Relative safety of first-time volunteer and replacement donors in West Africa

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.

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.

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.

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.