Recent relaxation of deferral policies for MSM blood donors : a systematic review
Notice bibliographique
Résumé
Background: Blood safety is important to blood transfusion. As men who have sex with men (MSM) are considered to have a higher risk of sexually transmitted infections (STIs) compared to the general population, blood donations from MSM may lead to a higher risk of transfusion-transmitted infections (TTIs). For this reason, many countries have established lifelong deferral policies for MSM blood donors since 1980s. Research have been conducted to evaluate the risks and benefits of relaxing MSM deferral policies from lifelong to a finite period, and countries such as the United Kingdom have implemented such relaxation in recent years. Nevertheless, there remains a lack of risk-benefit analyses on this topic in many countries, especially the developing ones. This review can help such countries to reconsider their MSM deferral policies. \n \nObjective: The objectives of this review are (i) to review the current deferral policies of blood donation from MSM implemented in major countries and (ii) to review the major determining factors in the risk-benefit analyses of these countries. \n \nMethod: PubMed, Google Scholar, and China Journal Net were used for literature search. Only literatures with abstract and/or available full text in English or Chinese were included. The PICOS approach was used for study selection, and 37 articles were finally selected. Surveys, cohort studies, cross-sectional studies reviews, and national reports were included in this systematic review. \n \nResult: Countries with permanent/indefinite MSM deferral policy include the United States, Canada, France, Mexico, Germany, Norway, Sweden and China (including Hong Kong). Countries with a finite deferral period include New Zealand (5 years), the United Kingdom (12 months), Australia (12 months), Brazil (12 months), Argentina (12 months), Japan (6 months) and South Africa (6 months). Countries without specific deferral criteria for MSM include Spain, Italy, Poland and Russia. The recent relaxation of deferral policies was based on scientific evidence provided by risk-benefit analyses that evaluated the residual risk of TTIs associated with alternative deferral policies. Major determining factors of risk-benefit analyses include the following: 1. epidemiological characteristics that determine the proportion of MSM among HIV-infected patients; 2. screening technologies that have shortened the window period and improved the early detection of STIs; and 3. non-compliance after relaxation, which determines the increasing risk of TTIs. \n \nConclusion: Majority of countries that have recently relaxed their deferral policies for MSM blood donor reduced the deferral period to 12 or 6 months. Most of the risk-benefit analyses found that relaxation of deferral policies for MSM blood donors would lead to a relatively small increase in the risk of TTIs. Policies aimed at lowering the non-compliance may be an effective way to reduce the residual risk of TTIs from MSM blood donors who are within the window period.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,012 | 0,055 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,005 | 0,006 |
| Bibliométrie | 0,008 | 0,009 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».