Towards total voluntary non-remunerated blood donation in Trinidad and Tobago

Objective: Investigate the historical origins of voluntary nonremunerated blood donation (VNRD) and describe a UWI-led initiative. Design and Methodology: Historical review was performed using internet searches, documents, books, journals, interviews. Data from blood donor cards and Microsoft Excel spreadsheets was collected prospectively and analysed retrospectively. Donors were classified by age, gender, donation status (first-time or repeat) and donation outcome (accepted or deferred). The prevalence of transfusion transmissible infections and deferrals in donors was compared to the national donor pool using Chi square analysis to compare proportions and a p value < 0.05 to assign statistical significance. Results: Human to human blood transfusion and voluntary non-remunerated blood donation were first practised in metropolitan countries and amplified in large scale community blood donation programmes during World War II. Blood donation systems based on individual, transactional donations emerged in most developing countries, including Trinidad and Tobago, causing low donation rates, chronic blood shortage, unequal access, high donor infections and high donor deferrals. A voluntary non-remunerated blood donation programme started by the UWI Blood Donor Foundation and the North Central Health Authority has collected 660 units of blood in its first three years, the majority from persons aged 16 -25 age (52%), females (52%) and repeat donors (51%). Deferrals were < 10% and total transfusion transmissible infections in donors 0.9% compared with 43.6% and 2.4 % respectively (p < 0.05 for both) for the involuntary national donor pool. Conclusion: This model could be extended to all blood donation centres and the community to achieve 100% VNRD.

[Correlation between automated optical reading and double human reading for two tests of fetal membranes rupture]. / Concordance entre la lecture optique automatisée et la lecture visuelle double pour deux tests de rupture des membranes.

OBJECTIVES: To assess concordance between double human and automated optical reading (AOR) concerning two biological tests for rupture of membranes (ROM) METHODS: We conducted a monocentric, prospective, observational study comparing Actim Prom® (Alere SAS, Jouy-en Josas, France) and Hiprom Duo® (Fumouze, Levallois-Perret, France). Each test was performed simultaneously in patients with suspected ROM and read independently by 2 biologists and AOR device. ROM was clinically confirmed in case of recurrent leakage or spontaneous labour with no perceived membranes within 48hours. RESULTS: Concerning Actim Prom®, concordance was 100 %, 92.5 % and 91.6 % between biologists, biologists-AOR device and biologists or AOR vs. clinical presentation respectively. Concerning Hiprom Duo®, concordance was 97.2 % between biologists, 97.2 % between biologist 1 and AOR, 95.3 % between biologist 2 and AOR, 63.5 % between clinical presentation and human reading, 62.3 % between clinical presentation and AOR. False positive cases were significantly associated with modified cervix (21 % vs. 46 %, P=0.006). CONCLUSION: We demonstrated excellent correlation between biologists and good or excellent correlation between AOR and human reading supporting the use of AOR in clinical practice.