Abstract
Brucellosis can be transmitted by blood transfusion. This study aimed to further explore the necessity of initiating brucellosis serological testing among blood donors in highly endemic areas by conducting a systematic review and meta-analysis of the detection rate of human brucellosis seropositivity to reduce the risk of transfusion-transmitted brucellosis and inform blood safety practices in endemic areas. We searched English databases (Medline, Embase, Web of Science and Cochran Library) and Chinese databases (China Knowledge Network, Wanfang Data Knowledge Service Platform, Wipro Chinese Biomedical Journal Database and China Biomedical Literature Service) for all articles on brucellosis serology in the blood donor population from January 1990 to July 2024, and analysed the results. The combined detection rate and its 95% confidence interval (CI) were estimated using R 4.0.3. Sensitivity analyses were performed to address heterogeneity. Egger's test was used to evaluate publication bias. The meta-analysis included 76,860 subjects from 15 eligible studies. The pooled estimate of the seropositive detection rate for Brucella abortus disease among the included subjects was 0.91% (95% CI: 0.65-1.16%). A certain level of seropositive detection is sufficient to suggest that recipients can be transfused with blood products from donors already infected with brucellosis, with a high likelihood of transfusion-transmitted brucellosis infection. There is a potential risk of blood-borne transmission of brucellosis. In order to lower the risk of brucellosis transmission through blood transfusion, it is necessary to screen the population of blood donors in highly endemic areas using health counseling and serological testing for Brucella.