Effects of a major earthquake on blood donor types and infectious diseases marker rates

Perception of blood donation among employees of healthcare organizations during COVID-19 pandemic: A national multicenter cross-sectional study

BACKGROUND

Maintaining a safe and adequate blood supply during a crisis is a major challenge facing blood banks around the world. With the recent global COVID-19 crisis and the enforced "stay at home" lockdown, access to blood donors was limited. Since employees of healthcare facilities may act as potential blood donors, their perception of blood donation and their willingness to donate during the pandemic period is important to be assessed.

STUDY DESIGN AND METHOD

A national cross-sectional study at six centers in Saudi Arabia was conducted using an online-based questionnaire that was distributed to all healthcare employees in these facilities between June and August 2020.

RESULTS

Among the total of 1664 participants, 63.2% (n = 1051) did not donate blood during the last 2 years. However, 53% (n = 882) of participants reported they are likely to donate blood during the COVID-19 crisis. Furthermore, 85% (n = 1424) did not donate blood during the current pandemic, with the biggest worries of getting the COVID-19 infection in the donor center. The main concerns of participants were about adherence to physical distancing requirements and the safety of the donation procedure. The majority of health care participants (88.2%) support implementing a hospital policy for a voluntary blood donation by employees during crises.

CONCLUSION

Recruitment of more blood donors among health care employees is a feasible solution to improve the blood supply during a crisis. This should be based on efforts throughout the year including regular awareness campaigns and effective communication.

Impact of disasters on blood donation rates and blood safety: A systematic review and meta-analysis

Background and Objectives

Timely and adequate access to safe blood forms an integral part of universal health coverage, but it may be compromised by natural or man‐made disasters. This systematic review provides an overview of the best available scientific evidence on the impact of disasters on blood donation rates and safety outcomes.

Materials and Methods

Five databases (The Cochrane Library, MEDLINE, Embase, Web of Science and CINAHL) were searched until 27 March 2020 for (un)controlled studies investigating the impact of disasters on blood donation rates and/or safety. Risk of bias and overall certainty of the evidence were assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results

Eighteen observational studies were identified, providing very low certainty of evidence (due to high risk of bias, inconsistency and/or imprecision) on the impact of natural (12 studies) and man‐made/technological (6 studies) disasters. The available evidence did not enable us to form any generalizable conclusions on the impact on blood donation rates. Meta‐analyses could not detect any statistically significant changes in transfusion‐transmissible infection (TTI) rates [hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV)‐1/2, human T‐lymphotropic virus I and II (HTLV‐I/II) and syphilis] in donated blood after a disaster, either in first‐time or repeat donors, although the evidence is very uncertain.

Conclusion

The very low certainty of evidence synthetized in this systematic review indicates that it is very uncertain whether there is an association between disaster occurrence and changes in TTI rates in donated blood. The currently available evidence did not allow us to draw generalizable conclusions on the impact of disasters on blood donation rates.

Evaluating the Effect of Inert Recruiting on Blood Donations Immediately After the Consecutive Earthquakes

OBJECTIVE

Disasters can have impact on the demand and supply of blood, with such a difficult perspective, planning of an appropriate response to counterbalance the need for blood is of paramount importance. The primary objective of this study was to evaluate how the impact of blood imbalances may be absorbed by inert recruitment of donors during 2 life-threatening earthquakes that shook Taiwan on the same date in 2016 and 2018.

METHOD

A retrospective database search from blood bank registries was developed.

RESULTS

Despite the public efforts to restrain the flow, a 3- to 4-fold increase in volunteers responded to the earthquakes. This surge alleviated after a day and did not contribute to sub-par collections. Those who donated more than usual immediately after the event were identified as first-time, younger, and female populations. The hospitals providing inpatient care to the injured transfused a slightly decreased amount of packed red cells, whereas the use of whole blood, platelets, and plasma remained stable. The inert recruiting was effective in reducing the duration of donor overabundance.

CONCLUSION

Compared with other examples, the inert recruiting approach was effective in reducing the duration of donor overabundance to 1 day and may be useful for disaster preparedness of transfusion supplies.

Simulation-optimization model for production planning in the blood supply chain

Production planning in the blood supply chain is a challenging task. Many complex factors such as uncertain supply and demand, blood group proportions, shelf life constraints and different collection and production methods have to be taken into account, and thus advanced methodologies are required for decision making. This paper presents an integrated simulation-optimization model to support both strategic and operational decisions in production planning. Discrete-event simulation is used to represent the flows through the supply chain, incorporating collection, production, storing and distribution. On the other hand, an integer linear optimization model running over a rolling planning horizon is used to support daily decisions, such as the required number of donors, collection methods and production planning. This approach is evaluated using real data from a blood center in Colombia. The results show that, using the proposed model, key indicators such as shortages, outdated units, donors required and cost are improved.

The great East Japan earthquake of March 11, 2011, from the vantage point of blood banking and transfusion medicine

BACKGROUND

The Great East Japan Earthquake of March 11, 2011, and subsequent tsunami took nearly 20 000 lives in Tohoku, the northeastern part of Japan's main island. Most victims were either carried away by the tsunami or drowned. The ability to collect blood was disrupted on the Pacific coast of Tohoku. Inland areas were less affected, but allogeneic blood collected in Tohoku is tested at the Miyagi Red Cross Blood Center (Miyagi Center) in the coastal city of Sendai. Miyagi Center was damaged and could not test for 2 months.

OBJECTIVES

The aims of this study are as follows: (1) to assess transfusion practice at 8 disaster response hospitals in Tohoku's Fukushima Prefecture, for equal intervals before and after March 11, 2011; (2) to report activities related to blood collection and distribution in response to the disaster; and (3) to describe the Great East Japan Earthquake in the context of other disasters.

METHODS

Data were collected through a survey of transfusion services at 8 major disaster response hospitals, communication at transfusion conferences, and literature review.

RESULTS

Transfused patients and units transfused were about 70% and 60% of normal in the surveyed hospitals because this was a disaster of mass casualty rather than mass injury, and patients requiring chronic care were evacuated out. A nationally coordinated effort allowed excess blood collected outside Tohoku to be transported in, despite infrastructure damage.

CONCLUSION

Japan's national system of blood collection and distribution responded effectively to local needs after the Great East Japan Earthquake. Disasters such as Japan's 3.11 should guide discourse about emergency preparedness and centralization of services.

First-time donors responding to a national disaster may be an untapped resource for the blood centre

BACKGROUND

On 12 May 2008, a severe earthquake struck Sichuan in China. Many people donated blood for the first time, leading us to question whether these donors might become repeat donors in the future. The return pattern of post-earthquake first-time donors (PEFTD) was compared with that of first-time donors (FTD) in a comparable period.

METHODS

Demographic characteristics, transfusion-transmissible infection rates and 1-year return rates were compared between 5147 PEFTD (5/13-5/19, 2008) and 3176 FTD (5/13-5/19, 2009) from five Chinese blood centres using chi-squared tests. Adjusted logistic regression was used to detect earthquake effect on donor return.

RESULTS

Post-earthquake first-time donors were more frequently between 26 and 45 years, men, and better educated compared with the control group. Slightly higher but not statistically significant increased rates of hepatitis B virus surface antigen (HBsAg) (0·87% vs. 0·50%, P=0·054), hepatitis C virus (HCV) (0·70% vs. 0·63%, P=0·414), syphilis (0·9% vs. 0·7%, P=0·489) and lower rates of human immunodeficiency virus (HIV) (0·31% vs. 0·60%, P=0·078) reactivity were detected for PEFTD. The 1-year return rate for PEFTD was significantly lower than that of the controls (8·0% vs. 13·0%, P<0·001). After adjusting for demographic factors, donation volume and sites, the PEFTD were less likely to return in 1 year than the controls (OR: 0·520; 95% CI: 0·442, 0·611).

CONCLUSION

Post-earthquake first-time donors may be less likely to donate again without continuing motivation strategies. Further studies on PEFTD's lack of motivation to return for donation are needed to design recruitment strategies to convert PEFTD to become repeat donors to continuously replenish the blood supply.

Evaluation of blood supply operation and infectious disease markers in blood donors during the Egyptian revolution

BACKGROUND

The Egyptian revolution took place on January 25, 2011. Millions of protesters demanded the overthrow of the Egyptian president's regime. Many people suffered from life-threatening injuries after violent clashes between police and protesters.

STUDY DESIGN AND METHODS

The overall management of the blood bank operation at Cairo University Hospital was described, in an attempt to evaluate blood safety and establish a standard effective plan to manage blood supply during crisis.

RESULTS

Three days after the uprising, thousands of Egyptians rushed to the hospital to alleviate the blood shortage. A total of 3425 units were collected in 3 days and thousands of donors were turned away. An error delayed processing of 1000 units and they were used as stored whole blood. Apheresis platelets were donated by protesters who were particularly motivated to donate for two victims with liver injury. The usual positive rate of hepatitis C virus (HCV) antibody in Egyptian donors is 3.8%. However, the positive rate of HCV markers in the collected units was only 1.6%. The mean age of donors during the revolution was 31.7±10.4 years while the usual mean age of donors is 39.2±8.5 years. Operating theaters were used only for emergencies. A blood surplus developed that met the hospital needs for 1 month.

CONCLUSION

Revolution resulted in an influx of first-time donors with a relatively low positive rate of HCV antibody. To be prepared for disasters, a systematic approach to spread donors evenly on a daily basis is needed.

Impact of the May 12, 2008, Earthquake on blood donations across five Chinese blood centers

BACKGROUND

On May 12, 2008, a severe earthquake struck China's Sichuan Province. The nationwide outpouring of charity resulted in a surge of subsequent blood donations. The quantity and quality of these donations were examined in comparison with routine donations.

STUDY DESIGN AND METHODS

Whole blood and apheresis donations from five geographically different blood centers collected within 1 week postearthquake were compared with those collected during the rest of the year. Regional differences, demographic characteristics, first-time and repeat donor status, and infectious disease screening markers associated with these donations were compared by earthquake status using chi-square statistics. Poisson regression analysis examined the number of daily donations by earthquake status after adjusting for center, day of week, and seasonal variations.

RESULTS

The number of daily donations across five blood centers increased from 685 on a typical day to 1151 in the postearthquake week. The surge was observed in both sexes and across different education levels, age, and ethnicity groups and three blood centers and was significant after adjusting for confounding covariates. The influx of first-time donors (89.5%) was higher than that of repeat donors (34%). There was a significant change in the overall screening reactive marker rates excluding alanine aminotransferase (2.06% vs. 1.72%% vs. 4.96%). However, when the individual screening test was analyzed separately, no significant differences were found.

CONCLUSION

Timely donations in response to a disaster are crucial to ensure emergency blood transfusion. The dramatically increased postearthquake donations suggest that Chinese blood centers are capable of handling emergency blood needs. Measures to maintain blood safety should be taken in times of emergency.