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The iron status of South African blood donors: balancing donor safety and blood demand

BACKGROUND Several studies in developed countries have demonstrated high levels of iron deficiency (ID) among blood donors. There is a paucity of data for developing countries where blood shortages remain a major concern. STUDY DESIGN AND METHODS A total of 4412 donors were enrolled in the study. Sp...

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Bibliographic Details
Published in:Transfusion (Philadelphia, Pa.) Pa.), 2019-01, Vol.59 (1), p.232-241
Main Authors: van den Berg, Karin, Swanevelder, Ronel, Ingram, Charlotte, Lawrie, Denise, Glencross, Deborah Kim, Hilton, Caroline, Nieuwoudt, Martin
Format: Article
Language:English
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Summary:BACKGROUND Several studies in developed countries have demonstrated high levels of iron deficiency (ID) among blood donors. There is a paucity of data for developing countries where blood shortages remain a major concern. STUDY DESIGN AND METHODS A total of 4412 donors were enrolled in the study. Specimens were collected for full blood count, iron, transferrin saturation, and ferritin assessment. Donor demographics were recorded. ID was indicated by a ferritin level of less than 20 ng/mL for men and less than 12 ng/mL for women. Anemia was defined as hemoglobin levels less than 12.5 g/dL. Regression models for predictors of ID were developed. RESULTS A total of 17.5% of all donors had ID, with 16.3% prevalence in women and 18.6% in men. Low hemoglobin had the highest association with ID (adjusted odds ratio [AOR], 11.078; 95% confidence interval [CI], 7.915–15.505); male donors had twice the odds of ID compared to female donors (AOR, 2.501; 95% CI, 1.964–3.185), while increasing age was associated with lower odds (AOD, 0.965; 95% CI, 0.956–0.975). Among male donors, an interdonation interval of less than 3 months (AOR, 2.679; 95% CI, 1.929–3.720) was associated with ID. Compared to other females combined, colored female donors (AOR, 2.335; 95% CI, 1.310–4.160) had higher odds and black female donors (AOR, 0.559; 95% CI, 0.369–0.845) lower odds of ID. CONCLUSION ID is common among South African donors; low hemoglobin, gender, ethnicity, and past donation history is independently associated with ID. Recommendations aimed at protecting donor health may increase blood shortages in South Africa.
ISSN:0041-1132
1537-2995
DOI:10.1111/trf.15001