Malaria was identified as one of the first infectious diseases recognised to spread through blood transfusion. Although transfusion acquired malaria is rare, nevertheless it can be lethal if it not diagnosed or treated immediately. It is a continuous challenge for the blood services to identify and exclude asymptomatic malaria infected donors, while minimising the exclusion of uninfected donors. The diagnostic tests in current use present certain limitations which include the use of inherently antigenically variable vaccine candidate proteins that have limited sensitivity against all human malaria species. Additionally, the blood transfusion services also require alternative methods for test and reagents that may be critical to the blood supply. There is therefore a scientific and an operational requirement to use alternative strategies to develop sensitive tests to all the species of malaria. In this study, we have used immunoproteomic approach to define conserved immunogenic malaria proteins. A total of 17 target P. falciparum proteins have been identified using cohorts of malaria immune sera from adults living in endemic areas, as well as by control sera from Europeans, who have never been exposed to malaria. The identified blood stage target antigens were cloned and expressed as recombinant proteins in a suitable bacterial system. In total, 15 target proteins have been expressed with 13 of them have been successfully purified. An ELISA-based system was developed, and the antigenicity of nine target antigens were evaluated using both non-malaria and malaria sera. Single antigen testing gave overall sensitivity of 50 - 84 %, with specificity consistently over 90%. Antigens such as Alpha tubulin and 26s protease showed promising immunogenicity, while Nucleosome assembly protein achieved 100% specificity. Further development of multiple antigens in an ELISA test will be required for continued evaluation of these antigens and the humoral immune response in malaria in general.

Transfusion of blood products is a common medical procedure, and maintaining adequate blood supply depends on the unpaid donation of a small share of the general population. The absence of pre-donation testing for iron status allows many donors with iron deficiency to donate blood. This dissertation seeks to enhance our understanding of the causes of iron deficiency among blood donors, the resultant symptoms, and the likely effectiveness of alternate strategies for reducing the risk of iron deficiency. In Study 1, we used data from the REDS-II RISE prospective cohort study, over a 2-year follow-up period, to evaluate whether higher levels of dietary iron protect against incident iron deficiency in blood donors. Responses to a brief checklist of consumption of animal proteins were combined into an Iron Composite Score weighted for iron content and reported frequency. We found that donors reporting the lowest levels of iron consumption were more likely to develop advanced iron depletion during follow-up. In Study 2, we performed an analysis of observational data from the STRIDE study, a randomized trial, to evaluate whether improvements in iron status were associated with improvements in reported fatigue levels. Using linear regression, we found that many donors had sizable changes in both reported levels of fatigue and in measures of iron status, but neither iron status nor changes in iron status was associated with fatigue at the end of 20–24 months follow-up. In Study 3, we conducted a simulation study to evaluate the range of outcomes of different strategies that might be adopted by blood centers to reduce the prevalence of iron depletion in blood donors. Using inputs primarily from the REDS-II program, we simulated approaches that extended the minimum interval between donations, that promoted use of iron supplementation by blood donors, and that performed ferritin testing to determine donor iron stores and extended the donation interval to those with iron depletion. Only extending the current 8-week interval to 26 weeks approached a reduction by half of the proportion of blood donors who were iron deficient, but the estimated impact on blood supply was a 21% drop in blood availability. Those interventions impacting supply less were also less effective in reducing iron depletion.

Thesis (M.S.)--Ohio University, November, 2009. / Release of full electronic text on OhioLINK has been delayed until December 1, 2011. Title from PDF t.p. Includes bibliographical references.

Thesis (Ph.D.)--Ohio University, November, 2004. / Includes bibliographical references (leaves 101-112)

Thesis (M.A.) University of Missouri-Columbia, 2006. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file viewed on (June 26, 2007) Includes bibliographical references.

No description available.

Foram estudados 151 doadores de sangue encaminhados pelo Hemocentro de Ribeirão Preto ao Ambulatório de Hepatites do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto em função de terem apresentado resultados foram positivos para hepatite C nos testes de triagem pré-doação, entre 2001 e 2010. Todos tiveram confirmação diagnóstica mediante uso de técnicas de biologia molecular. No momento de chegada ao Hospital foram entrevistados por uma assistente social ligada ao Núcleo Hospitalar de Epidemiologia, com o objetivo de caracterizá-los segundo variáveis sociodemográficas, estudar fatores de risco presentes e genótipos encontrados. Houve predominância de indivíduos do sexo masculino, com baixos níveis de escolaridade e de estratos sociais menos favorecidos, com idade mediana de 36 anos. Observou-se uma tendência decrescente de infectados ao longo dos anos estudados. O genótipo mais prevalente foi o 1 com percentual de 68,8%, seguido do genótipo 3 (27,0%). Os potenciais fatores de risco mais prevalentes foram história pregressa de hospitalização sem e com cirurgia, multiplicidade de parceiros sexuais no passado, convivência com usuários de drogas, contato com sangue em atendimentos a terceiros, múltiplos parceiros sexuais no presente e contato domiciliar com casos de hepatite. Também com elevadas frequências foram observados os seguintes fatores: antecedente de transfusão sanguínea, uso coletivo de escova de dentes, história de contato sexual com usuários de drogas, frequência a creches na infância e tatuagem. Uso passado de drogas injetáveis e compartilhamento de seringas e agulhas foram relatados por 15,2% e 9,9%, respectivamente. Conclui-se que deve ter ocorrido omissão de inúmeros fatores de risco por ocasião da triagem clínica, possivelmente indicativo do desejo de se utilizar o Banco de Sangue como controle da situação sorológica por parte de parte dos doadores. / 151 blood donators were analyzed sent from the Hemocenter of Ribeirão Preto to the Hepatitis Clinic of the University Hospital of the Ribeirão Preto Medical School, University of São Paulo, because these individuals had presented positive results for Hepatitis C in the screening tests for pre-donation, taken between 2001 and 2010. All of them had diagnosis confirmation through the use of molecular biology techniques. At the moment of arrival in the hospital, they were interviewed by a Social Assistant from the Hospital Nucleus of Epidemiology, in order to characterize them according to socio-demographic variables, to study risk factors that might be present, and genotypes found. The predominance was of male individuals, with low school levels, and coming from a less favored social stratum, with a median age of 36 years. There was a decreasing tendency of infected individuals along the years of study. The most prevailing genotype was type 1 with a percentage of 68.8%, followed by the genotype 3 (27.0%). The most prevailing potential risk factors were previous history of hospitalization with and without surgery, multiplicity of sexual partners in the past, acquaintance with drug user, contact with blood on dealing with to third parties, multiple current sexual partners and home contact with hepatitis cases. The following factors were also observed with high frequency: antecedent of blood transfusion, collective use of tooth brush, history of sexual contact with drug users, attendance to day care clinics in childhood and tattoos. Past use of injectable drugs and syringe and needle sharing were reported by 15.2% and 9.9%, respectively. The conclusion was that there must have been the omission of a number of risk factors at the time of the clinical screening, possibly indicating the desire of using the Blood Bank to make control of the serological status by some of the donators

Foram estudados 151 doadores de sangue encaminhados pelo Hemocentro de Ribeirão Preto ao Ambulatório de Hepatites do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto em função de terem apresentado resultados foram positivos para hepatite C nos testes de triagem pré-doação, entre 2001 e 2010. Todos tiveram confirmação diagnóstica mediante uso de técnicas de biologia molecular. No momento de chegada ao Hospital foram entrevistados por uma assistente social ligada ao Núcleo Hospitalar de Epidemiologia, com o objetivo de caracterizá-los segundo variáveis sociodemográficas, estudar fatores de risco presentes e genótipos encontrados. Houve predominância de indivíduos do sexo masculino, com baixos níveis de escolaridade e de estratos sociais menos favorecidos, com idade mediana de 36 anos. Observou-se uma tendência decrescente de infectados ao longo dos anos estudados. O genótipo mais prevalente foi o 1 com percentual de 68,8%, seguido do genótipo 3 (27,0%). Os potenciais fatores de risco mais prevalentes foram história pregressa de hospitalização sem e com cirurgia, multiplicidade de parceiros sexuais no passado, convivência com usuários de drogas, contato com sangue em atendimentos a terceiros, múltiplos parceiros sexuais no presente e contato domiciliar com casos de hepatite. Também com elevadas frequências foram observados os seguintes fatores: antecedente de transfusão sanguínea, uso coletivo de escova de dentes, história de contato sexual com usuários de drogas, frequência a creches na infância e tatuagem. Uso passado de drogas injetáveis e compartilhamento de seringas e agulhas foram relatados por 15,2% e 9,9%, respectivamente. Conclui-se que deve ter ocorrido omissão de inúmeros fatores de risco por ocasião da triagem clínica, possivelmente indicativo do desejo de se utilizar o Banco de Sangue como controle da situação sorológica por parte de parte dos doadores. / 151 blood donators were analyzed sent from the Hemocenter of Ribeirão Preto to the Hepatitis Clinic of the University Hospital of the Ribeirão Preto Medical School, University of São Paulo, because these individuals had presented positive results for Hepatitis C in the screening tests for pre-donation, taken between 2001 and 2010. All of them had diagnosis confirmation through the use of molecular biology techniques. At the moment of arrival in the hospital, they were interviewed by a Social Assistant from the Hospital Nucleus of Epidemiology, in order to characterize them according to socio-demographic variables, to study risk factors that might be present, and genotypes found. The predominance was of male individuals, with low school levels, and coming from a less favored social stratum, with a median age of 36 years. There was a decreasing tendency of infected individuals along the years of study. The most prevailing genotype was type 1 with a percentage of 68.8%, followed by the genotype 3 (27.0%). The most prevailing potential risk factors were previous history of hospitalization with and without surgery, multiplicity of sexual partners in the past, acquaintance with drug user, contact with blood on dealing with to third parties, multiple current sexual partners and home contact with hepatitis cases. The following factors were also observed with high frequency: antecedent of blood transfusion, collective use of tooth brush, history of sexual contact with drug users, attendance to day care clinics in childhood and tattoos. Past use of injectable drugs and syringe and needle sharing were reported by 15.2% and 9.9%, respectively. The conclusion was that there must have been the omission of a number of risk factors at the time of the clinical screening, possibly indicating the desire of using the Blood Bank to make control of the serological status by some of the donators

Inledning: Sjukvården är beroende av frivilliga bloddonatorer. Det behövs alltid fler bloddonatorer då vi med dagens sjukvård kan utföra alltmer avancerad kirurgi samt rädda och hjälpa allt fler sjuka samt skadade, med hjälp av blod från frivilliga donatorer. Syfte: Syftet var att undersöka vilka skäl som anges till att inte donera blod, samt undersöka om viljan att ge blod skiljer sig beroende på kön, ålder och om man har yrkes- eller studieanknytning till sjukvård. Syftet var också att undersöka vilka faktorer potentiella blodgivare anger som motiverande till att donera blod. Metod: Denna uppsats baseras på en kvantitativ tvärsnittsstudie, bestående av en webbenkät som delats av författarnas på det sociala mediet Facebook. Enkäten vände sig till personer som enligt blodcentralens kriterier får donera blod, totalt inkom 90 svar, med ett bortfall på totalt 11 personer. Enkäter analyserades sedan kvantitativt med hjälp av statistikprogrammet SPSS. Resultat: Studien visar att den vanligaste orsaken till att respondenten inte gått och donerat blod är att de tillfrågade har tänkt på det men att det inte blivit av. Det finns ingen skillnad i motivationen att donera blod gällande kön, ålder och om man har yrkes-/studieanknytning till sjukvården. Det som respondenterna uppgett som mest motiverande till att gå och donera blod är att få svar på olika provsvar som till exempel kolesterol och infektionsparametrar. Slutsats: Att försöka göra blodgivningen mer tillgänglig skulle förhoppningsvis kunna öka antalet blodgivare, eftersom en tredjedel av de tillfrågade har tänkt på det, men att det inte blivit av. Att erbjuda bloddonatorerna svar på olika blodprover skulle troligtvis också öka chanserna för att flera personer ska bli återkommande bloddonatorer. / Introduction: Hospitals and general healthcare are dependent on volunteers to donate blood. Due to today’s advanced surgery there is an everlasting need for new and more blood donors. With the aid of donated blood more people in need could receive the appropriate treatment. Aim: The aim was to investigate what reasons would be given for not donating blood, and to investigate whether the will to donate blood may depend on gender, age and whether the subject has a work- or study relation to healthcare. The aim was also to determine the motivating factors to blood donation of future donors. Method: This essay is based on a quantitative cross-sectional study consisting of a web based survey shared by the authors on the social networking service Facebook. The target group of the survey was people who are suitable to donate blood according to the criteria of the blood donation centre. A total of 90 individuals responded to the survey, with a loss of 11 people. The surveys were analyzed quantitatively using the statistical program SPSS. Results: The study indicates that the most common reason to why the respondent has not donated blood is that he or she has thought of donating blood, but that it has simply not yet happened. The motivation of donating blood is not dependent on the person’s gender, age or whether or not the person has a work- or study relation to healthcare. The most motivating factor to donating blood is the opportunity to be informed of test results such as cholesterol levels and infection parameters. Conclusion: Since one third of the respondents have considered donating blood, but that they still have not done so, there would probably be an increase in the numbers of blood donors if blood donating centres were more accessible. To offer the donors the results of various kinds of blood tests would probably motivate more persons to become regular blood donors.

published_or_final_version / Psychology / Master / Master of Philosophy