BACKGROUNDBlood donor selection, consisting of a pre‐donation questionnaire and interview, excludes potential donors who may be at risk of transfusion‐transmissible infections. Assessing the reasons for noncompliance with blood donor selection criteria is important to maintain a high level of viral safety of blood products.STUDY DESIGN AND METHODSAn anonymous French online survey of a sample of blood donors (Complidon) was conducted from September to December 2017. Data were poststratified to be representative of all donors who donated blood between July 2016 and December 2017.RESULTSOf 420,190 solicited donors, 108,386 completed the survey (26%). Overall, noncompliance was estimated at 5.6%. The least respected criteria regarded sex with more than one partner during the previous 4 months for donors (1.9%) and for donors' partners (1%), travel‐related criteria (1.2%) and sex between men during the previous 12 months (0.73% of men). Reasons for noncompliance differed according to criteria. Donors who were non‐compliant to sexuality‐based criteria mainly said they did not want to be excluded or that the questions were too personal. Conversely, donors who were exclusively non‐compliant to criteria other than sexuality‐based criteria more often mentioned their non‐compliance during the pre‐donation interview but were nevertheless authorized to donate blood.CONCLUSIONDespite noncompliance to blood donor criteria being relatively low in France, it still represents a threat to blood safety. Accordingly, improved communication is important to ensure that donors fully understand each selection criterion and to emphasize to health professionals the importance of listening carefully without judging during pre‐donation interviews.
Background
The objectives of this study are to estimate the prevalence of iron deficiency (ID) among French whole‐blood (WB) donors to identify factors associated with ID and to generate decision trees.
Study design and methods
A prospective National multicentre study was performed on WB donors from March 11, to April 5th, 2019. Samples were selected randomly to perform serum ferritin. ID was defined as ferritin value under 26 ng/ml. All results were stratified by sex. Factors associated with ID were analysed using multivariate logistic regression model. CART algorithm was used for decision trees.
Results
Eleven thousand two hundred fifty eight WB donors were included. ID was more frequent in women (39·5%) than in men (18·0%). Among 7200 repeated donors, women below 50 yo had a higher risk (OR = 2·37; [1·97–2·85] IC95) than those above 50 yo. Factors associated with ID were: haemoglobin level under the threshold at donation n‐1 except for women and n‐2 donation; a low mean corpuscular haemoglobin at n‐1 and n‐2 donations; a shorter interval since n‐1 donation and between n‐1 and n‐2 donations except for women; and women who had given three or four times in the last year. CART algorithm defined high risk of ID subgroups within three populations of donors, new female donors, repeated male donors and repeated female donors. In these identified subgroups, prevalence of ID was up to 72·1%.
Conclusions
Our study showed the high prevalence of ID among French WB donors, identified well‐known and new factors associated with ID and defined algorithms predicting ID in three populations.
This study demonstrated the need for more communication on the epidemiologic basis for donor selection criteria and on the window period to facilitate donor compliance. These findings have already advanced improvements to predonation documents, in a larger context of 2016 donor selection criteria revision.
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