Investigating the prevalence of transfusion transmission of Plasmodium within a hyperendemic blood donation system

Abstract

None of the currently available screening assays appear suitable to minimize transfusion malaria without compromising the blood supply in endemic areas.

Residual risk of transfusion-transmitted malaria infection in a malaria endemic sub-Saharan African setting

“…Indeed, a study conducted in Ghana revealed that the parasite density in blood units that caused TTM was 280 p/μL [49], which could lead to severe and often fatal disease, especially for non-immune recipients [51,52]. Additionally, a study conducted in a hyperendemic area in Ghana showed that as few as ten parasites are sufficient to initiate fulminant malaria in humans [53], and various studies have reported the detection of P. falciparum by PCR or microscopy in some patients soon after blood transfusion despite receiving microscopy-negative blood [45,49]. It is worth-noting that microscopy is very less sensitive in asymptomatic malaria cases wherein PCRbased methods are most preferred [45,49,54].…”

What is the best strategy for the prevention of transfusion-transmitted malaria in sub-Saharan African countries where malaria is endemic?

“…Malaria is a protozoan parasitic infection of humans resulting from one or more of the five species of the genus Plasmodium ( Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae and Plasmodium knowlesi ) [1]. It is one of the most important parasitic diseases in the world and remains a major challenge to mankind.…”

“…As a result, there has been a paucity of information concerning the distribution and potential role of the different Plasmodium species in transfusion-related malaria cases, and the clinical impact of parasitaemic blood in recipients, particularly young children and pregnant women who are the highest consumers of blood transfusions in sub-Saharan Africa (SSA) [4,5]. When malaria is transmitted through blood transfusion to a non-immune recipient, it can progress rapidly and may lead to significant morbidity and mortality, specifically when diagnosis is delayed [1,3]. …”

“…For many years, presumptive anti-malarial treatment with inexpensive chloroquine was given to blood recipients to prevent TTM [1,2]. However, the spread of chloroquine resistance across SSA has led to such a strategy becoming redundant and ineffective [1,2].…”

“…For many years, presumptive anti-malarial treatment with inexpensive chloroquine was given to blood recipients to prevent TTM [1,2]. However, the spread of chloroquine resistance across SSA has led to such a strategy becoming redundant and ineffective [1,2]. Alternatives to chloroquine, such as artemisinin and artemisinin-based combination therapy (ACT) are considerably more expensive, weakening the applicability and usefulness of anti-malarial prophylaxis in resource-poor settings until latterly [2,3].…”