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Public perspectives on potential changes to malaria deferral criteria in Canada
Courtney Joshua1, Carmen Charlton2,3,4,5,6, Joelle Kasongo2,3
1Department of Anthropology and Sociology, Carleton University, Ottawa, Ontario, Canada.
Insights
Implementing malaria nucleic acid testing (NAT) could ease blood donation deferrals for diverse communities. Clear communication is vital, as participants expressed concern about potential positive malaria NAT results.
Area of Science:
- Public health
- Blood donation policy
- Infectious disease screening
Background:
- Blood collection agencies (BCAs) aim to increase donor diversity.
- Current malaria deferral criteria create barriers for some communities, particularly African, Caribbean, and Black (ACB) communities.
- Implementing malaria nucleic acid testing (NAT) could allow for easing deferral criteria.
Purpose of the Study:
- To explore public views on potential changes to malaria deferral criteria in blood donation.
- To understand donor perspectives on screening processes and potential malaria NAT implementation.
Main Methods:
- A mixed-methods, community-based study was conducted in Canada.
- Qualitative component involved semi-structured interviews with 26 participants.
- Topics included donation experiences, knowledge of deferral criteria, and responses to potential positive malaria NAT results.
Main Results:
- Participants viewed blood safety as a shared responsibility.
- Most participants were comfortable with screening questions.
- A positive malaria NAT result could elicit concern, fear, and uncertainty.
Conclusions:
- Clear and effective communication is essential if BCAs implement malaria NAT and ease deferral criteria.
- Focus communication efforts on impacted communities.
- Collaboration with community partners is recommended for effective communication.
Background And Objectives:
As blood collection agencies (BCAs) seek to increase donor diversity, making changes to eligibility criteria to enable more people to donate is an important consideration. BCAs in Canada have a permanent deferral from whole blood and platelet donation for anyone with a history of malaria, a barrier to donation for many in African, Caribbean and Black (ACB) communities. If a malaria nucleic acid test (NAT) is implemented in donor screening, malaria-related deferral criteria could be eased. This study explored the public's views on potential changes to malaria deferral criteria.
Materials And Methods:
A mixed-methods community-based study was conducted in Canada. This paper reports results from the qualitative component (n = 26). Topics explored in semi-structured interviews included experiences with donation, awareness and knowledge of deferral criteria, cognitive interview questions and potential responses to receiving a positive test result for malaria.
Results:
Participants understood blood donor screening processes as a shared responsibility of both BCAs and donors for ensuring blood safety. Participants had a literal interpretation of donor screening questions assessed, and most would feel comfortable answering the questions in a blood donation context. If malaria NAT is implemented and they were to receive a positive test result, participants shared they would respond with concern, fear and uncertainty.
Conclusion:
If BCAs work to implement a malaria NAT and ease deferral criteria, this must be communicated clearly and effectively to the public and donors, with particular focus on communities impacted. BCAs should work with community partners to communicate these changes.
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