Sickle cell disease and the need for blood: Barriers to donation for African, Caribbean, and Black young adults in Canada

Abstract

Background: Many blood operators around the world face the challenge of increasing the number of donors of African ancestry to meet the transfusion needs of people living with sickle cell disease. This article reports results of the barriers to blood donation for young adults (aged 19-35) in Canada who identify as African, Caribbean, or Black. Study Design and Methods: A community-based qualitative study was conducted by researchers from community organizations, blood operator, and universities. In-depth focus groups and interviews (n = 23) were conducted from Dec 2021 to Apr 2022 and thematic analysis was completed. Results: Applying a socio-ecological model, multiple levels of interacting barriers to blood donation were identified. These included macro-level barriers (e.g., systemic racism, mistrust of the healthcare system, sociocultural beliefs and views about blood and sickle cell disease), mezzo-level barriers (e.g., deferral criteria, minimum hemoglobin levels, donor questionnaire, access, parental concerns), and microlevel barriers (e.g., limited knowledge of blood needs for people with sickle cell disease, lacking information about blood donation process, fear of needles, personal health concerns). Discussion: This study is the first to focus on barriers to donation for African, Caribbean, and Black young adults across Canada. Parental concerns, informed by parents' experiences of inequitable healthcare and mistrust, emerged as a novel finding in our study population. Results suggest that higher order (macro-level) barriers influence and may reinforce lower order (mezzoand microlevel) barriers.

Awareness, Motivation, and Barrier of Blood Donation among Adults in Puncak Alam

“…In the study conducted by Chin et al (2018), the most prevalent barrier to blood donation was fear of needle prick, pain, or discomfort (45.3%). People are willing to donate blood within their community when they know there's a need, but the barriers to donation vary by context and population, so it's important to understand these barriers locally for specific groups (Haw et al, 2023). According to Mishra (2016), the same conclusion was reached in other studies in which the majority of respondents feared needles and needle insertion pain.…”

HLA-F and LILRB1 Genetic Polymorphisms Associated with Alloimmunisation in Sickle Cell Disease

“…Thus, the limited availability of phenotypically matched RBCs from donors of African ancestry is an important alloimmunisation risk factor in SCD patients. To enhance the recruitment of ethnic minorities in Western countries, studies focused on barriers and motivators to blood donation have revealed significant differences between Caucasian-and African-descent respondents and have advocated dedicated campaigns [14,15]. This imbalance between supply and demand is particularly acute for the highly polymorphic RH and Kell blood group systems, for which recipient/donor compatibility is critical in transfusion practices; consequently, most alloantibodies described in SCD patients are directed against the Rh and Kell systems [10,[16][17][18][19][20].…”