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Whole-blood donors are at increased risk for iron deficiency and anaemia. The current standard of haemoglobin monitoring is insufficient to ensure the maintenance of proper iron reserves and donor health. We aimed to determine the effects of ferritin-guided donation intervals for blood donor health and blood supply in the Netherlands. In this stepped-wedge cluster-randomised trial (FIND'EM), the 138 fixed and mobile donation centres in the Netherlands are organised into 29 geographical clusters and the clusters were randomly assigned to four treatment groups, with two groups being further split into two per a protocol amendment. Eligible donors were whole-blood donors who consented for use of their leftover material in the study. Each group was sequentially crossed over from the existing policy (haemoglobin-based screening; control) to a ferritin-guided donation interval policy over a 3-year period. In the intervention groups, in addition to the existing haemoglobin screening, ferritin was measured in all new donors and at every fifth donation in repeat donors. Subsequent donation intervals were extended to 6 months if ferritin concentrations were 15–30 ng/mL and to 12 months if they were less than 15 ng/mL. Outcomes were measured cross-sectionally across all donation centres at four timepoints. Primary outcomes were ferritin and haemoglobin concentrations, iron deficiency, and haemoglobin-based deferrals. We assessed all outcomes by sex and menopausal status and significance for primary outcomes was indicated by a p value of less than 0·0125. This trial is registered in the Dutch trial registry, NTR6738, and is complete. Between Sept 11, 2017, and Nov 27, 2020, 412 888 whole-blood donors visited a donation centre, and we did measurements on samples from 37 621 donations from 36 099 donors. Over 38 months, ferritin-guided donation intervals increased mean ferritin concentrations (by 0·18 log10 ng/mL [95% CI 0·15–0·22; p<0·0001] in male donors, 0·10 log10 ng/mL [0·06–0·15; p<0·0001] in premenopausal female donors, and 0·17 log10 ng/mL [0·12–0·21; p<0·0001] in postmenopausal female donors) and mean haemoglobin concentrations (by 0·30 g/dL [95% CI 0·22–0·38; p<0·0001] in male donors, 0·12 g/dL [0·03–0·20; p<0·0074] in premenopausal female donors, and 0·16 g/dL [0·05–0·27; p<0·0044] in postmenopausal female donors). Iron deficiency decreased by 36–38 months (odds ratio [OR] 0·24 [95% CI 0·18–0·31; p<0·0001] for male donors, 0·49 [0·37–0·64; p<0·0001] for premenopausal female donors, and 0·24 [0·15–0·37; p<0·0001] for postmenopausal female donors). At 36–38 months, haemoglobin-based deferral decreased significantly in male donors (OR at 36–38 months 0·21 [95% CI 0·10–0·40, p<0·0001]) but not significantly in premenopausal or postmenopausal female donors (0·81 [0·54–1·20; p=0·29] and 0·50 [95% CI 0·25–0·98; p=0·051], respectively). Ferritin-guided donation intervals significantly improved haemoglobin and ferritin concentrations and significantly decreased iron deficiency over the study period. Haemoglobin-based deferrals decreased significantly for male donors, but not female donors. Although this intervention is overall beneficial for maintenance of iron and haemoglobin concentrations in donors, increased efforts are needed to recruit and retain donors. The Sanquin Research Programming Committee. [ABSTRACT FROM AUTHOR] more...

Background Traditionally, during crises the number of new blood donors increases. However, the current coronavirus disease 2019 (COVID‐19) pandemic created additional barriers to donate due to governmental prevention measures and increased personal health risks. In this report, we examined how the pandemic affected new donor registrations in the Netherlands, especially among groups with higher risk profiles for severe COVID‐19. Additionally, we explored the role of media for blood donation and new donor registrations. Study Design and Methods We analyzed new donor registrations and attention for blood donation in newspapers and on social media from January until May 2020, in comparison to the same period in 2017 to 2019. Results: After the introduction of nationwide prevention measures, several peaks in new donor registrations occurred, which coincided with peaks in media attention. Interestingly, people with a higher risk profile for COVID‐19 (e.g., due to age or region of residence) were overrepresented among new registrants. Discussion In sum, the first peak of the current pandemic has led to increased new blood donor registrations, despite the associated increased health risks. Time and future studies will have to tell whether these new donors are one‐off 'pandemic' donors or if they will become regular, loyal donors. [ABSTRACT FROM AUTHOR] more...

Background: To better understand donor behavior and ensure a safe and sufficient blood supply, various observational studies have examined barriers to blood donation. This study used Facebook and Twitter data to enhance existing research on donation barriers and associated emotions communicated on social media by both donors and non-donors.Study Design and Methods: We conducted a semantic network analysis (SNA) with 168 232 public Dutch language social media messages from Facebook and Twitter during 2012-2018. SNA uses concepts as nodes in a network and the relationship (ie, co-occurrence) as links between them. We identified the relationship between donation barriers, non-donation (voluntary and involuntary), and dissatisfaction (anger and disappointment) within social media messages. This computational method was combined with an analysis examining significant relationships in-depth.Results: Twelve donation barriers were identified: lifestyle, donation location, medical reasons, no invitation, opening times, physical reactions, pregnancy, remuneration, sexual risk behavior, time constraints, travels, and waiting times. More messages related to involuntary non-donation compared to voluntary non-donation. Involuntary non-donation was associated most strongly with medical reasons and sexual risk behavior, while voluntary non-donation was associated most strongly with resentment regarding remuneration of the blood bank's top management. Anger associated most strongly with sexual risk behavior and disappointment most strongly with medical reasons.Conclusion: Discussions around blood donation are increasingly taking place online. Donation barriers found in this study differ from those in survey research. Insights into how donation barriers are communicated in an ever-growing online environment can be utilized to enhance recruitment and retention strategies. [ABSTRACT FROM AUTHOR] more...

Background: To prevent (negative consequences of) temporary deferral due to low hemoglobin, the Dutch national blood service Sanquin introduced a ferritin monitoring policy in 2017. Ferritin is measured after the donation (as opposed to before donation for hemoglobin), and low ferritin levels lead to deferral of 6 (ferritin 15-30 ng/mL) or 12 months (ferritin <15 ng/mL). We explored the consequences of this policy on donor behavior and availability., Study Design and Methods: We included all Dutch whole blood donors who made a donation (attempt) between 13 November and 31 December 2017. At that point, the ferritin monitoring policy was randomly implemented in 8 of 29 regional clusters of collection centers. We extracted information from Sanquin's donor database about donors' deferrals, subsequent donation attempts, and donation cessation (up to 31 December 2019). Donors deferred for low ferritin were compared to those deferred for low hemoglobin or other reasons, as well as to donors who were not deferred., Results: A total of 55 644 donors were included (11% deferred). For donor behavior, we found that donors deferred for low ferritin less often unsubscribed and switched to other donation types, yet also made fewer donations in the follow-up period. For availability, we found they were less often deferred, yet they were unavailable to donate for a longer period., Conclusion: Results suggest that the implementation of a ferritin monitoring policy may lead to a decrease in donor availability and reduced donations. However, the policy is successful in retaining more donors and reducing low hemoglobin deferrals., (© 2020 The Authors. Transfusion published by Wiley Periodicals LLC. on behalf of AABB.) more...

Awareness of infection with SARS-CoV-2 is crucial for the effectiveness of COVID-19 control measures. Here, we investigate awareness of infection and symptoms in relation to antibodies against SARS-CoV-2 in healthy plasma donors. We asked individuals donating plasma across the Netherlands between May 11 th and 18 th 2020 to report COVID-19-related symptoms, and we tested for antibodies indicative of a past infection with SARS-CoV-2. Among 3,676 with antibodies, and from questionnaire data, 239 (6.5%) are positive for SARS-CoV-2 antibodies. Of those, 48% suspect no COVID-19, despite the majority reporting symptoms; 11% of seropositive individuals report no symptoms and 27% very mild symptoms at any time during the first peak of the epidemic. Anosmia/ageusia and fever are most strongly associated with seropositivity. Almost half of seropositive individuals do not suspect SARS-CoV-2 infection. Improved recognition of COVID-19 symptoms, in particular, anosmia/ageusia and fever, is needed to reduce widespread SARS-CoV-2 transmission., Competing Interests: The authors declare no competing interests., (© 2021 The Author(s).) more...