Effectiveness of Blood Transfusion Screening Procedures in Preventing Transfusion- Related Infections

Abstract Background: Blood transfusion is an important life-saving procedure; however, transfusion risk infections (TRI) have remained a major problem of public health especially in resource-poor countries. Blood transfusions may still result in TRIs, even with screening protocols for blood-borne infections, such as HIV, Hepatitis B (HBV), Hepatitis C (HCV), Syphilis, and Malaria. Objective: The study aimed at evaluating the effectiveness of blood transfusion screening procedures at Kisii Teaching and Referral Hospital (KTRH) in preventing transfusion-related infections. Methods: A retrospective cohort study carried out analyses on data involving 108 blood transfusions done at KTRH between January 2022 to December 2023. Data were sourced from hospitals transfusion records including demographic data from patients, transfusion details, HIV screening results, Hepatitis B screening results, Hepatitis C screening results, Syphilis screening results, and Malaria screening results. Incidence of post-transfusion infections tracked and effectiveness of screening protocols determined as per sensitivity, specificity, and positive predictive value (PPV). Bivariate analysis was done to assess the risk factors for post-transfusion infections. Results: The overall incidence of infections following transfusion was recorded at 2.78% with bacterial infections as the most common types. High sensitivity and specificity were associated with HIV, Hepatitis B and Hepatitis C screening; however, Malaria screening was found to be low in some high-risk groups. Risk factors for post-transfusion infections include long duration of storage of blood and the volume transfused. The cost-effectiveness analysis showed that strengthening of screening protocols on Malaria and contamination by bacteria would enhance blood safety in KTRH. Conclusion: Findings of the study discovered that although the KTRH screening procedures were efficient in identifying the major bloodborne pathogens such as HIV, Hepatitis B, and Hepatitis C, screening gaps existed concerning Malaria and bacterial infections. Improving these procedures of screening would help to further decrease the incidences of transfusion-related infection into a more safe environment for patients. Recommendations on improving the screening protocols as well as addressing the identified risks have been given.