Improving donor and patient safety. Portuguese haemovigilance system — donor adverse reactions, errors and near miss events — reports

Understanding the critical points in the blood transfusion chain through reporting, monitoring and analysis of donor and transfusion adverse reactions, transfusion errors, near miss events and their (potential) consequences is essential for defining of appropriate prevention and corrective measures and is therefore crucial for improvement of donor and patient safety. The system of reporting transfusion-related adverse reactions was implemented in Portugal in 2008 however the process of notification of donor adverse reactions, blood establishment and hospital blood bank errors and near miss events was in use since 2009. As regards frequency and severity, the data concerning donor adverse reactions are consistent with data reported in medical literature and underline the safety of blood donation in Portugal. The most critical area for hospital blood bank near miss events and errors is the clinical area. In most of the cases these events are associated with patient misidentification. Correct patient identification must be considered the core clinical skill as errors due to misidentification have major impact in every field of medicine, particularly in transfusion where such errors may even be fatal. However, with effective education, training and competency assessment most of such errors and events are preventable and can be eliminated

Evolução da infeção pelo vírus da Hepatite C em dadores de sangue e população geral em Portugal entre 2015 e 2022

Introdução A elevada taxa de progressão para a cronicidade e o potencial evolutivo para cirrose e carcinoma hepatocelular, fazem da infeção pelo vírus da Hepatite C (VHC) um grave problema de saúde pública. O risco de transmissão do VHC por transfusão sanguínea tem sido minimizado pelo desenvolvimento de testes cada vez mais sensíveis na deteção dos anticorpos anti-VHC, bem como da implementação da detecção do RNA-VHC através de Testes de Amplificação de Ácidos Nucleicos. Objetivo Caracterizar a evolução da infeçáo por VHC em dadores de sangue e população geral em Portugal (2015-2022). Material e métodos Estudo retrospetivo com dados obtidos do Instituto Português do Sangue e da Transplantação (IPST), DGS e INE. Foi calculada a proporção anual de dadores VHC positivos por 100 000 dadores e a proporção de VHC positivos por 100 000 habitantes (população geral). A tendência da variação percentual média anual (AAPC) foi estimada através do software Joinpoint®. Resultados Entre 2015 e 2022, foram identificadas 135 dadores com VHC, correspondendo a uma média de 17 casos/ano (min-max: 9-22). Na população geral, foram notificados no mesmo período 1721 casos, correspondendo a uma média de 215 casos/ano. Em termos de tendência, a proporção de dádivas VHC positivas ter vindo a diminuir mas esta tendência decrescente não foi estatisticamente significativa (AAPC=-2.9, p=0.45). Na população geral, a tendência de casos notificados de VHC tem vindo a diminuir de forma estatisticamente significativa (AAPC=-7.4, p=0.02). Globalmente, a maioria dos casos são do sexo masculino em ambas as populações. Anualmente, na população em geral o número de homens é sempre cerca 3x superior ao das mulheres (2.5-3.6), mas nos dadores os valores são mais próximos ou chegando mesmo a inverter (mulheres>homens). Discussão e Conclusão Os resultados obtidos permitem constatar que a infecção pelo VHC permance um problema de saúde pública em Portugal, continuando a existir indivíduos que desconhecem que se encontram infetados. A não deteção destes casos assintomáticos representa um problema não só em termos de transmissão do agente na comunidade, mas também como potencial risco de transmissão através da dádiva de sangue. Os dados da hemovigilância em Portugal demonstram um esforço continuado na melhoria da deteção destes casos, especialmente através do avanço tecnológico das técnicas de rastreio, o que tem permitido manter o risco residual infecioso em valores perto de zero (0.0-0.06/100 000 dádivas).info:eu-repo/semantics/publishedVersio

The evolving role of information technology in haemovigilance systems

This work provides an overview and appraisal of the general evolution of IS/IT in haemovigilance, from which lessons can be learned for its future strategic management. An electronic survey was conducted among the members of the International Haemovigilance Network to compile information on the mechanisms implemented to gather, process, validate, and store these data, to monitor haemovigilance activity, and to produce analytical reports. Survey responses were analysed by means of descriptive statistics, and comments/observations were considered in the final discussion. The answers received from 23 haemovigilance organizations show a direct relationship between the number of collected notifications (i.e., communication of adverse effects and events) and the technical specifications of the haemovigilance system in use. Notably, IT is used in the notification reception of 17 of these systems, out of which 8 systems are exclusively based on Web solutions. Most assessments of the evolution of IS/IT tend to focus on the scalability and flexibility of data gathering and reporting, considering the ever-changing requirements of haemovigilance. Data validation is poorly implemented, and data reporting has not reached its full potential. Web-based solutions are seen as the most intuitive and flexible for a system-user interaction.This work would not be possible without the precious collaboration of the IHN and the generous participation of the survey respondents. The SING group thanks CITI (Centro de Investigación, Transferencia e Innovación) from UniversityofVigoforhostingitsITinfrastructure.Thiswork was partially funded by the European Union’s Seventh Framework Programme FP7/REGPOT-2012-2013.1 (Grant Agreement no. 316265, BIOCAPS), the Fundação para a Ciência eaTecnologia (FCT) under thescopeofthestrategic funding of the UID/BIO/04469/2013 unit, and COMPETE 2020 (POCI-01-0145-FEDER-006684).info:eu-repo/semantics/publishedVersio

Prevalence of asymptomatic Leishmania infection and knowledge, perceptions, and practices in blood donors in mainland Portugal

Funding Information: This paper has been sponsored by Elanco Animal Health in the framework of the CVBD®World Forum Symposium. The authors would like to acknowledge all the blood donors who agreed to participate in this study for contributing with their answers to the questionnaire and their blood samples. The authors would also like to acknowledge all the professionals of the following institutions that contributed to organization of physical equipment, presentation of the study to potential participants, obtaining of informed consent, separation and storage of samples and questionnaires: Instituto Português do Sangue e da Transplantação; Centro Hospitalar Universitário do Algarve; Hospital do Espírito Santo de Évora; Unidade Local de Sáude do Norte Alentejano; Unidade Local de Saúde do Baixo Alentejo and Unidade Local de Saúde do Litoral Alentejano. Lastly, the authors would like to acknowledge the researcher Regina Loesch for her contribution to filling in the electronic database with answers to the paper questionnaires, and the researcher Ana Rita Goes for her contributions to designing the questionnaire for this study. Funding Information: RR was supported by the Portuguese Ministry of Education and Science (via Fundação para a Ciência e a Tecnologia, I.P.—FCT) through a PhD grant (UI/BD/151067/2021). The authors would also like to acknowledge FCT for funding through contracts with GHTM (UID/Multi/04413/2020, UIDB/00006/2020 and UIDP/00006/2020) and LA-REAL (LA/P/0117/2020). This project was also funded by the Tropical Clinic Unit (Institute of Hygiene and Tropical Medicine [IHMT]). Publisher Copyright: © 2023, BioMed Central Ltd., part of Springer Nature.Background: Asymptomatic infection is the most common outcome of exposure to Leishmania parasites. In the Mediterranean region, where Leishmania infantum is endemic, studies on the prevalence of asymptomatic infection have often relied on serological testing in blood donors. In Spain, regional studies have shown seroprevalence in blood donors between 1 and 8%; in Portugal, values of 0 and 2% were suggested by two localized studies, in different populations. The purpose of this study was (i) to estimate the prevalence of asymptomatic Leishmania infection in blood donors in mainland Portugal, and (ii) to study the association between the detection of antibodies to Leishmania and sociodemographic factors, and also the knowledge, perceptions and practices (KPP) of the blood donors regarding leishmaniasis. Methods: A cross-sectional study targeted the population of people who donated blood in mainland Portugal. Participants, distributed proportionally by municipality and aged between 18 and 65 years, were selected randomly in 347 blood collection points between February and June 2022, and completed a sociodemographic and a KPP questionnaire. Detection of anti-Leishmania antibodies in serum was performed using an ELISA commercial kit. Individual KPP scores were calculated by adding grades defined for each question. Results: Globally, 201/3763 samples were positive. The estimated national true seroprevalence was 4.8% (95% CI 4.1–5.5%). The proportion of positive results was significantly different between NUTS (Nomenclature of Territorial Units for Statistics) regions. Models suggested that seropositivity was significantly higher in male sex, people older than 25 years, or residing in the Centro NUTS2 region, but not in dog owners nor people with lower KPP scores. Overall, 72.3% of participants had previously heard of leishmaniasis and, in multivariate analysis, a higher Knowledge score was associated with age 25–40 years, female sex, ownership of dogs, and higher education. Conclusions: Global estimated true seroprevalence (4.8%) was similar to previous regional studies in blood donors in neighboring Spain. Higher seroprevalence values in the NUTS2 Centro region were consistent with incidence data from humans and seroprevalence studies in dogs. On the other hand, the low values in the Alentejo and the high values in the northern subregions may be the result of geographical shifts in parasite circulation due to climate change and should prompt localized and integrated, vector, canine, and human research, following a One Health approach. Graphical Abstract: [Figure not available: see fulltext.].publishersversionpublishe

Additional file 1 of Prevalence of asymptomatic Leishmania infection and knowledge, perceptions, and practices in blood donors in mainland Portugal

Additional file 1: Table S1. List of NUTS (Nomenclature of Territorial Units for Statistics) 2 and NUTS3 regions in Continental Portugal

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved