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Blood Safety Sub Module - 1 Transfusion Transmitted Infections. Definition- TTI is an infection that can be transmitted through blood and blood products from an infected person to another during blood transfusion • Blood is a potent vehicle for the transmission of various microorganisms. Factors essential for a Disease Transfer • Give rise to asymptomatic • Be present in the blood stream -at the time of donation • Be transmitted parenterally- injection, infusion, or implantation • Survive during the storage of the blood Strategies to reduce TTIs • Careful selection of donors • Screening of blood • Removal of specific components of blood • Physical/chemical inactivation of contaminating agent Mandatory Testing • Human Immunodeficiency Virus • Hepatitis B & C • Malaria • Syphilis Why Blood safety? • Through Contaminated Blood Transfusion HIV Hepatitis B, Hepatitis C, Syphilis and Malaria • HIV transmission -5% to10% • HIV transmission -100% Blood Safety as a cost effective intervention • Unsafe or inadequate blood supply is more costly • Morbidity and mortality have a direct impact on individuals and their families • Rise in incidence of Transfusion-Transmitted Infection increases the treatment costs. WHO strategy for blood Safety • A well-organized, coordinated service • Voluntary Blood Donors • Testing of all donated blood • The rational use of blood Types of Blood Donors. • Replacement Donors : within the patient’s own family or community • Voluntary donors – Blood donation out of their own • Autologous blood donor -A patient who donates his/her blood • Apheresis donor- Donation of blood components through the process of cell separation • Commercial or professional donors- legally banned in India Voluntary Blood Donation • Given voluntarily and for altruistic reasons • Provides safe quality blood and blood components. • Few Donors because of poor awareness, motivation and superstition • A regular donor is one who donates blood two to three times a year and continues to donate at least once a year The Role of Counselors in a Blood Bank • Motivate Voluntary Blood donation • Motivate donors at risk for HIV testing • Maintain a permanent well-indexed record of voluntary blood donors • Educating the community • Promote AIDS awareness • Assist to reach voluntary donors Activity -1 Brainstorming Role of counsellors in Blood Bank Who is eligible to donate blood? • Age -18 - 60 years • Haemoglobin - not less than 12.5 g/dL • Pulse - between 50 and 100/minute with no irregularities • Blood Pressure -Systolic 100-180 mm Hg and Diastolic 50 - 100 mm Hg • Temperature - Normal • Body weight - not less than 45 Kg • Both male and female can donate blood Activity - 2 Time – 15 minutes Pasting the stickers Donor eligibility Who is an unsuitable donor? Poor health and nutritional status of donors nutritional deficiency or other health problems Replacement Donors - may have hidden favour or paid by the patient’s family. Risk Behavior –IDU, multi sexual partners, Once only or first time donors-donor could be in the window period Donor Criteria Should not • Have been treated for rabies in the past one year • be treated for Malaria in the past three months • have had any immunizations in the last one month • have had any dental work or taken Aspirin in the past 72 hours • have diabetes, heart disease or high BP, cancer, blood clotting problem or blood disease • have TB, bronchial asthma or allergic disorder, liver disease, kidney disease, fits or fainting Donor Criteria Should not • have cough, influenza or sore throat, common cold at the time of blood donation • have taken any antibiotics or any other medications (Allopathic or Ayurveda or Sidha or Homeo) in the past 48 hours • have taken alcoholic beverages in the past 24 hours • be pregnant or breast feeding or donate during her menstrual cycles • have donated blood in past 3 months Donor Screening • Registration and consent of the donor • Medical History • Limited physical examination • Simple laboratory tests Donor Selection • A good rapport will ease donor selection • Donor eligibility rules -to protect the health and safety of the donor and the recipient • Donor should understand the information shaed • Confidentiality is vital – for honest answers History Taking Activity – 3 Role Play Sample Questionnaire for Donor History