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Transfusion-transmitted malaria not preventable by current blood donor screening guidelines: a case report
Arthur Holtzclaw1, Zorana Mrsic2, Jim Managbanag3
1Department of Internal Medicine. arthur.w.holtzclaw.mil@mail.mil.
Transfusion
|June 15, 2016
Summary
Transfusion-transmitted malaria (TTM) is rare but can occur even with donor screening. A case highlights the need for better malaria screening in blood donations to prevent TTM.
Area of Science:
- Infectious Diseases
- Hematology
- Public Health
Background:
- Transfusion-transmitted malaria (TTM) is a rare but significant transfusion complication.
- Current prevention relies on deferring high-risk donors, lacking FDA-approved screening tests for donated blood in the US.
- Existing guidelines may not cover all TTM transmission scenarios.
Observation:
- A 76-year-old male developed TTM caused by Plasmodium malariae.
- The patient had no travel history but received multiple blood transfusions.
- The infectious donor had immigrated 15 years prior, outside current deferral periods.
Findings:
- A blood unit from an asymptomatic donor, who immigrated from Liberia 15 years prior, transmitted P. malariae.
- This case falls outside current donor deferral guidelines for malaria.
- Literature review indicates a significant percentage of TTM cases result from guideline application issues.
Implications:
- Highlights limitations of current donor deferral strategies for preventing TTM.
- Underscores the urgent need for developing sensitive and cost-effective screening methods for malaria in donated blood.
- Emphasizes the importance of re-evaluating and potentially updating donor screening protocols for transfusion-transmitted infections.
