Prevalence of Irregular Red Cell Antibodies in Eligible Blood Donors and Kell Blood Group Antigen among Antibody-positive Donors in Fako Division, Cameroon

Abstract

Background: Regular screening for irregular antibodies is an important prerequisite for safe blood transfusion. However, most blood banks in sub-Saharan Africa, including Cameroon, do not routinely screen for these antibodies or the Kell antigen. This study aimed to determine the prevalence of irregular (unexpected) antibodies among eligible blood donors and the Kell antigen (KEL1) among irregular (unexpected) antibody-positive donors in the Fako Division of the South West Region of Cameroon. Methods: A cross-sectional study was conducted in four blood banks, namely Buea Regional Hospital, Limbe Regional Hospital, CDC Cottage Hospital, Tiko, and Mount Mary Hospital, Buea, from January to May 2025. We collected 150 blood samples from eligible blood donors. The indirect antiglobulin test (IAT), performed at 37°C with group O-positive red cells and polyspecific antihuman globulin (AHG), was used to detect irregular antibodies. Monoclonal anti-K antibody was used for Kell blood group typing among irregular antibody-positive donors. A structured questionnaire was used to assess blood bank personnel's knowledge and practices. Student's t-test, ANOVA, and Pearson's correlation were used for statistical analysis, with a significance level of p < 0.05. The confidence interval was set at 95%. Results: Of the 150 blood donors screened, 10 (6.6%) tested positive for irregular antibodies, a prevalence higher than the literature range of 0.2–2%. In addition, 1 (10%) irregular antibody-positive donor was positive for the Kell blood group antigen. Haemoglobin concentration varied significantly between collection centres (p = 0.049). No blood bank routinely screened for irregular antibodies; however, two centres sent samples to other laboratories for this purpose. Conclusion: The prevalence of irregular antibodies among blood donors in Fako Division was 6.6%, compared with the reported literature range of 0.2–2%. No study site routinely screened for irregular antibodies. These findings indicate the importance of irregular (unexpected) antibody screening for improving transfusion safety in Cameroon.