Transfusion Medicine, 2010, 20, 1–10 doi: 10.1111/j.1365-3148.2009.00958.x REVIEW ARTICLE The blood donor in sub-Saharan Africa: a review C. T. Tagny, 1,2 S. Owusu-Ofori, 3 D. Mbanya 1,2 & V. Deneys 4 1 University Teaching Hospital of Yaound´ e, Cameroon, 2 Faculty of Medicine and Biomedicals Sciences, University of Yaound´ e, Cameroon, 3 Komfo Anokye Teaching Hospital, Kumasi, Ghana, and 4 Blood Transfusion Service, Belgian Red Cross, Belgium Received 21 October 2008; accepted for publication 16 June 2009 SUMMARY. The high prevalence of numerous endemic and epidemic diseases such as malaria, HIV infection and viral hepatitis in some areas of sub-Saharan Africa (SSA) affects the health status of blood donors. Consid- ering the difficulties in ensuring sufficient and safe blood supply, analysing epidemiological factors that impact blood donors in this community may further bring light on issues of supply and safety, and help in planning for its rational use. This review does not aim to propose new strategies but describes the main characteristics of blood donors in SSA as collected from different reports. Data were mainly obtained from the reports of the World Health Organization and national blood transfusion pro- grammes and also from relevant literature and con- ference reports. Several characteristics are common in blood donors, such as the predominance of young adult males, the high frequency of Transmission-transmitted Infections (TTIs) and some erythrocytic phenotypes. The data indicate variations in the level of improvement of blood collection and blood safety from one area to another, particularly in the field of donor motivation or screening strategies for TTIs. These data could be useful to supplement previous reports and to provide updates for governments and international organizations’ pro- grams involved in the improvement of blood safety in Africa. Key words: African culture, blood donor, sub-Saharan Africa, transfusion. There are several systems for provision of blood currently in operation in Africa. The hospital-based system consists of transfusion units attached to the main laboratories of a hospital, most of which use donor replacement schemes, or a centralized transfu- sion centre that usually has a system for voluntary, altruistic donors. Many African countries have a hybrid system that incorporates certain centralized functions such as transfusion guidelines and collection from vol- untary donors into their hospital-based system (Bates et al., 2007). Although blood safety in Africa is one of the World Health Organization (WHO) programme’s major priorities (WHO, 2001), this remains an issue of concern especially in developing countries where 82% Correspondence: Dr Claude Tayou Tagny, University Teaching Hospital, PO BOX 4806 Yaound´ e, Cameroon. Tel.: + 237 99 92 32 94; fax: + 237 22 21 17 38 e-mail: tayouclaude@yahoo.fr of the global population lives. Interestingly, only 39% of the world’s blood supply originates from there (WHO, 2004a). It is expected that by 2012, blood transfusion services in Africa should achieve specific targets such as drafting and/or implementing a national blood policy, screening all blood units for HIV and other selected transfusion-transmitted infections (TTIs), and collecting blood from more than 80% of voluntary non-remunerated donors (Takpo et al., 2007). The backbone of a well-organized blood transfusion service is the recruitment and retention of voluntary, non-remunerated low-risk blood donors and that has been a challenge for African countries (WHO, 2004b). Thus, knowing the characteristics of blood donors is fundamental in a setting where blood safety is ham- pered by several factors including the high prevalence of transfusion-transmissible diseases within the pop- ulations. This informs not only current strategies for donor selection but also how these might be adapted  2009 The Authors Journal compilation  2009 British Blood Transfusion Society 1