Controle da malária transfusional em região endêmica e não endêmica do Brasil

Abstract

The aim of the present work was to establish appropriate criteria for screening of donor blood from regions with distinct Malaria epidemiological characteristics. Three locations with different screening criteria were studied: São Paulo, SP (with no vectorial transmission), Belém, PA (with low active transmission) and Matupá and Peixoto de Azevedo, MT (with high active transmission). The Malaria parasite--Plasmodium sp--was searched for by "thick film", QBC Test and antigen Immunofluorescence test, and was not detected in any of the samples. There was, however, a great variation in the positivity of anti-plasmodial antibodies, as determined by IIF-IgG anti-P. vivax and -P. falciparum, between accepted donors in the 3 studied locations and between rejected and accepted donors in São Paulo (1.98% accepted, 22.3% rejected--p < 0.01) and Belém (17.2% accepted, 58.3% rejected--p < 0.01). These data endorse the use of the applied clinical and epidemiological screening. In Matupá and Peixoto de Azevedo, where there was no rejected donor, the serological positivity was 80.6%. We, therefore, consider that the Malaria screening in blood banks should follow clinical and epidemiological criteria suitable to each region. The laboratorial screening techniques should then detect either the parasites (thick film/QBC Test or the parasite antigens.

Detection of Plasmodium falciparum and Plasmodium vivax subclinical infection in non-endemic region: implications for blood transfusion and malaria epidemiology

“…Considering only Plasmodium , after the collection of the blood, the parasite can survive for at least one week at 4°C, as well as in frozen erythrocytes [44]. Plasmodium transmission by transfusion usually occurs through whole blood and red blood cells and may occur less frequently through platelet concentrates, white blood cells, cryoprecipitate, and fresh frozen plasma [18,45]. The blood bank is therefore an important target for controlling undesirable Plasmodium transmission in endemic [38,46] and non-endemic regions [43,47].…”

Malaria diagnosis from pooled blood samples: comparative analysis of real-time PCR, nested PCR and immunoassay as a platform for the molecular and serological diagnosis of malaria on a large-scale

“…At blood banks, individuals who report themselves as displaced to endemic areas for malaria are excluded. Nevertheless, this measure may not prevent transfusion transmission because there is often scarce knowledge of malaria in areas without active transmission and because asymptomatic infections in semi-immune individuals are common (Sáez-Alquézar et al 1998, Kitchen & Chiodini 2006. According to the Brazilian guidelines (ANviSA 2004) (resolution number 153), endemic areas have been classified as low, medium or high risk areas according to the Annual Parasite index.…”

Alternative transmission routes in the malaria elimination era: an overview of transfusion-transmitted malaria in the Americas

“…Malaria deferral practices were not consistent among endemic countries (Table 2 ). In Brazil, previous history of malaria, travel to endemic areas without prophylaxis in the last 6 months, living in malaria-endemic areas, travel to endemic area in the last 6 months, and previous malaria in the last year or fever in the last 30 days were considered as deferral causes, depending on the location where the candidate was tested [ 27 , 32 ]. In São Paulo, a non-endemic area, subjects with history of travel to endemic areas without prophylaxis in the last 6 months, living in malaria-endemic areas (deferral for 3 years) and previous malaria were considered non-eligible for blood donations, resulting in a 3% deferral rate [ 27 ].…”

“…In Brazil, previous history of malaria, travel to endemic areas without prophylaxis in the last 6 months, living in malaria-endemic areas, travel to endemic area in the last 6 months, and previous malaria in the last year or fever in the last 30 days were considered as deferral causes, depending on the location where the candidate was tested [ 27 , 32 ]. In São Paulo, a non-endemic area, subjects with history of travel to endemic areas without prophylaxis in the last 6 months, living in malaria-endemic areas (deferral for 3 years) and previous malaria were considered non-eligible for blood donations, resulting in a 3% deferral rate [ 27 ]. In malaria-endemic areas of the Brazilian Amazon, deferral donation rates ranged from no deferrals among 31 candidates in the State of Mato Grosso, using fever in the last 30 days as the deferral reason in a hyperendemic area [ 27 ], to 11.7% in Manaus where all candidates reporting a previous episode of malaria were deferred [ 32 ].…”