Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Uganda Cancer Institute, Kampala, Uganda.
Transfusion. 2020 May;60(5):955-964. doi: 10.1111/trf.15775. Epub 2020 Apr 13.
Malaria remains a leading transfusion associated infectious risk in endemic areas. However, the prevalence of malaria parasitemia has not been well characterized in blood donor populations. This study sought to determine the prevalence of Plasmodium in red blood cell (RBC) and whole blood (WB) units after the rainy season in Uganda.
Between May and July 2018, blood was collected from the sample diversion pouch of 1000 WB donors in Kampala and Jinja, Uganda. The RBC pellet from ethylenediamine tetraacetic acid (EDTA) anticoagulated blood was stored at -80°C until testing. DNA was extracted and nested PCR was used to screen samples at the genus level for Plasmodium, with positive samples further tested for species identification.
Malaria parasitemia among asymptomatic, eligible blood donors in two regions of Uganda was 15.4%; 87.7% (135/154) of infections were with P. falciparum, while P. malariae and P. ovale were also detected. There were 4.3% of blood donors who had mixed infection with multiple species. Older donors (>30 years vs. 17-19 years; aPR = 0.31 [95% CI = 0.17-0.58]), females (aPR = 0.60 [95% CI = 0.42-0.87]), repeat donors (aPR = 0.44 [95% CI = 0.27-0.72]) and those donating near the capital city of Kampala versus rural Jinja region (aPR = 0.49 [95% CI = 0.34-0.69]) had a lower prevalence of malaria parasitemia.
A high proportion of asymptomatic blood donors residing in a malaria endemic region demonstrate evidence of parasitemia at time of donation. Further research is needed to quantify the risk and associated burden of transfusion-transmitted malaria (TTM) in order to inform strategies to prevent TTM.
疟疾仍然是流行地区输血相关的主要传染病风险。然而，在献血人群中，疟疾寄生虫血症的流行情况尚未得到很好的描述。本研究旨在确定乌干达雨季过后红细胞（RBC）和全血（WB）单位中疟原虫的流行情况。
2018 年 5 月至 7 月期间，从乌干达坎帕拉和金贾的 1000 名 WB 献血者的样本分流袋中采集血液。EDTA 抗凝血液的 RBC 沉淀在-80°C 下储存，直到检测。提取 DNA 并进行巢式 PCR 检测，以在属水平上筛查疟原虫，对阳性样本进一步进行种属鉴定。
乌干达两个地区无症状合格献血者的疟疾寄生虫血症率为 15.4%；87.7%（135/154）的感染为恶性疟原虫，而也检测到间日疟原虫和卵形疟原虫。有 4.3%的献血者存在多种物种混合感染。年龄较大的献血者（>30 岁与 17-19 岁相比；aPR = 0.31 [95% CI = 0.17-0.58]）、女性（aPR = 0.60 [95% CI = 0.42-0.87]）、重复献血者（aPR = 0.44 [95% CI = 0.27-0.72]）和在首都坎帕拉附近献血者与农村金贾地区相比（aPR = 0.49 [95% CI = 0.34-0.69]），疟疾寄生虫血症的患病率较低。
在疟疾流行地区居住的大量无症状献血者在献血时表现出寄生虫血症的证据。需要进一步研究以量化输血传播疟疾（TTM）的风险和相关负担，以便为预防 TTM 提供策略。
