Importance of periodic review of protocols for transfusion transmitted infection sero-reactive blood donor notification- a study in a tertiary care hospital in South India
Keywords:
Donor recall, Notification, Sero-reactive, Transfusion-transmitted infection (TTIs)Abstract
Abstract:
Introduction: Blood donors found reactive for Transfusion Transmitted Infections (TTIs) on screening tests, must be notified and counselled about confirmation of the results, future management and donation. To ensure blood safety, all protocols for the same must be regularly revised and updated in accordance with available resources. Objective: To highlight the importance of reviewing existing protocols periodically, so as to identify, analyse and address challenges faced while notifying TTI reactive donors. Materials and Methods: From records maintained at the blood bank of sero-reactive donors, details of each viral TTI-reactive donor between March 2016 and May 2019 were collected. Initial notification protocol- telephonically contact sero-reactive donors only once. It had been modified on January 2019. New protocol- Attempt telephonic communication up to three times until the donor is notified, failing which written information to be sent by post or electronic mail. The same parameters were analysed between January and May 2019 and compared with the pre-modification data (March 2016-December 2018) to note any improvement in donor response. Results: Initial Protocol: Total donors 39,602, 497 donors were sero-reactive: HIV 72, HCV 138 and HBV 287, 213 of them were contacted (HIV 40, HCV 54 and HBV 119) and 57 of them returned for follow-up (HIV 14, HCV 15 and HBV 28). The main reason for inability to contact donors was wrong/ invalid contact information. After modification of the notification protocol: Total donors 5316, 67 were sero-reactive (HIV 9, HCV 26 and HBV 32), 40 of them were successfully informed (HIV 6, HCV 19 and HBV 15) and 16 (HIV 4, HCV 7 and HBV 5) returned for counselling. Conclusion: Regular review of donor notification data and modification of notification protocols help identify and address lacunae. This ensures maximum donor recall, proper follow-up and safety of the donors and that of any potential recipients of their blood components and/or products.
Downloads
References
Kaur G, Kaur P, Basu S, Kaur R, Sharma S. Donor notification and counseling- experience and challenges. Transfus Apher Sci. 2013;49:291-4.
World Health Organization. Screening donated blood for transfusion-transmissible infections. Recommendations. Geneva: World Health Organization; 2009. p. 50-54. Available from: https://www.who.int/bloodsafety/ScreeningTTI.pdf
Kotwal U, Doda V, Arora S, Bhardwaj S. Blood donor notification and counselling- our experience from a tertiary care hospital in India. Asian J Transfus Sci. 2015;9:18-22.
Miller D, Kalibala S, Anderson S, Emmanuel J, Petitgirard A. Blood donor counselling for HIV: results of a multi-country feasibility study. Public Health. 1994;108:219-26.
Kaur D, Pahuja S, Jain M, Khaspuria R. Donor notification: Streamlining the existing enigmatic process: an experience from a tertiary care hospital in Central Delhi, India. Transfus Apher Sci. 2015;53:173-5.
Delage G, Myhal G, Grégoire Y, Simmons-Coley GM. Donors’ psychological reactions to deferral following false-positive screening test results. Vox Sang. 2014;107:132-9.
National AIDS Control Organization. National guidelines for HIV testing. New Delhi: National AIDS Control Organization; 2015. Available from : naco.gov.in/sites/default/files/National_Guidelines_ for_HIV_Testing_21Apr2016.pdf
Stoyanov E, Gozlan Y, Wax M, Levin E, Shvatz L, Shinar E, et al. HIV-1/2 screening in blood centers: implementing a two-step serological screening assay approach to reduce donor deferral. Transfusion. 2019;59:2054-60.
Baveewo S, Kamya MR, Mayanja-Kizza H, Fatch R, Bangsberg DR, Coates T, et al. Potential for false positive HIV test results with the serial rapid HIV testing algorithm. BMC Res Notes. 2012;5:154.
Porto-Ferreira FA, de Almeida-Neto C, Murphy EL, Montebello SC, Nogueira FA, Koga da Silva EM, MacFarland W, Custer B. A randomized trial to evaluate the use of text messaging, letter, and telephone call reminders to improve return of blood donors with reactive serologic tests. Transfusion. 2017;57:102-7.
Kleinman S, Wang B, Wu Y, Glynn SA, Williams A, Nass C, et al. The Donor Notification process from the donor’s perspective. Transfusion. 2004;44:658-66.
Roshan TM, Rosline H, Ahmed SA, Rapiaah M, Khattak MN. Response rate of Malaysian blood donors with reactive screening test to transfusion medicine unit calls. Southeast Asian J Trop Med Public Health. 2009;40:1315-21.
Agarwal N. Response rate of blood donors in the Uttarakhand region of India after notification of reactive test results on their blood samples. Blood Transfus. 2014;12(Suppl 1):s51-3.
Chaurasia R, Zaman S, Das B, Chatterjee K. Screening donated blood for transfusion transmitted infections by serology along with NAT and response rate to notification of reactive results: an Indian experience. J Blood Transfus. 2014;2014:412105. doi: 10.1155/2014/412105.
Sachdev S, Mittal K, Patidar G, Marwaha N, Sharma RR, Duseja AK, et al. Risk factors for transfusion transmissible infections elicited on post donation counselling in blood donors: need to strengthen pre-donation counselling. Indian J Hematol Blood Transfus. 2015;31:378-84.
Raza N, Qureshi H, Qureshi A. Reactive donor notification; their responses and perceptions: experience from Southern Pakistan. J Ayub Med Coll Abbottabad. 2018;30:351-55.
Reynolds CA, Brailsford SR, Hewitt PE. Notifying blood donors of infection: results of a donor satisfaction survey. Transfus Med. 2015;25:358-65.
