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Evaluation of donor self exclusion program

P Chiewsilp¹, S Kitkornpan, S Stabunswadigan

¹Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

The Southeast Asian Journal of Tropical Medicine and Public Health

|January 1, 1993

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Donor self-exclusion programs aim to prevent HIV transmission through blood donations. A study found that while self-exclusion identified some unsafe donations, it wasn't perfectly specific and requires donor education.

Area of Science:

Public Health
Infectious Disease Epidemiology
Blood Transfusion Safety

Background:

Donor self-exclusion is a strategy to mitigate transfusion-associated Acquired Immunodeficiency Syndrome (AIDS) by excluding high-risk individuals.
This low-technology procedure has been adopted in Western countries to enhance blood safety.

Purpose of the Study:

To evaluate the effectiveness of a donor self-exclusion program in identifying unsafe blood donations at Ramathibodi Hospital.
To assess the prevalence of HIV, Hepatitis C, Hepatitis B, and Syphilis markers in self-excluded and non-excluded blood donations.

Main Methods:

A study was conducted from March to December 1991, analyzing 4,286 units of blood.
Donors self-excluded blood based on sexual behavior and intravenous drug use history.

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Blood donations were tested for HIV-Ag, anti-HIV, anti-HCV, HBsAg, and VDRL.

Main Results:

Between 2.60% and 6.55% of donors self-excluded their blood as potentially unsafe.
HIV-Ag was detected in one self-excluded unit, while anti-HIV was found in both self-excluded (3.46%) and safe (0.46%) donations.
Hepatitis C and B markers were significantly higher in self-excluded donations compared to safe donations.

Conclusions:

Confidential self-exclusion or HIV-Ag testing could have prevented the transfusion of HIV-Ag reactive units during the "window period".
Syphilis screening (VDRL) was not a valuable surrogate marker in this self-exclusion context.
Self-exclusion programs may lack specificity and require enhanced donor education for optimal effectiveness.