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Transfusion medicine

Tranfusion-transmitted disease

Malaria and transfusion


Reviewer: Huy Phu Pham, M.D. (see Reviewers page)
Revised: 5 November 2011, last major update October 2011
Copyright: (c) 2007-2011, PathologyOutlines.com, Inc.

General
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● There are four Plasmodium species that cause malaria in humans: P. falciparum, P. malariae, P. ovale, P. vivax
● Common transfusion transmitted infection worldwide
● In US, 1300 new cases of malaria/year, but only 1-2 cases are due to transfusion
● Prevention of malaria transmission is through deferral of donors who had malaria in the preceding 3 years and travelers to endemic areas (Vox Sang 2006;90:77)
● Most donors in transmission cases had traveled to an endemic area; are often “semi-immune” with low parasite loads (Transfus Med Rev 2005;19:229)

Risk of transfusion transmitted disease is estimated at 0.25 cases per million transfusions:
● Usually results from transmission of P. falciparum
● Symptoms can occur a week to several months after transfusions
● Rarely fatal

● May be marked difference in antigen versus antibody rate (Saudi Arabia 0.2% vs. 8%, Ann Saudi Med 2002;22:329)

Prevalence in donors (in endemic regions):
● Brazil - 1-3% (Rev Inst Med Trop Sao Paulo 2007;49:1)
● Kenya - 9% (East Afr Med J 2005;82:565)
● Nigeria - 10% (Trop Doct 2007;37:32)

● Countries with high donor infection rates may process donor blood in vivo with quinine or sulfadoxine-pyrimethamine to kill parasites (Saudi Med J 2006;27:986, Am J Trop Med Hyg 2005;73:1119)

Case reports
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● 69 year old man in Texas with blood donor from Ghana (MMWR Morb Mortal Wkly Rep 2003;52:1075)
● 70 year old man with donor from Cameroon (Swiss Med Wkly 001;131:320)
● 47 year old woman with striking fever (Mikrobiyol Bul 2005;39:101)
● Review of US cases (N Engl J Med 2001;344:1973)
● Canadian cases (CMAJ 2001;164:377)

End of Transfusion Medicine > Tranfusion-transmitted disease > Malaria and transfusion


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