Prevalence and incidence of transfusion-transmissible infections among blood donors in Malawi: A population-level study

Emmanuel Singogo, Maganizo Chagomerana, Collin Van Ryn, Robert M'bwana, Andrew Likaka, Bridon M'baya, Sydney Puerto-Meredith, Effie Chipeta, Victor Mwapasa, Adamson Muula, Cavan Reilly, Mina C. Hosseinipour

Research output: Contribution to journalArticlepeer-review


Background: Voluntary non-remunerated blood donors (VNRBDs) are essential to sustain national blood supplies. Expanding testing capacity for the major transfusion-transmitted infections (TTI) is crucial to ensure safe blood products. Understanding trends in TTIs can inform prioritisation of resources. Methods: We conducted a retrospective cohort data analysis of routine blood donation data collected from VNRBDs by the Malawi Blood Transfusion Service from January 2015 to October 2021. Variables included age, occupation; and screening results of TTIs (HIV, Hepatitis B and C, and syphilis). We estimated both prevalence and incidence per person-year for each TTI using longitudinal and spatial logistic regression models. Results: Of the 213 626 donors, 204 920 (95.8%) donors were included in the final analysis. Most donors (77.4%) were males, baseline median age was 19.9 (IQR 18.0, 24.1), 70.9% were students, and over 80.0% were single at first donation. Overall TTI prevalence among donors was 10.7%, with HBV having the highest prevalence (3.4%), followed by syphilis (3.3%), then HIV (2.4%) and HCV (2.4%). Incidence per 1000 person-years for syphilis was 20.1 (19.0, 21.3), HCV was 18.4 (17.3, 19.5), HBV was 13.7 (12.8, 14.7), and HIV was 11.4 (10.6, 12.3). We noted geographical variations with the northern region having lower rates of both prevalence and incidence compared to central and southern regions. Conclusion: The individual TTI prevalence and incidence rates from this study are consistent with Southern African regional estimates. By identifying geographical variations of TTI prevalence and incidence, these findings could potentially inform prioritisation of blood collection efforts to optimise blood collection processes.

Original languageEnglish (US)
Pages (from-to)483-496
Number of pages14
JournalTransfusion Medicine
Issue number6
StatePublished - Dec 2023

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society.


  • BLOODSAFE Project
  • blood transfusion
  • cohort data analysis
  • incidence
  • prevalence
  • spatial modelling
  • transfusion transmissible infections

PubMed: MeSH publication types

  • Journal Article


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