Relative safety of first-time volunteer and replacement donors in West Africa.
BACKGROUND
A significantly higher level of safety between nonremunerated volunteer and replacement donor blood is assumed. This is supported by global data without stratifying between genuine replacement and paid donors, for first-time or repeat volunteer, or according to age.


METHODS
In 2008, first-time volunteer and replacement donors were identified, and confirmed human immunodeficiency virus antibody (anti-HIV), hepatitis B surface antigen (HBsAg), and hepatitis C virus antibody (anti-HCV)-positive screening results were collated. Data were analyzed according to age and sex between the two types of donors.


RESULTS
In 6640 first-time volunteer and 4360 replacement donors, the prevalence of anti-HIV and HBsAg (1.03 and 13.8% vs. 1.1 and 14.9%, respectively) was not significantly different. Anti-HIV prevalence was higher in replacement donors less than age 20 than in first-time volunteers; the difference was not significant. HBsAg and anti-HIV confirmed-positive prevalence was significantly higher in first-time volunteer donors over age 20.


CONCLUSIONS
In Kumasi, Ghana, viral safety of replacement and first-time volunteer donors was similar, constituting a single population of donors. Safety increment is provided by repeat donation applicable to either group, through different approaches. A blood unit from replacement donor costs half or less than that from a volunteer donor; similar studies conducted elsewhere in sub-Saharan Africa may lead to changes in current strategies.
Division of Transfusion Medicine, Department of Haematology, University of Cambridge, Cambridge, UK. jpa1000@cam.ac.uk
Jean-Pierre
JP
Allain
Francis
F
Sarkodie
Kwame
K
Asenso-Mensah
Shirley
S
Owusu-Ofori
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001782:Blood Donors / Q000523:psychology / Q000706:statistics & numerical data*; D046148:Donor Selection / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D005869:Ghana / Q000453:epidemiology; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D015528:HIV Seroprevalence; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009042:Motivation; D012449:Safety; D016036:Seroepidemiologic Studies; D014838:Volunteers; D055815:Young Adult
D015483:HIV Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies