Evaluation of Rapid Diagnostic Test Method for Screening Blood Donors and Determining the Risk of Transfusion Transmitted Viral Infections in Selected Health Facilities in Central Region, Ghana

Abstract

Background: Blood transfusion is a life-saving practice in medicine but serves as a major route for spreading infections. It is therefore necessary to adopt sensitive screening technologies to guarantee the safety of blood. In Ghana, most districts and regional blood bank laboratories are limited in resources and resort to the use of rapid kits; a method less sensitive and liable to errors compared to enzyme-linked immunosorbent assay as the gold standard. This study seeks to determine the proportion of HIV and HBV infection among blood donors missed by RDT and the risk of transfusion transmitted infections when rapid diagnostic kit is solely used for screening blood donors. Aim: The aim of the study was to detect transfusion transmissible HIV and HBV infections in donor blood screened with RDT kits and labeled as safe for transfusion. Methods: The study was conducted in four facilities, namely Agona Swedru Municipal Hospital, Mercy Women’s Catholic Hospital, Ajumako District Hospital and St. Francis Xavier Catholic Hospital in the Central Region of Ghana. Blood screened with RDT and stored in blood bank refrigerator ready for transfusion were randomly sampled and sent to the National Public Health Reference Laboratory to be retested with Enzyme-linked Immunosorbent Assay. Results: A total of 196 donor samples were randomly selected but 194 samples with complete information were analysed. Out of 194 donor samples, 85.05% were from males and 14.95% were from females. RDT missed six (6) HIV and one (1) HBV infection but were detected with ELISA. The performance of RDT was less compared to ELISA and the calculated negative predictive value of First Response HIV 1-2, In Tec, LabAcon, Diaspot and Wondfo were 96.9%, 97.6%, 100%, 100% and 100% respectively. There was no significant association between HIV and HBV transfusion transmitted infections and sociodemographic and RDT -related factors. Conclusion: Rapid Diagnostic Test has limitations with regard to accuracy for screening blood donors for transfusion transmissible HIV and HBV infection and should not be the only test for guaranteeing the safety of blood for transfusion. ELISA had higher sensitivity and should be enforced as the Gold standard for blood screening in Ghana.