Department of Paediatrics, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria.
PLoS One. 2018 Apr 3;13(4):e0195319. doi: 10.1371/journal.pone.0195319. eCollection 2018.
Sick neonates in malaria endemic areas are frequently transfused with donor blood unscreened for malaria parasite. Consequently, they are at risk of transfusional malaria which can lead to increased neonatal mortality. The study aimed to determine the burden of transfusional malaria in neonates to help in policy formulation on prevention of transfusional malaria.
One hundred and sixty four neonates admitted into the neonatal unit of a tertiary hospital over a 10 month period who were scheduled for blood transfusion were screened for malaria parasites pre-transfusion, at three and 14 days post transfusion using Giemsa stained thick and thin films. Donor blood was screened for malaria parasites at the point of transfusion. Neonates who developed malaria parasitaemia post transfusion were followed up for signs of malaria.
All recruited neonates tested negative to malaria parasite pre- transfusion. One hundred and twenty (73.2%) were term neonates with 94(57.3%) aged 1-7days. Four (2.4%) neonates developed malaria parasitaemia three days post transfusion and all four developed fever that resolved on treatment for malaria. Three (1.8%) of 164 donor blood samples had malaria parasitaemia and all three (100%) neonates who were transfused with the infected donor blood developed malaria parasitaemia post transfusion. However, one neonate who developed malaria parasitaemia post transfusion was transfused with non-infected donor blood.
The prevalence of transfusional malaria in this study is low (2.4%). However, 100% of neonates who received malaria infected donor blood developed transfusional malaria. We therefore recommend routine screening of donor pre-transfusion, testing of neonates who develop fever post transfusion and treatment of those who test positive to malaria.
疟疾流行地区的患病新生儿经常输注未经疟疾寄生虫筛查的供体血液。因此，他们有发生输血性疟疾的风险，这可能导致新生儿死亡率增加。本研究旨在确定新生儿输血性疟疾的负担，以帮助制定预防输血性疟疾的政策。
在 10 个月的时间里，我们对一家三级医院新生儿病房中 164 名计划输血的新生儿进行了输血前、输血后 3 天和 14 天的厚、薄血涂片吉氏染色疟原虫筛查。在输血时筛查供体血液中的疟原虫。对输血后发生疟疾寄生虫血症的新生儿进行了疟疾相关症状的随访。
所有入组的新生儿输血前均未检测到疟原虫。120 名（73.2%）为足月新生儿，其中 94 名（57.3%）为 1-7 天龄。4 名（2.4%）新生儿在输血后 3 天发生疟疾寄生虫血症，所有 4 名新生儿均出现发热，经疟疾治疗后缓解。3 份（1.8%）供体血样本有疟原虫，所有接受感染供体血输注的 3 名（100%）新生儿在输血后均发生疟疾寄生虫血症。然而，1 名发生疟疾寄生虫血症的新生儿输注了非感染供体血。
本研究中输血性疟疾的患病率较低（2.4%）。然而，接受感染疟原虫供体血的新生儿 100%发生输血性疟疾。因此，我们建议常规筛查供体输血前、对输血后发热的新生儿进行检测，并对疟原虫检测阳性的新生儿进行治疗。
