Causes of Pre and Post-Donation Deferrals among Blood Donors, at Kwale Satellite Blood Transfusion Center, Kwale County, Kenya, 2018-2022.

Abstract Background: Both pre-donation and post-donation deferrals pose challenges to blood safety and availability. This study delved into the deferral rates before donations and their underlying reasons, also, transfusion transmissible infections (TTIs) leading to post-donation deferrals among potential blood donors at the Kwale satellite Blood Transfusion Centre (KSBTC) in Kenya. Methods: We performed a retrospective electronic record review of both pre and post donations deferrals among blood donors at KSBTC, 2018-2022. The pre-donations deferral rate and reasons for deferral were analyzed. Accepted donations were analyzed to determine the prevalence of HIV, hepatitis B (HBV), hepatitis C (HCV), and syphilis. Descriptive statistics were calculated and both crude odds ratio (COR) and adjusted odds ratio (AOR), and their 95% confidence intervals (CI) were calculated. Variables with p < 0.05 were considered statistically significant. Results: A review was conducted on 12,633 blood donation records. Among these, individuals 2,729/12,633 (21.60%) were deferred from donating with the primary reason being low hemoglobin levels, constituting 51.86% of deferrals. Around 773/9,904 (7.80%) of blood units, were discarded due to at least one TTI. Among these, HBV accounted for 4.73%, HIV for 2.01%, HCV for 1.21%, and Syphilis for 0.59% of cases. The adjusted odds ratio for male donors were, (aOR =1.3, 95% CI 1.01-1.57), donors with none or primary education level (aOR =1.4 95% CI 1.11-1.68), first timer donors (aOR=1.2, 95% CI 1.01-1.44), and static strategy for blood collection (aOR =1.4, 95%CI 1.12-1.63) were independently potentially associated with testing positive for at least one TTI. Conclusion: The study indicates that TTIs continue to pose a risk to the safety of Kenya's blood stock, with a notable prevalence of HBV infections. Male donors, individuals with limited education, first-time donors, and the utilization of a fixed strategy for blood collection were identified as potential risk factors independently associated with TTIs.