PHD-Department of Medical Laboratory Sciences

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Browsing PHD-Department of Medical Laboratory Sciences by Subject "blood volume"

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    Total blood volume, iron status and hematological profiles of whole blood donors at Kenyatta National Hospital, Nairobi City County, Kenya
    (Kenyatta University, 2023) Njenga, John K.; Scholastica Mathenge; Nelson Menza; Jessie Githanga
    The effectiveness of blood donation exercises relies on safeguarding prospective blood donors’ and recipients’ health. This may be realized through collection of safe and appropriate blood volume. An ineffective donor selection criterion may expose potential donors to vasovagal reactions and lead to collection of blood with hematological abnormalities. In Kenya, there is paucity of data on donors’ total blood volume (TBV), iron status, hematological profiles and deferral rates. The objectives of this study were to determine: the percentage of blood volume donation, reliability of using Nadler’s or Lemmens-Bernstein-Brodsky’s equations to calculate TBV, donor iron status, hematological profiles and deferral rates among blood donors attending Kenyatta National Hospital. A cross-sectional study design was adopted. Using a systematic random sampling technique, 384 study participants were recruited. Donors were grouped into two categories (eligible and deferred donors) based on the donor recruitment outcome. Study questionnaires were used to collect donors’ demographic information. Eligible donors were checked for the total blood volume using Nadler’s and LemmensBernstein-Brodsky’s equations. Eight (8) ml of blood samples were collected from the donated units and halved into plain tubes and EDTA tubes. Serum ferritin levels were analyzed using Biomeriex Mini Vidas® analyzer while hematological parameters were determined using HumaCount 5D® analyzer. Ethical approval was sought from KNHUoN ethical review committee. Non-parametric variables were analyzed using Mann Whitney U test and Kruskal Wallis H test. Intra–class Correlation Coefficient (ICC) was used to assess reliability of using the two total blood volume equations. This study identified 202 eligible donors, majority being male donors (173 vs. 29). Using Nadler’s and Lemmens-Bernstein-Brodsky’s equations the percentage of blood volume donated by eligible donors was 11.7% and 11.6%, respectively. Female donors donated significantly higher blood volume than their male counterparts (P=0.01). Reliability tests showed an excellent reliability of using either Nadler’s or Lemmens-Bernstein-Brodskys’ equations (average measure of 0.996 and single measure 0.991). Among eligible donors the prevalence of iron deficiency was 2.5%, whereas the prevalence of anemia was 7.4%. Female blood donors had a higher prevalence of iron deficiency (6.9% vs. 1.7%), whereas male donors had a high prevalence of anemia (7.4%vs.0%). Male donors had a significantly higher ferritin levels than female donors (P=0.01). The median counts of all eighteen hematological parameters analyzed were within local reference ranges. However, seven hematological parameters (RBC, Hgb, MCH, MCHC, monocytes, eosinophils and platelets) had significant variation from normal values (P<0.05). Additionally, male donors had significantly higher values for; red cell count, hematocrit and hemoglobin (P=0.01) whereas female donors had significantly higher lymphocyte and platelet counts (P=0.05). This study found a donor deferral rate of 47.4%. Temporarily deferred donors had a higher rate than permanent ones (93.4% vs. 6.6%). Donors with high deferral rates were first-time donors and female donors. In addition, deferral rates increased with the advancement of age. The leading causes of temporary deferrals were medication and low hemoglobin, whereas high blood pressure and diabetes were the main causes for permanent deferral. In conclusion, this study observed majority of donors met the threshold for safe blood donation. However, few donors had lower TBV, others had iron deficiency, anemia and hematological abnormalities. This study recommends a review of donor recruitment criteria to incorporate assessment of total blood volume, iron status, total blood count and advocate for blood donation awareness campaigns.