A systematic review and meta-analysis published on March 18, 2025, has shed light on the prevalence and risk factors of syphilis among blood donors in Thailand, revealing significant insights critical for enhancing blood safety. The research, which is documented in a comprehensive systematic review, was conducted by a team of researchers including Rattanatham, Mala, and Kotepui, and aimed to tackle the glaring gaps in current data concerning sexually transmitted infections (STIs) in the Thai blood donation landscape.
The study, which registered its protocol in PROSPERO and followed PRISMA guidelines, analyzed data from 23 studies, encompassing a staggering total of 1,142,910 blood donors. The results showed a pooled prevalence of syphilis among blood donors to be 0.42% (95% CI 0.27–0.66%), translating to around 6,173 recorded infections. Notably, these figures suggest a declining trend over the years, marking a notable improvement in blood safety practices.
Analysis revealed that male donors were approximately 76% more likely than their female counterparts to test positive for syphilis. This increased vulnerability underscores ongoing behavioral factors that must be addressed. Furthermore, an alarming association was found between first-time donors and syphilis risk; first-time donors had double the odds (OR: 2.02, 95% CI 1.10–3.70) of syphilis compared to repeat donors. Age also proved significant: donors aged 41 to 60 years exhibited the highest risk, with a nearly sevenfold likelihood of syphilis infection compared to those aged 17 to 20 (OR: 6.91, 95% CI 3.23–14.76).
The comprehensive nature of this research provides a crucial stepping stone for future interventions aimed at blood donor safety. As the authors of the article noted, "To enhance blood safety, targeted interventions are needed, including refining donor screening questionnaires, expanding educational campaigns for high-risk groups, and incorporating advanced screening technologies." Such measures are essential to mitigate the potential for syphilis transmission through blood products and to maintain the integrity of Thailand's blood supply.
Despite these positive trends in blood donor syphilis prevalence, the study emphasizes a less than ideal picture in broader societal contexts, particularly among high-risk groups, such as the youth and men who have sex with men, where rates continue to climb. This paradox indicates that while blood donation practices are improving, public health messaging and education surrounding STIs need to be equally robust.
The declining prevalence of syphilis among blood donors, changing from 1.3% in studies published before 2000 to 0.2% between 2020 and 2024, may reflect effective strategies in blood donation screening protocols. The findings of this study signal the importance of ongoing monitoring and advocacy, particularly for demographics that are most at risk for contracting syphilis and other STIs.
In conclusion, the systematic review and meta-analysis indicate that while the prevalence of syphilis among blood donors in Thailand has decreased, vital populations such as males, first-time donors, and older age groups still endure a higher risk. This development calls for continuous reevaluation and adaptation of blood safety practices through targeted public health interventions, ensuring the safety and well-being of all blood donation recipients.
