Transfusion-transmitted malaria: donor prevalence of parasitaemia and a survey of healthcare workers knowledge and practices in a district hospital in Ghana

Abstract

BackgroundTransfusion-transmitted malaria (TTM) is a risk of transfusion that has not been well described in malaria endemic regions. The risk of the recipient getting malaria is related to the prevalence of malaria in the blood donors. There is however little information on the prevalence of malaria among donors in Akatsi district of Ghana. Further, the knowledge and practices of healthcare workers to TTM is unknown. The study was undertaken to determine the prevalence of malaria parasite infection among blood donors and to evaluate the knowledge and practices of healthcare workers to TTM in the Akatsi district of Ghana.MethodsThe study was conducted at Akatsi South District Hospital between May and August 2014. To screen for Plasmodium falciparum, 5 µl of capillary blood was obtained by finger prick from 200 participants (100 donors and 100 healthy controls). Plasmodium falciparum screening was done using CareStart™ Malaria Antigen kit. To obtain information regarding TTM knowledge and practices, questionnaires were completed by 100 health workers including nurses, doctors and laboratory staff.ResultsThe prevalence of P. falciparum was the same (10 %) in both donors and controls. All those who were malaria RDT positive were aged 15–25 years. Out of the 100 healthcare workers (31 males and 69 females) surveyed, 45 % of respondents (45/100) had never heard of transfusion-transmitted malaria. Almost all respondents (91 %) had not attended any lecture/seminar/workshop on blood transfusion in the past 12 months. There were 44 respondents (44 %) who wrongly said malaria was being screened for prior to transfusion in their hospital. However, 98.2 % (54/55) of those who had heard about TTM rightly stated that TTM can be prevented.ConclusionThe prevalence of P. falciparum parasitaemia is 10 % in healthy blood donors in the Akatsi district and represents a risk for TTM though the extent of this risk is unclear. Knowledge about TTM in healthcare workers in the district is low. Continuous education and in-service training may be a means to improve TTM knowledge and preventive practices by the health workers in the district.

Storage related haematological and biochemical changes in Plasmodium falciparum infected and sickle cell trait donor blood

“…In Brazil, Solomon Islands and Cambodia, asymptomatic malaria has been found to be 37.5, 82.2 and 92% respectively [4–6]. In Africa, the prevalence of asymptomatic malaria in blood donors in Ghana has been found to be 10.0% [7]. In Cameroon, Senegal, Benin and Nigeria, asymptomatic malaria parasitaemia in blood donors have been found to be 27.54% [8], 65.3% [9], > 30% [10] and 40% [11] respectively.…”

Prevalence of Malaria in blood donor population from a tertiary care centre and effective donor notification and counselling policy

“…Malaria rapid diagnostic tests (RDTs) are increasingly used in malaria‐endemic settings and are in accordance with the WHO strategy to confirm the diagnosis. They are available in kits, and the results can be interpreted within 12–15 minutes without the requirement of extensive training .…”

“…Stringent blood donor selection criteria, especially for malaria in endemic countries, add on to the pre‐existing diagnostic challenge. As India is an endemic region for malaria, donors with a history of malaria within the preceding 3‐month interval are deferred from donating blood , whereas the South African National Blood Service recommends deferral for 3 years after completion of treatment for malaria. Also for those who have travelled to other malaria‐endemic regions, the deferral period is 4 weeks .…”

“…Also for those who have travelled to other malaria‐endemic regions, the deferral period is 4 weeks . In the non‐endemic countries, the transfusion services utilize the travel history and serologic tests to identify donors at risk of transmitting malaria .…”

Transfusion‐transmitted malaria masquerading as sickle cell crisis with multisystem organ failure

“…US blood donation centers screen potential donors at risk of harboring Plasmodium species through the use of a donor questionnaire mandated by the Food and Drug Administration, which results in a national deferral rate of about 1% and an estimated incidence of transfusion‐transmitted malaria (TTM) of less than one case per million units collected . Malaria infection remains a significant obstacle to safe blood transfusion outside the United States in endemic areas where the donor prevalence is high and knowledge about TTM is low …”