title: Transfusion-transmitted malaria: case report of asymptomatic donor harboring Plasmodium malariae.
abstract: Malaria in Brazil is endemic in the Amazon region, but autochthonous cases with low parasitaemia occur in the Atlantic Forest area of the country. According to Brazilian legislation no test is mandatory for blood donors from non-endemic areas. However if they have traveled to malaria transmission regions they are deferred for six months before they can donate. This report describes a transfusion-transmitted malaria case in Sao Paulo, Brazil, where one recipient received infected blood and developed the disease. He lived in Sao Paulo and had no previous transfusion or trips to endemic areas, including those of low endemicity, such as Atlantic Forest. Thick blood smears confirmed Plasmodium malariae. All donors lived in Sao Paulo and one of them (Donor 045-0) showed positive hemoscopy and PCR. This asymptomatic donor had traveled to Juquia, in the Atlantic Forest area of S ao Paulo State, where sporadic cases of autochthonous malaria are described. DNA assay revealed P. malariae in the donor's (Donor 045-0) blood. Serum archives of the recipient and of all blood donors were analyzed by ELISA using both P. vivax and P. falciparum antigens, and IFAT with P. malariae. Donor 045-0's serum was P. malariae IFAT positive and the P. vivax ELISA was reactive. In addition, two out of 44 donors' archive sera were also P. vivax ELISA reactive. All sera were P. falciparum ELISA negative. This case suggests the need of reviewing donor selection criteria and deferral strategies to prevent possible cases of transfusion-transmitted malaria.
authors.affiliation: Banco de Sangue de São Paulo, São Paulo, SP, Brasil.
authors.forename: Patricia
authors.initials: P
authors.lastname: Scuracchio
authors.forename: Sergio Domingos
authors.initials: SD
authors.lastname: Vieira
authors.forename: Denise Albuquerque
authors.initials: DA
authors.lastname: Dourado
authors.forename: Luciana Moro
authors.initials: LM
authors.lastname: Bueno
authors.forename: Rafael
authors.initials: R
authors.lastname: Colella
authors.forename: Eduardo Milton
authors.initials: EM
authors.lastname: Ramos-Sanchez
authors.forename: Giselle F M Castro
authors.initials: GF
authors.lastname: Lima
authors.forename: Juliana
authors.initials: J
authors.lastname: Inoue
authors.forename: Maria Carmen Arroyo
authors.initials: MC
authors.lastname: Sanchez
authors.forename: Silvia Maria
authors.initials: SM
authors.lastname: Di Santi
mesh_terms: D000913:Antibodies, Protozoan / Q000097:blood*; D000953:Antigens, Protozoan / Q000276:immunology*; D058345:Asymptomatic Infections; D006801:Humans; D008288:Malaria / Q000175:diagnosis / Q000635:transmission*; D010965:Plasmodium malariae / Q000276:immunology*; D065227:Transfusion Reaction
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan