Transfusion Medicine | SHORT COMMUNICATION Hepatitis B in Moroccan blood donors: a decade trend of the HBsAg prevalence in a resources limited country B. Adouani, 1,2 R. Alami, 1 A. Laouina, 1,2 A. Benahadi, 1,2 S. Boulahdid, 1,2 A. Mokhtari, 2 A. Soulaymani, 2 A. Abouyoub 1 & M. Benajiba 1 1 Centre National de Transfusion Sanguine (CNTS)/Centre R´ egional de Transfusion Sanguine de Rabat (CRTSR), Rabat, Morocco, and 2 Laboratoire de G´ en´ etique et de Biom´ etrie, Facult´ e des Sciences, Universit´ e Ibn Tofa¨ ıl, K´ enitra, Morocco Received 22 November 2012; accepted for publication 30 May 2013 SUMMARY Objectives: To calculate the hepatitis B surface antigen (HBsAg) reactive rate for 2011 blood donors (BD) across Morocco. In addition, to monitor the profile of donors bearing the HBsAg during 2000 and 2011, we calculated the percentage of the prevalence in both sexes, in different age groups and in first- time replacement and regular BD from the Rabat Regional Blood Transfusion Centre. Background: Hepatitis B is a viral infection that spreads through blood and other biological fluids. The hepatitis B virus remains one of the most common serious complications of transfusion. No information exists on the real prevalence of hepatitis B in Moroccan BD. Methods: For the 2011 national HBsAg reactive rate, the per- centage was calculated based on enzyme-linked immunosorbent assay (ELISA) results of the 232 190 blood donations collected around the country. For the Rabat blood Centre, we calculated the hepatitis B sero-prevalence from donations made at the donors’ suite during 2000 and 2011. Results: The national prevalence of HBsAg was 1·34%. The HBsAg variations among different regions was between 0·43 and 2·86%. The Rabat donors’ suite hepatitis B prevalence decreased from 2·47% in 2000 to 0·91% in 2011 (P < 0·001). In both years, family/replacement donors were found as safe as first-time BD and female donors were the safest. Conclusions: These results, presented for the first time in the country, mapped the hepatitis B distribution across Morocco in a healthy population. The findings of this study could be of great importance in setting up strategies for the recruitment of the BD and keeping blood safety at the highest level. Key words: blood donors, developing country, hepatitis B, Morocco, prevalence. Correspondence: Raouf Alami, PhD, Centre National de Transfusion Sanguine, Rue Lamfadel Cherkaoui, Madinat Al Irfane, Rabat Institutes, Rabat, Morocco. Tel.: +212 537 77 4993/5148; fax: +212 537 77 4987; e-mail: raoufalami@yahoo.com Hepatitis B virus (HBV) is a global issue; about one in every three people in the world has been in contact with this virus. However, HBV prevalence is different throughout various regions of the world. There are regions with high prevalence and others with low prevalence. South Mediterranean countries have been previously classified as a low to intermediate endemic countries for HBV with prevalence estimated between 2 and 7% (World Health Organization, 2001). The HBV remains one of the most common serious complications of transfusion (Schreiber et al., 1996; Busch, 2000; Glynn et al., 2000). Today, the use of nucleic acid testing (NAT) has shortened considerably the long pre-seroconversion window period during which the virus is transmissible (Busch et al., 2005; Weusten et al., 2011). In fact, many studies have reported that the risk of post-transfusion HBV infection has steadily decreased (Dodd et al., 2002; Zou et al., 2004; Comanor & Holland, 2006). Resource-limited countries, where NAT is too expensive to make it mandatory for all blood donations, have been required to look for other practical tools to keep the blood supply at a reasonable level, and practice the best blood safety. Therefore, a focus for resource-limited countries has been to develop better methods used in recruiting and screening of voluntary BD, as well as the education and selection of the potential donors and so on (Alter et al., 1999; Matee et al., 1999; Soldan et al., 2002; Nantachit et al., 2003). In Morocco, all potential donors are reviewed by a medical doctor to discuss the donor’s health history. Each donor receives a brief examination, which includes temperature, pulse and blood pressure readings. Screening for hepatitis B surface antigen (HBsAg) in all donators has been mandatory since 1987. However, little is known about HBV prevalence among the Moroccan population. Recently, a few studies have given the prevalence in some specific populations in Morocco, as in the active population study from Rabat (Sbai et al., 2012), with 1·66% and the hospitalised patient from the University hospital of Rabat with 15·8% (Rouibaa et al., 2008). Morocco’s blood transfusion system is composed of 16 regional blood transfusion centres (CRTS), which are located throughout the country as shown in Fig. 1. These CRTS are under the supervision of the National Blood Transfusion Centre (CNTS) (Plaquettes du CNTS, 2009).  2013 The Authors Transfusion Medicine  2013 British Blood Transfusion Society doi: 10.1111/tme.12054