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transfusion services and blood programme managers from each WHO region (refer to Acknowledgements). The composition of the ERG was designed to ensure a wide range of specialist expertise and 19 experience from blood transfusion services in all regions at different stages of development. The role of the ERG was to review the draft guidelines and advise WHO on their relevance and applicability in their countries in the context of epidemiology, risk behaviours and activities, cultural practices and available blood screening and confirmatory testing technologies. An early draft of the guidelines was pilot-tested in Ethiopia in 2010 and revised drafts were circulated electronically to members of the ERG in 2010 and 2011; their comments were carefully reviewed by the GDG and incorporated into the guidelines. The guidelines were submitted for review and approval to the WHO Guidelines Review Committee (GRC), which reviewed and provided guidance on the process and methodology for evidence retrieval and the assessment and synthesis of evidence to ensure that the evidence collected was unbiased, upto-date and relevant. Detailed comments received from the GRC were addressed systematically and the guidelines were modified to incorporate these comments. A further external review of the advanced draft of the guidelines to assess the feasibility of their implementation was undertaken by participants in an interregional workshop on blood donor selection and donor counselling for priority countries in the African and Eastern Mediterranean regions, June 2011, Nairobi, Kenya (17) (refer to Acknowledgements); and, relevant comments were addressed by the GDG in developing the final draft. Evidence base A systematic literature search was conducted to collect and review the evidence (1995–2011, and also in 2012 for selected topics) on defined physiological conditions, diseases and risk behaviours in relation to the suitability of individuals for blood donation. The literature search covered the more widely consulted published literature from peer-reviewed journals, regional journals, book chapters, institutional and other knowledge databases, as well as lesser-known published literature and unpublished and non-reviewed “grey literature”. As these guidelines have been developed particularly for use in countries that have not yet established national systems for blood donor selection, the literature search strategy was specially designed to collect literature from low and middleincome countries. Searched domains A systematic search of the following databases was undertaken: PubMed, Cochrane Library, WHO Library Database (WHOLIS), Institute for Scientific Information (ISI) Web of Knowledge, World Bank eLibrary and WHO regional databases: African Index Medicus (AIM), Index Medicus for the Eastern Mediterranean (IMEMR), Index Medicus for South-East Asia (IMSEAR), Western Pacific Region Index Medicus (WPRIM), Virtual Health Library – Latin American and Caribbean Literature on Health Sciences Information (VHL-LILACS), Virtual Health Library – MEDCARIB and the Pan American Health Organization. The “grey literature” was retrieved using the public search engines Google and Yahoo mainly to collect literature from low and middle-income countries, focusing on a) the existence and availability of national guidelines and criteria for blood donor selection, and b) current practice in blood donor selection in countries. Keywords and medical subject heading (MeSH) terms, and key authors and institutions were used to retrieve relevant citations on each topic from various databases. Detailed search strategies with the date and time of the search, 20 databases searched, keywords and MeSH terms used and the search strings are documented in Annex 3. A preliminary screen by review of titles was carried out by the searcher to eliminate obviously irrelevant and duplicate citations. Citations of possible relevance were then forwarded to the chair of the GDG who undertook a further review of the titles and the abstracts, where appropriate. Key papers that addressed each of the study questions were then selected and the full text of these papers was reviewed. Quality of evidence The evaluation of the quality of evidence, the safety profiles of interventions, the assessment of current medical and scientific knowledge and practice, and the cost-effectiveness of practices was undertaken by the guideline development group and WHO/BTS. This formed the basis for the formulation of recommendations on criteria for the acceptance and deferral of prospective blood donors. It is recognized that there is a paucity of high quality evidence on which to base decisions on blood donor selection. While some attempts have been made to apply the principles

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