| Background In view of the safety of blood transfusion in China,the Health Department has issued a series of rules and regulations,improved various management guidelines and service systems,which have reduced the risk of blood donation and blood transfusion infection to a certain extent.However,the objective factors caused by non-human factors are still the key issues threatening blood safety.In recent years,the detection technology and reagent quality have been improved continuously,the risk of transfusion transmitted disease caused by virus detection "window period" still exists,which threatens the life safety of blood recipients.In view of this,it is very important to strengthen the health consultation work and eliminate the high-risk groups before blood collection for improving the blood safety and quality.Xinyang is located in the southernmost part of Henan Province,connecting Anhui Province in the East and Hubei Province in the south,which is the thoroughfare of three provinces.However,no special investigation has been found on the unqualified rate of blood samples of voluntary blood donors in this area,and there is no research on its influencing factors.Objective To analyze the disqualification of alanine aminotransferase(ALT),hepatitis B surface antigen(HBs Ag),human immunodeficiency virus antibody(HIV-Ab),treponema pallidum antibody(TP-Ab),hepatitis C virus antibody(HCV-Ab)in blood samples of voluntary blood donors in Xinyang area,for providing basis for recruiting low-risk fixed blood donors,reducing the rate of blood scrap and improving blood safety.Methods From January 2012 to December 2018,297676 blood samples from voluntary blood donors in Xinyang were tested.ALT was detected by rate method,HBs Ag,HIV-Ab,TP-Ab and HCV-Ab were detected by enzyme-linked reaction adsorption(ELISA),DNA of hepatitis B virus(HBV-DNA),RNA of hepatitis C virus(HCV-RNA)and RNA of human immunodeficiency virus(HIV-RNA)were detected by nucleic acid amplification technology(NAT),and those with positive nucleic acid detection results were analyzed by resolution test.(1)The overall unqualified rate of blood sample of voluntary blood donors from2012 to 2018 and the unqualified rate of ALT,HBs Ag,HBs Ag,HIV-Ab,TP-Ab,HCV-Ab and NAT testing were analyzed.(2)The overall unqualified rate and unqualified rate of each index of blood sample of voluntary blood donors and the above items in 2012-2015 and 2016-2018 were observed;then the age,occupation and education distribution of the general unqualified samples and the unqualified samples in these two periods were observed.(3)Taking demographic characteristics(blood type,gender,nationality,age,occupation,education level)as independent variables,and taking the overall blood sample and whether each index is qualified as dependent variables,single factor and multi factor Logistic regression analysis were carried out to evaluate the independent influencing factors leading to the unqualified blood sample test.Results(1)Annual change trend: From 2012 to 2018,the number of voluntary blood donors in Xinyang increased year by year,and the overall unqualified rate of blood samples and the unqualified rate of ALT,HBs Ag,TP-Ab and HCV-Ab were all decreasing year by year(P < 0.01),the unqualified rate of NAT was increasing year by year(P < 0.01),while there was no significant change in HIV AB unqualified rate(P > 0.05);the unqualified rate of each test index was HBs Ag>ALT>TP-Ab>HCV-Ab>HIV-Ab>NAT from high to low.(2)Change trend in different time periods: compared with 2012-2015,the overall unqualified rate of blood samples and the unqualified rate of ALT,HBs Ag,TP-Ab,HCV-Ab decreased significantly(P < 0.01),while the difference of unqualified rate of HIV-Ab test was not statistically significant(P > 0.05).The probability of unqualified blood test was relatively high in the age group of 36-45 years old,and the probability of unqualified blood test in most occupations was in a downward trend.(3)Univariate analysis results:(1)single factor Logistic regression analysis showed that except for HIV-Ab,there were statistically significant differences in the unqualified rate of ALT,HBs Ag,TP-Ab,HCV-Ab in terms of gender,age,occupation and education.(2)Multi factor analysis showed that male,age 26-45,occupation as staff were the independent risk factors of ALT disqualification,occupation as students were the independent protective factors;age ? 36 was the independent risk factors of HBs Ag disqualification,occupation as soldiers and students were the independent protective factors;age ? 36 was the independent protective factors of ALT disqualification-The independent risk factors of TP disqualification were soldiers and students;the independent risk factors of HCV-Ab disqualification were age ndependent risk factors of TP disqualification were soldiers and students;the independent risk fa students;the independent protection factors were men and age Over 36 years old,high school education and below were the independent risk factors for the overall unqualified blood sample test of voluntary blood donors while the occupation of soldiers and students were the independent protective factors.Conclusion(1)The number of voluntary blood donors in Xinyang area has increased year by year,the unqualified rate of blood samples has decreased year by year,and the accumulated unqualified rate is at a low level in the country.Compared with the previous years,the proportion of the elderly and the occupation of cadres,soldiers,students and farmers has decreased,and the blood test unqualified rate of the high educated has been low.(2)Women,18-25-year-old soldiers and students,as well as those with high educational background may be the low-risk group recruited for voluntary blood donors.Therefore,the establishment of fixed low-risk voluntary blood donors team may be conducive to reducing the rate of blood disqualification and scrap of voluntary blood donors. |
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