<p>Since the discovery in 1989 of hepatitis C virus (HCV) as the infectious agent responsible for the vast majority of post-transfusion non-A non-B hepatitis, blood transfusions are no longer a source for HCV transmission in Sweden. Anti-HCV testing was implemented for all blood donations in 1992. Since then intravenous drug use (IDU) has become the major route of transmission in the western world. Six genotypes and more than 80 subtypes of HCV have now been identified world-wide. These genotypes and subtypes are determined by genetic divergences between the HCV strains. Subtypes 1a, 1b, 2b, 2c, and 3a have global spread, while the other subtypes have a more limited geographical distribution. Little was known on the prevalence of HCV among blood donors and on which genotypes and subtypes of HCV were circulating in Sweden before the testing of all blood donations was implemented. The prevalence of anti-HCV was therefore investigated in sera sent to the Swedish Institute for Infectious Disease Control (SMI) from 412 patients; 241 were sampled between 1970 and 1991 before the universal screening in 1992, while 171 were sampled between 1992 and 2002. The samples derived from 193 (47%) blood donors, (104 sampled before, and 89 after 1992), and from seven other groups of patients. Two groups had suspected known routes of infection, intravenous drug use (IDU) 33 patients and hemodialysis, 16 patients, while it was unknown for the other patients. Anti-HCV was detected in 120 (29%) samples. The highest frequency was found among IDUs, (91%). Before general screening was implemented, 2.8% of the blood donors were positive for hepatitis C, whereas 28% of those sampled after 1992 were anti-HCV positive. Those latter samples were sent to SMI due to anti-HCV reactivity in a primary test at the blood centre. HCV RNA could be detected by PCR in 56 (47%) of the anti-HCV positive samples, the subtype could be determined by sequencing in 45 (80%) of those. The subtypes found were 1a in 31 %, 1b in 18%, 2b in 22%, and 3a in 27%. One sample was of subtype 2c. There was a tendency of increase of genotype 2 and a decrease in subtype 1a with time. 1a was found in 38% of the samples collected before 1992, while it was only found in 19% of the samples from 1992 or later. On the other hand genotype 2 was found in 17% sera sampled before 1992 and in 37% of the samples collected 1992 or later. It is not known if this genotype has recently been introduced into Sweden. Further analysis on larger series of samples is needed to confirm these preliminary results.</p> / AcknowledgmentsI would like to express my gratitude to several people who have been supportive in different ways throughout this project.First of all, I want to thank my supervisor Helene Norder, for giving me the possibility to do my diploma thesis at the Department of Virology, Swedish Institute for Infectious Disease control (SMI) and for helping me during this study and for the many insightful conversations during the design and development stages of the application, and also for the many helpful comments and suggestions on the text of the thesis.I want to express my appreciation to my laboratory supervisor Regina Wallin, Camilla Jern and Josefine Ederth for helping me during the procedure for this study. Then, I want to thank my examiner Magnus Johansson from the Södertörns university collegefor his advice on writing this paper. Finally, I would like to thank my family and specially my mother Bahar Hamid for always supporting me during my whole life.Last, but not least, I would like to thank my friends Annika Andersson and Yourdons Yemane for being encouraging, understanding and always supportive.

Objective: To describe and compare the characteristics of blood donors and non-donors and to examine factors associated with donation, including motivators and barriers of blood donation in Guangzhou, China. Design: Cross-sectional survey using self-administered standardized structured questionnaires on both donors and non-donors. Setting: 12 mobile and 4 permanent blood donation stations in Guangzhou during the whole operation time. Participants: 500 blood donors who donated at the donation sites and 500 non-donors who never donated and passed by the station were asked to complete a self-administered questionnaire during Dec 10, 2013 to Jun 25, 2014. Main outcome measures: Blood donation or no donation. Results: 1080 questionnaires were collected, of which 1034(95.7%) questionnaires were valid. 602(58.2%) participants were donors and 432(41.8%) were non-donors. Older people (OR: 1.46, 95% confidence interval: 1.24 to 1.72, p<0.01), males (1.33, CI: 1.02 to 1.71, p=0.03), non-college-students (1.76, CI: 1.16 to 2.56, p<0.01) and people with higher education level (1.27, CI: 1.11 to 1.45, p<0.01) were more likely to be donors. The main objective of blood donation was helping patients (n=405, 68.2%), and the main reason of not donating was being in poor health (n=138, 33.1%). However, other motives, such as benefiting health and free check for blood type and body, and obstacles, such as failing to meet the requirements and fear, were also important. More male donors would donate again than females (80.5% vs. 68.5%, p<0.01), whereas more female donors showed uncertainty than males (25.9% vs. 16.6%, p<0.01). Usage of blood (n=182, 46.7%) was what non-donors wanted to know the most if they were to donate in the future. The majority of participants (n=730, 71.3%) considered raising the awareness of blood donation among people was one of the most effective ways of blood donation promotion. Television was considered as one of the most effective methods of blood donation promotion and recruitment, and was more acceptable to females. Younger participants preferred the internet. Conclusion: These findings suggest that raising the awareness of blood donation is vital. Campaigns should focus on multiple aspects targeting different groups of people. Television and the internet are useful tools of blood donation promotion and recruitment. / published_or_final_version / Public Health / Master / Master of Public Health

SUMMARY Importance of blood safety by voluntary and altruistic blood donation is presented in the Master degree thesis. The major theoretical and practical solution of blood donations adopted during the analysis of Lithuanian and foreign legislation, results of analysis of society blood donor’s motivation and blood donors focusing problems. Master degree thesis consists of four main parts: analysis of the problem, background literature review, practical research and final conclusions. The first part of the thesis emphasizes the necessity for EU member states to ensure the provision for safe blood products which quality must fulfil the same EU standards, to restore public confidence. The main problem is transition from paid and relative’s blood donations to unpaid (voluntary) donations, which is revealed in the first part of thesis. The legislation regulating blood donations, the types of current donors and factors influencing on donors motivation are discussed in the second part. The second part consists of three chapters. The review of Lithuanian legislation about donor ship in Lithuania is considered in the first chapter. It is possible to state that till the year 2004 in Lithuania legal paid blood donations system was established which today barrier in transition is from paid and relatives blood donation to unpaid (voluntary) process. The second chapter describes the changing during last 3 year among Lithuanian blood donors and in donations. on process. And the last... [to full text]

In Sweden, lowest acceptable haemoglobin levels in blood donators are 125g/L for women and 135g/L for men for a test sample taken in the beginning of the blood donation. Levels, which are 10g/L lower, are accepted if the sample is taken after the blood donation. Earlier studies show that the haemoglobin level decreases for a person that is lying down. The two aims of this study were to examine how much the haemoglobin levels change during blood donation and to examine if the photometrical instrument Pronto-7TM shows equivalent results to that of the established method Cell-Dyn Sapphire. In the study, 120 blood donors participated. Blood samples were taken in the beginning and in the end of the donation. Analyses by Pronto-7TM were done before and after the donation. The haemoglobin level decreased significantly during the blood donation. The difference was in mean value 5,9g/L according to Cell-Dyn Sapphire. The decrease was significantly less than 10g/L. The Pronto-7TM gave levels that were 1,6g/L higher than Cell-Dyn Sapphire in mean and the standard deviation was higher for Pronto-7TM than for Cell-Dyn Sapphire. In conclusion, the decrease of the haemoglobin levels was significantly less than the expected difference 10g/L. Pronto-7TM gives results that differs a little from the results of the established method.

This thesis explored the impact on whole blood donors of a six month deferral from giving blood due to a low haemoglobin (Hb) concentration. The aims were two-fold: first, to quantify the effect of a temporary deferral on donation patterns once eligible to return, and second, to identify the processes contributing to the effect. The mixed methods design utilised four distinct research phases: statistical analysis of donation patterns over a three year period, surveys of whole blood donors three and twelve months after deferral, and semi-structured interviews with 25 blood donors in the weeks immediately following deferral. Deferral for a low Hb increased the likelihood of non-return in both new and repeat donors, and, amongst those who did return, delayed first return, reduced donation frequency and increased the likelihood of drop-out in later years. Qualitative interviews suggested that, predominantly, individuals give blood because it represents an easy and convenient way to help others, and provides additional rewards, such as enhancing positive self-concepts and a free health check. Returning promptly after deferral appears to be related to three aspects of a person and his/her context: an individual’s other obligations, especially parenting; the extent to which donation is considered personally rewarding; and whether donation arrangements were facilitated by a range of supports prior to deferral. Over three quarters of surveyed deferred donors seek further advice and investigations from their medical practitioner and nearly half of those are encouraged to change their donation patterns. With the exception of having a low haemoglobin level confirmed at follow-up testing, experiences seeking further investigations were not associated with either intentions or return. Triangulation of findings suggests that deferral disrupts the habit of regular donation, and that this disruption makes donors more vulnerable to changes to their personal circumstances or collection practices. Deferral may also increase the perceived inconvenience of the activity, decrease self-perceptions of competence and good health, and diminish the “blood donor” identity. Practical implications of these findings are recommendations that may increase retention of deferred donors, including encouraging donors to return promptly once eligible, enhancing the convenience of blood donation, and improving aspects of the deferral event. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1381077 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2010

This thesis explored the impact on whole blood donors of a six month deferral from giving blood due to a low haemoglobin (Hb) concentration. The aims were two-fold: first, to quantify the effect of a temporary deferral on donation patterns once eligible to return, and second, to identify the processes contributing to the effect. The mixed methods design utilised four distinct research phases: statistical analysis of donation patterns over a three year period, surveys of whole blood donors three and twelve months after deferral, and semi-structured interviews with 25 blood donors in the weeks immediately following deferral. Deferral for a low Hb increased the likelihood of non-return in both new and repeat donors, and, amongst those who did return, delayed first return, reduced donation frequency and increased the likelihood of drop-out in later years. Qualitative interviews suggested that, predominantly, individuals give blood because it represents an easy and convenient way to help others, and provides additional rewards, such as enhancing positive self-concepts and a free health check. Returning promptly after deferral appears to be related to three aspects of a person and his/her context: an individual’s other obligations, especially parenting; the extent to which donation is considered personally rewarding; and whether donation arrangements were facilitated by a range of supports prior to deferral. Over three quarters of surveyed deferred donors seek further advice and investigations from their medical practitioner and nearly half of those are encouraged to change their donation patterns. With the exception of having a low haemoglobin level confirmed at follow-up testing, experiences seeking further investigations were not associated with either intentions or return. Triangulation of findings suggests that deferral disrupts the habit of regular donation, and that this disruption makes donors more vulnerable to changes to their personal circumstances or collection practices. Deferral may also increase the perceived inconvenience of the activity, decrease self-perceptions of competence and good health, and diminish the “blood donor” identity. Practical implications of these findings are recommendations that may increase retention of deferred donors, including encouraging donors to return promptly once eligible, enhancing the convenience of blood donation, and improving aspects of the deferral event. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1381077 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2010

Foram analisadas 197.032 doações no período de janeiro de 1998 a junho de 2008, realizadas no Banco de Sangue do Hospital de Clínicas de Porto Alegre. Os doadores de sangue foram triados por um teste de enzimaimunoensaio (EIE) de terceira geração para HTLV I/II. Também foram realizados testes para hepatites B e C, HIV 1/2, sífilis e doença de Chagas. Os dados das fichas cadastrais foram revisados após o diagnóstico do doador. Como teste confirmatório, foi utilizado o Western Blot (WB). Foram excluídos os doadores considerados negativos após a confirmação dos testes iniciais. Ao todo, 204 doadores foram reagentes para HTLV I ou II. A prevalência de HTLV I/II foi de 0,1%, sendo 0,08% do tipo I e 0,02% do tipo II. A média de idade foi de 38 anos; 73,5% dos doadores eram brancos e 53,9% do sexo feminino. Cerca de 65% deles completaram o ensino fundamental e apenas 1% o ensino superior; 59,3% eram procedentes de Porto Alegre. A frequência de casados e solteiros foi de 40,2% e 42,4%, respectivamente, sendo os demais separados, divorciados ou viúvos. Os soropositivos para HTLV apresentaram ainda 30,4% de coinfecção com os outros marcadores testados. AntiHCV e anti-HBc foram os marcadores com maior prevalência (19,1% e 18,6%, respectivamente), seguidos por VDRL (2,94%), anti-HIV 1/2 (2,45%) e doença de Chagas (1,96%). / A total of 197,032 donors from the Blood Bank of Hospital de Clínicas de Porto Alegre, in southern Brazil, were assessed from January 1998 to June 2008. Blood donors were screened for HTLV I/II using a third-generation enzyme immunoassay (EIA). Tests for hepatites B and C, HIV 1 and 2, syphilis and Chagas disease were also performed. The information on blood donor forms was reviewed after the diagnosis. The Western Blot (WB) was used as confirmatory test. Seronegative donors were excluded from the study after initial test results were confirmed. Two hundred and four donors were positive for HTLV I or II. The prevalence of HTLV I/II was 0.1% (0.08% for HTLV I and 0.02% for HTLV II). The mean age was 38 years, 73.5% were whites and there was a female predominance (53.9%). Approximately 65% of seropositive individuals had attended elementary school, only 1% had college education, and 59.3% came from Porto Alegre. The frequency of married and single individuals was similar (40.2 and 42.4%, respectively), whereas the remaining donors were separated, divorced or widowed. This population also showed 30.4% of coinfection, according to the other tested markers. Anti-HCV and anti-HBc were the most prevalent markers (19.1 and 18.6%, respectively), followed by VDRL (2.94%), anti-HIV 1/2 (2.45%), Chagas disease (1.96%).

Foram analisadas 197.032 doações no período de janeiro de 1998 a junho de 2008, realizadas no Banco de Sangue do Hospital de Clínicas de Porto Alegre. Os doadores de sangue foram triados por um teste de enzimaimunoensaio (EIE) de terceira geração para HTLV I/II. Também foram realizados testes para hepatites B e C, HIV 1/2, sífilis e doença de Chagas. Os dados das fichas cadastrais foram revisados após o diagnóstico do doador. Como teste confirmatório, foi utilizado o Western Blot (WB). Foram excluídos os doadores considerados negativos após a confirmação dos testes iniciais. Ao todo, 204 doadores foram reagentes para HTLV I ou II. A prevalência de HTLV I/II foi de 0,1%, sendo 0,08% do tipo I e 0,02% do tipo II. A média de idade foi de 38 anos; 73,5% dos doadores eram brancos e 53,9% do sexo feminino. Cerca de 65% deles completaram o ensino fundamental e apenas 1% o ensino superior; 59,3% eram procedentes de Porto Alegre. A frequência de casados e solteiros foi de 40,2% e 42,4%, respectivamente, sendo os demais separados, divorciados ou viúvos. Os soropositivos para HTLV apresentaram ainda 30,4% de coinfecção com os outros marcadores testados. AntiHCV e anti-HBc foram os marcadores com maior prevalência (19,1% e 18,6%, respectivamente), seguidos por VDRL (2,94%), anti-HIV 1/2 (2,45%) e doença de Chagas (1,96%). / A total of 197,032 donors from the Blood Bank of Hospital de Clínicas de Porto Alegre, in southern Brazil, were assessed from January 1998 to June 2008. Blood donors were screened for HTLV I/II using a third-generation enzyme immunoassay (EIA). Tests for hepatites B and C, HIV 1 and 2, syphilis and Chagas disease were also performed. The information on blood donor forms was reviewed after the diagnosis. The Western Blot (WB) was used as confirmatory test. Seronegative donors were excluded from the study after initial test results were confirmed. Two hundred and four donors were positive for HTLV I or II. The prevalence of HTLV I/II was 0.1% (0.08% for HTLV I and 0.02% for HTLV II). The mean age was 38 years, 73.5% were whites and there was a female predominance (53.9%). Approximately 65% of seropositive individuals had attended elementary school, only 1% had college education, and 59.3% came from Porto Alegre. The frequency of married and single individuals was similar (40.2 and 42.4%, respectively), whereas the remaining donors were separated, divorced or widowed. This population also showed 30.4% of coinfection, according to the other tested markers. Anti-HCV and anti-HBc were the most prevalent markers (19.1 and 18.6%, respectively), followed by VDRL (2.94%), anti-HIV 1/2 (2.45%), Chagas disease (1.96%).

Made available in DSpace on 2014-06-11T19:23:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-08-27Bitstream added on 2014-06-13T18:09:20Z : No. of bitstreams: 1 bueno_l_me_botfm.pdf: 328709 bytes, checksum: 085dc669d232db13d9fdf6315c4a5245 (MD5) / Fundação Amaral Carvalho / O Ministério da Saúde muito tem se preocupado com a segurança transfusional, tendo a utilização da ferramenta “Voto de Autoexclusão – VAE” como mecanismo de barreira na transmissão de doenças, visto que A triagem sorológica em doadores de sangue não possibilita segurança de 100% quanto a possibilidade de transmissão de agentes infecto-contagiosos. O objetivo desse trabalho foi avaliar o índice de autoexclusão (AE) no Hemonúcleo Regional de Jaú no período de 2006 a 2010, de acordo com o tipo de doador, gênero, faixa-etária, estado civil, tempo de doação na unidade, procedência e comparar a frequência dos testes sorológicos reagente entre doadores que se AE e não se auto-excluíram. De 2006 a 2010, o Hemonúcleo Regional de Jaú coletou 42.509 bolsas de sangue, das quais 818(2%) doações foram desprezadas pelo VAE. Estas 818 doações correspondem a 742 doadores devido ao fato de que 26 doadores se AE mais de uma vez no período da pesquisa. A taxa de AE no grupo masculino foi significativamente maior que no grupo feminino, bem como a chance de AE neste grupo foi 1,9 vezes maior que no grupo feminino. Quanto à faixa etária, a taxa de AE foi maior em doadores mais jovens (18 a 29 anos). Quanto à raça, houve um equilíbrio entre brancos, negros e pardos. Em relação ao estado civil, doadores casados são menos frequentes que solteiros e indivíduos com outros tipos de relacionamento. A chance de se autoexcluírem em doadores de 1ª vez foi de 1,7 vezes maior do que no grupo de repetição. Este resultado pode evidenciar uma falta de entendimento do doador quanto ao significado do VAE, além de mostrar a importância de se elaborar um instrumento auto-explicativo que facilite a compreensão do doador. Quanto ao índice de soropositividade para o conjunto de marcadores de doenças... / The ministry of health has long been concerned about the safety of blood transfusion, and the use of the tool vow of self-exclusion - VAE as a barrier machanism in the transmission of diseases, considering that serologial screening of blood donors does not allow 100% security as possibility of transmission of infectious and contagious agents. The aim of this study was to evaluate the index of self-exclusion (AE) in Hemonúcleo Regional of Jaú, in the period of 2006 to 2010, according to the donor type, gender, age group, marital status, time of donation in the unit, procedure and comparison of serologic frequency, testing reagents among donors that self-excluded themselves and those who didn't. From 2006 to 2010, the Hemonúcleo Reginal of Jaú collected 42.509 units of blood, of which 818 (2%) donations were discarted by a vote of self-exclusion. These 818 donations from 742 donors match due to the fact that 26 donors excluded themselves more than once in the period of this research.The rate of self-exclusion in the male group was significantly higher than in the female group, as well as the chance of self-exclusion in this group was 1.9 times higher than in the female group.The age group of 60 to 69 years predominates over the age group of 18 to 49 years. As for the race group, there was a balance between white, black and brown. Regarding marital status, married donors are less frequent than single and relationships with other individuals. The chance of self-excluded donors at a first time was 1.7 times higher than in the repeating group. This result may show a lack of understanding of the donors as to the meaning of the vow of self exclusion, and show the importance of preparing a self explanatory that facilitates understanding of the donor. In the rate of seropositivity for all markers of viral diseases was found that the chance of positive... (Complete abstract click electronic access below)

Orientador: Rosana Rossi Ferreira / Banca: Marjorie de Assis Golim / Banca: Michele Janegitz Acorse Valério / Resumo: O Ministério da Saúde muito tem se preocupado com a segurança transfusional, tendo a utilização da ferramenta "Voto de Autoexclusão - VAE" como mecanismo de barreira na transmissão de doenças, visto que A triagem sorológica em doadores de sangue não possibilita segurança de 100% quanto a possibilidade de transmissão de agentes infecto-contagiosos. O objetivo desse trabalho foi avaliar o índice de autoexclusão (AE) no Hemonúcleo Regional de Jaú no período de 2006 a 2010, de acordo com o tipo de doador, gênero, faixa-etária, estado civil, tempo de doação na unidade, procedência e comparar a frequência dos testes sorológicos reagente entre doadores que se AE e não se auto-excluíram. De 2006 a 2010, o Hemonúcleo Regional de Jaú coletou 42.509 bolsas de sangue, das quais 818(2%) doações foram desprezadas pelo VAE. Estas 818 doações correspondem a 742 doadores devido ao fato de que 26 doadores se AE mais de uma vez no período da pesquisa. A taxa de AE no grupo masculino foi significativamente maior que no grupo feminino, bem como a chance de AE neste grupo foi 1,9 vezes maior que no grupo feminino. Quanto à faixa etária, a taxa de AE foi maior em doadores mais jovens (18 a 29 anos). Quanto à raça, houve um equilíbrio entre brancos, negros e pardos. Em relação ao estado civil, doadores casados são menos frequentes que solteiros e indivíduos com outros tipos de relacionamento. A chance de se autoexcluírem em doadores de 1ª vez foi de 1,7 vezes maior do que no grupo de repetição. Este resultado pode evidenciar uma falta de entendimento do doador quanto ao significado do VAE, além de mostrar a importância de se elaborar um instrumento auto-explicativo que facilite a compreensão do doador. Quanto ao índice de soropositividade para o conjunto de marcadores de doenças... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The ministry of health has long been concerned about the safety of blood transfusion, and the use of the tool "vow of self-exclusion - VAE" as a barrier machanism in the transmission of diseases, considering that serologial screening of blood donors does not allow 100% security as possibility of transmission of infectious and contagious agents. The aim of this study was to evaluate the index of self-exclusion (AE) in Hemonúcleo Regional of Jaú, in the period of 2006 to 2010, according to the donor type, gender, age group, marital status, time of donation in the unit, procedure and comparison of serologic frequency, testing reagents among donors that self-excluded themselves and those who didn't. From 2006 to 2010, the Hemonúcleo Reginal of Jaú collected 42.509 units of blood, of which 818 (2%) donations were discarted by a vote of self-exclusion. These 818 donations from 742 donors match due to the fact that 26 donors excluded themselves more than once in the period of this research.The rate of self-exclusion in the male group was significantly higher than in the female group, as well as the chance of self-exclusion in this group was 1.9 times higher than in the female group.The age group of 60 to 69 years predominates over the age group of 18 to 49 years. As for the race group, there was a balance between white, black and brown. Regarding marital status, married donors are less frequent than single and relationships with other individuals. The chance of self-excluded donors at a first time was 1.7 times higher than in the repeating group. This result may show a lack of understanding of the donors as to the meaning of the vow of self exclusion, and show the importance of preparing a self explanatory that facilitates understanding of the donor. In the rate of seropositivity for all markers of viral diseases was found that the chance of positive... (Complete abstract click electronic access below) / Mestre