Laboratory detection of donors implicated in transfusion-transmitted malaria
1Medical Affairs - Donor Screening, Roche Diagnostics Solutions, Pleasanton, California, USA.
Transfusion
|November 6, 2024
Summary
Transfusion-transmitted malaria (TTM) is rare but fatal in non-endemic areas. Molecular PCR tests detected Plasmodium in most TTM donors, while antibody tests were less effective, suggesting improved molecular screening for blood safety.
Area of Science:
- Medical Science
- Infectious Diseases
- Public Health
Background:
- Transfusion-transmitted malaria (TTM) poses a rare but serious risk in non-endemic regions.
- Prompt diagnosis and prevention are crucial for blood safety.
Purpose of the Study:
- To evaluate the effectiveness of laboratory tests in detecting Plasmodium infection in blood donors implicated in TTM cases.
- To assess the performance of molecular (PCR) and antibody tests for identifying infectious donors.
Main Methods:
- A literature review identified TTM cases in the US, Canada, and Europe since 2010.
- Laboratory results from source donors were analyzed, focusing on Plasmodium polymerase chain reaction (PCR) and antibody enzyme immunoassays (EIA).
- Sample types and storage conditions were considered in the analysis.
Main Results:
- Of 13 TTM donors, 12 were tested by PCR, with 10 positive. Antibody EIA detected infection in only 3 of 7 donors.
- PCR detected Plasmodium DNA in most donors, with higher sensitivity on fresh samples compared to stored ones.
- Antibody tests showed limited sensitivity in detecting Plasmodium infection in TTM donors.
Conclusions:
- Antibody EIAs are insufficient for detecting TTM donors, failing in 4 of 7 cases.
- DNA-based PCR is effective, especially with fresh samples, but highly sensitive ribosomal RNA-based assays show promise for future TTM reduction.
- Enhanced molecular screening of blood donations is recommended to further minimize the risk of TTM.
