peer review
Blood transfusions carry significant safety risks if biosafety standards cannot be upheld. In the Democratic Republic of the Congo, more than 90 percent of transfusions occur as warm transfusions, where blood is administered before screening for infectious markers is complete. An investigation conducted across four hospitals in Mbujimayi evaluated hepatitis C virus infection rates among 223 individuals who received transfusions at least two months prior. The overall post-transfusion hepatitis C seroprevalence was 4.9 percent. Receiving multiple blood transfusions and being unemployed were identified as independent risk factors for infection. Among individuals who received warm transfusions, repeated transfusion increased the odds of contracting hepatitis C tenfold. The findings highlight the critical need to secure continuous screening for transfusion-transmitted infections, promote voluntary non-remunerated blood donation, and enforce the systematic use of thoroughly pre-tested blood units.
Unscreened or partially screened blood transfusions expose vulnerable patients to preventable, chronic viral infections like hepatitis C. In healthcare systems where emergency demands frequently bypass standard testing procedures, identifying and quantifying these risks is essential for public health authorities. Establishing systematic pre-testing protocols and voluntary donor networks can substantially lower infection rates and protect recipient health in resource-limited hospital settings.
The findings highlight a clear clinical demand for rapid, point-of-care screening diagnostics that can deliver reliable infectious disease verification before blood is transfused. Potential users include clinical staff and blood bank operators in resource-constrained hospitals. However, the abstract reports observational clinical research rather than product development, meaning that practical commercial solutions or diagnostic interventions would require applied testing and health system integration to reach real-world implementation.
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Background Blood transfusion remains a cornerstone of clinical care but continues to pose risks when biosafety standards are not rigorously applied. In the Democratic Republic of the Congo (DRC), more than 90% of transfusions are delivered as warm transfusions, in which blood is released before full infectious marker screening is completed. This study aimed to quantify the additional risk of hepatitis C virus (HCV) transmission associated with this practice in Mbujimayi. Methods We conducted a prospective analytical cross-sectional study in four high transfusion-volume hospitals of Mbujimayi. A total of 223 previously transfused individuals (≥ 2 months post-transfusion) were enrolled and stratified into exposed (warm transfusion) and unexposed (cold transfusion) groups. Anti-HCV antibodies were detected using an HCV Scan rapid immunochromatographic assay performed on serum. Crude (cOR) and adjusted (aOR) odds ratios with 95% confidence intervals were estimated using bivariate analyses and multivariable logistic regression in IBM SPSS Statistics version 27, p < 0.05 was considered statistically significant. Results The post-transfusion HCV seroprevalence was 4.9% (11/223). After adjustment, two factors remained independently associated with HCV seropositivity: receiving more than one transfusion (aOR = 5.41; 95% CI: 1.22–24.02; p = 0.027) and unemployment (aOR = 4.66; 95% CI: 1.18–18.41; p = 0.028). Among those exposed to warm transfusion, repeated transfusions increased the likelihood of HCV infection tenfold (aOR = 10.03; 95% CI: 3.85–26.16; p < 0.001). Conclusion Warm transfusion, the prevailing modality in the DRC, constitutes a significant additional route of HCV transmission. Strengthening voluntary non-remunerated blood donation, ensuring uninterrupted screening for transfusion-transmitted infections, and enforcing systematic use of pre-tested blood units are critical strategies to reduce this preventable burden.
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DOI: 10.5256/f1000research.202631.r510342
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