Blood donors screening for malaria in non-endemic area in the Kingdom of Saudi Arabia: Is it necessary to introduce immunological testing?

Abstract

IntroductionIn Saudi Arabia, where malaria is not endemic, the incidence is very low. However, malaria transmission cases have been reported, mainly in Asir and Jazan provinces along the Southwestern border with Yemen. Imported cases also have been reported. The aims of this study were to determine the prevalence of malaria in blood donors in a tertiary care hospital in the central area of Saudi Arabia and to assess the effectiveness of malaria screening methods used by transfusion services in Prince Sultan Military Medical City.MethodsThis study was conducted on 180,000 people who donated blood during 2006–2015. All blood smears from blood donors were screened for malaria infection using Giemsa staining, low power and high power microscopic examinations, and using oil immersion lens. The data were analyzed and reported in descriptive statistics and prevalence.ResultsFrom the total of 180,000 blood donors who were screened for malaria, 156,000 (87%) and 23.400 (13%) were Saudi Arabia citizens and non-Saudi residents, respectively. The mean age of the blood donors was 32 (ranging from 18 to 65), 97% and 3% were male and female, respectively. Using our current method for malaria screening, the prevalence of malaria in the study population was zero.ConclusionThe current methods of malaria screening in blood donors is not suitable for screening low-level parasiotemia. Adding the immunoassay and molecular screening methods is suggested.

The Most Common Causes of Transfusion-Transmitted Diseases among Blood Donors in the Middle Eastern States

“…They believed that blood donors' current screening methods could not be deemed fit for low-level identification of parasitaemic malaria cases. A new collection and upgrade of reference tests are suggested [58]. The prevalence rate of malaria among blood donors from Prince Sultan Military Medical City was different from similar studies conducted in Saudi Arabia [109][110][111].…”

“…Also, some Plasmodium species do not cause symptoms in their hosts, and those who may have acquired immunity to the parasite may still carry a low level of infectious parasitemia [57]. Blood from asymptomatic donors or blood from imported malaria cases is becoming increasingly available due to travel and demand for transfusions [58]. Transmission of malaria has been reported mostly from singledonor products such as red cells, platelets or white cell concentrates, cryoprecipitate, and red cells after thawing and washing [59].…”

“…The risk of Targeted temperature management (TTM) is complicated because, for a long, relatively-asymptomatic time, infectious organisms may remain viable in the blood. In Saudi Arabia, Falciparum malaria is normal and can persist in the bloodstream for years while displaying no infection signs [58]. Therefore, most facilities for blood transfusions have a policy of excluding donors that may be at risk.…”

“…Just 60 blood donors tested syphilis positive. In addition, during the same time, we examined 202 stem cell transplant donors, of which % were male, and none were positive for syphilis [58].…”