| Objective: we conducted this study to analysis the source and distribution of the unpaid blood donation volunteers in Xi’an city for the first time to solve the blood safety problem and to provide the theoretical basis for the establishment of a stable team of unpaid voluntary donors from the low-risk population. Meanwhile, based on the investigation on the blood donation volunteers in Xi’an related to the blood donating motives and associated factors, we aim to provide the reference basis for further standardizing and promoting the blood donating work in Xi’an.Methods: Part I: We collected the data in blood donor centers of Xi’ an from the year 1999 to 2013. A total of 415,657 blood samples were obtained.(Male sample 261,032, Female sample 154,625) ELISA method was used for the detection of HBs Ag, anti-HCV, anti-HIV and anti-TP. Part II : After getting the informed consent of the participants, the self-administrated questionnaire was conducted among 456 subjects.(218 in 2010 year and 238 in 2014 year) The database was established and entered by Epidata v3.0 software. Pearson’s chi-square was used to test the difference between categorical variables. Chi-square trend test was used to judge the trend of the infectious blood samples over the years. Statistical analyses were was calculated via Statistical Package for the Social Sciences(SPSS) version 19.0 software package for Windows(SPSS Inc., Chicago, IL,USA). All the statistical significance levels were two-tailed and set at p<0.05.Results:Part I:(1) The infection status of common diseases among the blood donors were as follows: The infection rate of HBV was significantly getting higher over time(χ2=7.35, p for trend=0.007), The infection rate of HBV in the year 2013 was significantly lower than the year of 1999(0.80% vs 1.90%; χ2=136.70, p<0.0001); Although there is no significant trend for the infection rate of HCV over the years, the infection rate of HCV in the year 2013 was significantly lower than that in the year 1999(0.30% vs 1.10%; χ2=134.38, p<0.0001); The infection rate of HIV has a sharp rise over time(χ2=7.52, p for trend=0.006); The infection rate of syphilis also presented a significant upward trend over time(χ2=8.39, p for trend=0.004);(2) the unqualified ratio the blood among the first blood donation volunteers was about 3.94% and the highest rate was appeared in 30-49 age group(5.38%);(3) The infection rate of the infectious disease in male was significant higher than that in female volunteers.(2.09% vs 2.01% in female; χ2=198.99, p<0.0001) Furthermore, the highest infection rate in both male and female donators were all appeared in 30-39 age group.(6.38% in male, 4.76% in female; χ2=121.63, p<0.0001)Part II :(1) The investigation in 2010 found 83.0% of the study population considered the blood donation as a moral obligation, while 81.2% and 72.6% of the respondents considered the blood donation as personal responsibility and social responsibility. Among the respondents in 2014, the support rate of the above three points were as high as 76.0%, 73.1% and 68.0%, respectively. Furthermore, the survey in 2010 found 83.9% of the participants’ motivations for blood donation were to help other people and that rate in 2014 was as high as 95.0%. However, we found that 47.8% of the motivations for blood donation were to have a free test of their bloods.(56.5% in 2010; 40.0% in 2014);(2) Other peoples’ behavior and attitudes may have significant influence on the unpaid donors;(3) The number of male donors was larger than that of female donors and more than 85.0% of the donating volunteers were in the 17-39 age group.(4) Generally, 94.7% of the people believed that blood collection agencies would use sterile needles(94.5% vs 95.0% in 2014; χ2=0.05, p=0.83) while 94.5% of the donors believed they would not infected by infectious disease via blood donation.(94.1% vs 95.0% in 2014; χ2=0.19, p=0.67) For the people who did not satisfied with the donation process, 3.70% of the subjects worried the nurse may collecting more blood than it need,(5.1% vs 2.5% in 2014; χ2=2.02, p=0.16) 17.3% of the respondents did not satisfied with some of the blood donation site.(18.8% vs 16.1% in 2014; χ2=0.64, p=0.42) 36.0% of the donors worried they may infected byblood-transmitted disease, such as HIV.(4.6% vs 2.5% in 2014; χ2=1.43, p=0.23)Conclusion: The first part: the infection rate of HBV, HCV, HIV and TP was at lower levels among the unpaired blood donors in Xi’an, which is relative safe for the clinical use. The main reason for the unqualified blood was the HBV infection. However, that infection rate declined from 1999 to 2013 and the infection rate of HIV and TP both have a rising trend and we should pay more attention to this phenomenon. The second part: the most important motivation for the blood donors was achieving their own values and their social cognitions in Xi’an. More than 94.5% of the blood donors approve of the unpaired blood donation and the most important factors that affected the donors’ satisfaction were the poor condition of blood donation sites,the fear of infection due to the blood donation and the worry that nurses may collect more blood than they needed.Advices:(1) To revise the "Blood Donation Law" according to the local characteristics;(2)Based on the local characteristics, in view of the different population to carry out various recruitment strategies to form a diverse blood donors’ team;(3) To further improve the level of the blood collecting service;(4) To provide healthcare education for the donors in order to improve the donors’ healthy knowledge and healthy level. |
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