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Chen G, Barlow M, Down L, Mounce LTA, Merriel SWD, Watson J, Martins T, Bailey SER. Exploring ethnic differences in the distribution of blood test results in healthy adult populations to inform earlier cancer detection: a systematic review. Fam Pract 2024; 41:638-648. [PMID: 38706165 PMCID: PMC11461158 DOI: 10.1093/fampra/cmae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND In primary care, health professionals use blood tests to investigate nonspecific presentations to inform referral decisions. Reference ranges for the commonly used blood tests in western countries were developed in predominately White populations, and so may perform differently when applied to non-White populations. Knowledge of ethnic variation in blood test results in healthy/general populations could help address ethnic inequalities in cancer referral for diagnosis and outcomes. OBJECTIVE This systematic review explored evidence of ethnic differences in the distribution of selected blood test results among healthy/general populations to inform future research aimed at addressing inequalities in cancer diagnosis. METHODS We searched PubMed and EMBASE to identify studies reporting measures of haemoglobin, MCV, calcium, albumin, platelet count, and CRP in nondiseased adults from at least 2 different ethnic groups. Two reviewers independently screened studies, completed data extraction and quality assessment using an adapted Newcastle-Ottawa scale. Participants were stratified into White, Black, Asian, Mixed, and Other groups. Data were synthesised narratively and meta-analyses were conducted where possible. RESULTS A total of 47 papers were included. Black men and women have lower average values of haemoglobin, MCV, and albumin, and higher average values of CRP relative to their White counterparts. Additionally, Black men have lower average haemoglobin than Asian men, whereas Asian women have lower average CRP values when compared with White women. CONCLUSIONS There is evidence of ethnic differences in average values of haemoglobin, MCV, CRP, and albumin in healthy/general populations. Further research is needed to explore the reasons for these differences. Systematic review registration: CRD42021274580.
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Affiliation(s)
- Ge Chen
- Department of Health and Community Sciences, University of Exeter, Exeter, UK
- Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Melissa Barlow
- Department of Health and Community Sciences, University of Exeter, Exeter, UK
| | - Liz Down
- Department of Health and Community Sciences, University of Exeter, Exeter, UK
| | | | - Samuel William David Merriel
- Department of Health and Community Sciences, University of Exeter, Exeter, UK
- Centre for Primary Care & Health Services Research, University of Manchester, Manchester, United Kingdom
| | - Jessica Watson
- Centre for Academic Primary Care (CAPC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Tanimola Martins
- Department of Health and Community Sciences, University of Exeter, Exeter, UK
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Anabire NG, Billak GD, Helegbe GK. Alcohol intake, smoking, self-medication practices and burden of anaemia among traders in Tamale metropolis of Ghana. BMC Res Notes 2023; 16:214. [PMID: 37700371 PMCID: PMC10498630 DOI: 10.1186/s13104-023-06480-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023] Open
Abstract
OBJECTIVE Lifestyle choices including physical inactivity, smoking, abuse of alcohol and drugs, unhealthy diet are common among traders and market women and these behavioural activities predispose individuals to ill-health conditions including cardiovascular diseases and chronic anaemia. We evaluated lifestyle choices such as alcohol intake, smoking and resorting to self-medication among traders in the Tamale Central market in Ghana. We then associated these lifestyle choices with anaemia. RESULTS A total of 400 participants were recruited for this study. Haemoglobin (Hb) levels of participants were measured using Mission® Plus Hb meter and anaemia was diagnosed by Hb < 12 g/dl for non-pregnant females and Hb < 13 g/dl for males. Of the participants, a majority (69.3%) were males, and most of them (56.0%) were within 18-35 years age bracket. While alcohol intake and smoking were uncommon, self-medication was a common practice among the participants. Anaemia was a common condition; diagnosed in 44.5% of participants, but was independent of age, alcohol intake and smoking. However, anaemia was more common in females (χ2 = 15.9, p < 0.001) and was associated with self-medication (χ2 = 5.7, p = 0.017). We recommend that traders in the Tamale metropolis should seek routine health check-ups to help avert adverse health consequences associated with anaemia.
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Affiliation(s)
- Nsoh Godwin Anabire
- Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Tamale, Ghana
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry Cell and Molecular Biology, University of Ghana, Ghana, Accra, Ghana
| | - George Doopaar Billak
- Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Tamale, Ghana
| | - Gideon Kofi Helegbe
- Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Tamale, Ghana.
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Impact of blood donor characteristics on quality of packed red blood cell concentrates. Transfus Clin Biol 2021; 29:49-52. [PMID: 34391926 DOI: 10.1016/j.tracli.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/29/2021] [Accepted: 08/05/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Impact of blood donor characteristics on quality of packed red blood cell concentrates. OBJECTIVE To determine the impact of donor factors on the quality of packed red blood cell concentrates. MATERIAL AND METHODS The analytical cross sectional study was conducted on 505 whole blood donors after approval by the Institutional Ethics Committee and written informed consent from blood donors. Two mL EDTA sample was collected for pre-donation haemoglobin estimation and all relevant donor details were recorded. Whole blood was collected in 350mL double blood bags. PRBCs were prepared as per the departmental SOP. Volume of each PRBC was recorded and sample from each bag was taken for estimation of total haemoglobin content and haematocrit. RESULTS Of 505 blood donors, 459 (90.9%) were males and 324 donors (64.2%) were less than 30 years of age. The majority of the donors were repeat donors (61%, n=308 repeat donors), vegetarians (52.9%, n=267 vegetarians) and non-smokers (92.7%, n=468). Mean haemoglobin was found to be significantly higher in males (14.9 vs. 13.3; P≤0.001), donors more than 30 years of age (15 vs. 14.7; P=0.042), repeat donors (14.9 vs. 14.7), non-vegetarians (15.1 vs. 14.6; P≤0.001) and smokers (15.3 vs. 14.8g/dL; P=0.020). PRBC units prepared from male blood donors, repeat donors and non vegetarians had significantly higher mean volume and mean total haemoglobin content. Strong positive correlation was observed between haemoglobin of the blood donor and total haemoglobin content of the PRBC and volume of blood collected. CONCLUSIONS Donor characteristics do have effect on total haemoglobin content of packed red blood cells.
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Association between Dietary Pattern, Lifestyle, Anthropometric Status, and Anemia-Related Biomarkers among Adults: A Population-Based Study from 2001 to 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073438. [PMID: 33810272 PMCID: PMC8037593 DOI: 10.3390/ijerph18073438] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 12/13/2022]
Abstract
Inadequate dietary intake, poor nutritional status, heavy smoking, and alcohol consumption are associated with the risk of anemia. The objective of this study was to investigate the associations between dietary patterns, lifestyle, nutritional status, and anemia-related biomarkers among adults using a multivariable regression model. Taiwanese adults aged 20–45 years (n = 118,924, 43,055 men and 75,869 women) were obtained from the Mei Jau Health Management Institution database, between 2001 and 2015, for data analysis. The anemia–inflammation-related dietary pattern was derived by reduced rank regression analysis. Dietary patterns with high intakes of eggs, meat, organ meats, rice or flour products, fried foods, sugary beverages, and processed foods significantly increased the risk of anemia, and was associated with decreased hemoglobin, hematocrit, and red blood cells, but increased white blood cells and C-reactive protein levels. Moreover, current alcohol drinkers, as well as people who were underweight, overweight, obese, and central obese, were more likely to increase their risk of anemia by 46%, 20%, 23%, 34%, and 28%, respectively. Interestingly, participants who are current or past smokers were inversely associated with risk of anemia. In conclusion, adherence to the anemia–inflammation dietary pattern was associated with an increased risk of anemia in Taiwanese adults. Furthermore, abnormal weight status and alcohol drinking were correlated with an increased risk of anemia.
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Roubinian NH, Kanias T. Blood donor component-recipient linkages: is there fire where there is smoke? Transfusion 2020; 59:2485-2488. [PMID: 31374151 DOI: 10.1111/trf.15450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/01/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Nareg H Roubinian
- Kaiser Permanente Northern California Division of Research, Oakland, California.,Vitalant Research Institute, San Francisco, California.,University of California, San Francisco, San Francisco, California
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Mast AE, Langer JC, Guo Y, Bialkowski W, Spencer BR, Lee TH, Kiss J, Cable RG, Brambilla D, Busch MP, Page GP. Genetic and behavioral modification of hemoglobin and iron status among first-time and high-intensity blood donors. Transfusion 2020; 60:747-758. [PMID: 32163187 DOI: 10.1111/trf.15743] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/23/2020] [Accepted: 01/23/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Some people rapidly develop iron deficiency anemia following blood donation, while others can repeatedly donate without becoming anemic. METHODS Two cohorts of blood donors were studied. Participants (775) selected from a 2-year longitudinal study were classified into six analysis groups based on sex, donation intensity, and low hemoglobin deferral. Associations with iron supplement use, cigarette smoking, and four genetic variants of iron metabolism were examined at enrollment and with longitudinal regression models. An unbiased assessment of genetic variability and ability to repeatedly donate blood without experiencing low hemoglobin deferral was conducted on participants (13,403) in a cross-sectional study who were examined by genome wide association (GWA). RESULTS Behaviors and genetic variants were associated with differences in hemoglobin and ferritin change following repeated donation. At least weekly iron supplement use was associated with improved status in first-time donors, while daily use was associated with improved status in high-intensity donors. Cigarette smoking was associated with 0.5 g/dL increased hemoglobin in high-intensity donors. A736V in TMPRSS6 was associated with a rapid drop in hemoglobin and ferritin in first-time females following repeated donation. Conversely, the protective TMPRSS6 genotype was not enriched among high-intensity donors. H63D in HFE was associated with increased hemoglobin in female high-intensity donors. However, no differences in genotype between first-time and high-intensity donors were found in GWA analyses. CONCLUSION Behavioral and genetic modifiers contributed to first-time donor hemoglobin and iron status, while iron supplement use was more important than underlying genetics in high-intensity donors.
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Affiliation(s)
- Alan E Mast
- Blood Research Institute Versiti, Milwaukee, Wisconsin, USA.,Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Yuelong Guo
- RTI International, Durham, North Carolina, USA
| | | | - Bryan R Spencer
- American Red Cross Scientific Affairs, Dedham, Massachusetts, USA
| | - Tzong-Hae Lee
- Vitalant Research Institute, San Francisco, California, USA
| | - Joseph Kiss
- Vitalant Northeast Division, Pittsburgh, Pennsylvania, USA
| | - Ritchard G Cable
- American Red Cross Scientific Affairs, Farmington, Connecticut, USA
| | | | - Michael P Busch
- American Red Cross Scientific Affairs, Dedham, Massachusetts, USA
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Roubinian NH, Westlake M, St Lezin EM, Edgren G, Brambilla DJ, Lee C, Bruhn R, Cable RG, Triulzi DJ, Glynn SA, Kleinman S, Murphy EL. Association of donor age, body mass index, hemoglobin, and smoking status with in-hospital mortality and length of stay among red blood cell-transfused recipients. Transfusion 2019; 59:3362-3370. [PMID: 31602669 DOI: 10.1111/trf.15541] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recent publications have reported conflicting findings regarding associations of blood donor demographics and mortality of transfused patients. We hypothesized that the analysis of additional donor characteristics and consideration of alternative outcomes might provide insight into these disparate results. STUDY DESIGN AND METHODS We analyzed data from a retrospective cohort of transfused patients from the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III). We used stratified Cox regression models to estimate associations between blood donor characteristics and hospital mortality and posttransfusion length of stay among patients transfused red blood cell (RBC) units. Donor characteristics evaluated included age, body mass index, hemoglobin levels, and smoking status. The statistical analyses were adjusted for recipient factors, including total number of transfusions. RESULTS We studied 93,726 patients in 130,381 hospitalizations during which 428,461 RBC units were transfused. There were no associations between blood donor characteristics and hospital mortality. Receipt of RBC units from donors less than 20 years of age was associated with a shorter hospital length of stay (hazard ratio for discharge per transfused unit, 1.03; 95% confidence interval, 1.02-1.04; p < 0.001) but not for other donor characteristics. CONCLUSION We found no evidence of associations between blood donor factors and in-hospital mortality. Our finding of shorter hospital length of stay in patients transfused RBCs from younger donors is intriguing but requires confirmation. Future collaborations are needed to develop a framework of appropriate methodologic approaches to be used in linked analyses across large cohorts.
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Affiliation(s)
- Nareg H Roubinian
- Kaiser Permanente Northern California Division of Research, Oakland, California.,Vitalant Research Institute, San Francisco, California.,Department of Laboratory Medicine, UCSF, San Francisco, California
| | | | - Elizabeth M St Lezin
- Department of Laboratory Medicine, UCSF, San Francisco, California.,Veterans Affairs Healthcare System, San Francisco, California
| | - Gustaf Edgren
- Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Södersjukhuset, Stockholm, Sweden
| | | | - Catherine Lee
- Kaiser Permanente Northern California Division of Research, Oakland, California
| | - Roberta Bruhn
- Vitalant Research Institute, San Francisco, California
| | - Ritchard G Cable
- American Red Cross Blood Services, Connecticut Region, Farmington, Connecticut
| | | | - Simone A Glynn
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | | | - Edward L Murphy
- Vitalant Research Institute, San Francisco, California.,Department of Laboratory Medicine, UCSF, San Francisco, California
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Okoroiwu HU, Asemota EA. Blood donors deferral prevalence and causes in a tertiary health care hospital, southern Nigeria. BMC Health Serv Res 2019; 19:510. [PMID: 31331326 PMCID: PMC6647304 DOI: 10.1186/s12913-019-4352-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 07/16/2019] [Indexed: 12/27/2022] Open
Abstract
Background Blood transfusion is a life-saving intervention. However, the safety of the donor and the recipient is paramount. This study was aimed at determining the blood donation deferral pattern of University of Calabar Teaching Hospital. Methods A retrospective analysis of the prospective donors’ data of University of Calabar Donor clinic within the period of March 2015 to February 2016 was conducted. Data were extracted from the donor register and analyzed. Prospective donors were screened and interviewed for causes of temporary and permanent deferrals. Result Out of the 1886 screened prospective donors, 164 (8.69%) were deferred. Though the minority of the donor population, female donors had the highest deferral rate (33.33%). There were 31.10 and 68.90% cases of temporary and permanent deferrals, respectively. Hepatitis B virus (HBV) was the highest (31.71%) cause of overall deferral as well as permanent deferral. Anemia was the major (21.95%) cause of temporary deferral as well as the second cause of overall deferrals. Commercial and replacement donors constituted 68.28 and 31.71% of the deferral cases, respectively. Conclusion HBV was found to be the overall leading cause of deferral in the studied area. This outcome poses a public health concern and should elicit measures to curb the infection rate.
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Affiliation(s)
- Henshaw Uchechi Okoroiwu
- Department of Medical Laboratory Science, Haematology Unit, University of Calabar, Calabar, Nigeria.
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9
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DeSimone RA, Hayden JA, Mazur CA, Vasovic LV, Sachais BS, Zhao Z, Goel R, Hsu YMS, Racine-Brzostek SE, Cushing MM. Red blood cells donated by smokers: A pilot investigation of recipient transfusion outcomes. Transfusion 2019; 59:2537-2543. [PMID: 31074905 DOI: 10.1111/trf.15339] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 04/10/2019] [Accepted: 04/21/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Current regulations do not require blood collection facilities to ask donors about cigarette smoking, and the prevalence of nicotine and its metabolites in blood products is not well established. Although smokers have higher hemoglobin (Hb) levels, smoking may adversely affect the quality of donated red blood cells through higher carboxyhemoglobin (COHb) content and premature hemolysis. STUDY DESIGN AND METHODS Red blood cell (RBC) unit segments from 100 unique donors were tested for nicotine and its metabolite cotinine by mass spectrometry and for COHb spectrophotometrically. Outcomes were evaluated retrospectively in adult non-bleeding patients receiving single RBC units. RESULTS Thirteen of 100 RBC segments (13%) were positive for cotinine at levels consistent with current smoking (> 10 ng/mL). The cotinine positive RBCs showed significantly greater COHb content compared to cotinine negative units (median 3.0% vs. 0.8%, p = 0.007). For patients transfused cotinine-positive units, there was no significant change in their vital signs following transfusion and no transfusion reactions were observed. However, patients transfused cotinine-positive units showed significantly reduced hematocrit and hemoglobin increments (median +1.2% and +0.4 g/dL) following transfusion compared to patients receiving cotinine negative units (median +3.6% and +1.4 g/dL) (p = 0.014). CONCLUSION Thirteen percent of RBC units tested positive for cotinine at levels consistent with active smoking, accordant with the estimated national smoking rate of 15.5%. Cotinine-positive RBC units had greater COHb content and showed reduced hematocrit and hemoglobin increments following transfusion. These preliminary results should be validated in a larger cohort.
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Affiliation(s)
- Robert A DeSimone
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Joshua A Hayden
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Chase A Mazur
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Ljiljana V Vasovic
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | | | - Zhen Zhao
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Ruchika Goel
- Simmons Cancer Institute at Southern Illinois University School of Medicine, Springfield, Illinois.,Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | - Yen-Michael S Hsu
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Sabrina E Racine-Brzostek
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York.,New York Blood Center, New York, New York
| | - Melissa M Cushing
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
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Patel EU, White JL, Bloch EM, Grabowski MK, Gehrie EA, Lokhandwala PM, Brunker PAR, Goel R, Shaz BH, Ness PM, Tobian AAR. Association of blood donation with iron deficiency among adolescent and adult females in the United States: a nationally representative study. Transfusion 2019; 59:1723-1733. [PMID: 30779173 PMCID: PMC6791124 DOI: 10.1111/trf.15179] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Blood donation results in a loss of iron stores, which is particularly concerning for young female blood donors. This study examines the association of blood donation and iron deficiency among adolescent and adult females in the United States. STUDY DESIGN AND METHODS A cross-sectional analysis was performed using data from the 1999-2010 National Health and Nutrition Examination Survey (NHANES). Females who reported their blood donation history in the preceding year and had serum ferritin (SF) measurements were included. Analyses were weighted and stratified by adolescents (16-19 years; n = 2419) and adults (20-49 years; n = 7228). Adjusted prevalence ratios (aPRs) were estimated by multivariable Poisson regression. Standard errors were estimated by Taylor series linearization. RESULTS Geometric mean SF levels (ng/mL) were lower in blood donors compared to nondonors among adolescents (21.2 vs. 31.4; p < 0.001) and among adults (26.2 vs. 43.7; p < 0.001). The prevalence of absent iron stores (SF < 12 ng/mL) was higher in blood donors compared to nondonors among adolescents (22.6% vs. 12.2%; aPR = 2.03 [95% confidence interval (CI) = 1.45-2.85]) and among adults (18.3% vs. 9.8%; aPR = 2.06 [95% CI = 1.48-2.88]). Additionally, the prevalence of iron deficiency anemia (SF < 26 ng/mL and hemoglobin < 12.0 g/dL) was also higher in blood donors compared to nondonors among adolescents (9.5% vs. 6.1%; aPR = 2.10 [95% CI = 1.13-3.90]) and among adults (7.9% vs. 6.1%; aPR = 1.74 [95% CI = 1.06-2.85]). Similar results were observed in a sensitivity analysis restricted to adolescents aged 16 to 18 years. CONCLUSIONS Blood donation is associated with iron deficiency among adolescent and adult females in the United States. These national data call for further development and implementation of blood donation practices aimed toward mitigating iron deficiency.
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Affiliation(s)
- Eshan U. Patel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jodie L White
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Evan M. Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mary K. Grabowski
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Eric A. Gehrie
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Parvez M. Lokhandwala
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patricia A. R Brunker
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Biomedical Services, Greater Chesapeake and Potomac Region, The American Red Cross, Baltimore, Maryland
| | - Ruchika Goel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine, Springfield, Illinois
| | | | - Paul M. Ness
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Aaron A. R. Tobian
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Prevalence and Risk Factors for Anemia in Non-pregnant Childbearing Women from the Chinese Fifth National Health and Nutrition Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071290. [PMID: 30974871 PMCID: PMC6479821 DOI: 10.3390/ijerph16071290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/04/2019] [Accepted: 04/06/2019] [Indexed: 01/30/2023]
Abstract
Anemia is a public health issue for developing countries, especially for women of childbearing age. The aim of this study was to assess the anemia status and analyze the risk factors for anemia in Chinese childbearing women aged 18–49 years. Hemoglobin concentration was measured by the HiCN method in the Fifth Chinese National Nutrition and Health Survey (CNNHS) in 2010–2012. Age, region type, ethnicity, bodyweight, height, education, season and smoke habit were recorded in unified questionnaires. Latitude was divided by China’s Qinling Mountains and Huaihe River. Childbearing women (28,289) from the CNNHS 2010–2012 were included in this study. The median hemoglobin concentration was 136.2(126.6–145.0) g/L, and it was significantly higher than in CNNHS 2002 (132.5 (122.3–141.6) g/L). The prevalence of anemia was 15.0%, and it was significantly lower than 10 years ago. The logistic regression analysis showed anemia in Chinese childbearing women was specifically related to 30–39 age group (P = 0.004), in spring (P < 0.0001) or in winter (P = 0.006), small and medium-sized cities (P = 0.044) and middle school education level (P = 0.027). The results showed that anemia status among childbearing women was greatly improved over 10 years since 2002, but it was still more severe than the rest of the populations. The nutrition propaganda and education is recommended for childbearing women to help them to improve the nutritional status on their own.
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Custer B, Zou S, Glynn SA, Makani J, Tayou Tagny C, El Ekiaby M, Sabino EC, Choudhury N, Teo D, Nelson K, Peprah E, Price L, Engelgau MM. Addressing gaps in international blood availability and transfusion safety in low- and middle-income countries: a NHLBI workshop. Transfusion 2018. [PMID: 29542130 DOI: 10.1111/trf.14598] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In April 2017, a workshop sponsored by the National Heart, Lung, and Blood Institute, Division of Blood Diseases and Resources, and the Center for Translation Research and Implementation Science was held to discuss blood availability and transfusion safety in low- and middle-income countries (LMICs). The purpose of the workshop was to identify research opportunities for implementation science (IS) to improve the availability of safe blood and blood components and transfusion practices in LMICs. IS describes the late stages of the translational research spectrum and studies optimal and sustainable strategies to deliver proven-effective interventions. Regional working groups were formed to focus on opportunities and challenges in East Africa, Central/West Africa, Middle East and North Africa, Latin America and the Caribbean, Southeast Asia, Western Pacific Asia, Eastern Europe, and Central Asia. The need for an "adequate supply of safe blood" emerged as the major overriding theme. Among the regional working groups, common cross-cutting themes were evident. The majority of research questions, priorities, and strategies fell into the categories of blood availability, blood transfusion safety, appropriate use of blood, quality systems, health economics and budgeting, and training and education in IS. The workshop also brought into focus inadequate country-level data that can be used as the basis for IS initiatives. A mixed approach of needs assessment and targeted interventions with sufficient evidence base to move toward sustainment is an appropriate next step for blood availability and transfusion safety research in LMICs.
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Affiliation(s)
- Brian Custer
- Blood Systems Research Institute, San Francisco, California.,Department of Laboratory Medicine, University of California at San Francisco, San Francisco, California
| | | | | | - Julie Makani
- Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Claude Tayou Tagny
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | | | - Ester C Sabino
- Instituto de Medicina Tropical e Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Diana Teo
- Health Sciences Authority, Singapore
| | - Kenrad Nelson
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Emmanuel Peprah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, Maryland
| | - LeShawndra Price
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, Maryland
| | - Michael M Engelgau
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, Maryland
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Ryberg-Nørholt J, Frederiksen H, Nybo M. Changing reference intervals for haemoglobin in Denmark: Clinical and financial aspects. Biochem Med (Zagreb) 2017; 27:030702. [PMID: 28900365 PMCID: PMC5575647 DOI: 10.11613/bm.2017.030702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/22/2017] [Indexed: 11/30/2022] Open
Abstract
Introduction Based on international experiences and altering demography the reference intervals (RI) for haemoglobin (Hb) concentrations in blood were changed in Denmark in 2013 from 113 - 161 g/L to 117 - 153 g/L for women and from 129 - 177 g/L to 134 - 170 g/L for men. The aim of this study was to determine the derived change in prevalence of anaemia and the change in yearly health care costs of diagnostic investigations associated with the expected, as we hypothesized, increased prevalence and health care costs. Materials and methods Data from 96,314 non-hospitalised patients (55,341 females and 40,973 males, aged 18 - 105 years) from general practitioners and community specialists of Funen, Denmark, were extracted from the laboratory information system. The prevalence of anaemia according to the new and the old RI were investigated, and additional costs were calculated based on estimated additional blood analyses and nationally recommended endoscopic procedures. Results Changing the Hb RI increased the number of anaemic patients by 52% (3450 patients) over a two-year period. With new RI the proportion of anaemic elderly above 80 years was 20.5% for females and 43.9% for males. Annual costs of derived additional assessments due to the altered RI were estimated to be 5.7 million €, which equals the cost of 1214 knee replacement surgeries in Denmark. Conclusions Changing the Hb RI has been expensive, despite the fact that no outcome studies have justified the alteration. The methodological approach for establishing new RI, here particularly for Hb, should be thoroughly considered. In general, physicians should use RI with caution.
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Affiliation(s)
| | | | - Mads Nybo
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
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Satake M, Iwanaga M, Sagara Y, Watanabe T, Okuma K, Hamaguchi I. Incidence of human T-lymphotropic virus 1 infection in adolescent and adult blood donors in Japan: a nationwide retrospective cohort analysis. THE LANCET. INFECTIOUS DISEASES 2016; 16:1246-1254. [PMID: 27567105 DOI: 10.1016/s1473-3099(16)30252-3] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 07/07/2016] [Accepted: 07/07/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Human T-lymphotropic virus 1 (HTLV-1) infection has an especially high prevalence in Japan. Transmission has been confirmed in infancy through breastfeeding; however, little is known about the epidemiological aspects of new HTLV-1 infections later in life. We aimed to estimate the nationwide annual number of new HTLV-1 infections among adolescents and adults in Japan. METHODS In this retrospective cohort analysis, we assessed new HTLV-1 infections of repeat blood donors aged 16-69 years between Jan 1, 2005, and Dec 31, 2006, in the Japanese Red Cross Blood Centres database. We used results of antibody tests done in repeat blood samples collected until Dec 31, 2011, to assess the number who seroconverted to HTLV-1. We calculated the incidence density by dividing the number of seroconverters by the number of person-years of follow-up, and then extrapolated densities to regional populations to estimate the annual number of new HTLV-1 infections. FINDINGS We included 3 375 821 HTLV-1-seronegative blood donors (2 100 915 men and 1 274 906 women). Within a median follow-up of 4·5 years (IQR 2·3-5·8), 532 people (204 men and 328 women) had seroconverted. The incidence density was significantly higher in women (6·88 per 100 000 person-years; 95% CI 6·17-7·66) than in men (2·29 per 100 000 person-years; 95% CI 1·99-2·62; p<0·0001). The estimated annual number of new HTLV-1 infections was 4190 (95% CI 4064-4318) with 975 (914-1038) infections in men and 3215 (3104-3328) in women. INTERPRETATION New HTLV-1 infections in adolescents and adults are an important public health concern in Japan and preventive strategies are needed to reduce new transmission. FUNDING Ministry of Health, Labour, and Welfare of Japan; Japan Agency for Medical Research and Development.
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Affiliation(s)
| | - Masako Iwanaga
- Department of Frontier Life Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Yasuko Sagara
- Kyushu Block Blood Center, Japanese Red Cross, Fukuoka, Japan
| | - Toshiki Watanabe
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Kazu Okuma
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Isao Hamaguchi
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
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Mast AE. Low hemoglobin deferral in blood donors. Transfus Med Rev 2013; 28:18-22. [PMID: 24332843 DOI: 10.1016/j.tmrv.2013.11.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 11/04/2013] [Accepted: 11/08/2013] [Indexed: 11/18/2022]
Abstract
Low hemoglobin deferral occurs in about 10% of attempted whole blood donations and commonly is a consequence of iron deficiency anemia. Pre-menopausal women often have iron deficiency anemia caused by menstruation and pregnancy and have low hemoglobin deferral on their first donation attempt. Frequent donors also develop iron deficiency and iron deficiency anemia because blood donation removes a large amount of iron from the donor and the 56-day minimum inter-donation interval for donors in the United States is not sufficient for recovery of hemoglobin and iron stores. Other causes for low hemoglobin deferral range from a medically insignificant deferral of a woman with hemoglobin between 12.0 and 12.4 g/dL, which is within the normal reference range but below the 12.5 g/dL needed to donate blood, to anemia caused by an unrecognized malignancy in a "healthy" individual attempting to donate blood. The diverse causes of anemia in blood donors make it difficult to provide accurate information to donors about the cause of their low hemoglobin deferral and complicate implementation of programs to prevent them by blood collecting agencies. This article reviews how hemoglobin is measured and the demographics and causes of low hemoglobin deferral in blood donors. It provides recommendations for how blood collection agencies can provide donors with accurate information about the cause of their deferral and discusses programs that can be implemented to decrease these deferrals in regular donors.
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Affiliation(s)
- Alan E Mast
- Blood Research Institute, Blood Center of Wisconsin, Milwaukee, WI, USA; Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA.
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