Infection specific risk factors and ABO blood group associations among blood donors in northern and Bono East Ghana

This is the authors' abstract. We don't add key points for this paper.

Transfusion-transmissible infections (TTIs) remain a substantial public health problem in sub-Saharan Africa. Most surveillance reports describe overall burden among blood donors, but determinants of individual infections are less well characterised. We describe the burden of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among donors in northern and Bono East Ghana and identify donor characteristics associated with each infection, with exploratory analysis of ABO and Rhesus blood groups. We conducted a retrospective cross-sectional analysis of routine records from 3,348 blood donors with complete data, collected between 2017 and 2022 at six secondary-level hospitals across northern and Bono East Ghana. Separate logistic regression models were fitted for each infection. Sparse-data analyses (HCV, co-infections, HIV) were treated as exploratory. Among 3,348 donors (91.2% male; mean age 28.9 years), 495 (14.78%) were positive for at least one TTI. Syphilis was the most common (8.18%), followed by HBV (5.05%), HCV (2.21%) and HIV (0.72%). First-time donation was independently associated with HBV (AOR 2.75, 95% CI 1.53–5.41). Regional differences dominated the syphilis model, with markedly higher odds in the Upper West and Oti areas. Blood group AB was associated with HBV (AOR 3.34, p = 0.005) but this did not survive correction for multiple comparisons and is hypothesis-generating. A first time-by-residence interaction was detected ( p = 0.004): first-time rural donors had the highest prevalence (22.5%) and repeat rural donors the lowest (1.0%). TTI burden among donors was high and strongly patterned by donor type and region. First-time and rural donors, and the Oti area, carry a disproportionate share of infections and are the logical focus for donor-conversion and screening efforts. ABO findings are exploratory and do not support blood-group-based risk stratification.