Viral hepatitis remains a major global public health concern, accounting for approximately 1.46 million deaths annually [1]. These infections impose a significant burden on healthcare systems due to their high prevalence and potential for severe complications, including cirrhosis and hepatocellular carcinoma [2]. The primary causative agents include hepatitis A (HAV), B (HBV), C (HCV), D (HDV), and E (HEV) viruses, with emerging pathogens such as hepatitis G virus (HGV) also under investigation. While these viruses are distributed worldwide, their prevalence varies significantly based on socioeconomic conditions, with HAV, HBV, and HCV being the most prevalent [3].

Despite their impact, many countries—particularly in resource-limited settings—lack comprehensive epidemiological data necessary for strategic planning, implementation, and evaluation of prevention programs [3]. These viruses differ in their transmission routes, immunology, and clinical outcomes [4]. HBV and HCV are primarily transmitted through blood exposure, vertical transmission, and sexual contact, whereas HAV and HEV are predominantly food- and waterborne, often leading to outbreaks in areas with poor sanitation [5][6].

HAV, an RNA virus of the Picornaviridae family, is responsible for the most symptomatic acute hepatitis [7]. Globally, HAV caused 14,900 deaths in 2013, though this figure is likely underestimated due to surveillance limitations [8].

HBV, a DNA virus of the Hepadnaviridae family, exhibits marked regional variability in mortality, ranging from 5.7% in North America to 48.9% in sub-Saharan Africa [9]. Africa remains a high-endemicity zone, with HBV prevalence ranging from 8% to 18% [3]. In Burkina Faso, the national HBV prevalence is estimated at 8.77% [10], underscoring the need for ongoing surveillance and preventive measures, particularly in blood transfusion safety [11].

Given the paucity of recent data on HAV prevalence and the dynamic epidemiology of HBV following vaccination campaigns, this study aimed to assess the serological and molecular prevalence of HAV and HBV among blood donors in Burkina Faso. The findings will contribute to evidence-based public health strategies and reinforce transfusion safety protocols.

Blood samples were collected at the Centre Regional de Transfusion Sanguine (CRTS), Koudougou, a regional branch of the Centre National de Transfusion Sanguine (CNTS), Burkina Faso’s national blood service. The sample size was calculated using Schwartz’s formula: n = (t2 × p (1 − p))/(e2), where “t” is the confidence level (1.96 for 95% confidence), p is the estimated prevalence for HVB and e is the margin of error (5%). Approximately 200 samples were obtained from both first-time and repeat donors between February and March 2022. Whole blood was collected in EDTA tubes by CRTS staff and subsequently transported to Ouagadougou for analysis at the Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA) and the Laboratoire de Biologie Moléculaire et de Génétique (LABIOGENE), Université Joseph KI-ZERBO. In accordance with CNTS policy, all donations were routinely screened for HIV, hepatitis B and C, and syphilis to ensure transfusion safety.

Blood was collected in dry tubes during donation. Serum was obtained by centrifugation and used for HAV and HBV serological screening. HBsAg was detected using the Hepanostika HBsAg Ultra kit (Biomérieux, Boxtel, Netherlands) at CERBA. HAV IgG and IgM antibodies were detected using the FLOWflex™ rapid diagnostic test (immunochromatography; specificity: 98.4%, sensitivity: 97.9%).

The primary objective of this study was to determine the seroprevalence and molecular prevalence of HAV (IgM and IgG) and HBV among blood donors, while also assessing socio-demographic characteristics and potential co-infections.

Our study population was predominantly male (90.5%), consistent with reports by Wongjarupong et al. (2021) (71.7% male donors in Burkina Faso) [12] and Haeri Mazanderani et al. (2019) (90% male donors in South Africa) [13]. This gender imbalance may reflect physiological and social factors limiting female blood donation, including menstruation, pregnancy, and breastfeeding. Pupils and students constituted the largest occupational group (44%), reflecting their role as primary blood donors in Burkina Faso; blood supply often decreases during school holidays. The mean age of donors was 27 years for women and 29.7 years for men, comparable to 28.9 years reported by Zhou et al. (2023) in China [14].

The seroprevalence of HAV IgM was 13.5%, higher than the 3.3% reported by Haeri et al. [13] in South Africa, whereas HAV IgG prevalence was 8.5%, markedly lower than their reported 88.4%. These discrepancies may reflect differences in sample size and age distribution. In our study, IgM antibodies were detected in 13.8% of men and 10.5% of women, and IgG antibodies in 8.8% of men and 5.3% of women, differing from Traoré et al. [15], who reported 4.5% (women) and 3% (men) for IgM, and 18.2% (women) and 13% (men) for IgG in a smaller cohort (n = 91). The overall HAV seroprevalence was 22%, lower than the 80.7% reported in Sri Lanka [16] and 96.9% in Rwanda [17], likely due to the variations in endemicity, sanitation and hygiene conditions, socio-demographic characteristics, and age distributions of the study populations rather than the larger sample sizes in those studies (n = 1403 and 1045, respectively), suggesting comparatively lower HAV exposure in Burkina Faso.

The HBV seroprevalence in our study was 2.5%, lower than reported in Ghana in 2017 (7.5%), and previous studies in Burkina Faso: Nagalo et al. (2012) (13.4%) [18], Tao et al. (2014) (12.47%) [19], and Yooda et al. (2019) (8.56%) [11]. This apparent decline over time (13.4% → 12.47% → 8.56% → 2.5%) may reflect effective national HBV control efforts.

HBV infection was observed only in men (2.5%), aligning with previous findings in Burkina Faso (Nagalo et al., 2011): 16.06% men vs. 11.52% women; (Bisseye et al., 2013): 1.7% men vs. 1.1% women), possibly due to higher engagement in risk behaviors.

Conversely, some studies, such as Osei et al. (2017) in Ghana [20], report higher prevalence among women (14.3%) than men (6.7%). The highest HBV prevalence occurred in the 20 - 30 age group, likely reflecting increased sexual activity and lower awareness of sexually transmitted infections, consistent with Nagalo et al. (2011), though Osei et al. (2017) found the highest prevalence in donors aged 30–39.

HAV antibodies were most common among pupils and students, the youngest donors. This contrasts with studies from Türkiye (Yilmaz, 2020) [21] and Rwanda [17], where IgG prevalence was highest in older age groups (>46 years), reflecting differing patterns of exposure. The absence of HAV RNA amplification in our molecular analysis may indicate mutations in circulating strains affecting the target region of the assay.

The molecular prevalence of HBV in this study was 4%, comparable to Hennig et al. (2002) (4% in Germany) [22], but lower than reports from Burkina Faso by Doumbia et al. (2023) (11.9%) [23] and Diarra et al. (2018) (25.6%) [24], likely due to differences in detection methods and target populations. The overall HAV/HBV co-infection rate was 5.9%, higher than 0.8% reported by Nagu et al. (2008) in Tanzania [25]. Co-infection studies remain limited, underscoring the need for further research.

Overall, our findings highlight a moderate HAV exposure, a low and declining HBV prevalence, and the predominance of young male donors as key drivers of blood donation in Burkina Faso, providing valuable insights for public health interventions and blood safety programs.

This study has several limitations. First, the sample was restricted to blood donors, predominantly young males, which may not reflect the general population. Second, the relatively small sample size may limit the generalizability of the findings, particularly for low-prevalence infections. Third, the molecular non-amplification of HAV could reflect assay limitations or viral mutations, preventing precise determination of HAV viremia. Finally, co-infection analysis was limited by the small number of positive cases, restricting statistical power for subgroup comparisons.

In conclusion, our study indicates a moderate HAV exposure (22% seroprevalence) and a low, declining HBV prevalence (2.5% seroprevalence; 4% molecular prevalence) among blood donors in Burkina Faso. Young male donors, particularly pupils and students, represent the main contributor to blood donation. The findings highlight the need for continued HBV surveillance, targeted vaccination programs, and further research on circulating HAV variants and co-infections to strengthen blood safety and public health strategies.