Indian Medical Gazette JANUARY 2012 1 Original Article Knowledge, Attitude and Practice (KAP) of Blood Safety and Donation H. Sanayaima Devi, Associate Professor, Jalina Laishram, Demonstrator, Shantibala K, Assistant Professor, Vijaya Elangbam, Assistant Professor, Department of Community Medicine, Regional Institute of Medical Sciences, Imphal. Abstract The present study was carried out to assess the knowledge, attitude and practice about blood safety and donation among 1st and 2nd MBBS students of RIMS, Imphal and to determine any association between knowledge level and selected variables like gender, those who had ever donated blood and were willing to donate in future. This cross sectional study was conducted in Regional Institute of Medical Sciences, Imphal during September to December 2010. Students were interviewed face to face using a pre-tested, pre-designed semi-structured questionnaire. Students level of knowledge was assessed by scoring scale. Data were presented in percentages, mean and standard deviation. Pearson chi square test was used for significance testing. The proportion of students having adequate knowledge was 33.1% with the mean score of 12.2±2. 89.8% intended to donate blood in future, but only 13.9% had ever donated blood and out of which, 64.8% of donors were first timers. Knowledge on blood safety and donation was significantly associated with blood donation status. Regular CMEs and seminars should be conducted to increase awareness about blood safety and donation and to increase the number of voluntary blood donation. Keywords KAP, blood safety and donation, cross-sectional, voluntary non-remunerated donors Introduction Donating blood is an act that can save the lives of thousands of people worldwide because blood is an essential element of human life and there are no substitutes for it. In spite of extensive efforts and a number of blood donation programmes being organized worldwide, the availability of blood still remains short to meet the increased demand for it. World Health Organization advocates that 3-5% of the population should donate blood every year, which would be the ideal rate for maintaining a country s stock of blood and blood products at acceptable level 1. The collection of blood should only be from voluntary donors (low risk population), that is one of the four components of WHO s integral strategy to promote global safety and minimize risk associated with transfussion 2. Unfortunately, 83% of the global population who are living in developing countries have access to only 40% of blood supplied, and this blood in 60% of cases is collected from paid or replacement blood donors rather than from voluntary non-remunerated low risk donors 3. In India there is a need of about 8 million units of blood every year, out of which only about one third are obtained from voluntary donors 4. The first step towards blood safety is to encourage blood donations from voluntary non-remunerated donors and obtained from low risk and regular donors, who donating blood two to three times a year and continues to donate at Address for correspondence: Dr H. Sanayaima Devi, Associate Professor, Wangkhei Lourembam Leikai (Near Durga Puja Lampak), Imphal East 795 001. E-mail: drsanahj@gmail.com
2 Indian Medical Gazette JANUARY 2012 least once a year. Youths including medical students who are healthy, enthusiastic and approachable as a group, if recruited young may become future donors and motivators. So, keeping in view the significance of blood donation and transfusion, the present study was conducted to assess the knowledge, attitude and practice about blood donation among 1st and 2nd year MBBS students of RIMS, Imphal and to determine any association between knowledge level and selected variables like gender, those who had ever donated blood and were willing to donate blood in future. Materials and Methods A cross sectional analytical study was conducted among undergraduate medical students of Regional Institute of Medical Sciences, Imphal during September to December 2010. Different studies have different proportion of respondents having good knowledge on different aspects of blood safety and donation 5,6. A sample size of 277 was estimated based on the prevalence of adequate knowledge as 60% with 6% admissible error. A pre-tested, semistructured interview schedule was used to assess the level of knowledge, attitudes and practice regarding blood safety and donation in randomly selected sample of 1st and 2nd year MBBS students. Each student was interviewed face to face after taking verbal consent however, those who were not willing to participate were excluded from the study. Knowledge scoring: Respondent s level of knowledge was assessed using a set of 15 questions. Maximum score a respondent could get was 19 and the score obtained out of 19 was calculated for each participant. Adequate knowledge was classified as having a score of 14 and above (75th percentile of the score). Descriptive statistics were used to assess the level of knowledge, attitude and practice of blood donations. Chisquare test was applied to examine the association between knowledge level and independent variables like sex and blood donation status. A p-value of <0.05 was taken as statistically significant. Results Out of 280 students approached for the interview, 14 students (5%) were not willing to participate. Mean age of the respondents was 21.1 years. More number of females was participated in the study (59.8% vs 40.2%). Respondents knowledge about blood safety and donation are shown in Table 1. On the basis of the scoring scale,
Indian Medical Gazette JANUARY 2012 3 the proportion of students having adequate knowledge was 88 (33.1%) with the mean score of 12.2 ± 2.8. As shown in Table 2, around one third of the students thought that one could contract disease while donating blood. As reckoned by the students, fear (40.9%) and ignorance (31.0%) were the main reasons why people are reluctant to donate blood. Majority of the respondents (89.8%) were willing to donate blood in the future. Very few respondents (13.9%) had ever donated blood out of which 64.8% had donated within the last one year. Main reason for not donating blood was that they claimed of not having ever chance to donate blood (Table 3). Maximum number of the respondents (92.5%) has heard about blood donation camps and mode of acquaintance with blood donation and donation camps were from RIMS hospital itself and also through TV, radio and friends. Those students who had donated blood have more adequate knowledge about blood safety and donation as compared to those who have had never donated blood. This difference was statistically significant. However, having adequate knowledge was not significantly associated with gender and those who were willing to donate blood in future (Table 4). Discussion Maintaining an adequate and safe blood supply is an issue of concern to health planners especially with the increase in demand. Therefore, understanding the beliefs, attitude and level of knowledge associated with blood safety and donation is crucial. In this study only 33.1% of the students had adequate knowledge about blood safety and donation. Almost all the students knew about blood grouping and Rh typing. More than half of the students (56.8%) in the present study knew correct age limit for donating blood. Shahshahani et al 7 reported that 45% in the general population had correct knowledge regarding minimum age requirement for blood donation. In other studies 3,6 however, it was correctly known by only 3-6% of the respondents. Correct knowledge regarding the minimum gap between two donations was
4 Indian Medical Gazette JANUARY 2012 recorded in 36.5% of the students as also observed in other studies 1,2,3,4. However, another study 5 reported that 75% of an urban population knew it correctly. Less than one third of the students knew the diseases transmitted through unscreened blood transfusion. A similar finding was reported by other workers 3,5. Around 35% of the participants in the current study thought that donating blood can contract diseases. In certain studies, most of the people believed that blood donation can lead to human immunodeficiency virus infection and hepatitis C and or deterioration of health 8,9. Ninety percent of the respondents in this study intended to donate blood in future and they thought that fear (40.9%), ignorance (31%) and lack of motivations (19.1%) were the main reasons for not donating blood by people. Similar reasons were cited by other workers in their studies 5,7.10. Therefore, different fears, mistrust in hospital and lack of information and motivation may serve as important issues to be addressed when developing donors recruitment programs or campaigns to clear misconceptions about blood donation. In our study, the prevalence of having ever donated blood was found to be only 13.9% which is consistent with other study findings 5,11. A higher prevalence was reported by different researchers 1,7,9. A direct relationship was observed between adequate knowledge and voluntary blood donation. In other studies too, there was a strong relationship between knowledge level and performance 5,7. In this study, having adequate knowledge was not associated with gender and willingness to donate blood in the future. However, in many studies, donation of blood was higher among males than females 1,7,8. Most of the respondents acquired their information about blood safety and donation and its associated services through television and radio mainly. Other workers also reported similar results 7,8. Conclusion Only one third of the medical students under study had adequate knowledge on blood safety and donation. Majority of them intended to donate blood in future however, a very few had ever actually donated blood. Information, education and communication activities should be increased using mass media like television and radio. Regular CMEs and seminars should be conducted to increase awareness about blood safety and donation as well as to encourage healthy people and particularly students to donate blood regularly to make sure that blood is available for all patients in need. References 1. Zago A., Silveira M.F., Dumith C.S. Blood donation prevalence and associated factors in Pelotas, Southern Brazil. Rev Saudi Publica. 44(1):112-120, 2010. 2. WHO. The clinical use of blood-handbook, Geneva, 1, 2001. 3. Mitra K., Mandal P.K., Nandy S., Roy R., Joardar G.K., Mishra R. A study on awareness and perceptions regarding blood safety and blood donation among Health care providers in a Teaching Hospital of Calcutta. Ind J of Comm Med. XXVI(1):21-26, 2001. 4. Ghose A., Basu A. Blood. West Bengal: Voluntary Blood Donors Forum, 59, 1996.
Indian Medical Gazette JANUARY 2012 5 5. Hosain G. M., Anisuzzaman M., Begum A. Knowledge and attitude towards voluntary blood donation among Dhaka University Students in Bangladesh. East Afr Med J. 74(9):549-553, 1997. 6. Dixit J.V., Mahale A.R., Kulkarni A.P., Rathod S.B. Impact of blood donation awareness campaign by National Service Schemeof Government Medical College, Nanded. Ind J Comm Med. XXVI(1):12-15, 2001. 7. Shahshahani H.J., Yavari M.T., Attar M., Ahmadiyeh M.H. Knowledge, attitude and practice study about blood donation in the urban population of Yard, Iran, 2004. Tranfusion Medicine. 16:403-409, 2006. 8. Al-Drees A.M. Attitude, belief and knowledge about blood donation and transfusion in Saudi population. Pak J Med Sci. 24(1):74-79, 2008. 9. Zaller N., Nelson K.E., Ness P., Wen G., Bai X., Shan H. Knowledge, attitude and practice survey regarding blood donation in Northwestern Chinese city. Transfusion Medicine. 15:277-279, 2005. 10. Rajagopalan M., Pulimood R. Attitudes of medical and nursing students towards blood donation. Natl Med J. 11(1):12-13, 1998. 11. Androulaki Z., Merkoures A., Tsouras C., Androulakis M. Knowledge and attitude towards voluntary blood donation among a sample of students in TEI of Crete, Greece. Nurs Web J. 23:1-9, 2005.