Related Experiment Video
Updated: Sep 26, 2025
High Yield Purification of Plasmodium falciparum Merozoites For Use in Opsonizing Antibody Assays
Published on: July 17, 2014
Whole Blood Transfusion for Severe Malarial Anemia in a High Plasmodium falciparum Transmission Setting
Matthew M Ippolito1,2,3, Jean-Bertin B Kabuya4, Manuela Hauser5,6
1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Insights
Whole blood transfusions improve survival in children with severe malarial anemia (SMA). Transfusions were most beneficial for children with SMA and thrombocytopenia, especially when using blood stored for less than four weeks.
Area of Science:
- Pediatric Infectious Diseases
- Hematology
- Global Health
Background:
- Severe malaria caused by Plasmodium falciparum is a leading cause of childhood death globally.
- Severe malarial anemia (SMA) is the most frequent clinical presentation of severe malaria.
- Current blood transfusion guidelines for SMA lack robust supporting evidence.
Purpose of the Study:
- To investigate the association between whole blood transfusion and in-hospital survival in children with SMA.
- To identify patient subgroups that may benefit most from blood transfusions.
Main Methods:
- Retrospective cohort study involving 911 hospitalized children with SMA in Zambia.
- Analysis using adjusted logistic regression models with multiple imputation for missing data.
Main Results:
- Blood transfusion was linked to a 35% reduction in mortality for children with SMA (OR, 0.65; P = .0002).
- The number-needed-to-treat (NNT) for transfusion was 14, and 5 for children with concomitant thrombocytopenia.
- Shorter whole blood storage (<4 weeks) correlated with better survival and post-transfusion platelet counts.
Conclusions:
- Whole blood transfusion is associated with improved survival in pediatric SMA patients.
- Thrombocytopenia is a key factor in identifying SMA patients who benefit from transfusion.
- Optimizing blood storage duration and ensuring reliable blood supply are crucial for managing severe malaria.
Background:
Severe malaria resulting from Plasmodium falciparum infection is the leading parasitic cause of death in children worldwide, and severe malarial anemia (SMA) is the most common clinical presentation. The evidence in support of current blood transfusion guidelines for patients with SMA is limited.
Methods:
We conducted a retrospective cohort study of 911 hospitalized children with SMA in a holoendemic region of Zambia to examine the association of whole blood transfusion with in-hospital survival. Data were analyzed in adjusted logistic regression models using multiple imputation for missing data.
Results:
The median age of patients was 24 months (interquartile range, 16-30) and overall case fatality was 16%. Blood transfusion was associated with 35% reduced odds of death in children with SMA (odds ratio, 0.65; 95% confidence interval, .52-.81; P = .0002) corresponding to a number-needed-to-treat (NNT) of 14 patients. Children with SMA complicated by thrombocytopenia were more likely to benefit from transfusion than those without thrombocytopenia (NNT = 5). Longer storage time of whole blood was negatively associated with survival and with the posttransfusion rise in the platelet count but was not associated with the posttransfusion change in hemoglobin concentration.
Conclusions:
Whole blood given to pediatric patients with SMA was associated with improved survival, mainly among those with thrombocytopenia who received whole blood stored for <4 weeks. These findings point to a potential use for incorporating thrombocytopenia into clinical decision making and management of severe malaria, which can be further assessed in prospective studies, and underline the importance of maintaining reliable blood donation networks in areas of high malaria transmission.
More Related Videos
07:27A Simple Protocol for Platelet-mediated Clumping of Plasmodium falciparum-infected Erythrocytes in a Resource Poor Setting
Published on: May 16, 2013
10:50Detection and Quantification of Plasmodium falciparum in Aqueous Red Blood Cells by Attenuated Total Reflection Infrared Spectroscopy and Multivariate Data Analysis
Published on: November 2, 2018
Related Concept Videos
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
00:58Symbiosis