Understanding the problem of transfusion transmitted malaria in the deployed military environment

Haemorrhage is a leading cause of preventable trauma death in the deployed military environment. Access to whole blood transfusion in military environments with constrained logistics has driven renewed operational interest in emergency blood donor panels. When activated in malaria-endemic environments, emergency donor systems pose unique risks for transfusion-transmitted malaria. In military contexts, where transfusion capability is a force-enabler, risk management must reflect operational realities. Conventional civilian donor deferral criteria may be impractical or overly restrictive, requiring context-specific approaches to infectious risk management. This review aims to examine the risk of transfusion-transmitted malaria from emergency donor panels in military environments, explore the operational role of walking blood banks and evaluate risk mitigation strategies that ensure transfusion safety while preserving operational capability.