Systematic substantiation of the medical questionnaire for blood donors
One of CEBaP’s tasks consists of providing the scientific basis for the selection criteria applied to blood donors. These criteria are intended to guarantee the safety of both blood donors and recipients.
As for the safety of recipients, we published a systematic review regarding the risk of blood-borne infections in blood donated by men who have sex with men (MSM). We assessed 18,987 references for this purpose and selected 15 observational studies. The available evidence was of a low quality (partly due to the observational study design) and suggests a link between MSM blood donors and HIV infections. However, the evidence is too limited to substantiate any specific deferral period for blood donors.
We also developed a systematic review of the risk of blood-borne infections in blood donors who have undergone an endoscopy. The invasive procedure and the fact that endoscopes are reused may pose an obstacle to the safety of the blood supply. Based on a systematic literature review, we selected 28 observational studies (of a very low quality). Using various meta-analyses, we demonstrated the link between endoscopies and Hepatitis B and C infections. Pending more extensive studies of higher quality (experimental investigation), we therefore maintain the current policy applied by Belgian Red Cross-Flanders (a deferral period of at least two months following an endoscopy).
Review of our first aid publications
All guidelines developed by CEBaP are reviewed every five years so that the recommendations are up-to-date in line with the most recent scientific studies. We reviewed our first aid manual Help! Eerste hulp voor iedereen last year, as well as the manual for our emergency services. In total we developed 314 evidence summaries and also consulted the recently reviewed and published guidelines from the International Liaison Committee on Resuscitation (in which CEBaP was also involved). The scientific evidence served as the basis for reviewing current recommendations and formulating new ones, together with input from our First Aid and Intervention Services and expert opinions from medical doctors of the Belgian Red Cross-Flanders Medical Committee. The reviewed manuals will be available later in 2016.
Promoting first aid in schools
We published an "educational programme for First Aid" at the start of the 2014 school year. This educational tool must enable teachers to incorporate first aid in the school curricula for pupils aged between five and eighteen. The development of this curriculum is an excellent example of how the principles of Evidence-Based Practice can be applied: (1) we compiled an overview of pertinent evidence regarding first aid training for children; (2) we gathered expert opinions and information on practical experience from teachers, educators, experts with didactic experience, psychologists, first aid instructors and medical doctors; and (3) we took into account the preferences of the target audience (children and teachers). This educational programme was included on the new First Aid at School website launched by the Education Department of the Flemish Government in 2015. The project was also published in Resuscitation.
Preparing for disasters
In order to improve the effectiveness and efficiency of humanitarian efforts, minimum standards and indicators for humanitarian assistance are available. However, these indicators are based on consensus rather than operations that are proven to be effective. A key indicator for disasters is the quantity of water needed per person per day for drinking, cooking and hygiene purposes. CEBaP developed a systematic review to gather scientific evidence for this indicator, which specifies that victims of a disaster must each receive at least 15 litres of water per day. We selected six studies out of 3,630 articles; but no evidence supporting this indicator could be found. However, we could conclude that the more water available per person, the better the impact on health. The results of this systematic review were published in early 2015 in PLOS One.
In August, CEBaP took on a prestigious project, for which funding is provided by 3ie (International Initiative for Impact Evaluation), an international NGO that awards subsidies to projects that provide scientific evidence for policies and programmes in developing countries. Led by CEBaP, the Scientific Coordinator of the Humanitarian Services and the Centre for Evidence-Based Health Care (Stellenbosch University, South Africa), we are currently conducting a major review of scientific literature on how effective WASH (water, sanitation and hygiene) programmes are with regard to changing behaviours (e.g. washing hands) in developing countries.
Based on the scientific studies found, Belgian Red Cross-Flanders will publish a report in late 2016 that international bodies and governments in developing countries can use to offer scientifically based WASH programmes to local people.