June 14th is World Blood Donor Day. This year’s theme stresses the importance of donating now before a disaster strikes. This requires good storage facilities (and strong systems) in countries where disasters may occur, which may not always be the case. We know that blood donation facilities are concerned about testing for infectious diseases like HIV and Hepatitis C. What of malaria?
Studies have found that when people return to a non-endemic setting from malaria endemic countries, “Semi-immune individuals are more likely to transmit malaria as they may be asymptomatic” and serological data, not just circumstantial epidemiological information are also needed that if transmission through blood donations are to be prevented. There is also concern about the longevity of malaria infection depending on the species of Plasmodium in different parts of the world.
In endemic countries malaria antibodies can be present in basically all of asymptomatic adult blood donors. Unfortunately currently available screening assays appear unsuitable to minimize transfusion malaria.
Researchers in Brazil reported that, “The real-time PCR with TaqMan probes enabled the identification of P. vivax in a high proportion of clinically healthy donors, highlighting the potential risk for transfusion-transmitted malaria. Additionally, this molecular diagnostic tool can be adopted as a new laboratory screening method in haemotherapy centres, especially in malaria-endemic areas.”
Knowing the seasonal prevalence of malaria among blood donors in Bamako, Kouriba et al. suggest “A prevention strategy of transfusion malaria based on the combination of selection of blood donors through the medical interview, promoting a voluntary low-risk blood donation and screening all blood bags intended to be transfused” to vulnerable groups.
So while we recognize the life saving importance of adequate blood donations and supplies for transfusion, we also stress the importance of blood safety and expand our horizons to the possibility that malaria may be one of the potential problems shared with blood.