Sociodemographic and blood group characteristics of the blood donors
Table 1 presents the sociodemographic and blood group characteristics of the prospective family replacement blood donors. The median age of the blood donors was 29 years (with 25th-75th percentiles being 24-35 years). Of the 6847 family replacement blood donors screened, the majority (88.1% [6033]) were males, ≤24 years of age (27.4% [1874]), screened in the rainy season (62.1% [4251]), had the O blood type (69.8% [4776]), and were Rh-positive (89.9% [6154]) (Table 1).
Table 1. Sociodemographic characteristics of blood donors at the Sunyani Municipal Hospital, Ghana (2018- 2021).
Variable
|
Frequency (n)
|
Proportion (%)
|
Gender
|
|
|
Male
|
6033
|
88.1
|
Female
|
814
|
11.9
|
Age (years)
|
|
|
≤24
|
1874
|
27.4
|
25-29
|
1706
|
24.9
|
30-35
|
1611
|
23.5
|
≥36
|
1656
|
24.2
|
Median (IQR)
|
29 (24, 35)
|
Season
|
|
|
Rainy season
|
4251
|
62.1
|
Dry season
|
2596
|
37.9
|
ABO blood group
|
|
|
O
|
4776
|
69.8
|
A
|
914
|
13.3
|
B
|
1124
|
16.4
|
AB
|
33
|
0.5
|
Rh blood group
|
|
|
Positive
|
6154
|
89.9
|
Negative
|
693
|
10.1
|
Total
|
6847
|
100.0
|
Data are presented as frequencies and proportions. Age is presented as median with interquartile range (IQR) in parenthesis; n: Sample size.
Seroprevalence of hepatitis B and C stratified by sociodemographic characteristics of the blood donors
Table 2 shows the seroprevalence of hepatitis B and C stratified by sociodemographic characteristics of the blood donors. The overall seroprevalences of HBV and HCV were 3.2% (216/6847) and 1.9% (130/6847), respectively. The seroprevalence of HBV was increased in male donors (3.4% [206/6033]), 3.7% (60/1611) in 30-35 years, and 3.3% (86/2596) in the dry season. Hepatitis B infection among the donors was significantly associated with gender, but not age and season (p≤0.001, vs p=0.411, vs p=0.569, respectively). The seroprevalence of HCV was increased in male donors (2.0% [123/6033]), 2.3% (38/1656) in the ≥36-year group, and 2.2% (92/4259) in the rainy season. Hepatitis C was significantly associated with gender and season, but not age (p=0.019, vs p=0.044, vs p=0.341, respectively) (Table 2).
Table 2. Seroprevalence of hepatitis B and C stratified by sociodemographic characteristics of blood donors at the Sunyani Municipal Hospital, Ghana (2015-2021).
Variable
|
Total screened
|
HBV
|
|
HCV
|
R
n (%)
|
NR
n (%)
|
R
n (%)
|
NR
n (%)
|
Gender
|
|
p≤0.001
|
|
p=0.019
|
Male
|
6033
|
206 (3.4)
|
5827 (96.6)
|
|
123 (2.0)
|
5910 (98.0)
|
Female
|
814
|
10 (1.2)
|
804 (98.8)
|
|
7 (0.9)
|
807 (99.1)
|
Age (years)
|
|
p=0.411
|
|
p=0.341
|
≤24
|
1874
|
51 (2.7)
|
1823 (97.3)
|
|
39 (2.1)
|
1835 (97.9)
|
25-29
|
1706
|
53 (3.1)
|
1653 (96.9)
|
|
27 (1.6)
|
1679 (98.4)
|
30-35
|
1611
|
60 (3.7)
|
1551 (96.3)
|
|
26 (1.6)
|
1585 (98.4)
|
≥36
|
1656
|
52 (3.1)
|
1604 (96.9)
|
|
38 (2.3)
|
1618 (97.7)
|
Season
|
|
p=0.569
|
|
p=0.044
|
Rainy season
|
4251
|
130 (3.1)
|
4121 (96.9)
|
|
92 (2.2)
|
4159 (97.8)
|
Dry season
|
2596
|
86 (3.3)
|
2510 (96.7)
|
|
38 (1.5)
|
2558 (98.5)
|
Total
|
6847
|
216 (3.2)
|
6631 (96.8)
|
|
130 (1.9)
|
6717 (98.1)
|
Data are presented as frequencies, with corresponding proportions in parentheses; Pearson Chi-Square and Fisher’s exact tests were used to compare differences in proportions of reactive vs non-reactive tests for HBV and HCV; HBV: Hepatitis B virus; HCV: Hepatitis C virus; R: Reactive; NR: Non-Reactive; n: Sample size; p: P-value; p≤0.05 was considered significant.
Seroprevalence of hepatitis B and C stratified by ABO and Rh blood groups of blood donors
Table 3 shows the seroprevalence of hepatitis B and C, stratified by ABO and Rh blood groups of blood donors. An increased percentage (3.6% [40/1124]) of the blood donors with blood group B tested reactive for HBV, followed by 3.4% (31/914) in blood group A, and 3.0% each in blood groups O and AB. An increased percentage of blood donors in the Rh-negative blood group tested reactive for HBV compared to 3.1% (191/6154) in the Rh-positive group. Hepatitis B infection had no significant association with either ABO or Rh blood groups (p=0.783 and p=0.491, respectively). Unlike HBV, an increased percentage (2.8% [31/1124]) of blood group B donors tested reactive to HCV, followed by 1.8% (86/4776) in blood group O, and 1.4% (13/914) in blood group A. With regards to the Rh blood group, an increased percentage of the Rh-positive than Rh-negative blood donors tested reactive to HCV (1.9% [118/6154] vs 1.7% [12/693]). Hepatitis C infection among the blood donors had no significant associations with ABO and Rh blood groups (p=0.091 and p=0.883, respectively) (Table 3).
Table 3. Seroprevalence of hepatitis B and C stratified by ABO and Rh blood groups of blood donors at the Sunyani Municipal Hospital, Ghana (2015-2021).
Variable
|
Total screened
|
HBV
|
|
HCV
|
R
n (%)
|
NR
n (%)
|
R
n (%)
|
NR
n (%)
|
ABO blood group
|
|
p=0.783
|
|
p=0.091
|
O
|
4776
|
144 (3.0)
|
4632 (97.0)
|
|
86 (1.8)
|
4690 (98.2)
|
A
|
914
|
31 (3.4)
|
883 (96.6)
|
|
13 (1.4)
|
901 (98.6)
|
B
|
1124
|
40 (3.6)
|
1084 (96.4)
|
|
31 (2.8)
|
1093 (97.2)
|
AB
|
33
|
1 (3.0)
|
32 (97.0)
|
|
0 (0.0)
|
33 (100.0)
|
Rh blood group
|
|
p=0.491
|
|
p=0.883
|
Positive
|
6154
|
191 (3.1)
|
5963 (96.9)
|
|
118 (1.9)
|
5963 (98.1)
|
Negative
|
693
|
25 (3.6)
|
668 (96.4)
|
|
12 (1.7)
|
681 (98.3)
|
Data are presented as frequencies, with corresponding proportions in parentheses; Pearson Chi-Square and Fisher’s exact tests were used to compare differences in proportions of reactive vs non-reactive tests for HBV and HCV; HBV: Hepatitis B virus; HCV: Hepatitis C virus; R: Reactive; NR: Non-Reactive; n: Sample size; p: P-value; p≤0.05 was considered significant.
Sociodemographic risk factors of hepatitis B and C among the blood donors
Table 4 shows the sociodemographic risk factors of HBV and HCV among the blood donors. Male blood donors were 2.842 times (CI: 1.500-5.385, p=0.001) and 2.399 times (CI: 1.116-5.157, p=0.025) more likely than females to be infected with HBV and HCV, respectively. The risk of the blood donors being infected with either HBV or HCV did not significantly differ across different age groups. Blood donors screened during the rainy season were 1.489 times (CI: 1.017-2.180, p=0.041) more likely to be infected with HCV. The risks of the donors being infected with HBV, and HCV were significantly different between gender, whereas for season the risks of being infected with HCV was significant. The age of blood donors, however, was not a significant risk factor for HBV and HCV in this study (Table 4).
Table 4. Sociodemographic risk factors of hepatitis B and C among blood donors at the Sunyani Municipal Hospital, Ghana (2015-2021).
Variable
|
HBV
|
|
HCV
|
OR (95% CI)
|
p
|
OR (95% CI)
|
p
|
Gender
|
|
|
|
|
|
Male
|
2.842 (1.500-5.385)
|
0.001
|
|
2.399 (1.116-5.157)
|
0.025
|
Female
|
1.000
|
-
|
|
1.000
|
-
|
Age (years)
|
|
|
|
|
|
≤24
|
0.981 (0.667-1.443)
|
0. 922
|
|
1.026 (0.657-1.604)
|
0.909
|
25-29
|
1.019 (0.695-1.494)
|
0.922
|
|
0.711 (0.434-1.164)
|
0.175
|
30-35
|
1.154 (0.796-1.673)
|
0.450
|
|
0.684 (0.415-1.127)
|
0.136
|
≥36
|
1.000
|
-
|
|
1.000
|
-
|
Season
|
|
|
|
|
|
Rainy season
|
0.921 (0.698-1.214)
|
0.559
|
|
1.489 (1.017-2.180)
|
0.041
|
Dry season
|
1.000
|
-
|
|
1.000
|
-
|
Data are presented as odds ratio and 95% confidence interval in parentheses; Binary logistic regression was used to determine the risk of HBV and HCV between gender and season; Multinomial logistic regression was used to determine the risk of HBV and HCV across age groups; HBV: Hepatitis B virus; HCV: Hepatitis C virus; OR: Odds ratio; CI: Confidence interval; p: P-value; p≤0.05 was considered significant.
Year-on-year trends of hepatitis b and c among the blood donors
Figure 1 shows a year-on-year trend of HBV and HCV among the blood donors. The seroprevalence of HBV declined moderately from 2015 to 2016, followed by a sharp rise from 2016 to 2017, and further to 2018. It then declined sharply in 2019, followed by a moderate and transient increase in seroprevalence in 2020 and a further decline in 2021, with a slope of -0.5464. However, the seroprevalence of HCV showed a steep decline from 2015 to 2016, followed by a sharp increase in 2017. The seroprevalence of HCV then declined in 2018, and further showed a steady decline to 2021, yielding a slope of -0.6179. The declining trends in seroprevalence of HBV and HCV over the seven years were statistically significant (p≤0.001 and p≤0.001, respectively) (Figure 1).
INSERT FIGURE 1