Etiology of anemia of blood donor candidates deferred by hematologic screening

Abstract

Objective: Iron deficiency is the most common cause of anemia and one of the main factors in the clinical deferral of blood donors. This fact prompted the current study that aimed to determine the prevalence and etiology of anemia in blood donor candidates and to evaluate the hematological screening technique used for the exclusion of these donors. Methods: This was a prospective study that compared two groups (Anemic and Non-anemic). Initially screening for anemia was performed by manually measuring hemoglobin (Bioclin® Kit); the results were subsequently compared with an automated screening method (Coulter T-890). The etiology was investigated by hemoglobin electrophoresis in alkaline and acid pH, Hb A2 dosage and measurement of the ferritin concentration by immunoagglutination. Differences and associations of interest were analyzed using the Yates and McNemar's Chi-square tests and the Fisher, Mann-Whitney, Wilcoxon and Kruskal-Wallis tests. Results: The deferral rate due to anemia was 4.2%; iron deficiency was identified in 37.5% and beta thalassemia in 9.3% of the excluded candidates. There was a significant discrepancy between the two techniques used to measure hemoglobin with 38.1% of initially deferred donors presenting normal hemoglobin levels by the automated method. Conclusion: The results show a high rate of blood donors being deferred for anemia and confirm that iron deficiency is the most prevalent cause. The discrepancies found by comparing screening methods suggest that hemoglobin and hematocrit levels should be confirmed before deferring a donor due to anemia; this may increase supplies in blood banks.

Anaemia and its association with month and blood phenotype in blood donors in Fako division, Cameroon

“…This may have resulted in a selection bias against females consequently influencing the true representation of the prevalence of anaemia in this group. The finding of fewer female donors in this study corroborate with work done by Silva et al [13]. In this study, the prevalence of anaemia was observed to be higher in participants of 20 years and below irrespective of gender.…”

“…A high prevalence of 31.44% was observed in this study. The prevalence was higher compared to the 16% reported in Nigeria [18], 4.2% in Brazil [13], and 1.8% in India [19]. The difference between the prevalence of anaemia in these studies compared to ours could be attributed to the differences in the nutritional habits of these populations.…”

“…Anaemia is one of the main reasons for deferral (disqualification) of potential blood donors [13]. In countries where the prevalence of anaemia is high, this will have a profound effect on the blood stock, eventually compromising the quality of health care.…”

Low‐grade inflammation is associated with lower haemoglobin levels in healthy individuals: results from the Danish blood donor study

“…The normal daily iron intake is around 15 mg, with only a small proportion of this being absorbed . This makes it difficult for regular blood donors to sustain iron levels, and low Hb is a common cause of deferral from donation . In theory, LGI should lead to slightly higher levels of hepcidin and thus be associated with lower Hb levels.…”

Anemia and the Blood Donor

“…Recent publications have suggested that serum ferritin levels could be a reliable indicator for body iron stores since they provide a determination of iron deficiency at an early stage (11,12) . …”