Pinheiro Thereza Cristina Picado, Santos Sabrina Silva, Simião Fernanda Moura El Bayet, Mello Aline Rosa de Lavigne, Pimentel Cinara de Barros, Lomonaco Leonardo Assad, Alvarez Patrícia, Daniel-Ribeiro Cláudio Tadeu, Koifman Rosalina Jorge, Ferreira-da-Cruz Maria de Fátima
Universidade Federal do Acre, Programa de Pós-Graduação em Saúde Coletiva, Rio Branco, AC, Brasil.
Centro de Hematologia e Hemoterapia do Acre, Hemoacre, Rio Branco, AC, Brasil.
Mem Inst Oswaldo Cruz. 2024 Dec 9;119:e240109. doi: 10.1590/0074-02760240109. eCollection 2024.
Although blood transfusion is an essential therapeutic procedure, it can present risks, including transmitting infectious diseases, such as malaria. In Acre, the thick blood smear microscopic examination (TBS) is used to screen infected malaria blood donors. However, TBS has low sensitivity for detecting Plasmodium in situations of low parasitaemia, such as those presented by asymptomatic clinically healthy individuals.
To investigate the pertinence of using polymerase chain reaction (PCR) to detect malarial infection for screening blood donors in Cruzeiro do Sul, Acre, an endemic high-risk malaria area in the Legal Amazon.
A cross-sectional study was conducted among individuals eligible and ineligible to be blood donors, according to clinical and epidemiological criteria. Besides the mandatory screening of HCV, HBV, and HIV tests, malaria PCR and TBS were also carried out on all blood donor candidates who attended the Cruzeiro do Sul Blood Centre from July to September 2022.
Of the 230 participants, 209 (91%) were eligible for blood donation by clinical-epidemiological screening. Surprisingly, no blood donor candidate reported a history of malaria. All TBS microscopic tests were negative at the time of recruitment. However, samples from four blood donor candidates (two eligible by clinical and epidemiological malaria criteria and two ineligible by hypertension and recent tattoo) were positive by Plasmodium and P. vivax molecular tests.
Malaria molecular techniques for screening blood donors should be introduced in the Brazilian Blood Centres to maximise recipient safety. Furthermore, selecting zero-risk donors could pave the way to build a transmissible malaria-free environment in the blood bank context in the near future.
尽管输血是一项必不可少的治疗手段，但它也存在风险，包括传播传染病，如疟疾。在阿克里州，采用厚血涂片显微镜检查（TBS）来筛查感染疟疾的献血者。然而，TBS在检测低疟原虫血症情况下的疟原虫时灵敏度较低，比如无症状的临床健康个体所呈现的情况。
调查在南克鲁塞罗（位于亚马孙法定地区的疟疾高流行风险地区阿克里州）使用聚合酶链反应（PCR）检测疟疾感染以筛查献血者的相关性。
根据临床和流行病学标准，对符合和不符合献血条件的个体进行了一项横断面研究。除了对丙型肝炎病毒、乙型肝炎病毒和艾滋病毒检测进行强制性筛查外，2022年7月至9月期间前往南克鲁塞罗血液中心的所有献血候选者还进行了疟疾PCR检测和TBS检测。
在230名参与者中，209名（91%）通过临床流行病学筛查符合献血条件。令人惊讶的是，没有献血候选者报告有疟疾病史。在招募时，所有TBS显微镜检测结果均为阴性。然而，四名献血候选者（两名根据临床和流行病学疟疾标准符合条件，两名因高血压和近期纹身不符合条件）的样本经疟原虫和间日疟原虫分子检测呈阳性。
巴西血液中心应引入用于筛查献血者的疟疾分子技术，以最大限度地保障受血者安全。此外，选择零风险献血者可为在不久的将来在血库环境中营造无疟疾传播环境铺平道路。
