Characteristics of 66 000 consecutive blood donations in the metropolitan area of Kano, Nigeria: a prospective study

Key points: • Family replacement donation overwhelmingly dominates blood supply in Kano, Nigeria and female blood donors are grossly under represented. • Blood donation services should be regionally centralized to maintain minimal quality standards Access to safe blood remains a critical challenge in sub-Saharan Africa, but studies on blood donation are scarce. In a prospective study we assessed blood donation patterns and donor characteristics within nine hospitals in Kano, Northern Nigeria, over one year, covering a 4.6 million metropolitan area (Jini na study; PACTR202310892230317). A total of 66,398 consecutive blood donations were registered, revealing a strong reliance on family replacement donation (FRD) which accounted for 95.2% of all donations, with 64.3% being donations of repeat donors. Voluntary non-remunerated blood donation (VNRBD) comprised only 4.1% of donations, largely concentrated within a single teaching hospital. The donor population was overwhelmingly male (98.7%) and predominantly aged 20-40 years. Significant variation in donation volume existed between hospitals (range 400 to 21,000). Donation rates per months remained rather stable over 14 months, including hot summer and Ramadan seasons. These findings highlight the dominance of FRD and the critical under representation of female donors in Kano. Strengthening existing FRD systems, alongside targeted initiatives to increase VNRBD participation and addressing sociocultural barriers to female donation, are crucial for ensuring a sustainable and safe blood supply. The blood donation processes require standardization across facilities, including centralization to centers with sufficient size to maintain a robust quality management system, while maintaining access to donor clinics without long-distance travelling. This study is one of the largest prospective, longitudinal studies on blood donation in sub-Saharan Africa. It underscores the need for context-specific, multi-pronged approaches to blood donation in resource-limited settings.