Abstract:
Blood transfusion is an essential therapeutic procedure. Although timely transfusion saves
millions of human lives worldwide each year, unsafe transfusion practices can put millions
of people at risk of transfusion transmissible infections. In Kenya the blood transfusion
policy requires screening of blood for HIV-1 and HIV-2, hepatitis B surface antigen
(HBsAg), hepatitis C virus antibodies (ant-HCV) and syphilis. Malaria is also a blood-borne
disease which is not currently screened for. Blood donor selection criteria in Kenya were
reviewed in 2009. Since the epidemiology of Transfusion Transmissible Infections (TTIs)
evolves with time, regular review of effectiveness of donor selection criteria can help reduce
TTI’s prevalence amongst donors and thus make blood supply safer. A cross sectional study
was conducted among blood donors in Regional Blood Transfusion Center Nakuru and
Tenwek Mission Hospital, Kenya. Donor samples were obtained through systematic
sampling. Each donor sample was screened, for HIV-1 and HIV-2, hepatitis B surface
antigen (HBsAg), hepatitis C virus antibodies (ant-HCV), syphilis and malaria parasites.
Associated risk factors were determined using the standard donor questionnaire. A total of
594 participants were enrolled into the study. Males constituted 72% (n=429), 53% (n=315)
of overall donors being between 16-20 years of age. Sixty two percent of donors (n=367)
were students, 75% (n=446) were single and 67% (n=399) had attained secondary school
education. The overall prevalence of TTI’s was 14.1%; n=84 (11.9% in Nakuru and 25% in
Tenwek). The prevalence of Transfusion Transmissible Infections among blood donors in
xviii
the two sites ranged from 0.7% for malaria to 5.6% for HBsAg. In multivariate analysis,
blood donors who were married (OR=4.56; P-value=0.0057) with non-formal/primary
education (OR=9.05; P-value=0.0262), informal occupation (OR=4.08; P-value=0.0176) and
multiple sexual activity (OR=189.78; P-value=0.0144), were at higher risk of HIV infection.
History of blood transfusion/blood products (OR=9727.90; P-value=0.0055) and being
married (OR=12.27; P-value=0.0053) were high risk factors associated with positive
syphilis. Male gender (OR=2.92; P-value=0.0479) was a high risk factor to HBV infection.
This study identifies a low risk donor as unmarried, less than 30 years of age, and having
education beyond primary level who donates voluntarily. Potential donors with history of
previous transfusion and multiple sexual activity should be deferred from donation.
Measures should be taken to prevent transfusion transmission of malaria. The donor
selection questionnaire should be updated to screen persons exposed to malaria.
