Preventing transfusion‐transmitted malaria in France

Cam, Sophie Le; Houzé, Sandrine; Barlet, Valérie; Maugard, Claude; Narboux, Céline; Morel, Pascal; Garraud, Olivier; Tiberghien, Pierre; Gallian, Pierre

doi:10.1111/vox.13097

Cited by 7 publications

(7 citation statements)

References 10 publications

(10 reference statements)

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“…The findings in this study are promising and should trigger various levels of interest depending on current strategies in place to mitigate the risk of TTIs by vector‐borne pathogens in the United States. Of note, TTIs continue to be reported, albeit infrequently, for WNV 10,55,56 and Plasmodium , 57–59 as examples, even with the current interventions of donor health histories and/or testing in place. In Europe, seasonal deferrals and blood donation screening for WNV, 60–66 DENV, and CHIKV have been implemented in some of the Mediterranean countries, but regulatory authorities such as PEI in Germany, 8 are now recommending the use of PRT as an alternative to WNV deferrals and screening to maintain the platelet supply.…”

Section: Discussionmentioning

confidence: 99%

Mitigating the risk of transfusion‐transmitted infections with vector‐borne agents solely by means of pathogen reduction

Stramer

Lanteri

Brodsky³

et al. 2022

Transfusion

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Background: This study evaluated whether pathogen reduction technology (PRT) in plasma and platelets using amotosalen/ultraviolet A light (A/UVA) or in red blood cells using amustaline/glutathione (S-303/GSH) may be used as the sole mitigation strategy preventing transfusion-transmitted West Nile (WNV), dengue (DENV), Zika (ZIKV), and chikungunya (CHIKV) viral, and Babesia microti, Trypanosoma cruzi, and Plasmodium parasitic infections. Methods: Antibody (Ab) status and pathogen loads (copies/mL) were obtained for donations from US blood donors testing nucleic acid (NAT)positive for WNV, DENV, ZIKV, CHIKV, and B. microti. Infectivity titers derived from pathogen loads were compared to published PRT log 10 reduction factors (LRF); LRFs were also reviewed for Plasmodium and T. cruzi. The potential positive impact on donor retention following removal of deferrals from required questioning and testing for WNV, Babesia, Plasmodium, and T. cruzi was estimated for American Red Cross (ARC) donors.Results: A/UVA and S-303/GSH reduced infectivity to levels in accordance with those recognized by FDA as suitable to replace testing for all agents evaluated. If PRT replaced deferrals resulting from health history questions and/or NAT for WNV, Babesia, Plasmodium, and T. cruzi, 27,758 ARC donors could be retained allowing approximately 50,000 additional donations/year based on 1.79 donations/donor for calendar year 2019 (extrapolated to an estimated 125,000 additional donations nationally). Conclusion: Pathogen loads in donations from US blood donors demonstrated that robust PRT may provide an opportunity to replace deferrals associated with donor questioning and NAT for vector-borne agents allowing for significant donor retention and likely increased blood availability.

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Section: Discussionmentioning

confidence: 99%

Mitigating the risk of transfusion‐transmitted infections with vector‐borne agents solely by means of pathogen reduction

Stramer

Lanteri

Brodsky³

et al. 2022

Transfusion

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“…falciparum from a former resident of Benin, the donor's infection was detected by PCR and antibody but not antigen [ 80 ]. In the two French TTM cases described above that were missed by antibody screening, both donors were detectable by PCR [ 57 ]. In some cases, molecular testing was only performed on samples that had been stored in the refrigerator for several weeks, which likely caused degradation of molecular targets.…”

Section: Testing Methods/methodologies: Molecular Methodsmentioning

confidence: 99%

“…The donors all came from West Africa [ 42 ]. In France, four TTMs have been reported since 2002 [ 57 ]. The last TTM case in France occurred in 2015 [ 58 ].…”

Section: Ttm Cases In Nonendemic Countriesmentioning

confidence: 99%

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Transfusion-Transmitted Malaria and Mitigation Strategies in Nonendemic Regions

Niederhauser

Galel

2022

Transfus Med Hemother

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Background: Malaria is a mosquito-borne infectious disease caused by protozoan parasites of the genus Plasmodium. These parasites can be transmitted by blood transfusion especially through Red Cell Blood Concentrates collected from asymptomatic and parasitemic donors. As migration of populations from endemic areas to Europe and overseas recreational travel to endemic regions increase, there is growing risk of transfusion-transmitted malaria (TTM) in nonendemic regions of the world. The present work provides an overview of the mitigation strategies in nonendemic countries and their effectiveness and discusses possible approaches to evolve the strategies in order to maintain both a safe and adequate blood supply. Summary: The historical and current situation of malaria and TTM in Europe and on the North American continent are described. The infectivity of Plasmodium in blood components and the consequences of TTM are presented, along with the regulations and guidelines for TTM mitigation in Europe, USA, and Canada. The regulations/guidelines currently in place in Europe allow a certain amount of leeway for local policies. A questionnaire was used to survey European countries regarding their current strategies and recent TTM cases. From the questionnaire and published cases, approximately 20 cases of TTM were identified in the past 20 years in the USA and Europe. The vast majority of implicated donors have been former residents of malaria-endemic areas, particularly former residents of hyperendemic areas in Africa. The most recent TTM cases are discussed in detail to provide insight into the gaps in current strategies. The utility and uncertainties of pathogen reduction and serological and molecular testing methods are discussed. Key Messages: Overall, the risk of transfusion-associated malaria in nonendemic countries is considered to be low and very few TTM cases occurred in these regions in the last 20 years. The questionnaire-based strategy with questions about risk in relation to malaria exposure with or without selective testing based on questioning seems to be relatively effective, although rare and sometimes fatal transmissions still occur. An outstanding question is whether in the future molecular methods may further improve the safety of blood products and help constrain the loss of donors.

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“…The latter are often burdened by a higher prevalence of infectious diseases, endemic for vector-borne parasitic or viral agents, and are at risk of outbreaks of new emerging infectious diseases (EIDs). Over the past decade, Brazil has experienced recurring or new EID outbreaks of dengue, chikungunya, and Zika viruses [11,12]. Blood donor screening strategies, such as donor health questionnaires and deferrals, as well as blood screening using serological and molecular assays, have contributed to mitigating the risk of TTI [13,14].…”

Section: Introductionmentioning

confidence: 99%

The 4-Year Experience with Implementation and Routine Use of Pathogen Inactivation in a Brazilian Hospital

Fachini¹,

Fontão-Wendel²,

Achkar³

et al. 2021

Preprint

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(1) Background: We reviewed the logistics of the implementation of pathogen inactivation (PI) using the INTERCEPT Blood System™ for platelets and the experience with routine use and clinical outcomes in the patient population at the Sírio-Libanês Hospital of São Paulo, Brazil. (2) Methods: Platelet concentrate (PC), including pathogen reduced (PR-PC) production, inventory management, discard rates, blood utilization, and clinical outcomes were analyzed over the 40 months before and after PI implementation. Age distribution and wastage rates were compared over the 10 months before and after approval for PR-PC to be stored for up to 7 days. (3) Results: A 100% PR-PC inventory was achieved by increasing double apheresis collections and production of double doses using pools of two single apheresis units. Discard rates decreased from 6% to 3% after PI implementation and further decreased to 1.2% after 7-day storage extension for PR-PCs. The blood utilization remained stable, with no increase in component utilization. A significant decrease in adverse transfusion events was observed after the PI implementation. (4) Conclusion: Our experience demonstrates the feasibility for Brazilian blood centers to achieve a 100% PR-PC inventory. All patients at our hospital received PR-PC and showed no increase in blood component utilization and decreased rates of adverse transfusion reactions.

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Preventing transfusion‐transmitted malaria in France

Cited by 7 publications

References 10 publications

Mitigating the risk of transfusion‐transmitted infections with vector‐borne agents solely by means of pathogen reduction

Mitigating the risk of transfusion‐transmitted infections with vector‐borne agents solely by means of pathogen reduction

Transfusion-Transmitted Malaria and Mitigation Strategies in Nonendemic Regions

The 4-Year Experience with Implementation and Routine Use of Pathogen Inactivation in a Brazilian Hospital

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