Use of a NAT-based assay to improve the surveillance system and prevent transfusion-transmitted malaria in blood banks

Malar J. 2020 Jul 31;19(1):275. doi: 10.1186/s12936-020-03345-y.

Abstract

Background: Malaria can be transmitted by blood transfusion through donations collected from asymptomatic donors. Transfusion-transmitted malaria (TTM) poses a great risk to blood services worldwide. A good screening tool for Plasmodium spp. detection in blood banks must have a high sensitivity for prevention of TTM. However, in Brazilian blood banks, screening for malaria still relies on microscopy.

Methods: In Brazil, screening for human immunodeficiency virus type 1 (HIV), RNA/DNA for hepatitis C (HCV) and hepatitis B (HBV) viruses is mandatory for every blood donation and uses nucleic acid amplification testing (NAT). The aim of this study was to evaluate the inclusion of an assay for malaria to identify Plasmodium sp. from total nucleic acid (TNA; DNA/RNA) by targeting the 18S rRNA gene of the parasite.

Results: Considering the limitations of microscopy and the wide availability of the Brazilian NAT platform in the screening of blood units for HIV, HCV, and HBV, a molecular diagnostic tool was validated for detection of Plasmodium sp. in blood banks; a pilot study showed that using this novel NAT assay could reduce the risk of TTM.

Conclusion: The prototype HIV/HCV/HBV/malaria NAT assay was effective in detecting infected candidate donors and has good prospects to be applied in routine screening for preventing TTM.

Keywords: Blood transfusion; Hemovigilance; Malaria; Molecular diagnostic; Nucleic acid testing; Plasmodium; Transfusion-transmitted malaria.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Blood Banks
  • Blood Transfusion
  • Brazil
  • Epidemiological Monitoring
  • Female
  • HIV Infections / diagnosis
  • Hepatitis B / diagnosis
  • Hepatitis C / diagnosis
  • Humans
  • Malaria / prevention & control*
  • Malaria / transmission
  • Male
  • Mass Screening / instrumentation
  • Mass Screening / methods*
  • Middle Aged
  • Nucleic Acid Amplification Techniques / methods*
  • Pilot Projects
  • Plasmodium / genetics
  • Plasmodium / isolation & purification*
  • Population Surveillance / methods*
  • RNA, Protozoan / analysis
  • RNA, Ribosomal, 18S / analysis
  • Young Adult

Substances

  • RNA, Protozoan
  • RNA, Ribosomal, 18S