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立陶宛全血捐献的报酬:传染病标志物风险

Payment for whole blood donations in Lithuania: the risk for infectious disease markers.

作者信息

Kalibatas V

机构信息

National Blood Center, Vilnius, Lithuania.

出版信息

Vox Sang. 2008 Apr;94(3):209-215. doi: 10.1111/j.1423-0410.2007.01015.x. Epub 2007 Dec 7.

Abstract

BACKGROUND AND OBJECTIVES

In Lithuania, remuneration for whole blood donations still prevails, with the government covering payment for the donors. The payment per donation in cash is equal to 40 litas (euro11.6); it is offered to all blood donors and accepted by the majority of them. Donors who gave blood and received the payment are treated as remunerated donors; those who gave blood and did not take the payment are treated as non-remunerated ones. The purpose of this study was to assess the risk of payment for whole blood donations and to analyse the prevalence of infectious diseases markers per 100 remunerated and non-remunerated, first-time and regular whole blood donations, and to compare the risk ratios of infectious disease markers of remunerated and non-remunerated whole blood donations in 2005 and 2006 at the National Blood Center in Lithuania.

MATERIALS AND METHODS

Whole blood donors were categorized as follows: (i) first-time donor, remunerated; (ii) first-time donor, non-remunerated; (iii) regular donor, remunerated; and (iv) regular donor, non-remunerated. The blood donations were analysed for the presence or absence of the following infectious disease markers: anti-hepatitis C virus (anti-HCV), hepatitis B surface antigen (HBsAg), anti-human immunodeficiency virus (anti-HIV (1)/(2)) and syphilis. Only confirmed infectious disease markers were classified. To assess the risk of payment for whole blood donations, the prevalence of infectious disease markers per 100 donations in the different donor groups and the risk ratios between the remunerated and non-remunerated donations were determined.

RESULTS

The prevalence per 100 first-time remunerated donations was: for anti-HCV 1.84 (2005) and 2.98 (2006); for HBsAg 1.73 (2005) and 2.03 (2006); for syphilis 0.67 (2005) and 1.03 (2006). The prevalence per 100 first-time non-remunerated donations was: for anti-HCV 0.93 (2005) and 0.98 (2006); for HBsAg 1.57 (2005) and 1.33 (2006); for syphilis 0.29 (2005) and 0.47 (2006). The first-time donors who were remunerated for whole blood donations had a significantly higher prevalence of infectious disease markers per 100 donations and a higher risk ratio for at least three infectious disease markers (HBsAg, anti-HCV and syphilis) as compared to first-time donors who were non-remunerated. The regular donors who were non-remunerated for whole blood donations had the lowest prevalence of all infectious disease markers: anti-HCV -0.03 (2005) and 0.04 (2005); syphilis -0.06 (2005) and 0.02 (2006); and any positive cases of HBsAg and anti-HIV (1)/(2) were found both in 2005 and 2006. No statistically significance differences in incidence and risk ratio existed when comparing the regular donations who were remunerated and non-remunerated.

CONCLUSION

The payment for whole blood donors provides a higher risk for infectious disease markers of first-time donations at the National Blood Center in Lithuania.

摘要

背景与目的

在立陶宛,全血捐献仍以有偿为主,政府为捐献者支付报酬。每次捐献的现金报酬为40立特(11.6欧元);所有献血者均可获得该报酬,且大多数人会接受。接受报酬的献血者被视为有偿献血者;献血但未接受报酬的则被视为无偿献血者。本研究旨在评估全血捐献有偿模式的风险,分析每100例首次及定期全血捐献中传染病标志物的流行情况,并比较2005年和2006年立陶宛国家血液中心有偿与无偿全血捐献传染病标志物的风险比。

材料与方法

全血捐献者分为以下几类:(i)首次有偿捐献者;(ii)首次无偿捐献者;(iii)定期有偿捐献者;(iv)定期无偿捐献者。分析所捐献血液中是否存在以下传染病标志物:抗丙型肝炎病毒(抗-HCV)、乙型肝炎表面抗原(HBsAg)、抗人类免疫缺陷病毒(抗-HIV(1)/(2))和梅毒。仅对确诊的传染病标志物进行分类。为评估全血捐献有偿模式的风险,确定了不同捐献者组中每100次捐献的传染病标志物流行率以及有偿与无偿捐献之间的风险比。

结果

每100例首次有偿捐献中,抗-HCV的流行率2005年为1.84、2006年为2.98;HBsAg的流行率2005年为1.73、2006年为2.03;梅毒的流行率2005年为0.67、2006年为1.03。每l00例首次无偿捐献中,抗-HCV的流行率2005年为0.93、2006年为0.98;HBsAg的流行率2005年为1.57、2006年为1.33;梅毒的流行率2005年为0.29、2006年为0.47。与首次无偿捐献者相比,首次全血捐献获得报酬的捐献者每100次捐献中传染病标志物的流行率显著更高,且至少三种传染病标志物(HBsAg、抗-HCV和梅毒)的风险比更高。全血捐献未获报酬的定期捐献者所有传染病标志物的流行率最低:抗-HCV——2005年为0.03、2006年为0.04;梅毒——2005年为0.06、2006年为0.02;2005年和2006年均未发现HBsAg和抗-HIV(1)/(2)的任何阳性病例。比较有偿与无偿定期捐献时,发病率和风险比无统计学显著差异。

结论

在立陶宛国家血液中心,全血捐献有偿模式使首次捐献传染病标志物的风险更高。

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