<p><strong>Background</strong>: Safe blood is a critical component in improving health care and in preventing the spread of infectious disease. But the quality and safety of blood transfusion is still a concern for health-care personnel’s. We analyzed the sero-prevalence and changing trends of transfusion transmitted infections (TTIs) among blood donors in a tertiary care hospital. <strong>Objectives</strong>: This retrospective study aimed to analyze the percentage of voluntary and replacement blood donors and to know the sero-prevalence and changing trends of TTIs among blood donors in a tertiary care hospital. <strong>Methods</strong>: Blood donations collected over a 6-year period were studied for the type of donation (voluntary or replacement), number of seroreactive cases. Samples were screened for anti HIV 1 & 2, HBsAg, anti HCV, syphilis and malaria. All reactive samples were retested before being labeled as seropositive. <strong>Results</strong>: Of the 187575 donors, 134391 (71.6%) were replacement and 53184 (28.4%) voluntary donors .Of all the blood donors there were 8577 (4.57%) seroreactive cases which included 492 (0.26%) of anti HIV 1&2 , 1937 (1.03%) of HBsAg, 2867 (1.53%) of anti HCV, 3270 (1.74%) of syphilis and 11 (0.006%) of malaria. The overall seropositivity for various TTIs are more in replacement donor i.e. (3.8%), where as it was only (0.7%) among voluntary blood donors and this was statistically significant (p<0.05). <strong>Conclusion</strong>: Voluntary donations are safer as compared with replacement ones and need to be encouraged. The screening of blood donors is the corner stone in assuring the safety of blood transfusion.</p
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