title: Transfusion-transmitted malaria in Ghana.
abstract: BACKGROUND
  In sub-Saharan Africa, the prevalence of malaria parasitemia in blood donors varies from 0.6% to 50%. Although the burden of TTM in malaria-endemic countries is unknown, it is recommended that all donated blood is screened for malaria parasites. This study aimed to establish the incidence of TTM and identify a suitable screening test.
  
  
  METHODS
  Pregnant women, children, and immunocompromised malaria-negative transfusion recipients in a teaching hospital in Ghana were recruited over the course of 1 year. Parasites detected in recipients within 14 days of the transfusion were genotyped and compared to parasites in the transfused blood. The presence of genotypically identical parasites in the recipient and the transfused blood confirmed transfusion-transmitted malaria. Four malaria screening tests were compared to assess their usefulness in the context of African blood banks.
  
  
  RESULTS
  Of the 50 patients who received transfusions that were positive for Plasmodium falciparum by polymerase chain reaction (PCR), 7 recipients developed PCR-detectable parasitemia. In only 1 of the 50 recipients (2%) was the parasite identical to that in the transfused blood. The prevalence of P. falciparum malaria in transfused blood was 4.7% (21/445) by microscopy, 13.7% (60/440) by rapid diagnostic test, 18% (78/436) by PCR, and 22.2% (98/442) by enzyme immunoassay.
  
  
  CONCLUSIONS
  Although malaria parasites are commonly detected in blood donors in malaria-endemic areas, transfusion-transmitted malaria occurs infrequently. Policies recommend screening blood donors for malaria, but none of the commonly used methods is sufficiently sensitive to be used by blood banks in malaria-endemic countries.
authors: Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana. owusu_ofori@yahoo.com
authors: Alex K
authors: AK
authors: Owusu-Ofori
authors: Martha
authors: M
authors: Betson
authors: Christopher M
authors: CM
authors: Parry
authors: J Russell
authors: JR
authors: Stothard
authors: Imelda
authors: I
authors: Bates
mesh_terms: D000293:Adolescent; D000328:Adult; D001782:Blood Donors; D001803:Blood Transfusion / Q000592:standards / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019353:Endemic Diseases; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007118:Immunoassay; D015994:Incidence; D007223:Infant; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008853:Microscopy; D008875:Middle Aged; D018512:Parasitemia / Q000175:diagnosis / Q000469:parasitology / Q000635:transmission; D010274:Parasitology / Q000379:methods*; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D065227:Transfusion Reaction
keywords: Plasmodium falciparum; Transfusion-transmitted malaria; blood donor; blood transfusion; screening