title: Syphilis screening practices in blood transfusion facilities in Ghana.
abstract: OBJECTIVE
  The primary objective of this study was to compare laboratory practices for screening blood donors for syphilis at blood transfusion facilities in Ghana with the recommendations of the World Health Organization and the National Blood Service, Ghana (NBSG). The prevalence of syphilis antibodies in blood donors in Ghana was also estimated.
  
  
  METHODS
  Over an 11-month period, from February 2014 to January 2015, a semi-structured questionnaire was administered to 122 laboratory technical heads out of a total of 149 transfusion facilities in Ghana. The response rate was 81.9%.
  
  
  RESULTS
  A total of 58 (48%) transfusion facilities tested donors for syphilis, with an estimated 3.7% seroprevalence (95% confidence interval 3.6-3.8%). A total of 62782 out of 91386 (68.7%) donations were tested with assays that are not recommended. The estimated syphilis seroprevalence in voluntary donations was 2.9%, compared to 4.0% in family donations (p=0.001). Only 6.9% of the health facilities were using standard operating procedures (SOPs).
  
  
  CONCLUSIONS
  Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening blood donations for syphilis. These data show a considerable mismatch between recommendations and practice, with serious consequences for blood safety and public health.
authors.affiliation: Komfo Anokye Teaching Hospital, Kumasi, Ghana; Liverpool School of Tropical Medicine, Liverpool, UK. Electronic address: fsarkodie29@gmail.com.
authors.forename: Francis
authors.initials: F
authors.lastname: Sarkodie
authors.affiliation: Liverpool School of Tropical Medicine, Liverpool, UK. Electronic address: ohassall@gmail.com.
authors.forename: Oliver
authors.initials: O
authors.lastname: Hassall
authors.affiliation: School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Electronic address: owusudabo@yahoo.com.
authors.forename: Ellis
authors.initials: E
authors.lastname: Owusu-Dabo
authors.affiliation: Komfo Anokye Teaching Hospital, Kumasi, Ghana. Electronic address: sowusu_ofori@hotmail.com.
authors.forename: Shirley
authors.initials: S
authors.lastname: Owusu-Ofori
authors.affiliation: Liverpool School of Tropical Medicine, Liverpool, UK. Electronic address: ibates@liverpool.ac.uk.
authors.forename: Imelda
authors.initials: I
authors.lastname: Bates
authors.affiliation: Department of Public Health, University of Copenhagen, Copenhagen, Denmark. Electronic address: iby@sund.ku.dk.
authors.forename: Ib C
authors.initials: IC
authors.lastname: Bygbjerg
authors.affiliation: National Blood Service, Accra, Ghana. Electronic address: kordaiansah@yahoo.com.
authors.forename: Justina Kordai
authors.initials: JK
authors.lastname: Ansah
authors.affiliation: Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark. Electronic address: henrik.ullum@regionh.dk.
authors.forename: Henrik
authors.initials: H
authors.lastname: Ullum
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood*; D001782:Blood Donors / Q000706:statistics & numerical data; D058731:Blood Safety / Q000592:standards*; D001803:Blood Transfusion / Q000592:standards*; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000175:diagnosis* / Q000382:microbiology; D013588:Syphilis Serodiagnosis; D065227:Transfusion Reaction
chemical_list: D000907:Antibodies, Bacterial
keywords: Blood donors; Rapid diagnostic tests; Seroprevalence; Standard operating procedures; Transfusion facilities