A cross-sectional study was carried out in University of Malaya Medical Centre, Kuala Lumpur. Blood samples from 100 HIV-infected patients and 203 Healthy Blood Donors (HBD) were collected and anti-Toxoplasma antibodies were detected by using conventional ELISA. The seroprevalence of toxoplasmosis in HIV/AIDS and Healthy Blood Donors were found to be 21% and 28.1% respectively. There was no significant association between the seroprevalence of toxoplasmosis and various possible risk factors i.e. contact with cat, consumption of undercooked meat and history of blood transfusion in both groups. No significant differences between Toxoplasma seroprevalence in HIV/AIDS and Healthy Blood Donors in association with presence of single or multiple risk factors were found. The mean CD4 count among HIV/AIDS patients in this study was 202.23 cell/cumm. There was no significant association between CD4 count and seropositivity for Toxoplasma antibodies in HIV/AIDS patients.
Anti-HCV antibody was detected in 1.9% of the blood donors in University Hospital. Among the risk groups, 33.3% of the patients with post-transfusion hepatitis were tested positive for anti-HCV antibody. The anti-HCV antibody was detected in 30% of the IDU. Haemodialysis patients, patients with acute and chronic hepatitis and patients with liver cirrhosis appeared to have increased risk of Hepatitis C virus infection. The results indicate that the frequency of HCV infection increases with the exposure to blood or blood products.
Neorickettsia sennetsu has been described from Japan and Malaysia, causing a largely forgotten infectious mononucleosis-like disease. Because it is believed to be contracted from eating raw fish, frequently consumed in the Lao PDR, we looked for evidence of N. sennetsu among Lao patients and fish. A buffy coat from 1 of 91 patients with undifferentiated fever was positive by 16S rRNA amplification and sequencing and real-time polymerase chain reactions (PCR) targeting two N. sennetsu genes. Lao blood donors and patients with fever, hepatitis, or jaundice (N = 1,132) had a high prevalence (17%) of immunofluorescence assay IgG anti-N. sennetsu antibodies compared with 4% and 0% from febrile patients (N = 848) in Thailand and Malaysia, respectively. We found N. sennetsu DNA by PCR, for the first time, in a fish (Anabas testudineus). These data suggest that sennetsu may be an under-recognized cause of fever and are consistent with the hypothesis that it may be contracted from eating raw fish.
The World Health Organization (WHO) recommend that all donated blood are to be screened for at least three viral infections [human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV)]. The National Blood Centre, Kuala Lumpur (NBCKL) aims to reduce transfusion transmitted infections (TTI) as it still remains as one of the major risk for blood transfusion. A cross sectional study was conducted at the National Blood Centre, Kuala Lumpur from 1st January 2009 to 31st June 2010. Data from 581,020 donors were analyzed from year 2004 to 2008. All data were retrieved from NBCKL Blood Bank Information System (BBIS). A total of 201 repeat donors were included in the study based on the inclusion criteria but only 132 repeat donors agreed to participate. Information on sociodemographic, risk factors, knowledge of donors and high risk behavior were extracted from standardize questionnaire. Data were analyzed using SPSS version 14.0. The aim of this study was to determine the predictors of the seropositive infectivity among repeat blood donors at the NBCKL. The results showed Syphilis accounts for the highest and increasing seroconversion rate among other infections from 20.83 % in year 2004 to 44.6 % in year in year 2008. HIV and HCV infection also showed increasing seroconversion rate in 5 years' time from 6.41 % in year 2004 to 17.54 % in year 2008 and 4.8 % in year 2004 to 5.94 % in year 2008 respectively. However, HBV infection alone showed a decreasing seroconversion rate from 20.83 % in year 2004 to 10.4 % in year 2008. Level of donors' awareness regarding high risk factors (activities or behaviour) can lead to higher risk of TTI with significant p value in this predictors model(p blood donors with high risk activities are more likely to have seropositive results for HBV, HIV and Syphilis. This study found that the frequency of HCV seropositivity is higher among lapsed donor. Socio demographic factors such as male and working in the private sector predominates in all TTI markers. Majority of the respondents were aware about relation of high risk activities and risk of TTI.
Iron deficiency is a major complication of regular blood donation as a result of regular iron loss from each donated blood unit. Ninety-two regular blood donors and 95 first time blood donors attending a hospital-based blood transfusion centre were assessed as to their haematological and iron status by blood counts and serum ferritin levels as an indicator of iron stores. All donors had passed the haemoglobin-screening test using a copper sulphate method prior to blood donation. Ferritin levels were found to be significantly lower among regular blood donors (47.8 mmol/L) as compared to first time blood donors (94.2 mmol/L). Iron deficiency as observed by low ferritin levels was seen in 7.4% of all first time donors as compared to 17.4% in regular donors. Male first time donors showed a low prevalence of iron deficiency but the prevalence significantly increased with regular blood donation. Female first time and regular blood donors however did not show any significant differences in prevalence of iron deficiency, with both groups exhibiting prevalence rates similar to male regular donors. The association between haemoglobin levels and iron deficiency was poor and the copper sulphate-screening test was found insensitive to anaemia with many donors passing the test and donating blood despite being anaemic. It is concluded that a high prevalence of iron deficiency is present among regular male blood donors and all female donors. Besides, the use of the copper sulphate screening test as a sole criterion for anaemia screening should be reviewed. Ferritin measurements should be included in the routine assessment of blood donors especially among regular blood donors.
The objective of this study was to identify haematological parameters useful in screening for iron deficiency among blood donors. Iron deficiency is a common complication of blood donation and often goes unrecognized until anaemia develops. Biochemical markers such as soluble transferrin receptor (TfR), ferritin and log(TfR/F) have been proposed as more valid indicators of body iron status. Red blood cell (RBC) parameters are, however, more easily measured and have also been proposed as indicators of iron depletion. We measured ferritin and TfR in 192 blood donors together with RBC analysis, performed on two haematology analysers. Thirteen donors had parameters suggestive of haemoglobinopathy and were excluded from further analysis. Overall, 10% (18/179) of the remaining donors had iron deficiency, as defined by log(TfR/F) exceeding the 95th percentile of the value in the population of first-time donors. Using receiver operating characteristic analysis, the sensitivity of ferritin was 100%, with a specificity of 90% at a cut-off of 15 mug L(-1). The sensitivity and specificity of RBC-Y at a cut-off of 152 for detecting iron deficiency were 81 and 89%, respectively. Haemoglobin content of reticulocytes, meanwhile, showed sensitivity of 69% and specificity of 93% when a cut-off of 28 pg was used. Both measures compare favourably with haemoglobin which only showed a sensitivity of 50%, although specificity was 91% at a cut-off value of 125 g L(-1). The parameter RBC-Y can be useful as a screening measure for iron deficiency in blood donors.
Dengue virus is one of the emerging agents that can be transmitted via blood transfusion from infected blood donors to recipients. In Malaysia, the increase in dengue infection may contribute to the existence of asymptomatic blood donors and increase the risk of blood supply contaminated with this virus. The aims of this study were to investigate the prevalence of NS1 dengue antigen among blood donors and to ascertain the demographic data of blood donors in Penang and and Perak. Methods: A total of 374 voluntary blood donors were recruited from two blood donation campaigns organised by Hospital Pulau Pinang, Penang and Hospital Raja Permaisuri Bainun, Ipoh, Perak from April to May 2016. From each centre, 187 voluntary blood donors were enrolled, blood was collected and Dengue NS1 Ag was screened on all the samples using Platelia dengue antigen test kit from Bio-Rad Laboratories, France. Results: All 374 samples were found to be negative for the Dengue NS1 antigen. Demographic data of these blood donors showed that the most common blood group was O Rh positive, men donated more than women and Chinese blood donors were the biggest group of donors. Conclusion: Even though dengue is endemic in Malaysia, none of the blood donors was screened positive for dengue NS1 antigen in the areas studied. This indicates that none of the blood donor at the time of donation was in viraemia stage. The established donor screening program ensures that the dengue transmission through transfusion is minimal in the areas studied.
We report the first case of young woman with the p phenotype and anti-PP1P(k) antibody in the Malaysian population who was identified during a blood grouping and antibody screening procedure after her first miscarriage. Further family screening detected two other siblings who possessed the same rare phenotype and antibody. Because of difficulties in finding compatible units in the local population, the patient and her two siblings were advised to become regular blood donor. Their blood was frozen for future use. After she had two recurrent miscarriages, her third pregnancy was successfully managed using oral dydrogesterone, which was started from 10 weeks into the pregnancy. Her pregnancy was uneventful and she gave birth to a healthy term neonate.
OBJECTIVE: We here report the first study on the distribution of red cell antigens and phenotype frequencies of various blood group systems in Maldives.
METHOD: Randomly selected 123 regular blood donors of O group were phenotyped for seven blood group systems by direct tube agglutination and or indirect antiglobulin tests. Blood group systems studied were Rh, Kidd, Duffy, Lewis, Kell, P and MNS system.
RESULTS: Rh blood grouping showed, 7.3% donors were Rh(D) negative, 92.7% were Rh(D) positive with the predominance of genotype complex of DCe/DCe (39.0%). The incidence of Jk(a+b+) phenotype was the most common in Kidd system. In Duffy system, the incidence of Fy(a+b+) phenotype was 50.4%. Lewis system was predominated by Le(a-b+) phenotype accounting to 80.5% of the donors. In the Kell system only two phenotypes were present, K+k- (5.7%) and k+k+ (94.3%), in the Maldivian blood donors. P system was represented by P1, P2 and P2k phenotypes with an incidence of 28.5%, 70.7% and 0.8% respectively. In the MNS system, MNss and MNSs phenotypes summed up to 48.8% of blood donors.
CONCLUSION: The detail knowledge of red cell antigen composition and their frequencies in the Maldivian population will be helpful in terms of population genetic perspectives, in establishing a donor data-bank for in-house production of indigenous screening and identification cell panels, and facilitate availability of antigen negative compatible blood for patients with previously identified multiple alloantibodies.
Malaysia is a medium endemic country for hepatitis B virus (HBV) infection but little is known about HBV strains circulating in Malaysian blood donors. Viral load, HBsAg concentrations and nested PCR products from 84 HBV surface antigen (HBsAg) positive samples were analysed in detail. Median viral load was 3050 IU/mL and median HBsAg 1150 IU/mL. Fifty-six full genome, 20 pre-S/S, 1 S gene and six basic core promoter/precore-only sequences were obtained. Genotypes B and C were present at a ratio of 2:1, and two genotype D samples were obtained, both from donors of Indian background. Phylogenetically, genotype B was more diverse with subgenotypes B2-5, B7 and B8 present, while most genotype C strains were from subgenotype C1. Genotypes B and C were equally frequent in ethnic Malays, but 80% of strains from Chinese were genotype B. HBsAg concentrations were higher in genotype C than in genotype B, in Chinese than Malays and in donors under the age of 30. HBV vaccine escape substitutions (P120S/T, I126N and G145G) were present in six strains. In the large surface protein, immuno-inactive regions were more mutated than CD8 epitopes and the major hydrophilic region. Strains of genotype B or from ethnic Malays had higher genetic diversity than strains of genotype C or from Chinese donors. Hence HBV strains circulating in Malaysia are phylogenetically diverse reflecting the ethnic mix of its population. Ethnic Malays carry lower HBsAg levels and higher genetic diversity of the surface antigen, possibly resulting in more effective immune control of the infection.
Introduction: The healthy, active, and receptive huge student population is potential blood donors to meet safe blood requirements. The study aimed to assess the current level of knowledge regarding blood donation of nursing students of the Faculty of Medicine & Health Sciences, UMS and to observe their attitude towards voluntary blood donation and to explore their practice as a voluntary blood donor. Methods: This cross-sectional study was con- ducted from July 2015 to June 2018 among one hundred and eight (108) nursing students who were included in this study by simple random sampling. The researchers explained the study design, objectives, and methodology to the selected subjects and obtained written consent from them. The study assessed the current level of knowledge and observed their attitude towards voluntary blood donation and explored their active involvement in donating blood through a validated questionnaire. Results: There were 89 female and 19 male participants in the study. Almost ev- ery student (96%) knew their blood group and most of them were correct about the health status of a blood donor. They had a lack of knowledge regarding the time required for blood donation and the amount of blood collected in each bag. Although most of the students were very favourable to donate blood, only 34% had previous experience of donating blood out of them; only 6% regularly donated voluntarily and on demand. Conclusion: From this finding, it can be recommended that measures for increasing knowledge regarding blood donation should be taken, and that would result in increased blood donation.
This paper is based on the beta-thalassaemia programme at the Duchess of Kent Hospital, Sandakan, Sabah. It seeks to show that a hypertransfusion regimen which improves the quality of life of children with thalassaemia major can be practised in district and general hospitals if there is an organised blood recruitment programme, at least at departmental level. Such a programme reduces the demand on the hardpressed hospitals' blood banks. Frequent and regular transfusions can be given with minimal interference with the school and family life of affected children and reduces immeasurably the social, emotional and financial strain on the affected families. There is also an urgent need to define the magnitude of the problem of beta-thalassaemia through population studies so that genetic counselling can be given and adequate resources can be allocated to improve the quality of life of affected patients.
Objective: This study was done to identify blood donors with thalassaemia and iron deficiency. A cross sectional study was carried out at Pusat Darah Negara (PDN), Kuala Lumpur in November 2003.
Methods: Full blood counts were done on 242 blood donors (166 males and 76 females) Hb analysis and serum ferritin assay were done for all the samples. The first time donors were used as controls.
Results: Only 20 (8.3%) donors had MCV <80 fL and MCH <26pg. Six of the 25 donors with iron deficiency had a low MCV <80 fL) and low MCH <26 pg) but all the 8 (40%) donors with thalassaemia or HbE had a low MCV and MCH! The mean ferritin levels were found to be lower among regular blood donors (95.3 ug/L) compared to first time blood donors (116.6 ug/L) but this was not statistically significant. There were 25 donors who were iron deficient: one was a first time donor and 24 were regular donors - 12 (50%) had donated 3 times a year in the last two years. Iron deficiency was seen in 12 Malays, and 9 Chinese, and 4 Indians. 13.3% of the males (22 out of 166 donors) and 4% (3 of 76) of female donors were iron deficient. Thalassaemia and HbE were found in 8 donors. HbE trait was identified in 5 Malay donors. One Malay and 1 Chinese donor had beta-thalassaemia trait. Another Chinese had alpha (a^o) thalassaemia trait. Neither HbE nor thalassaemia were seen in the Indian donors.
Conclusion: In this study thalassaemia and RbE were seen in 3.3% and iron deficiency in 10.3% of the 242 blood donors at PDN. Iron deficiency was present in 3.2% of the first time donors and 12.8% of the regular donors. Regular donors should have the serum ferritin done for their iron status and if their MCV and MCH are low, Hb analysis for thalassaemia or haemoglobinopathy.
Keywords: Blood donors, serum ferritin, iron deficiency, haemoglobinopathy
Introduction: Reduction or complete absence of α-globin chain production may result α-thalassemia. Alpha thalassemia carrier may have normal haemoglobin level and thus will be eligible as blood donor. Few complications may happen in which the carrier who donated the blood might be at risk of hypoxia and their blood components might not suitable for transfusion. Thus, it is important to screen for α-thalassemia to prevent any complications happen
after donation. The objective of this study is to investigate the interaction of red blood cell indices and α-globin genotypes among eligible blood donors in a private university, Universiti Tunku Abdul Rahman (UTAR), Malaysia. Methods: A total of 270 eligible blood donors were recruited for this study. Red cell indices were analysed using Horiba hematology analyser and α-globin genotyping was performed for seven alpha deletions, six alpha point mutations
and two alpha triplications. Results: Our study showed high prevalence of α-thalassemia carriers among the eligible blood donors (7.7%, 21/270), with all of them showed normal Hb level (>12 gm/dl). Five genotypes were detected consisting of 249 αα/αα (92.2%), 9 -α3.7/αα (3.3%), 9 --SEA/αα (3.3%), 2 -α4.2/αα (0.7%) and 1 ααCS/αα (0.4%). All α-globin genotypes showed normal Hb level with no significant difference between genotypes (p=0.167). Different
α-globin genotypes showed significant difference in RBC, MCV, MCH, MCHC, RDW and Hct/Hb ratio at the p
We studied the knowledge, attitude and practice of 27 parents of children with Thalassaemia towards their children's disease. The parents' knowledge was satisfactory. Most of them did not reveal details of the disease to their affected children. Some of them had further children despite being explained the risk of recurrence. Parents found it difficult to obtain regular blood donors and some had to resort to 'buying' blood. The Malaysian Association of Thalassaemia has a role to play in the education of patients, their parents and the public.