Analysis and Evaluation of Blood Screening Testing Strategies in Nagqu, Tibet: One of The Highest Cities in the World

The aim of this study was to evaluate the performance of blood screening strategies in Nagqu City, with a focus on serological and nucleic acid testing effectiveness. Analysis of blood donation data from 2017 to 2023 revealed a gradual increase in local blood donation rates, but the rate of unqualified donations remained higher than the national average. Serological performance verification showed good repeatability and precision, but improvements are needed in the accuracy of certain markers. Nucleic acid performance verification demonstrated excellent detection capability for low viral load HBV infections. The conclusion highlights significant progress in the screening strategies of Nagqu City, with the nucleic acid testing system showing outstanding performance. The findings provide valuable insights for blood screening in other high-altitude regions. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Yes ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study is part of the Special Fund for Aid-Tibet Project supported by the Natural Science Foundation of Liaoning Province. In this research, all blood donors were provided with comprehensive information and gave informed consent by signing the consent form before specimen collection. The study protocol has been reviewed and approved by the Ethics Committee of Dalian Blood Center, with the ethics approval number LL-202202. All authors are fully aware of and have adhered to the relevant ethical regulations and highly prioritize safeguarding the privacy of our research subjects. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All relevant data are within the manuscript and its Supporting Information files.