Premium
Analyzing actual risk in malaria‐deferred donors through selective serologic testing
Author(s) -
Nguyen Megan L.,
Goff Tami,
Gibble Joan,
Steele Whitney R.,
Leiby David A.
Publication year - 2013
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12004
Subject(s) - malaria , medicine , serology , relative risk , immunology , antibody , confidence interval
Background Approximately 150,000 US blood donors are deferred annually for travel to malaria‐endemic areas. However, the majority do not travel to the high‐risk areas of Africa associated with transfusion‐transmitted malaria ( TTM ) but visit low‐risk areas such as M exico. This study tests for Plasmodium infection among malaria‐deferred donors, particularly those visiting M exico. Study Design and Methods Blood donors deferred for malaria risk (travel, residence, or previous infection) provided blood samples and completed a questionnaire. Plasma was tested for Plasmodium antibodies by enzyme immunoassay ( EIA ); repeat‐reactive ( RR ) samples were considered positive and tested by real‐time polymerase chain reaction ( PCR ). Accepted donors provided background testing data. Results During 2005 to 2011, a total of 5610 malaria‐deferred donors were tested by EIA , including 5412 travel deferrals. Overall, 88 (1.6%) were EIA RR ; none were PCR positive. Forty‐nine (55.7%) RR donors previously had malaria irrespective of deferral category, including 34 deferred for travel. Among 1121 travelers to M exico, 90% visited Q uintana R oo (no or very low risk), but just 2.2% visited O axaca/ C hiapas (moderate or high risk). Only two M exican travelers tested RR ; both previously had malaria not acquired in M exico. Conclusions Travel to M exico represents a large percentage of US donors deferred for malaria risk; however, these donors primarily visit no‐ or very‐low‐risk areas. No malaria cases acquired in M exico were identified thereby supporting previous risk estimates. Consideration should be given to allowing blood donations from US donors who travel to Q uintana R oo and other low‐risk areas in M exico. A more effective approach to preventing TTM would be to defer all donors with a history of malaria, even if remote.