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Malaria antibody persistence correlates with duration of exposure

H M Faddy1, C R Seed, M J Faddy

  • 1Research and Development, Australian Red Cross Blood Service, Brisbane, Qld, Australia. hfaddy@redcrossblood.org.au

Vox Sanguinis
|November 9, 2012
PubMed
Abstract

Insights

Malaria antibody persistence in blood donors varies by exposure. Semi-immune residents retain antibodies longer than non-immune visitors, impacting donor screening strategies.

Area of Science:

  • Immunology
  • Transfusion Medicine
  • Epidemiology

Background:

  • Transfusion-transmitted malaria risk in Australia is managed by screening blood donors for malaria antibodies using enzyme-linked immunoassay (EIA).
  • Donor management categorizes individuals based on duration of exposure in malarious regions ('Resident' >6 months, 'Visitor' <6 months) or malaria diagnosis history.
  • Current screening relies on identifying 'at-risk' donors and excluding those with reactive antibody tests from fresh blood component manufacture.

Purpose of the Study:

  • To investigate antibody persistence dynamics in malaria-exposed blood donors.
  • To estimate the proportion of donors who become non-reactive (serorevert) within three years of an initial EIA-reactive result.
  • To correlate antibody persistence with donor exposure categories (Resident vs. Visitor).

Main Methods:

  • Analysis of malaria enzyme-linked immunoassay (EIA) test results and donor demographic data.
  • Estimation of time since last possible malaria exposure for each donor.
  • Modeling of antibody survival to predict seroreversion rates over time.

Main Results:

  • The time since last possible malaria exposure was significantly shorter in 'Visitors' who seroreverted compared to 'Residents'.
  • Antibody survival modeling predicted that 20% of previously EIA-reactive 'Visitors' would become non-reactive within three years.
  • Conversely, only 2% of 'Residents' were predicted to become non-reactive within the same three-year period.

Conclusions:

  • Antibody persistence in blood donors is significantly influenced by their exposure category.
  • Semi-immune 'Residents' maintain detectable malaria antibodies for longer periods than non-immune 'Visitors'.
  • These findings have implications for optimizing donor screening and blood safety protocols regarding transfusion-transmitted malaria.

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