{"id":1052,"date":"2017-06-14T13:06:50","date_gmt":"2017-06-14T13:06:50","guid":{"rendered":"https:\/\/blogs.imperial.ac.uk\/ighi\/?p=1052"},"modified":"2019-03-28T16:45:52","modified_gmt":"2019-03-28T16:45:52","slug":"world-blood-donor-day-what-can-you-do-give-blood-give-now-give-often","status":"publish","type":"post","link":"https:\/\/blogs.imperial.ac.uk\/ighi\/2017\/06\/14\/world-blood-donor-day-what-can-you-do-give-blood-give-now-give-often\/","title":{"rendered":"World Blood Donor Day: What can you do? Give blood, give now, give often"},"content":{"rendered":"<p><strong><em>By Stella Nikolaou, Clinical Research Fellow, The Royal Marsden Hospital and Imperial College London and\u00a0<\/em><\/strong><strong><em>Shahnawaz Rasheed, Consultant Surgeon, The Royal Marsden Hospital and Senior Lecturer, Imperial College London.<\/em><\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"225\" class=\" wp-image-1053 alignleft\" src=\"https:\/\/blogs.imperial.ac.uk\/ighi\/files\/2017\/06\/blood-300x225.jpg\" alt=\"\" \/>Worldwide, there are more than 5 million people who die from violence and injury<sup>1<\/sup>. Uncontrolled bleeding causes more than 40% of trauma-related deaths<sup>1<\/sup>. More than 530 000 women die each year during pregnancy, childbirth or post partum and 99% of these women are in low and middle-income countries with severe bleeding being the commonest cause of death<sup>1<\/sup>. Safe and affordable surgery, therefore relies on access to a sufficient volume of blood which can be safely transfused<sup>2<\/sup>. Unfortunately this is not the case in most of the world<sup>2<\/sup>.<\/p>\n<p>Blood donation rates are lowest in nations, which are afflicted with high rates of malnutrition, chronic anaemia and transfusion-transmissible infections (TTIs) which further decrease the blood donor pool<sup>2<\/sup>.<\/p>\n<p>The Lancet Commission of Global surgery recommends blood donation of at least 15 units per 1000 people per year<sup>3<\/sup>. However according to the WHO data in 2015, the median blood donation in low income countries (LICs) is 3.9 units\/1000 people\/year and 11.7 units\/1000 people\/year in Middle Income Countries (MICs) which is a tenth of what high income countries are estimated to have (36.8 units\/1000 people\/year)<sup>4<\/sup>.<\/p>\n<p>These figures are likely to be overestimated as they include blood that is unsafe to use due to TTIs (e.g. AIDS, malaria and syphilis)<sup>2<\/sup>.<!--more--><\/p>\n<p>The reasons for such low blood donations are many and include poor health infrastructure and misconceptions regarding blood donations which are influenced by cultural and religious factors<sup>5<\/sup>. In countries like India, despite the fact that 68% of its population is rural, most of its blood banks and donation centres are actually situated in urban areas<sup>4<\/sup>.<\/p>\n<p>There are 3 types of blood donors: voluntary unpaid, family and paid<sup>6<\/sup>. According to WHO data, the first group which is also the safest group to provide blood, is gradually increasing in LMICS, despite the above limitations<sup>6<\/sup>. There are still countries (61 LMICs and 11 HICs) where more than 50% of the blood supply is dependent on family\/replacement and paid blood donors with ethical, safety and logistical disadvantages<sup>6<\/sup>.<\/p>\n<p>Unbanked direct blood transfusion (UDBT) is an alternative many clinicians resort to. This involves a family member or friend to provide blood which is screened for TTIs with a rapid testing kit and a blood type cross match and then directly transfusing it to the patient<sup>7<\/sup>. Although this is not ideal as the rapid testing kit is not as sensitive in detecting TTIs, coercion for donation is high and the whole blood is transfused, it can provide an alternative in a situation where a blood transfusion is required for a life-saving operation<sup>4<\/sup>.<\/p>\n<p>The WHO has been at the forefront of raising awareness of unsafe blood and chronic blood shortage and has recommended strategies in order to tackle this<sup>6<\/sup>. Establishing a national blood system and providing the appropriate infrastructure with quality-assured screening of all donated blood for TTIs will lay the foundation for a better donor population<sup>2,6<\/sup>. By engaging the local community and religious leaders, myths regarding blood donation can be dispelled and a higher unpaid volunteer blood donor pool can be achieved<sup>2<\/sup>.<\/p>\n<p>1\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dhingra N. WHO Estimate Blood Requirements: a search for a Gloval Standard. http:\/\/www.who.int\/bloodsafety\/transfusion_services\/estimation_presentations.pdf?ua=1<\/p>\n<p>2\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Raykar NP, Kralievits K, Greenberg SLM, Gillies RD, Roy N, Meara JG. The blood drought in context. <em>Lancet Glob Heal<\/em> 2017; <strong>3<\/strong>: S4\u20135.<\/p>\n<p>3\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Meara JG, Leather AJM, Hagander L, <em>et al.<\/em> Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. <em>Lancet (London, England)<\/em> 2015; <strong>386<\/strong>: 569\u2013624.<\/p>\n<p>4\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Jenny HE, Saluja S, Sood R, <em>et al.<\/em> Access to safe blood in low-income and middle-income countries: lessons from India. <em>BMJ Glob Heal<\/em> 2017; <strong>2<\/strong>: 1\u20137.<\/p>\n<p>5\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dubey A, Sonker A, Chaurasia R, Chaudhary R. Knowledge, attitude and beliefs of people in North India regarding blood donation. <em>Blood Transfus<\/em> 2014; <strong>12<\/strong>. DOI:10.2450\/2012.0058-12.<\/p>\n<p>6\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 WHO | Blood safety and availability. <em>WHO<\/em> 2016.<\/p>\n<p>7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Alexander PE, Barty R, Fei Y, <em>et al.<\/em> Transfusion of fresher vs older red blood cells in hospitalized patients: A systematic review and meta-analysis. Blood. 2016; <strong>127<\/strong>: 400\u201310.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Stella Nikolaou, Clinical Research Fellow, The Royal Marsden Hospital and Imperial College London and\u00a0Shahnawaz Rasheed, Consultant Surgeon, The Royal Marsden Hospital and Senior Lecturer, Imperial College London. Worldwide, there are more than 5 million people who die from violence and injury1. Uncontrolled bleeding causes more than 40% of trauma-related deaths1. More than 530 000 [&hellip;]<\/p>\n","protected":false},"author":283,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[294],"tags":[],"class_list":["post-1052","post","type-post","status-publish","format-standard","hentry","category-global-health"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>World Blood Donor Day: What can you do? 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Uncontrolled bleeding causes more than 40% of trauma-related deaths1. 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