHO, 2008) despite of all the meticulous efforts being done for TB control programme, launched in 1997 (Park, 2007).
In this study 17% of donors were deferred for permanent reasons and the most common reason for the permanent deferral was hypertension 11.1 %. Arsalan
The deferral of donor due to any reason has a very negative impact and many temporarily deferred potential donors do not return to donate blood in the future. Zou