Nutritional Advice El Mondo
Objectives:
Malaria transmission through blood transfusion is an accidental but preventable cause of malaria infection and is increasingly becoming a matter of concern for blood transfusion services. Therefore, this review article (meta-analysis) has been conducted.
The aim of this review article is to provide a summary of evidence about the prevalence of Plasmodium infection in asymptomatic blood donors and the effectiveness of screening methods used based on the available literature.
Study design:
This review article included 71 studies from 21 countries and 5 continents.
3 types of diagnostic methods were used to detect the prevalence of malaria in the included studies: microscopy (n = 51), RDT (n = 25) and molecular techniques (n = 14).
A total of 984,975 blood samples were examined for malaria infection in all studies: 374,919 samples by microscopy, 604,693 by RDT including immunochromatographic test and 5,363 by molecular techniques (PCR, real-time PCR, PCR-restriction fragment length polymorphism (RFLP) and nested PCR).
Results and conclusions:
The investigators found the median prevalence of malaria parasitemia among 984,975 asymptomatic healthy blood donors was 10.54% [95% CI = 8.44%-12.84%], 5.36% [95% CI = 2.25%-9.70%] and 0.38% [95% CI = 0.25%-0.54%] by microscopy, molecular methods (polymerase chain reaction) and rapid diagnostic tests, respectively.
The most commonly detected Plasmodium species was P. falciparum.
The investigators found the pooled prevalence of malaria infection in asymptomatic blood donors was 7.14% [95% CI = 3.61%-11.74%] among studies conducted before 2010 vs 13.61% [95% CI = 9.33%-18.55%] among those conducted after 2010. However, this difference in prevalence was not statistically significant [p = 0.1872].
The investigators found the highest prevalence of malaria infection among blood donors was observed in Africa; 21% [95% CI = 14%-29%] of blood donors had a positive malaria test detected by microscopy.
By RDT, the highest prevalence was observed in Africa [7.4%, 95% CI = 3%-12%] and no parasitemia was detected in other continents.
Molecular methods (PCR) have indicated a higher prevalence of malaria infection in the blood donor population in Africa [36%, 95% CI = 11%-72%].
However, using a molecular technique did not impact the observed prevalence in other continents: Asia 4% [95% CI = 1%-13%], Americas 2% [95% CI = 1%-7%] and Europe 1% [95% CI = 0%-3%].
The investigators found according to the multivariate analysis, a positive association was observed between malaria infection and female sex, commercial donor type and blood group A [p 0.005].
Those individuals residing in rural areas and with no history of previous transfusion had a higher prevalence of infection; however, this was not statistically significant.
The investigators concluded that transfusion-transmitted malaria is one of the most significant transfusion-associated infections, especially in Sub-Saharan Africa, compared with other transfusion-linked infections. World Health Organization guidelines for screening and deferral need to be reinforced in each country and tailored to the local context. Future work must aim to understand the clinical significance of transfusion-transmitted malaria in malaria-endemic settings.
Original title:
Transfusion-Transmitted Malaria: A Systematic Review and Meta-analysis by Ahmadpour E, Foroutan-Rad M, […], Cevik M.
Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6634438/
Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and malaria right here.