To analyze the unqualified situation of blood test of voluntary blood donors in Changsha from 2018 to 2022, and to provide reference for the formulation of recruitment strategy of voluntary blood donors.

From January 2018 to December 2022, 792 508 voluntary blood donors in Changsha area (Changsha Blood Center) were selected as the subjects of this study. Blood samples were tested by enzyme-linked immunosorbent assay (ELISA) twice and nucleic acid detection (NAT) once. The unqualified blood tests in different years and populations were described.

The total unqualified rate of voluntary blood donors in Changsha from 2018 to 2022 was 1.76%, with the highest rate in 2018 (1.90%) and the lowest rate in 2022 (1.56%). The total failure rate of alanine aminotransferase (ALT) and hepatitis B virus surface antigen (HBsAg) ranked first (1.00%) and second (0.62%), respectively. There were significant differences in the unqualified rate of blood test for HBsAg, anti-HCV, anti-HIV, anti-TP, ALT and the single reactivity rate of nucleic acid test (NAT) among different years (P<0.05), and there were significant differences in the unqualified rate of blood test for volunteer blood donors with different gender, age, education level and occupation (P<0.05).

The total unqualified rate of blood testing of voluntary blood donors in Changsha from 2018 to 2022 has significantly decreased compared with that before 2018 in the same region, and ALT and HBsAg are the main reasons for unqualified blood testing. In order to promote the sustainable and healthy development of voluntary blood donation in Changsha, it is necessary to further improve the blood testing technology, optimize the blood collection and supply process, and then improve the accuracy of the test results.