title: Transfusion-transmitted malaria in endemic zone: epidemiological profile of blood donors at the Fundação HEMOAM and use of rapid diagnostic tests for malaria screening in Manaus.
abstract: OBJECTIVE
  With 99% of the cases in Brazil, malaria is endemic in the Amazon region. Transfusion-transmitted malaria, an important risk in endemic areas, has been reported. The aim of this study was to describe the epidemiological profile of blood donor candidates at the Fundação de Hematologia e Hemoterapia do Amazonas and evaluate the efficacy of rapid diagnostic tests used for malaria screening of blood donors within endemic regions.
  
  
  METHODS
  Between May 2008 and May 2009, 407 blood donor candidates were selected and grouped based on the Malaria Annual Parasite Index of the geographic area in which they originated: Group 1 (eligible donors - n=265) originated from areas of low to medium risk of exposure to malaria and Group 2 (ineligible donors - n=142) originated from high-risk areas. All samples were concurrently screened using two immunochromatic antigen-based rapid tests and by the thick smear test.
  
  
  RESULTS
  All samples were negative by all three methods. The demographic profile indicated that the majority of participants were male, ages ranged from 18 to 39 years and less than half the candidates had only elementary schooling. Two issues need to be addressed: one is the ineligibility of donors and its impact on blood donor centers as, in this study, 22.7% of the donors were considered ineligible. The other is the limited sensitivity of the parasitological tests used, allowing a risk of false-negative results.
  
  
  CONCLUSIONS
  New methods are needed to ensure transfusion safety without rejecting potential donors, which would ensure safe transfusion without harming the blood supply.
authors.affiliation: Fundação Centro de Controle de Oncologia do Amazonas, Manaus, AM, Brazil; Fundação Hospitalar de Hematologia e Hemoterapia, Manaus, AM, Brazil; Universidade Federal do Amazonas, Manaus, AM, Brazil. Electronic address: katialuztorres@hotmail.com.
authors.forename: Kátia Luz
authors.initials: KL
authors.lastname: Torres
authors.affiliation: Fundação Hospitalar de Hematologia e Hemoterapia, Manaus, AM, Brazil; Universidade Federal do Amazonas, Manaus, AM, Brazil.
authors.forename: Mônica Nascimento
authors.initials: MN
authors.lastname: Dos Santos Moresco
authors.affiliation: Fundação Centro de Controle de Oncologia do Amazonas, Manaus, AM, Brazil; Universidade Federal do Amazonas, Manaus, AM, Brazil.
authors.forename: Luciane Rodrigues
authors.initials: LR
authors.lastname: Sales
authors.affiliation: Fundação Hospitalar de Hematologia e Hemoterapia, Manaus, AM, Brazil.
authors.forename: Josilene
authors.initials: J
authors.lastname: da Silva Abranches
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil; Universidade do Estado do Amazonas, Manaus, AM, Brazil.
authors.forename: Márcia Almeida
authors.initials: MA
authors.lastname: Araújo Alexandre
authors.affiliation: Fundação Hospitalar de Hematologia e Hemoterapia, Manaus, AM, Brazil; Universidade Federal do Amazonas, Manaus, AM, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Malheiro
keywords: Immunochromatography; Malaria; Microscopy; Risk factors