The iron status of Zimbabwe blood donors

Abstract

Background Transfusion medicine is a distinct and expanding discipline with a vital role in the health care system, according to the permanent secretary in the ministry of health and child welfare. In Zimbabwe the number of people who failed the copper sulphate test (haemoglobin screening test) shot up from 1249 in 2011 to 2360 in 2012 (89% increase). Failing this screening test is caused among other things by low haemoglobin levels which in turn are caused by low iron levels in the body. Checking haemoglobin levels alone is not enough to check the status of the donors, but a complete iron profile is necessary to ascertain the actual status of the blood donors. Aim To find out the iron status of blood donors in Zimbabwe. Materials and Methods A cross sectional study was done on 190 blood donors at the National Blood Service Zimbabwe (NBSZ). Left over samples were analysed for serum iron, serum ferritin, TIBC (total iron binding capacity) and transferrin saturation at Premier Clinical Laboratory. Donors recruited into the study ranged from first time donors to donors who had donated up to 8 times in the past two years. Results A total of 190 (109 males and 81 females) blood donors participated in this study. The median age was 23 years and the inter quartile range was 19.0-27 years. The range of the age was from 16 years to 67 years. The median number of donations was 4 and the interquartile iii range was 5-6 units over the two year period under study. The median serum iron levels was 13 μmol/L with the inter quartile ranges from 10.0-17.8 μmol/L. For ferritin the median value was 30 ng/ml with the inter quartile ranges from 18.0-56.8 ng/ml. The median for TIBC was 74.1 μmol/L with the inter quartile ranges from 63.3-82.3 μmol/L. For transferrin saturation the median was 17.6 μmol/L with the inter quartile ranges from 12.0-26.9 %. The statistical analysis was done by the ANOVA test. As for serum ferritin levels there was statically significant differences in the mean ferritin levels between group 1 and groups 6,7 and 8 (p<0.01) for men. For females there was statistically significant difference in the mean ferritin levels between the control group and group 6 and 7 (p <0.05). The overall prevalence of iron deficiency in the study population was 13.2% and the prevalence of reduced iron stores was 37.4 %. Conclusion These findings suggest that repeated blood donation causes a reduction in the iron stores of the blood donors in Zimbabwe and there is need to include biochemical markers, (serum iron, serum ferritin, TIBC and transferrin saturation) in the screening of blood donors, especially from the fifth unit.