title: Normative evaluation of blood banks in the Brazilian Amazon region in respect to the prevention of transfusion-transmitted malaria.
abstract: OBJECTIVE
  To evaluate blood banks in the Brazilian Amazon region with regard to structure and procedures directed toward the prevention of transfusion-transmitted malaria (TTM).
  
  
  METHODS
  This was a normative evaluation based on the Brazilian National Health Surveillance Agency (ANVISA) Resolution RDC No. 153/2004. Ten blood banks were included in the study and classified as 'adequate' (≥80 points), 'partially adequate' (from 50 to 80 points), or 'inadequate' (<50 points). The following components were evaluated: 'donor education' (5 points), 'clinical screening' (40 points), 'laboratory screening' (40 points) and 'hemovigilance' (15 points).
  
  
  RESULTS
  The overall median score was 49.8 (minimum=16; maximum=78). Five blood banks were classified as 'inadequate' and five as 'partially adequate'. The median clinical screening score was 26 (minimum=16; maximum=32). The median laboratory screening score was 20 (minimum=0; maximum=32). Eight blood banks performed laboratory tests for malaria; six tested all donations. Seven used thick smears, but only one performed this procedure in accordance with Ministry of Health requirements. One service had a Program of External Quality Evaluation for malaria testing. With regard to hemovigilance, two institutions reported having procedures to detect cases of transfusion-transmitted malaria.
  
  
  CONCLUSIONS
  Malaria is neglected as a blood-borne disease in the blood banks of the Brazilian Amazon region. None of the institutions were classified as 'adequate' in the overall classification or with regard to clinical screening and laboratory screening. Blood bank professionals, the Ministry of Health and Health Surveillance service managers need to pay more attention to this matter so that the safety procedures required by law are complied with.
authors.affiliation: Universidade de Brasília (UnB), Brasília, DF, Brazil; Agência Nacional de Vigilância Sanitária (ANVISA), Brasília, DF, Brazil. Electronic address: danielcoradi@gmail.com.
authors.forename: Daniel Roberto Coradi
authors.initials: DR
authors.lastname: Freitas
authors.affiliation: Universidade de Brasília (UnB), Brasília, DF, Brazil.
authors.forename: Elisabeth Carmen
authors.initials: EC
authors.lastname: Duarte
keywords: Blood banks; Blood safety; Donor selection; Health evaluation; Malaria