91 1027-9520 Iranian Blood Transfusion Organization Research Center 46 General Transfusion medicine past, present, future Pourfathollah A.A. 1 1 2006 2 7 287 289 17 09 2006 19 08 2014   Transfusion medicine   past, present, future     Pourfathollah A.A.1,2(PhD)     1 Tarbiat Modarres University   2 Iranian Blood Transfusion Organization-Research Center
47 General Prevalence of hepatitis B, C and HIV in hemophiliac patients of East Azarbaijan in 2004 Torabi S.A. Abed-Ashtiani K. Dehkada R. Moghadam A.N. Bahram M.Kh. Dolatkhah R. Babaei J. Taheri N. 1 1 2006 2 7 291 299 17 09 2006 19 08 2014   Abstract     Background and Objectives   Due to frequent tranfusion of blood components, hemophiliac patients have been exposed to a wide range of blood-borne viruses, among which the human immune deficiency virus (HIV) and the hepatitis C virus (HCV) have had a considerable impact on their life. Prior to the introduction of virus-inactivation methods in 1985, almost all treated hemophiliacs had been infected with HCV transmited by factor concentrates, and in most countries almost 50% of hemophiliacs had also been infected with HIV.   Materials and Methods   162 patients with inherited coagulation disorders including 113 hemophilia A and 17 hemophilia B patients living in East Azarbaijan participated in this observational study. The patients started to be tested for anti-HCV, anti-HIV, and HBs-Ag in 2003. Demographic information were gathered through questionnaires and some other information was taken from patients' medical records.  Results   Among 113 hemophilia A and 17 hemophilia B patients, 63 (56%) and 9 (53%) were seropoitive for HCV-Ab respectively. The youngest patient who was seropositive for HCV-Ab was eleven years old, and his first blood transfusion occurred in 1993. No child under the age of 10 was HCV positive in other words, there was no case of HCV in 1995 (P<0.001). In hemophilia A group one patient (0.9%) was seropositive for HIV and 3 (2.7%) were seropositive for HBs-Ag. HCV status was also related to baseline factor activity level. In more severely affected patients of both group A and B (< 1% factor activity) , the prevalence of HCV was 75%.  Conclusions   Hemophiliac patients born after 1995 have no evidence of HIV infection. Only one patient (0.9%) was seropositive for HIV and in this respect our province as compared with other countries is in a good condition.     Key words: Hemophilia, Hepatitis C, Hepatitis B, HIV 48 General A comparison of seroprevalence of blood-borne infections among regular, sporadic, and first-time blood donors in Isfahan Masaeli Z. Jaberi M.R. Magsudlu M. 1 1 2006 2 7 301 307 17 09 2006 19 08 2014   Abstract  Background and Objectives In recent years there have been special interest in the donor selection strategies in blood banks in order to provide safer blood supply. Important steps are exclusion of paid and replacement donation and increase in the number of regular donors. In this survey the seroprevalence of blood-borne infections among regular, sporadic (lapsed) and first-time blood donors were compared (from August 2002 to March 2003).   Materials and Methods In a retrospective study the prevalence of transfusion transmitted infections was compared among regular, sporadic (lapsed) and first-time blood donors of Isfahan city. The total of 29458 blood donors donated blood during August 2002 to March 2003 in Isfahan out of this number, 16620 were regular donors (56.42%), 5742 sporadic donors (19.49%), and 7096 first-time donors (24.09%). Data were collected from the computerized data source of Isfahan Blood Transfusion Center and were then compared by the c 2 test.   Results Out of 16620 regular donors, 64 (0.385%) were HBsAg positive, 32 (0.192%) were HCV-Ab reactive, and all were HIV-Ab negative. Whereas, out of 5742 sporadic donors 55(0.958%) were HBsAg positive, 18 (0.313%) HCV-Ab reactive, and one (0.017%) was HIV-Ab reactive. Out of 7096 first-time blood donors, 42 (0.592%) were HBsAg positive, and 22 (0.31%) HCV-Ab reactive. No HIV-Ab reactive donors were detected. The prevalence of blood-borne infections (hepatitis B, hepatitis C and HIV) was less in regular than sporadic and first-time blood donors. The difference was significant (p=0.000 for regular and sporadic donors and p=0.005 for regular and first-time donors).   Conclusions Regular blood donation is one of the important steps in blood safety hence, retention of regular donors, and awareness-raising and recruitment of sporadic and first-time donors can increase the rate of regular donation leading in turn to higher blood safety.   Key words : Blood donor, Prevalence, Infection 594 Blood donation Impact of natural disasters on blood safety Banitalebi Dehkordi M. 1 1 2006 2 7 309 314 16 01 2012 19 08 2014 Abstract Background and Objectives The use of blood and blood products is one of the necessities of clinics. Blood donation should comply with international criteria because of the probability of transmission of infections following blood transfusion. One of the priorities in reliable blood transfusion centers in the world and in our country will be the improvement of the donor recruitment methods. It seems that recent methods are useful in non-emergencies. The use of such methods in emergency cases like what happened in Bam earthquake is practically impossible. This study aims to see if this would endanger blood safety. Materials and Methods In this cross-sectional study, 4188 blood units including 2094 blood units collected (as case group) immediately after Bam earthquake and 2094 units collected (as control group) before Bam earthquake were studied. In this process all blood units in the case and control groups were tested for HBV, HCV and HIV by Elisa method. We repeated positive results by Elisa. If test results were positive again, we would use confirmation tests (western blot and RIBA). Results The results show that there is a significant difference in Binomial test between control and case group (PV<0.001) for HBV and HCV before and after Bam earthquake however, no difference was observed for HIV between two groups. Conclusions Higher rate of serologically positive results in case group shows that there is a higher risk in emergencies for transmission of viral infections. To decrease this risk, it is proposed that blood donation is managed by implementing control mechanisms in emergency conditions. 595 Infectious disease Study of the prevalence of hepatitis B, C and HIV infection in hemophilia and thalassemia population of Yazd Javadzadeh Shahshahani H. Atar M. Yavari M.T. Savabieh Sh. 1 1 2006 2 7 315 322 16 01 2012 19 08 2014   Abstract  Background and Objectives As hemophilia and thalassemia patients are in regular need of blood or blood products, they are exposed to blood units of hundreds or even thousands of blood donors therefore, they are at a high risk of acquiring blood transmissible infections. Different prevalent rates of hepatitis B, C and HIV infection in hemophilia and thalassemia populations have been reported in various regions of Iran and the world. The present study was conducted to determine the prevalence of hepatitis B, C and HIV infection in hemophilia and thalassemia population of Yazd province of Iran.   Materials and Methods In this descriptive study, 85 thalassemia major and 74 hemophilia patients were included. The necessary information was gathered from the patients, blood samples were tested for serum markers of anti-HIV, anti-HCV and HBsAg by the ELISA method, and positive cases were confirmed by Western blot, RIBA and neutralization methods. The data were analyzed by Chi square and Fisher exact tests.   Results None of the thalassemia patients was positive for HIV Ab or HBsAg, while 9.4% were anti-HCV positive. In hemophilia patients, the prevalence of HIV Ab and HBsAg was 1.4%, while that of anti-HCV was 48.6%. The prevalence of anti-HCV in those patients who had received blood or blood products after implementation of the screening program in the country was significantly lower (P=0.02, P<0.000). Overall, the prevalence of hepatitis C as compared to hepatitis B and HIV was higher in both the hemophilia and thalassemia patients.   Conclusions Hepatitis C is the main problem of these patients, especially hemophiliacs. The screening program in the country has led to a significant reduction in the incidence of hepatitis C. In order to reduce the risks of transmissible infections by blood and blood products in the future, it is proposed tests that are more sensitive be used, especially for reduction of the window period of hepatitis C. For hemophiliacs, virally inactivated factor concentrates should be used in case such concentrates are not adequately available , donor retested quarantined plasma should be used.  52 General Evaluation of demographic profiles and prevalence of major viral markers in first time vs repeat blood donors in Esfahan Pourazar A. Akbari N. Hariri M. Yavari F. Akbari Sh. 1 1 2006 2 7 323 329 17 09 2006 19 08 2014   Abstract  Background and objectives Demographic profiles of blood donors and prevalence of major viral markers in them are important as for as blood supply and donor retention are concerned. In this study, profiles of blood donors and prevalence of viral markers were studied in first-time donors and were then compared with those of repeat donors.    Materials and Methods This study was carried out with census method in Esfahan Blood Transfusion Center in 2003. All samples were tested with ELISA method and reactive samples were confirmed. The findings were compared with those of repeat blood donors by c 2 and t- test.    Results The age average and marital status rate in first time blood donors were less than the repeat donors (CI: 95%, P<0.05). The frequency of first-time female blood donors was very low. Most of first-time blood donors were businessmen and the second larger group belonged to employees (CI: 95%, P<0.05). Frequency of HBs Ag and HCV Ab reactive results in first-time blood donors was 1.4% and 0.5% respectively, and HIV Ab was negative for all of them. These values for repeat donors were 0.5% and 0.2% respectively, and HIV Ab was positive in 0.004% of these donors.   Conclusions Iranian demographic data were different form developed countries. However, low frequency of female blood donors and lower prevalence of HBs Ag and HCV Ab in repeat blood donors were significant.      Key words : First-time donors, Repeat donors, Demographic, Viral markers  53 General Assessment of prevalence and risk factors of hepatitis C virus infection in haemodialysis patients in Ghazvin Bozorghi S.H. Ramezany H. Vahid T. Mostajeri A. Kareghar Fard H. Rezayi M. Ashayeri N. Alaviyan S.M. 1 1 2006 2 7 331 337 17 09 2006 19 08 2014  Abstract    Background and Objectives   Hepatitis C virus (HCV) is one of the most prevalent causes of viral hepatitis in haemodialysis (HD) and kidney transplant patients. In average, 20% of HD patients are infected with HCV. But this prevalence differs in various areas of the world. The aim of this study is to assess prevalence and risk factors of HCV infection in HD patients.     Materials and Methods   This descriptive cross-sectional study was performed on 89 HD patients in Ghazvin in 1383. Risk factors were assessed for each patient. Then, blood samples of these subjects were evaluated for Anti-HCV Ab by ELISA and RIBA. In analysis of t-test, Chi2 and Fisher exact were used. Logistic regression was also conducted to predict infection with HC.     Results   There were 45 (50.6%) female and 44 (49.4%) male subjects. Age average was 50.97 (SD=14.94). Anti-HCV Ab in 9 (10.3%) patients was positive by ELISA. Along risk factors, marital status, date of first blood transfusion attempt (before 1375 according to Iranian calendar ), frequency of blood transfusion (above 20 times), and HD duration had significant correlation with hepatitis C infection (p=0.002, p=0.003, p=0.032, and p= 0.00 respectively).     Conclusions   According to this study, the prevalence of hepatitis C in HD patients in Ghazvin was 6.4% that shows decrease in rate of infection in comparison to 23.9% in 1380. Because of various side effects and restricted efficacy of available drugs, prevention considering risk factors is necessary.     Key words: Hepatitis C virus, Haemodialysis patient, Prevalence 54 General Seroepidemiological investigation of hepatitis B,C and HIV virus in safe blood donors of Babol Blood Transfusion Center AghaJaniPoor K. Zandieh T. 1 1 2006 2 7 339 341 17 09 2006 19 08 2014   Seroepidemiological investigation of hepatitis B,C and HIV virus in safe blood donors of Babol Blood Transfusion Center       AghaJaniPoor K.1,2 (MD), Zandieh T.1(PhD)       1 Iranian Blood Transfusion Organization-Research Center   2 Amol Regional Blood Transfusion Center    55 General Prevalence of blood transmitted viral infections in regular and non-regular donors of Arak Blood Center Mahdaviani F. Saremi S. Maghsoudlu M. Pourfathollah A.A. 1 1 2006 2 7 343 351 17 09 2006 19 08 2014  Abstract   Background and Objectives  Blood transmitted infections have always made problems in the use of blood and blood products. In this study, the prevalence of hepatitis B, C and HIV and relevant factors were evaluated among regular and non-regular donors in Arak Blood Center in the first six months of the year 1383 (2004).     Materials and Methods   11615 donors of Arak Blood Transfusion Center were selected. The required data were gathered by reviewing donor forms. Finaly, the subjects divided into regular and non-reguler donors according to demographic properties were compared. Results were analyzed based on Fisher Exact Test and Logistic Regression in spss software.    Results  40% of donors were regular and 60% non-regular. According to confirmed tests, prevalence of HBV, HCV and HIV were 0.68% , 0.2% and 0% in blood donors. These fiqures were 0.1%, 0.02% and 0% in regular donors and 0.05%, 0.45% and 0% in non-regular donors respectively. 1.4% of all blood donations were discarded for being positive in Elisa tests this rate is 111 times higher among non-regular donors. In this study viral infections in non-regular donors had more prevalence (p<0.0001) prevalence of these infections in regular donors was higher among men and lower in employees (p<0.05) as tested by Elisa. The results for both groups of subjects were higher in mobile units (p<0.05). Prevalence of infections was lower among non-regular donors as appeared in confirmed tests in subjects with bachelor degree or higher (p<0.05).    Conclusions  Prevalence of viral infections among regular donors was much lower than non-regular donors. Proper awareness-raising of donors about viral diseases, criteria for blood donation, appropriate behavior for blood donation in order to promote regular donation are ways to decrease viral infections.    Key words: Prevalence, HIV, HCV, HBV 56 General Donor deferral and blood-borne infections in blood donors of Tehran Attarchi Z. Ghafouri M. Hajibaygi B. Assari Sh. Alavian S.M. 1 1 2006 2 7 353 364 17 09 2006 19 08 2014   Abstract  Background and Objectives Blood transfusion organizations screen blood donors by conducting interviews and serological tests to ensure blood safety. This study was conducted to study donor deferral, blood-borne infections, and related variables in Tehran Blood Transfusion Center (TBTC) during an 8- month period in 2003.   Materials and Methods In this cross-sectional study, 34823 volunteer blood donors were selected randomly from all clients of Tehran Blood Transfusion Center over a period of 8 months (from June 2003 to January 2004). The prevalence of HBV, HCV and HIV was studied in 26645 eligible blood donors. Correlation of donor deferral with blood-borne infections, demographic (gender, age, marital status, job, educational level) traits and donation-related variables (regular donation) was studied.   Results Deferral rate was 22.5% in the study period. Risk of blood transfusion transmitted diseases, disease/ exposure, medication, and other factors leading to blood deferral came out to happen in 43.36%, 34.02%, 13.91% and 15.42% of cases respectively. The age range less than 40, female gender, single status, low level education, non-regular donation and some job categories correlated with lower deferral rate. The prevalence rates of HBV, HCV and HIV were 0.6%, 0.2%, and 0.003%, respectively. Higher prevalence of HBV was significantly correlated with the age range over 40 years old (p=0.000), lower educational levels (p=0.002), and married status (p=0.001). HCV was not significantly correlated with any of these variables (p>0.05).   Conclusions This study highlights that the recruitment of males, those with age range below 40, singles, those with higher educational level, and regular donors in Tehran will increase the supply of blood components. Moreover, recruitment of females, those with age range below 40, those with higher educational levels, and regular donors will provide safer blood products. Such studies are recommended for all blood transfusion centers in all provinces of Iran.   Key words : Blood donation, Donor deferral, Cause of deferral, HBV, HCV, HIV 57 General Evaluation of knowledge and attitude of female teachers and students (above 17 years of age) about donation in Ardabil province girl high schools Bazazataei A. Davarnia B. SadegyyeAharry S. Haghighy S. Azami A. 1 1 2006 2 7 365 372 17 09 2006 19 08 2014   Abstract  Background and Objectives  To ensure safe and adequate blood supply to meet patients' needs is the main goal of blood centers. To this end, regular blood donors play an important role especially recruitment of female teachers and students is very significant. In this study, we aimed to study reasons why females as compared with males are less motivated to embark on blood donation.    Materials and Methods This survey was a cross-sectional research. A questionnaire was used to gather data on the knowledge and attitude of 280 female teachers and 280 female students about blood donation . SPSS statistical software was used for data analysis.    Results The age average of students and teachers were 17/9±1/39 and 33.7±6.74 respectively. 10% of female students and 21% of female teachers had the experience of blood donation. The main positive motivation for blood donation in both groups came out of altruistic causes. 35% of students and 21% of teachers were afraid of blood donation, 40% of students and 57% of teachers were afraid of anemia, and finally 32.2% of students and 17% of teachers were not allowed by their parents and hubands to donate blood.   Conclusions In this study , three main negative motivation causes for females to embark on blood donation came out to be fear of donation, fear of getting anemia, and lack of permission by their parents and husbands.    Key words : Blood donation, Safe and sufficient blood, Knowledge, Attitude, Teachers, Students above 17 years old, Girl high schools 58 General Evaluation of demographic characteristics and hepatitis B,C and HIV prevalence among blood donors in Jahrom Emamghorashi F. Fathi G.H. Mohtashami A. 1 1 2006 2 7 373 378 17 09 2006 19 08 2014   Abstract    Background and Objectives Evaluation of demography and prevalence of HBsAg, HCV and HIV in blood donors in Jahrom was the goal of this study.     Materials and Methods  Data includeing age, sex, job, education level, underlying diseases, serologic tests (HBsAg, HCV, HIV) were obtained from files of blood donors who referred to blood center in Jahrom during 2001-2003.    Results The average age of blood donors was 32.52±5.6 92.2% of them were male. Most of the blood donors (71.9%) were rural inhabitants. Having free jobs (43.5%) and being government employees (14.5%) were the most frequent job categories.The prevalence of HBsAg and HCV was 0.4 and 0.3% respectively. No case of HIV was detected.    Conclusions Age and sex distribution of blood donors in present study was similar to other studies, but job and education frequency was different. The prevalence of HBV, HCV and HIV was lower than others parts of the world.    Key words: Demography, Blood donor, HBV , HCV , HIV 59 General Haemoglobinometry of the 1st and 2nd blood drops by WHO haemoglobin colour scale and its comparison with automated blood cell counter Heidarzadeh M. Sultani Z. 1 1 2006 2 7 379 384 17 09 2006 19 08 2014   Abstract    Background and Objectives  After many blood donors being rejected cause of anaemia detected by WHO haemoglobin colour scale, we thought that the first blood drops may have been mixed with the extra cellular fluid leading to the lower range of Hb concentration. Then, we decided to assess the 2nd blood drops so as to compare the results of both 1st and 2nd drops with those of the automated blood cell counter.     Materials and Methods   A descriptive study was conducted. WHO haemoglobin colour scale and automated blood cell counter were used to test 100 blood donor samples. In this study, we considered 12.5g/dl as the cut off point.    Results  The study indicated that there are 26% false readings in the assessment of the 1st drop by WHO haemoglobin colour scale this figure includes 26% false rejection and 0% false acceptance. Test sensitivity and its specificity are 100 and 72.9% respectively. In the assessment of the 2nd drop, we faced 8% false reading including 5% false rejection and 3% false acceptance. Its sensitivity and specificity were 25 and 94.7% respectively.   Conclusions  Our research has shown that cause of 26% false rejection in the 1st drop and the low test sensitivity of 25% in the 2nd drop, none of the 1st and 2nd drops are the favorite scale test for screening anaemia among blood donors.    Key words: Anemia, Screening, Blood donors, Haemoglobinometry 60 General ‍Comparison of cell counter indices in differentiation of beta thalassemia minor from iron deficiency anemia Ghafouri M. Mostaan Sefat L. Sharifi Sh. Hosseini Gohari L. Attarchi Z. 1 1 2006 2 7 385 389 17 09 2006 19 08 2014   Abstract  Background and Objectives  Distinguishing two common hypochromic microcytic anemias (i.e. iron deficiency anemia and minor thalassemia) needs expensive laboratory tests not readily available everywhere. A number of indices derived from original cell counter parameters were tried to screen patients these indices are compared in this study.    Materials and Methods  Four indices of England, Mentzer, Shine and MDHL were calculated for 110 cases of known thalassemia minors and 61 iron deficients. The best cut-off point for each index was selected by receiver operator characteristic (ROC) analysis reaching the highest sensitivity to separate thalassemics from iron deficients. Sensitivity and specificity of indices were compared.�   Results  Mentzer’s index(sensitivity:90.9, specificity:80.3) had the best results.    Conclusions  It seems Mentzer’s index can be used widely to screen hypochromic microcytic anemic patients. Tests like hemoglobin electrophoresis, genetic studies, serum iron, TIBC and ferritin measurement should be reserved for selected patients in refferal centers. In this way we reduce public health costs significantly.    Key words : Differential diagnosis, Minor thalassemia, Iron deficiency 61 General The impact of economic factors on haemophilia care Gharehbaghian A. Arman L. 1 1 2006 2 7 391 393 17 09 2006 19 08 2014