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In addition to inadequate supply, most sub\u2010Saharan Africa (SSA) nations fail to meet their blood needs because many donated blood units are discarded because they are contaminated with transfusion\u2010transmitted infections (TTIs). We sought to estimate the prevalence of TTIs, identify the risk factors for TTIs among blood donors, and identify the efforts and interventions that have been made to improve blood safety in Southern African nations, particularly the nations of the South African Development Community (SADC). We investigated the prevalence and risk factors for TTIs, blood safety interventions, and blood quality improvement in the SADC region from major PubMed\/MEDLINE, Cochrane Library, and HINARI databases from 1 January 2011 to 31 April 2021. All investigations followed the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA). In meta\u2010analysis, we estimated the pooled TTIs prevalence and summarised the same using forest plots. A total of 180 articles published from the SSA region were identified covering our three targeted themes: TTI prevalence, risk factors for TTIs, and blood safety improvements. Of these 180 articles, only 27 (15%) focused on the SADC region. The overall pooled TTI prevalence estimate was 2.0% (95% CI: 1.0\u20133.0) and hepatitis B was the most prevalent TTI in the region (prevalence\u2009=\u20093.0; 95% CI: 2.0\u20135.0). The prevalence of HIV, HCV, and syphilis was 2.0% (95% CI: 1.0\u20134.0), 1.0% (95% CI: 0.0\u20132.0), and 2.0% (95% CI: 0.0\u20138.0), respectively. In general, replacement donors and first\u2010time donors were more likely to be infected with TTIs than repeat donors. Twelve articles explored blood safety research in the region; however, they vary greatly highlighting the need for consistent and more comprehensive research. Few publications were identified that were from the SADC region, indicating lack of research or resources towards improving both quantity and quality of blood donation. TTI prevalence remains one of the highest in the world and blood safety recommendations vary across the region. More effort should be directed towards developing a cohesive regional blood transfusion policy and effective blood monitoring and evaluation strategies.<\/jats:p>","DOI":"10.1111\/tme.12988","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T06:35:18Z","timestamp":1693290918000},"page":"355-371","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Systematic review of prevalence and risk factors of transfusion transmissible infections among blood donors, and blood safety improvements in Southern Africa"],"prefix":"10.1111","volume":"33","author":[{"given":"Sydney","family":"Puerto\u2010Meredith","sequence":"first","affiliation":[{"name":"UNC Project Malawi  Lilongwe Malawi"},{"name":"UNC\u2010CH School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2015-335X","authenticated-orcid":false,"given":"Emmanuel","family":"Singogo","sequence":"additional","affiliation":[{"name":"UNC Project Malawi  Lilongwe Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maganizo","family":"Chagomerana","sequence":"additional","affiliation":[{"name":"UNC Project Malawi  Lilongwe Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiya","family":"Nthani","sequence":"additional","affiliation":[{"name":"UNC Project Malawi  Lilongwe Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Likaka","sequence":"additional","affiliation":[{"name":"Kamuzu University of Health Sciences (KUHES)  Blantyre Malawi"},{"name":"Universidade Federal de Pernambuco  Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austrida","family":"Gondwe","sequence":"additional","affiliation":[{"name":"UNC Project Malawi  Lilongwe Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridon","family":"M'baya","sequence":"additional","affiliation":[{"name":"Malawi Blood Transfusion Services (MBTS)  Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina C.","family":"Hosseinipour","sequence":"additional","affiliation":[{"name":"UNC Project Malawi  Lilongwe Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,28]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Universal Access to Safe Blood Transfusion: Strategic Plan 2008\u20132015.2007."},{"key":"e_1_2_10_3_1","unstructured":"Integrated HIV Program Report Q3.2018."},{"issue":"1","key":"e_1_2_10_4_1","article-title":"Availability of blood for transfusion in maternity units in Malawi","volume":"7","author":"Kongnyuy E","year":"2007","journal-title":"Internet J Third World Med"},{"key":"e_1_2_10_5_1","unstructured":"Screening Donated Blood for Transfusion\u2010Transmissible Infections: Recommendations.2009."},{"key":"e_1_2_10_6_1","unstructured":"WHO.WHO African region status report on blood availability Safety and Quality;2022. 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