Silent Risks in the Blood Supply: Co-Inherited Glucose-6-Phosphate Dehydrogenase Deficiency and Sickle Cell Trait Among Donors at the Cape Coast Teaching Hospital, Ghana: A Cross-Sectional Study.

BACKGROUND AND AIMS: Blood transfusion saves lives, but red cell enzymopathies and hemoglobin variants can reduce red cell survival under oxidative stress. In sub-Saharan Africa, blood donors are not routinely screened for glucose-6-phosphate dehydrogenase (G6PD) deficiency or sickle cell trait (SCT). Evidence on co-inheritance in donors is limited, despite possible harm to vulnerable recipients such as neonates and chronically transfused patients. This study determined the prevalence of G6PD deficiency, SCT, and their co-inheritance among blood donors, and assessed donor awareness and selected laboratory findings relevant to transfusion safety.

METHODS

A hospital-based cross-sectional study was conducted between February and August 2023 among 250 blood donors aged 16-50 years selected through simple random sampling. Following informed consent, participants completed a structured questionnaire. G6PD status was determined using the methemoglobin reduction test, while sickling was screened using sodium metabisulfite. Hemoglobin electrophoresis was used to determine hemoglobin phenotype, and Full Blood Count (FBC) analysis was performed using the Sysmex XN-350 hematology analyzer. Data were analyzed using SPSS version 26.0, with p < 0.05 considered statistically significant.

RESULTS

The mean age was 21.8 ± 6.3 years. Most donors were males [146/250 (58.4%)], students [184/250 (73.6%)], and first-time donors (174/250, 69.6%). Most donors did not know their G6PD status (246/250, 98.4%), blood group (167/250, 66.8%), or sickling status (235/250, 94%). Laboratory testing showed 35/250, 14% had full G6PD deficiency, 55/250, 22% had sickle cell trait (predominantly Hb AS), and 15/250, 6% co-inherited both conditions. Blood group O Rh "D" positive was the most common (143/250, 57.2%). G6PD status and full blood count parameters differed by sex (p < 0.05).

CONCLUSION

The 6% co-inheritance of G6PD deficiency and SCT among blood donors, together with low donor awareness, highlights potential transfusion safety concerns. Targeted donor education, pre-donation counseling, and screening policies may improve transfusion safety in high-prevalence settings.