Blood banking in a malaria-endemic area: evaluating the problem posed by malarial parasitaemias

Ann Trop Med Parasitol. 2009 Jul;103(5):383-92. doi: 10.1179/136485909X451807.

Abstract

The emergence and wide dissemination of drug-resistant malarial parasites underscore the need to prevent post-transfusion malaria. In Nigeria, as in most of sub-Saharan Africa, however, blood donors are not routinely screened for malarial infection. Recently, 391 consecutive potential blood donors in a malaria-endemic area of south-western Nigeria were each checked for malarial parasitaemia using three methods: microscopy (all samples), OptiMAL (315 samples) and/or the Clinotech Malaria Cassette (142 samples). OptiMAL detects parasite-specific lactate dehydrogenase whereas the Clinotech test detects the surface proteins of merozoites and sporozoites. Microscopy revealed parasitaemias in 79 (20.2%) of the potential donors, the levels of parasitaemia varying from 34 to 6289 asexual parasites/microl (mean=445/microl). The prevalence of malarial parasitaemia, as detected by microscopy, was significantly higher during the rainy season than in the dry season (27.3% v. 5.5%; P<0.0001). There was no significant association between patent parasitaemia and fever (i.e. an axillary temperature > or =37.5 degrees C), blood group, gender or anaemia. The corresponding prevalences of malarial parasitaemia detected using the rapid diagnostic tests were 3.8% (12/315) for OptiMAL and 57.8% (82/142) for the Clinotech. With the results of the microscopy used as the 'gold standard', OptiMAL gave a sensitivity of only 16.0% but a specificity of 98.5%. The corresponding values for the Clinotech tests were 69.2% and 50.0%, respectively. It would clearly be beneficial to include screening for malaria parasitaemia in the routine investigation of potential blood donors in Nigeria, especially during the rainy season, when the risk of transfusion-transmitted malaria appears relatively high.

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Blood Donors*
  • Female
  • Humans
  • L-Lactate Dehydrogenase / analysis
  • Malaria, Falciparum / diagnosis
  • Malaria, Falciparum / epidemiology*
  • Male
  • Merozoites / chemistry
  • Middle Aged
  • Nigeria / epidemiology
  • Parasitemia / diagnosis
  • Parasitemia / epidemiology*
  • Plasmodium falciparum*
  • Prevalence
  • Protozoan Proteins / analysis
  • Sensitivity and Specificity
  • Sporozoites / chemistry
  • Young Adult

Substances

  • Protozoan Proteins
  • L-Lactate Dehydrogenase