Blood transfusion malaria: A literature review

Faruk, Jamilu Abdullahi

doi:10.4103/0331-3131.206210

Cited by 8 publications

(13 citation statements)

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“…First, neonates are selectively transfused with HbAA, which carries higher risk of AMP as found in this study. Second, neonates are often transfused with fresh blood (31), and malaria parasites remain viable in stored refrigerated blood for only about two weeks (34), hence fresh blood is more likely to transmit malaria than old stored blood (19). Third, relative to the size of the neonate, the parasite dose in infected donor blood is often massive, and it has been suggested that a massive infective dose would easily overwhelm the protective barriers and lead to the establishment of malaria (35).…”

Section: Parametersmentioning

confidence: 99%

“…As in many other tropical countries, donor screening for AMP and post transfusion haemovigilance of patients are not routinely conducted in Nigeria, hence the exact incidence of TTM among transfused patients in Nigeria is unknown (18,19). However, the incidence of TTM is presumably high because the prevalence of AMP among Nigerian donors was reported to range from 6% to as high as 45.8% (16,17).…”

Section: Introductionmentioning

confidence: 99%

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Haemoglobin phenotypes and the risk of asymptomatic malaria parasitemia among blood donors in northwest Nigeria: clinical implications in the practice of tropical transfusion medicine

Kani¹,

Ibrahim²,

Habeeb³

et al. 2021

Af J Clin Exp Micro

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Background: In malaria-endemic populations, sickle cell trait (SCT) protects against both severe and non-severe malaria, but inconsistencies exist about protective effect of SCT on asymptomatic malarial parasitemia (AMP). Surprisingly, the effect of Hb-phenotypes on AMP has not been explored among blood donors in Nigeria or other malaria-endemic countries, where risks of AMP and transfusion transmitted malaria (TTM) are high. The objective of this study is to determine risk of AMP with respect to donor Hb-phenotypes (SCT versus HbAA), and elucidate clinical implications of AMP with respect to risk of TTM vis-à-vis the practice of transfusion medicine in Nigeria, and by implication other malaria-endemic tropical countries.Methodology: Analysis of 100 blood donors with AMP (cases) and 100 donors without AMP (controls) was performed. Frequencies of SCT and HbAA (determined by Hb electrophoresis) among cases and controls were compared by X2 -test. Risks of AMP (detected by microscopy) with respect to Hb-phenotypes were expressed as Odds ratios (OR) by case-control logistic regression.Results: In comparison with blood donor without AMP (controls), donors with AMP had lower frequencies of SCT (12% vs 28%, p<0.05) with corresponding higher frequencies of HbAA (88% vs 72%, p<0.05). HbAA is associated with high risk of AMP (OR=2.91, 95%CI: 2.10-3.48, p=0.021), while SCT is associated low risk of AMP (OR=0.49, 95%CI: 0.27-0.73, p=0.032).Conclusion: This finding shows that donor SCT is a surreptitious mitigator of the risk of AMP and TTM in the tropics. Therefore, patients who are selectively transfused with HbAA blood (e. g. neonates and sickle cell disease patients) could be at greater risks of TTM, and such patients need closer post transfusion monitoring. The risk of TTM calls for diligent post transfusion haemovigilance in Nigeria and other malaria endemic tropical countries in Africa Keywords: blood donors, sickle cell trait, asymptomatic malaria parasitemia, transfusion transmitted malaria

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Section: Parametersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Haemoglobin phenotypes and the risk of asymptomatic malaria parasitemia among blood donors in northwest Nigeria: clinical implications in the practice of tropical transfusion medicine

Kani¹,

Ibrahim²,

Habeeb³

et al. 2021

Af J Clin Exp Micro

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“…Transfusion-transmitted malaria can have serious consequences, as infection with Plasmodium falciparum may prove rapidly fatal especially in non or less-immune recipients such as children under five years and pregnant women. A review of 17 studies carried out between 1980 and 2009 in sub-saharan countries where malaria is endemic revealed a median prevalence of 10.2% in blood donors [9,10]. This prevalence reached 55% in Nigeria, highlighting the necessity to care about transfusiontransmitted malaria, especially in endemic settings and when receivers present particular risk associated with young age, pregnancy or immunodepression.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B and C, HIV, Syphilis Seroprevalences and Asymptomatic Carriage of Hemoparasites Among Blood Donors at the Douala General Hospital in Cameroon, Central Africa

Ndo¹,

Ngalle²,

Ewodo

et al. 2019

BJSTR

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Background: Blood transfusion is a life-saving intervention, but that can also promote transmission of various infectious and parasitic diseases. To assure safe blood transfusion, all donor are systematically screened for transfusion-transmissible infections including HIV, hepatitis (B and C) and syphilis. However, less attention is paid for other endemic curable infections caused by hemoparasites such as malaria, and that may represent a threat for the safety of blood transfusion. This study aimed to assess the prevalence of transfusion-transmittable infections and hemoparasites in blood donors at the general hospital of Douala, with more emphasis on Plasmodium the causative agent of malaria.Methodology: Donated blood were first screened for HIV, Hepatitis (B & C) and syphilis infections. After exclusion of HIV, Hepatitis and syphilis infected bloods, the remaining ones were examined for the presence of hemoparasites including Plasmodium and microfilariasis species under light microscopy, after staining thick blood smears with Giemsa solution.Results: A total of 410 people were received at the Douala General Hospital and 37 (9.02%) were excluded based on exclusion criteria. Of the 373 pre-qualified donors, 41 (10.99%) were found infected by at least one viral or syphilis infections, and their blood was disqualified for transfusion. The seroprevalence of HIV, HVB, HVC and syphilis was 3.48%, 4.83%, 1.88% and 1.07% respectively. Only two hemoparasite species namely Loa loa and P. falciparum were found, but the prevalence of asymptomatic malaria (11.78%) was by far higher than that of microfilariasis (0.60%). However, malaria parasitemia was in most of cases low, with estimated densities ranging between 1 and 50 trophozoïtes/µl. Conclusion:We concluded that HIV and HBV are the greatest threats to blood safety in Douala, while underlining the necessity to test potential donors using rapid tests in order to avoid collection, manipulation and destruction of infected blood. The study also revealed moderate but non-negligible prevalence of asymptomatic P. falciparum infection in qualified blood samples, highlighting serious risk of transmission of this hemoparasite to receivers. We therefore re-advocate that all blood samples be additionally screened for malaria before transfusion in Cameroon where malaria is endemic in most parts of the country.

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“…Malaria deferrals would lead to high rates of donor exclusion (>30%) and blood shortages. Furthermore, screening for malaria parasites is not routinely performed . Instead, WHO recommends the administration of appropriate and effective malarial prophylaxis to all blood recipients to prevent symptomatic malaria infection .…”

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confidence: 99%

“…Furthermore, screening for malaria parasites is not routinely performed. 12 Instead, WHO recommends the administration of appropriate and effective malarial prophylaxis to all blood recipients to prevent symptomatic malaria infection. 13 However, there is little information in the literature on the level of implementation of the recommendation in the field.…”

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confidence: 99%

Inactivation of Plasmodium falciparum in whole blood using the amustaline and glutathione pathogen reduction technology

et al. 2020

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BACKGROUND Risk of transfusion‐transmitted (TT) malaria is mainly associated with whole blood (WB) or red blood cell (RBC) transfusion. Risk mitigation relies mostly on donor deferral while a limited number of countries perform blood testing, both negatively impacting blood availability. This study investigated the efficacy of the pathogen reduction system using amustaline and glutathione (GSH) to inactivate Plasmodium falciparum in WB. STUDY DESIGN AND METHODS WB units were spiked with ring stage P. falciparum infected RBCs. Parasite loads were measured in samples at time of infection, after 24 hours at room temperature (RT), and after a 24‐hour incubation at RT post‐treatment with 0.2 mM amustaline and 2 mM GSH. Serial 10‐fold dilutions of the samples were inoculated to RBC cultures and maintained up to 4 weeks. Parasitemia was quantified by cytometry. RESULTS The P. falciparum viability assay has a limit of detection of a single live parasite per sample. Input parasite titer was >5.7 log10 TCID50 per mL. A 24‐hour incubation at RT paused parasite development in controls, but they retained viability and infectivity when tested in culture. In contrast, no infectious parasites were detected in the amustaline/GSH‐treated sample after 4 weeks of culture. CONCLUSION A robust level of P. falciparum inactivation was achieved in WB using amustaline/GSH treatment. Parasite log reduction was >5.7 log10 TCID50 per mL. Development of such a pathogen reduction system may provide an opportunity to reduce the risk of TT malaria and improve blood availability.

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Blood transfusion malaria: A literature review

Cited by 8 publications

References 1 publication

Haemoglobin phenotypes and the risk of asymptomatic malaria parasitemia among blood donors in northwest Nigeria: clinical implications in the practice of tropical transfusion medicine

Haemoglobin phenotypes and the risk of asymptomatic malaria parasitemia among blood donors in northwest Nigeria: clinical implications in the practice of tropical transfusion medicine

Hepatitis B and C, HIV, Syphilis Seroprevalences and Asymptomatic Carriage of Hemoparasites Among Blood Donors at the Douala General Hospital in Cameroon, Central Africa

Inactivation of Plasmodium falciparum in whole blood using the amustaline and glutathione pathogen reduction technology

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