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

BACKGROUND: 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. STUDY DESIGN AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.