{'fraction_non_alphanumeric': 0.03061520603598375, 'fraction_numerical': 0.028148578061520605, 'mean_word_length': 4.896492728828058, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 1, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Analysis of Blood Donor Deferral in a Tertiary Care Hospital

Introduction : Selection of proper donor according to stringent selection criteria is the prerequisite for safe blood transfusion practice. It is widely known that a large number of blood donors are deferred for different reasons. Objective : The aim of present study is to evaluate the incidence and different reasons of blood donor deferral in atertiary care hospital. Methodology : This retrospective cross-sectional study was carried out in Transfusion Medicine and Clinical Haematology Department of BIRDEM General Hospital, Dhaka, during the period from July 2016 to June 2017.The blood donor of either sex attending the mentioned department were selected purposively and categorized into four groups according to their age for this study. Donors were selected and deferred by medical officer according to national guideline. Deferred blood donors were recorded in register book and were analyzed retrospectively. Results : In current study, 1152 blood donor (8.8%) were deferred attending for allogeneic blood donation during the study period. Out of 13082 registered blood donor 11961were male (91.43%) and 1121 were female (8.57%) and deferral rate was 2.37 times more in female. Majority of the deferred donors (55.38%) were under the age of 40 where 26.82% were in between 40-49 years and 17.8% were in the range of 50 years and above. Age range of highest deferred donors (32.20%) was between 30-39 years. The number of temporary and permanent deferral were 836 (72.57 %) and 316 (27.43%) respectively. Anaemia (33.01%), underweight (21.53%) and hypotension (17.34%) were the most common reason of temporary deferral. Chronic uncontrolled hypertension (42.4%), donors with medication (16.77%) and asthma (15.18%) was the most common cause of permanent deferral. Conclusion : The deferral rate was low and most of the deferred donors were young adult. Temporary deferred donors were higher than permanent deferred donors. The most common reasons for temporary deferral were anemia, underweight and hypotension. Permanent deferral causes were chronic uncontrolled hypertension, donors on medication for various reason and asthma. Donors should be informed with a clear message on their deferral status. It is important to determine the rate and causes of donor deferral for the safety of blood transfusion and to guide the recruitment efforts for safe blood transfusion and to avoid the permanent loss of blood donors.


Introduction
Blood transfusion is one of the common medical practice and also a life saving procedure that requiring sufficient supply of safe blood. For safe blood transfusion, many safety measures are commenced by the blood transfusion community where the most necessary is proper donor selection. 1 Individual disqualified from donating blood are known as "deferred" donors.

Original Article
Analysis of Blood Donor Deferral in a Tertiary Care Hospital

Results
The result showed that out of 13082 registered blood donors attending for allogeneic blood donation during the study period,  The main causes of temporary deferral were Anaemia 276(33.01%), underweight180 (21.53%) and hypotension145 (17.34%) (Table II) transmitted through blood, a preexisting medical disease or anemia. Due to this, blood donor selection is a cornerstone for blood transfusion safety, designed to safeguard the health of both donors and recipients. Blood donor eligibility is determined by medical interview, based on national guidelines for donor selection. 2 A prospective donor may be deferred at any point during the collection and testing process either temporarily or permanently depending on the specific reason for disqualification. If a donor is to be deferred, his or her name is entered into a list of deferred donors maintained by the blood transfusion center, often known as the "deferral registry." If a deferred donor attempts to give blood before the end of the deferral period, the donor will not be accepted for donation.
Once the reason for the deferral no longer exists and the temporary deferral period has lapsed, the donor may return to the blood transfusion center and be re-entered into the system, 3 Deferred donor experience a troublesome feeling during donor selection and mostly leaves them with negative perception, about themselves as well as the blood donation process.
Additionally these donors are less likely to come-back for future blood donation. 4

Materials and Methods
The current retrospective record based study was carried out on

Discussion
In our study the overall donor deferral rate was about 8.8% and deferral rate was 2.37 times higher in female compared with male which was similar to that observed by Bahaduret al. 5 The lowest reported donor deferral was by Talonu 6 (4%), Sundar 7 (5.84%) and high rate was reported by Zou et al 8 (12.8%) and Choudhary et al 9 (16.4%). However the highest incidence of donor deferral was observed by some studies was between 20-35.6%. 10,11   The temporary deferrals were more than permanent deferrals. The most common cause of temporary donor deferral was anaemia in many studies done by Naveen Agnihotri 13 (56%) and Halperin et al 14 (46%) which was comparable with ours. Anaemia was more common in female (48.73%) than male donor(28.16%) which highlight the prevalence of anaemia in general population among females in a developing country like Bangladesh. Chaudhary 9 observed the two most common cause of temporary donor deferral were low weight (32.3%) and anaemia (18.6%) which is also comparable with present study. In current study the most common cause of permanent deferral in male was chronic hypertension (42.4%) which was similar to Sundar P 7 and Kulkarni N 15 study. Chaudhary 9 and Ranveet 16 reported that the most common cause of permanent deferral was history of jaundice which was not similar with our study.

Study limitations
The present study was conducted in a selected transfusion center of Bangladesh. Generalization from this study, therefore, cannot be made for the whole country. Duration of this study was only 1 (one) year with relatively small sample size. More extensive study will give better insight.

Conclusion
In this study, reasons for deferral of volunteer blood donors were studied and found the deferral rate was low and most of the deferred donors were young adult. Temporary deferred were higher than permanent deferred donor. The most common reasons for temporary deferral were anemia, underweight and hypotension. Permanent deferral causes were chronic uncontrolled hypertension, donors on medication for various reason and asthma. Since most of the deferrals were temporary deferrals, we should give a clear message for the reason for deferral and duration of deferral so that they return for donation in the future on correction of the cause of deferral at appropriate duration.