Characterization of Anamae Among Deffered Blood Donors At The Southern Blood Area Center

ABSTRACT

Background: Anaemia is a state in which the amount of red blood cells (RBCs) is insufficient to meet the body’s physiologic needs depending on age, gender and residential elevation. Blood transfusion may be indicated when there is anaemia. Blood for transfusion is obtained from a healthy person who gives consent for his/her blood to be drawn for the intention of transfusion. To ensure safe blood transfusion, adoption of stringent donor selection criteria is applied and potential blood donors who do not meet the standards are termed deferred donors. Globally, anaemia among deferred blood donors is a problem but it is widespread in developing countries (e.g. Ghana). Most of the anaemias recorded are often times treatable. There is paucity of data on the causes of anaemia among deferred blood donors which is required to help put in place measures to reduce anaemia and ultimately decrease donor deferral and as a result increase blood supply to patients. Aim: The aim of this study was to characterise anaemia among deferred blood donors at the Southern Area Blood Centre. Methods: A cross-sectional study was carried out in deferred blood donors at sites operated by the Southern Area Blood Centre. Ethylenediamine tetra acetic acid (EDTA) anticoagulated blood samples were used in performing full blood count (using the ABX Micros ES60 OT haematology autoanalyser), film comment, malarial tests (thin and thick films). Sera obtained from spun clotted blood from gel separator were aliquoted into Eppendorf tubes and stored at -20oC and later used for biochemical analysis such as iron, ferritin, total iron binding capacity (TIBC) and C-reactive protein using the Urit - 8210 fully automated open system chemistry analyser. Data was entered into Microsoft Excel 2016 and transferred into Stata version 15 for statistical analysis. iv Results: A total of 150 participants (69 (46.0%) males and 81 (54.0%) females) were recruited. The ages of the participants ranged from 17 - 55 years (mean age = 27.19 ± 11.41 years). The deferred anaemic blood donors had haemoglobin (Hb), RBCs, mean cell volume (MCV) and mean cell haemoglobin (MCH) mean values that were lower and statistically significant (all Ps = 0.000) when compared to the non-anaemic deferred blood donors. In contrast, means of red cell distribution width (RDW) and platelet (Plt) in the anaemic category were significantly high (p=0.000) when compared with those of the non-anaemic deferred group. The biochemical profile means such as iron, ferritin and TSAT of the deferred anaemic females were lower than that of their male partners [e.g. iron levels: females 9.52 ± 1.50µmol/l, males 10.15 ± 2.18 µmol/l)]. However, there were no significant differences (p>0.05) between their biochemical profiles. The prevalence of anaemia among the deferred blood donors was 48%. The morphological types of anaemia recorded were microcytic hypochromic (62.5%) and normocytic normochromic (37.5%) and some of the causes of anaemia established in this study were iron deficiency anaemia (63.9%), anaemia of inflammation (18.1%), sickle cell disease (4.2%) and hereditary elliptocytosis (2.8%). Factors such as occupation (social class), being a female, menstrual cycle and duration of menses (among females of reproductive age) and dietary intake were found to be risks determinants for anaemia development. Conclusion: Prevalence of anaemia in potential healthy blood donors was found to be high (48%) and mostly due to iron deficiency anaemia (63.9%) which is a preventable cause of donor deferral. Dietary intake was found to be associated with anaemia and there is the need for nutrition counselling to help improve haemoglobin concentration. This will help prevent anaemia, reduce deferral rates and eventually increase blood supply