{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:58:41Z","timestamp":1790791121770,"version":"4.1.0"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["No. OPP1214435"],"award-info":[{"award-number":["No. OPP1214435"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Many settings in sub-Saharan Africa use rapid antibody assays to detect human immunodeficiency virus (HIV) infection among blood donor candidates. This study aimed to evaluate the analytical performance of HIV serological tests used to screen blood donor candidates in Mozambique. Determine HIV 1\/2\u2009+\u2009Uni-Gold HIV (the routine HIV testing at blood banks in Mozambique), and two newer rapid tests (Determine HIV Early Detect and Meriscreen HIV1\u20132 Western Blot) were compared with an Enzyme-Linked Immunosorbent Assays (Merilisa HIV Gen 4 test\u2009+\u2009Uni-Gold HIV). Additionally, all serological tests were compared with the molecular cobas MPX test. The sensitivity and specificity of Determine HIV 1\/2\u2009+\u2009Uni-Gold HIV; Determine HIV Early Detect, and Meriscreen HIV1\u20132 Western Blot compared to the Merilisa HIV Gen 4 test\u2009+\u2009Uni-Gold were 85.5% and 99.6%; 88.7% and 99.5%; 90.0% and 99.6% respectively. The sensitivity and specificity of Determine HIV 1\/2\u2009+\u2009Uni-Gold HIV; Determine HIV Early Detect, Meriscreen HIV1\u20132 Western Blot, and Merilisa HIV Gen 4 test\u2009+\u2009Uni-Gold compared to the cobas MPX test were 64.0% and 99.1%; 68.6% and 99.1%; 70.8% and 99.0%; 66.0% and 99.4%, respectively. The probability of undetected positive results in the rapid tests and Merilisa HIV Gen 4 test ranged from 5.6 to 6.7 per 1,000 blood donors. The results of this study point to the need for the introduction of molecular testing for HIV in blood banks in developing countries to improve transfusion safety and contribute to controlling HIV as a public health problem.<\/jats:p>","DOI":"10.1371\/journal.pgph.0007398","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:33:32Z","timestamp":1790789612000},"page":"e0007398","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["High transmission risk of Human Immunodeficiency Virus in blood transfusions: A critical evaluation of blood bank serological tests in Mozambique"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1848-4627","authenticated-orcid":true,"given":"N\u00e9dio","family":"Mabunda","sequence":"first","affiliation":[{"name":"Instituto Nacional de Sa\u00fade","place":["Marracuene, Mozambique"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odete","family":"Matola","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade","place":["Marracuene, Mozambique"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4246-7085","authenticated-orcid":true,"given":"J\u00falia","family":"Sambo","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade","place":["Marracuene, Mozambique"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imelda","family":"Chelene","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade","place":["Marracuene, Mozambique"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abras","family":"Munguambe","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative","place":["Maputo city, Mozambique"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuro","family":"Ab\u00edlio","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade","place":["Marracuene, Mozambique"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"Vubil","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade","place":["Marracuene, Mozambique"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osvaldo","family":"Loquiha","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative","place":["Maputo city, Mozambique"]},{"name":"Universidade Eduardo Mondlane","place":["Maputo city, Mozambique"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6880-6655","authenticated-orcid":true,"given":"Ilesh","family":"Jani","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade","place":["Marracuene, Mozambique"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"issue":"1","key":"pgph.0007398.ref001","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1111\/voxs.12082","article-title":"Infectious risks of blood transfusions: Recent advances in testing technologies and new approaches to surveillance and decision\u2010making","volume":"9","author":"MP Busch","year":"2014","journal-title":"ISBT Science Series"},{"key":"pgph.0007398.ref002","unstructured":"World Health Organization. Global status report on blood safety and availability 2021. 2022."},{"key":"pgph.0007398.ref003","volume-title":"Screening donated blood for transfusion-transmissible infections: recommendations","author":"World Health Organization","year":"2021"},{"issue":"1","key":"pgph.0007398.ref004","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s44313-024-00014-w","article-title":"Transfusion-transmitted infections","volume":"59","author":"HJ Kim","year":"2024","journal-title":"Blood Res"},{"issue":"2","key":"pgph.0007398.ref005","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1423-0410.2012.01640.x","article-title":"Reduction of the risk of transfusion-transmitted viral infection by nucleic acid amplification testing in the Western Cape of South Africa: A 5-year review","volume":"104","author":"R Cable","year":"2013","journal-title":"Vox Sang"},{"issue":"6","key":"pgph.0007398.ref006","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1111\/j.1600-6143.2010.03329.x","article-title":"Risk of window period HIV infection in high infectious risk donors: Systematic review and meta-analysis","volume":"11","author":"LM Kucirka","year":"2011","journal-title":"Am J Transplant"},{"issue":"3","key":"pgph.0007398.ref007","doi-asserted-by":"crossref","DOI":"10.1016\/S2352-3018(22)00328-9","article-title":"Adult HIV-1 incidence across 15 high-burden countries in sub-Saharan Africa from 2015 to 2019: A pooled analysis of nationally representative data","volume":"10","author":"NE Rosenberg","year":"2023","journal-title":"Lancet HIV"},{"issue":"3","key":"pgph.0007398.ref008","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/j.transci.2013.06.014","article-title":"The blood supply in Sub-Saharan Africa: Needs, challenges, and solutions","volume":"49","author":"TC Lund","year":"2013","journal-title":"Transfus Apher Sci"},{"issue":"1","key":"pgph.0007398.ref009","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.tmrv.2014.09.003","article-title":"The use of rapid diagnostic tests for transfusion infectious screening in Africa: A literature review","volume":"29","author":"CR Pruett","year":"2015","journal-title":"Transfus Med Rev"},{"issue":"2","key":"pgph.0007398.ref010","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/vox.12327","article-title":"Screening for transfusion transmissible infections using rapid diagnostic tests in Africa: a potential hazard to blood safety?","volume":"110","author":"C Prugger","year":"2016","journal-title":"Vox Sang"},{"key":"pgph.0007398.ref011","doi-asserted-by":"crossref","first-page":"287269","DOI":"10.1155\/2013\/287269","article-title":"Rapid point-of-care testing for detection of HIV and clinical monitoring","volume":"2013","author":"DR Arora","year":"2013","journal-title":"ISRN AIDS"},{"key":"pgph.0007398.ref012","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/j.idc.2019.04.001","article-title":"HIV diagnostics: current recommendations and opportunities for improvement","author":"BM Branson","year":"2019","journal-title":"Infectious Disease Clin North America"},{"key":"pgph.0007398.ref013","volume-title":"SARA 2018, inventario nacional","author":"Instituto Nacional de Saude, Organizacao Mundial de Saude E do C","year":"2019"},{"issue":"4","key":"pgph.0007398.ref014","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0267472","article-title":"Nucleic acid testing identifies high prevalence of blood borne viruses among approved blood donors in Mozambique","volume":"17","author":"N Mabunda","year":"2022","journal-title":"PLoS One"},{"key":"pgph.0007398.ref015","unstructured":"Instituto Nacional de Estatistica. Preliminares IV RGPH 2017. 2017. http:\/\/www.ine.gov.mz\/operacoes-estatisticas\/censos\/censo-2007\/censo-2017\/divulgacao-os-resultados-preliminares-iv-rgph-2017\/view"},{"key":"pgph.0007398.ref016","unstructured":"Instituto Nacional de Sa\u00fade (INS). Mozambique population-based HIV impact assessment 2021 (INSIDA 2021). 2023. http:\/\/ins.gov.mz"},{"key":"pgph.0007398.ref017","volume-title":"Directriz Nacional para Implementa\u00e7\u00e3o do Aconselhamento e Testagem em Sa\u00fade","author":"Minist\u00e9rio de Sa\u00fade de Mo\u00e7ambique","year":"2023"},{"issue":"3","key":"pgph.0007398.ref018","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1111\/trf.14457","article-title":"Sensitivity and specificity of a new automated system for the detection of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus nucleic acid in blood and plasma donations","volume":"58","author":"SA Galel","year":"2018","journal-title":"Transfusion"},{"key":"pgph.0007398.ref019","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.jcv.2017.09.010","article-title":"Evaluation of clinical sensitivity and specificity of hepatitis B virus (HBV), hepatitis C virus, and human immunodeficiency Virus-1 by cobas MPX: Detection of occult HBV infection in an HBV-endemic area","volume":"96","author":"J Ha","year":"2017","journal-title":"J Clin Virol"},{"issue":"6","key":"pgph.0007398.ref020","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1111\/j.1537-2995.2009.02110.x","article-title":"Impact of individual-donation nucleic acid testing on risk of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus transmission by blood transfusion in South Africa","volume":"49","author":"M Vermeulen","year":"2009","journal-title":"Transfusion"},{"issue":"1","key":"pgph.0007398.ref021","article-title":"The impact of nucleic acid testing to detect human immunodeficiency virus, hepatitis C virus, and hepatitis B virus yields from a single blood center in China with 10-years review","volume":"22","author":"D Wu","year":"2022","journal-title":"BMC Infect Dis"},{"issue":"9915","key":"pgph.0007398.ref022","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/S0140-6736(13)62073-5","article-title":"Feasibility, accuracy, and clinical effect of point-of-care Xpert MTB\/RIF testing for tuberculosis in primary-care settings in Africa: A multicentre, randomised, controlled trial","volume":"383","author":"G Theron","year":"2014","journal-title":"Lancet"},{"key":"pgph.0007398.ref023","article-title":"Point-of-care testing to achieve paediatric 95-95-95 targets","author":"TF Peter","year":"2023","journal-title":"The Lancet HIV"},{"issue":"12","key":"pgph.0007398.ref024","doi-asserted-by":"crossref","first-page":"3101","DOI":"10.1111\/trf.13858","article-title":"Cost effectiveness of adding nucleic acid testing to hepatitis B, hepatitis C, and human immunodeficiency virus screening of blood donations in Zimbabwe","volume":"56","author":"N Mafirakureva","year":"2016","journal-title":"Transfusion"},{"issue":"1","key":"pgph.0007398.ref025","doi-asserted-by":"crossref","first-page":"20109","DOI":"10.1038\/s41598-025-03506-6","article-title":"A comparative analysis between NAT and chemiluminescence in detection of transfusion transmitted viruses in two main university blood transfusion centers","volume":"15","author":"D Shahin","year":"2025","journal-title":"Scientific Reports"},{"issue":"3","key":"pgph.0007398.ref026","doi-asserted-by":"crossref","first-page":"104434","DOI":"10.1016\/j.transci.2026.104434","article-title":"A changing donor landscape revealed by 12.5 years of residual risk estimates of TTIs using the NAT-yield\/window period model with public health cost rationale for scale-up in India","volume":"65","author":"RD Setia","year":"2026","journal-title":"Transfus Apher Sci"},{"issue":"10","key":"pgph.0007398.ref027","first-page":"2413","article-title":"Donations in Zimbabwe: implications on blood safety","volume":"53","author":"T Mapako","year":"2013","journal-title":"Transfusion"},{"issue":"5","key":"pgph.0007398.ref028","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1111\/tme.12988","article-title":"Systematic review of prevalence and risk factors of transfusion transmissible infections among blood donors, and blood safety improvements in Southern Africa","volume":"33","author":"S Puerto-Meredith","year":"2023","journal-title":"Transfus Med"},{"issue":"2","key":"pgph.0007398.ref029","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/j.1537-2995.2004.04279.x","article-title":"Predonation screening of blood donors with rapid tests: Implementation and efficacy of a novel approach to blood safety in resource-poor settings","volume":"45","author":"S Owusu-Ofori","year":"2005","journal-title":"Transfusion"},{"issue":"1","key":"pgph.0007398.ref030","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-025-11393-5","article-title":"Analysis of the most common causes of blood donor deferral in Southern Mozambique","volume":"25","author":"C Nhachigule","year":"2025","journal-title":"BMC Infect Dis"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0007398","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:33:39Z","timestamp":1790789619000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0007398"}},"subtitle":[],"editor":[{"given":"Julia","family":"Robinson","sequence":"first","affiliation":[{"name":"PLOS: Public Library of Science","place":["UNITED STATES OF AMERICA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":30,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0007398","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]}}}