Prevalence and socio-demographic factors associated with transfusion transmissible infections among voluntary blood donors in Kigali, Rwanda

BACKGROUND: Transfusion transmissible infections (TTIs) such as Human Immunodeficiency Virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis, remain a major public health concern in low-income countries due to inadequate blood donation systems. This highlights the urgent need for continuous surveillance and a deeper understanding of the factors associated with TTIs in Rwanda. METHODS: A retrospective cross-sectional study analyzed voluntary blood donor records from the National Center for Blood Transfusion (NCBT) in Kigali, Rwanda, spanning January 2019 to December 2023. A census of all available records was used to select 38,345 eligible donors aged 18-60 years. Data were extracted from electronic databases and analyzed using SPSS version 25, with chi-square tests and multivariate logistic regression to identify predictors of transfusion-transmissible infections. RESULTS: The overall prevalence of transfusion-transmissible infections declined from 2019 to 2023, with HBV decreasing from 0.76% to 0.41%, HCV from 0.30% to 0.18%, HIV remaining stable at 0.04%-0.08%, and syphilis slightly increasing to 0.26%. Multivariate analysis showed that male gender was independently associated with HBV (aOR = 2.60, 95% CI: 1.54-4.38, p < 0.001) and HIV (aOR = 3.84, 95% CI: 1.63-9.05, p = 0.002). First-time donor status was independently associated with higher odds of HBV (aOR = 4.09, 95% CI: 2.26-7.39, p < 0.001) and HIV (aOR = 2.95, 95% CI: 0.77-11.34, p < 0.001). Gasabo district was independently associated with lower odds of HBV (aOR = 0.56, 95% CI: 0.34-0.90, p = 0.017) and higher odds of HCV (aOR = 2.34, 95% CI: 1.25-4.40, p = 0.008), relative to Nyarugenge. CONCLUSION: TTI prevalence among Kigali blood donors remained low with declining HBV and HCV trends from 2019 to 2023, while HIV rates stayed consistently low. Male gender, older age, first-time donor status, and specific occupations were independently associated with TTI positivity. Rwanda's blood screening protocols appear effective, though targeted interventions for high-risk groups and continued surveillance are recommended. CLINICAL TRIAL NUMBER: Not applicable.