During this period an internal WP discussion on the structure and areas of focus of the 4 subgroups was held with the decision reached to broaden the Parasitology subgroup into an Emerging Pathogens and Parasitology (EPP) subgroup. The expanded focus will allow this subgroup to engage in topics that are related to the work of the other subgroups, but with a perspective on horizon scanning for new or rare blood safety threats. The intent is for the EPP subgroup to develop close collaborations and projects with the other subgroups based on the areas of focus of the other subgroups.

Three TTID WP project funding requests were approved by ISBT.

Each subgroup has actively led several projects this past year. Activities are reported as bulleted lists by subgroup.

Bacteria

• Bacterial growth in delayed cold-stored platelet components. Seven participant laboratories worldwide: 5 have finished experimental work and 2 have initiated experimental work.
• Endotoxin detection in platelet concentrates. Six participant laboratories worldwide. Experimental work has finished, data analysis is on-going.
• Survey on syphilis screening. Survey was designed and sent to TTID WP members.

Emerging Pathogens and Parasitology (EPP)

• In November 2024, an updated Terms of Reference (TOR) for this subgroup was developed and reviewed by the OC. The updated TOR was accepted.
• Subgroup meetings in 2024 included presentations on the “Estimated Plasmodium 18S-rRNA prevalence in asymptomatic blood donors from three African countries”, and discussion of the OneHealth initiative and emerging infectious diseases.
• Subgroup meetings in early 2025 included guest speakers Michael Hawkes, (UBC, Vancouver, Canada), David Okweny (Uganda Blood Transfusion Services), John Kanyonyozi (Association for Health Innovation in Africa [AFHIA], Uganda).
• EPP is planning for research projects with themes expected to include surveillance for emerging pathogens, emergence of ‘Disease X’ in terms of blood safety and sufficiency, discussions on untracked or rare agents (e.g., bacterial/fungal toxins, beta-amyloids, chronic wasting disease).

Surveillance, Risk Assessment, and Policy (SRAP)

• This subgroup focuses on assessing donation testing, deferral policies, and other policies that support transfusion safety, such as lookback investigations. Ongoing work on wide-ranging topics to support policy reviews. These include reviewing deferral policies related to PrEP and PEP usage, improving compliance with donor health history questions, and assessing HTLV testing requirements.
• Initial discussions have begun on a project to develop standardized terminology that will support TTID WP members and their broader networks in ISBT and beyond.
• Two international surveys are planned for 2025. The first survey, ‘Optimising Inclusion for Blood Donors Post-IDRA Implementation’, will examine the impact of policy changes on transgender and nonbinary donors. The second survey, ‘Blood Bank Deferral Due to Antigen Risk’, will evaluate current deferral practices and explore potential improvements.

Virology

• The HBV infection vaccine breakthrough assessment project continues, and preliminary findings were reported at the EASL Congress 2024, and the 24th ANRS|EID AC42 Meeting 2024.
• Characterisation and follow-up of occult HBV infection (OBI) project. Laboratory testing has been completed. A manuscript has been drafted, and the final analysis of the genetic data is ongoing in the second aim of the study.
• Assessment of the need for anti-HCV donation testing when HCV ID-NAT is used. An agreement with corporate partners has been finalized and the study has commenced.
• Prevalence of HBV markers in African donors: held online meetings for preparation of the project to define clear objectives and to identify potential funding sources.
• Review of viral confirmatory testing and future donor eligibility: survey/data collection tool in development.
• Completion of the 10-year NAT survey analysis and reporting.