Background: Unsafe blood products may cause transfusion-transmissible infections. This study aimed to evaluate the knowledge and perceptions of blood donors regarding blood safety. Methods: This was a cross-sectional study conducted in the Kelantan state of Malaysia. The questionnaire comprised 39 questions that covered areas such as donors’ social demographic information, knowledge of transfusion-transmitted diseases, blood screening and donor eligibility and perceptions towards blood safety. The knowledge score was categorised as good or poor. Results: Of the 450 distributed questionnaires, 389 were suitable for analysis. Only 18.5% of the donors had good knowledge, with 81.5% having poor knowledge. Less than 30% were aware that people with multiple sexual partners, bisexual people and male homosexual people are permanently deferred from blood donation. Only 29.4% agreed that donors are responsible if their blood causes infection. Furthermore, 39.3% assumed that they could check their HIV status through blood donation, and 10.3% and 5.4% of the respondents believed that donors are free from infection if they wear a condom during sex or only have oral sex when involved in prostitution, respectively. Conclusion: Poor knowledge and notable misperceptions concerning safe blood donation were found among blood donors. The Ministry of Health should incorporate safe blood education in future public awareness programmes.

Massive transfusion protocol (MTP) was designed to improve the outcome of patients at risk of massive haemorrhage. This study focused on the prevalence, indications, factors associated with indication of MTP activation cases and twenty-four-hour mortality among those who received MTP in Hospital Universiti Sains Malaysia (USM). A retrospective cross-sectional study was performed on 110 patients for whom MTP was activated in Hospital USM. Data were extracted from the medical records and blood bank system (MyTransfusi). Descriptive statistics and logistic regression were used for statistical analysis. A total of 273,087 patients were admitted to Hospital USM and 193 patients required MTP activation during the study period. The prevalence of MTP activation was only 0.07%. This study included 110 MTP activation cases which consisted of 62 (56.3%) trauma and 48 (43.7%) non-trauma patients. The overall mean age of patients was 40.0 years old, and majority were male (66.4%). The two most common MTP activation indications were motor vehicle accidents (93.5%) and gastrointestinal bleeding (50%). Female and presence of comorbidity significantly associated with MTP activation indication. Meanwhile, no emergency procedure and non-compliance to activated MTP were significantly associated with high mortality within twenty-four-hour post MTP activation. The prevalence of MTP was low. Our result suggested that early emergency procedures and compliance towards MTP improved patient outcomes.
Compliance

Introduction: Unsafe blood products cause transfusion-transmissible infections. A good knowledge and perception about blood safety issues is crucial to ensure safe blood supply. The objective is to develop and validate a questionnaire about the knowledge and perception among blood donors on blood safety issues. Method: A cross-sectional study was conducted among 130 blood donors who attended the National Blood Centre, Kuala Lumpur in April and May 2018. The questionnaire was developed in the Malay language after extensive literature search. The self-administrated questionnaire consisted 39 items which required around 20 minutes to complete. The validation involved content validity, construct validity using exploratory factor analysis and reliability using test-retest analysis in IBM SPSS statistics. The same group of respondents was retested after two weeks using the same questionnaire. Results: Content validity was established through multidisciplinary expert meeting and two content reviewers. The factors loadings of all questionnaires were more than 0.40. Knowledge questions were divided into three domains; perception questions were divided into four domains. The intraclass correlation (ICC) values of the test-retest were more than 0.80 for the three knowledge domains and more than 0.60 for the four perception domains. The third domain of the perception section which consisted two questions had the lowest ICC value of 0.686 (95% CI 0.583-0.767). One of the questions was restructured to improve clarity. Conclusions: The questionnaire on knowledge and perception on blood safety issues has good validity and reliability, with appropriate items which warranted its utilization among blood donors.

Introduction: Cord blood (CB) is rich in hematopoietic stem cells. There has been significant growth in cord blood banks (CBBs) throughout the world. In Malaysia, the CB units cryopreserved in public CBB is below its optimal level. Lack of knowledge about CB banking among mothers in other countries influenced their decision to donate CB, however, there is no local data to support this in Malaysia. Moreover, no validated and reliable tool is available for measuring local women’s knowledge about CB banking. In this study, a questionnaire to assess pregnant women’s knowledge about CB banking was developed and validated. Method: Several steps were taken to develop the knowledge items in the questionnaire which includes comprehensive literature review, content validity by a panel of experts, and face validity by a group of pregnant women. The questionnaire was developed in Malay language and contained 18 items. After modifications, the self-administered questionnaire was distributed to 121 pregnant women to assess its psychometric properties using two-parameter logistic item response theory analysis and internal consistency reliability analysis. Results: The majority of the knowledge items showed acceptable difficulty and discriminatory values. The Cronbach’s alpha and ICC values were 0.831 and 0.887, respectively, indicating good reliability. All 18 knowledge items were retained for the final version of the questionnaire. Conclusion: The newly developed questionnaire demonstrated acceptable psychometric properties and can be used as a reliable tool to assess knowledge about CB banking among pregnant women in the local population.