Seroprevalence of transfusion-transmitted infections among blood donors in India: A systematic review and meta-analysis

Abstract

Background and Objectives: Blood transfusion is essential in healthcare but carries inherent risks of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and malaria transmission. National sero-epidemiology data on major transfusion-transmitted infections (TTI) in blood donors are lacking in India. This review aimed to estimate the prevalence of TTI in India, examine zonal variations, assess donor demographics and testing methodologies and analyse prevalence trends to further provide recommendations for blood safety. Materials and Methods: A systematic search of all original articles published in India from January 2019 to January 2024 in MEDLINE, SCOPUS, CINAHL and Google Scholar databases was conducted by following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Data regarding donor demographics, zonal distribution and TTI prevalence were retrieved from the studies after methodological evaluation. Meta-analysis was performed by the binary random-effects model. The risk of bias and publication bias were assessed utilizing RStudio. Results: The analysis included 41 studies with 1,860,594 blood donors. The pooled prevalence rates for HIV, HBV, HCV, syphilis and malaria among Indian blood donors were 0.12%, 0.91%, 0.28%, 0.14% and 0.01%, respectively. Males, replacement donors and first-time donors had a higher prevalence compared to females, voluntary donors and repeat donors, respectively. HIV (0.18%) and HCV (0.83%) were most prevalent in the North-east, HBV (1.57%) in the Central, syphilis (0.48%) in the North and malaria (0.04%) in the East zone. Conclusion: This review highlighted the influence of donor demographics and testing methodologies on TTI prevalence, emphasizing zonal disparities, with findings laying the groundwork for policy development and future research to improve blood supply reliability.