Evaluation of iron and folate deficiencies as possible causes of anaemia in unfit blood donors

Abstract

BACKGROUND Prospective blood donors are commonly deferred at the Blood Service of the University of Lagos Teaching Hospital, a tertiary health facility, majorly due to anaemia. Since experience shows that iron and folate deficiencies are common causes of anaemia in the population, it is desirable to investigate the iron and folate status of prospective donors who fail the blood donor fitness test to confirm whether or not, iron and folate deficiencies are part of the reasons for failure.
AIM AND OBJECTIVE The objective of this study was to establish whether or not, iron and folate deficiencies are the causes of anaemia in prospective blood donors who fail the  re-donation haemoglobin test.
MATERIALS AND METHODS A total of 263 prospective donors were recruited, and, based on the Copper Sulphate specific gravity test set at a haemoglobin concentration cut-off of 12.5g/dl, they were divided into unfit (study n=153) and fit (control n=110) groups. Ten (10ml) of venous blood was drawn from each subject and distributed into sodium- EDTA specimen bottle (5ml) for estimation of full blood count within 2 hours of collection and plain disposable plastic tubes (5ml) for the estimation of serum ferritin, serum homocysteine and serum folate in both study and control groups.
RESULTS There was a statistically significant decrease (p<0.05) in the haemoglobin (Hb) concentration and packed cell volume (PCV) of the study group compared to the control. There were 62 correctly rejected unfit donors who had haemoglobin level <12.5g/dL, of these, only 12 (19.36%) had serum ferritin level <15μg/L, 3 (4.8%), had homocysteine level >15μmol/L and 3 (4.8%) had folate level <3ng/ml, indicating iron and folate deficiency, respectively. There was no statistically significant association (P>0.05) between haemoglobin concentration and serum ferritin, homocysteine and folate levels within the study group.
CONCLUSION The findings in this study suggest that in only about 20%, and in less than 5% of cases was iron and folate deficiency, respectively, the cause of anaemia, leading to correct rejection as blood donors. Therefore, other factors which may be associated with anaemia in prospective blood donors need to be further investigated.