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Malarial antibodies in Auckland blood donors
N Davidson1, G Woodfield, S Henry
1Department of Transfusion Medicine, Auckland Regional Blood Centre and Auckland Institute of Technology.
Aim:
To determine the malarial exposure characteristics of "malarial risk" blood donors and measure the potential infectivity of their donations using a commercially available malarial antibody screening kit.
Method:
Malarial risk donors were identified according to standard protocols, questioned as to their degree of exposure to malaria and blood samples were tested for malarial antibodies using an enzyme immunoassay kit. The kit used detects IgG antibodies to P. falciparum, shows 50% crossreactivity with P. vivax and some crossreactivity with P. ovale. Antibody positive samples were further checked by a direct immunochromatographic test for P. falciparum.
Results:
We found 1.7% of the donors who were classified as a "malarial risk" to be positive for IgG malarial antibodies. None of these antibody positive samples was positive by the direct immunochromatographic test for P. falciparum.
Conclusion:
These results indicate that none of these donors tested were a risk of transmitting P. falciparum, the major and most serious cause of transfusion transmitted malaria. The introduction of malarial testing of malarial risk blood donors in Auckland, currently deferred for plasma donation only, could potentially recover 2300 units of red cells per year.
Insights
Malarial risk blood donors in Auckland showed low IgG malarial antibody positivity. Testing confirmed no risk of transmitting Plasmodium falciparum via blood donations, potentially recovering significant red cell units.
Area of Science:
- Transfusion Medicine
- Infectious Disease Epidemiology
- Immunoserology
Background:
- Blood donation safety is paramount, especially in regions with potential malaria exposure.
- Screening blood donors for transfusion-transmitted infections is a critical public health measure.
- Identifying and assessing 'malarial risk' donors is essential for preventing malaria transmission through blood transfusions.
Purpose of the Study:
- To characterize malarial exposure in blood donors identified as 'malarial risk'.
- To evaluate the infectivity of donations from these donors using antibody screening.
- To assess the risk of transfusion-transmitted malaria, particularly from Plasmodium falciparum.
Main Methods:
- Malarial risk donors were identified using standard protocols.
- Donors underwent questionnaires regarding malaria exposure.
- Blood samples were tested for malarial IgG antibodies using enzyme immunoassay (EIA) and confirmed with immunochromatographic tests (ICT) for P. falciparum.
Main Results:
- 1.7% of 'malarial risk' blood donors tested positive for IgG malarial antibodies.
- None of the antibody-positive samples were confirmed positive for Plasmodium falciparum by direct ICT.
- The EIA kit showed cross-reactivity with P. vivax and P. ovale, necessitating confirmatory testing.
Conclusions:
- The study indicates no detectable risk of transmitting Plasmodium falciparum from the tested 'malarial risk' blood donors.
- Current antibody screening methods, while useful, require confirmatory testing for specific Plasmodium species.
- Implementing malaria screening for blood donors in Auckland could significantly increase the availability of red cell units for transfusion.
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