Assessing the implications of using RDTS in donor blood screening for transfusion-transmissible infections (TTIs): analysis of trans-in donor blood at a Tertiary Hospital in Ghana

Background: Blood transfusion is a critical hemotherapeutic intervention. However, the widespread utilization of Rapid Diagnostic Test (RDT) methods in screening potential donors for TTIs poses a serious public health challenge. We investigated the prevalence of TTIs in donor blood units that were transported from external health facilities (Trans-in blood) to Ho Teaching Hospital for critical care. Method: We adopted a cross-sectional design to investigate 727 units of Trans-in blood at the Ho Teaching Hospital's blood bank between January 1, 2021, to December 31, 2022. An apriori-developed data capture form was used to collect the data for this study. The chi-square test and Cramer's V or Phi were used to assess the association between variables of interest. Binary logistic regression analysis was used to determine the association between TTIs and donor's blood groups whereas spatial visualization was employed to present the distribution of missed TTIs. Results: The overall prevalence of missed TTIs was 6.19 % (95 % CI: 4.66–8.18), comprising missed HIV, HBV, and Syphilis infection rates of 1.79 % (95 % CI: 1.72–1.86), 1.24 % (95 % CI: 1.17–1.31), and 3.16 % (95 % CI: 3.09–3.23), respectively. There was a higher rate of missed HIV infections in 2022 (2.04 %, 95 % CI: 1.04–3.97) compared to 2021 (1.49 %, 95 % CI: 0.64–3.45), and a decline in the rates of missed HBV and Syphilis infection within the period. The prevalence of TTI was highest among donors with ABO blood group 'O' (68.89 %, 95 % CI: 54.34–80.47) and Rh 'D' Positive blood group (95.56 %, 95 % CI: 85.17–98.77). Compared to donors with blood group O, non-O donors had 4.53 times the odds (95 % CI: 1.12–18.27; p-value=0.034) of missed HBV infection. Conclusion: The observed prevalence of missed TTIs highlights potential gaps in current screening practices, posing a significant public health concern. Efforts made to clamp down on the spread of these infections within the population may be impeded if the current trend of missed TTIs continues. Further studies on a larger scale with more comprehensive data are advised to better appreciate the public health implications of missed TTIs in Ghana.