Prevalence Of Transfusion-Transmissible Haemoparasites And Associated Disruptions In Serum Iron Profile Among Blood Donors In Ibadan, Nigeria
Keywords:
Blood donors, Haemoparasites, Ibadan, Malaria, Serum iron, TransferrinAbstract
Blood transfusion safety in sub-Saharan Africa remains compromised by transfusion-transmissible haemoparasites that fall outside routine mandatory donor screening. This study evaluated the prevalence of malaria parasitaemia and microfilaraemia among prospective blood donors and examined associated alterations in serum iron and transferrin at the Blood Bank, University College Hospital (UCH), Ibadan, Nigeria. In a descriptive cross-sectional study, 300 apparently healthy prospective donors were recruited using a structured questionnaire. Thick and thin blood films stained with Giemsa were examined for malaria parasites, and Knott's concentration technique was used to detect microfilariae. Serum iron and transferrin were quantified by colorimetric and immunoturbidimetric assay, respectively, on the Roche/Hitachi Cobas C system. Malaria parasitaemia was detected in 51 donors (17.0%) and microfilariae in 4 donors (1.3%); no trypanosomes were identified. Mean serum iron was significantly lower in malaria-positive donors (10.3±3.4 μmol/L) than malaria-negative donors (14.3±4.8 μmol/L, p<0.001), and in microfilaria-positive donors (12.5±0.37 μmol/L) than microfilaria-negative donors (13.6±4.9 μmol/L, p=0.004). Serum transferrin was significantly lower in malaria-positive donors (2.15±0.27 g/L) than malaria-negative donors (2.35±0.77 g/L, p<0.001) but did not differ significantly by microfilaria status. Abnormal serum iron was significantly associated with malaria positivity (χ²=14.400, p<0.001) but not with microfilaria status. These findings demonstrate that occult haemoparasitaemia among asymptomatic blood donors is associated with measurable derangement of iron homeostasis, with implications for donor health and recipient safety. Routine malaria screening should be considered within donor selection algorithms in malaria-endemic transfusion settings.
References
1. World Health Organization. The World Health Report 2002: Reducing Risks, Promoting Healthy Life. Geneva: World Health Organization; 2002.
2. World Health Organization, Global Malaria Programme. World Malaria Report 2011. Geneva: World Health Organization; 2011.
3. Owusu-Ofori AK, Betson M, Parry CM, Stothard JR, Bates I. Transfusion-transmitted malaria in Ghana. Clin Infect Dis. 2013;56(12):1735-41.
4. O'Brien SF, Delage G, Seed CR, Pillonel J, Fabra CC, Davison K. The epidemiology of imported malaria and transfusion policy in 5 non-endemic countries. Transfus Med Rev. 2015;29(3):162-71.
5. Mungai M, Tegtmeier G, Chamberland M, Parise M. Transfusion-transmitted malaria in the United States from 1963 through 1999. N Engl J Med. 2001;344(26):1973-8.
6. Diop S, Ndiaye M, Seck M, Chevalier B, Jambou R, Sarr A, et al. Prévention du paludisme post-transfusionnel en zone d'endémie. Transfus Clin Biol. 2009;16(5-6):454-9.
7. David AL. Transfusion-transmitted Babesia spp.: bull's-eye on Babesia microti. Clin Microbiol Rev. 2011;24(1):14-28.
8. Noubouossie D, Tagny CT, Same-Ekobo A, Mbanya D. Asymptomatic carriage of malaria parasites in blood donors in Yaoundé. Transfus Med. 2012;22(1):63-7.
9. Eder AF, Hillyer CD, Dy BA, Notari EP, Benjamin RJ. Adverse reactions to allogeneic whole blood donation by 16- and 17-year-olds. JAMA. 2008;299(19):2279-86.
10. Røsvik AS, Ulvik RJ, Wentzel-Larsen T, Hervig T. The effect of blood donation frequency on iron status. Transfus Apher Sci. 2009;41(3):165-9.
11. Tietz NW, Rinker AD, Morrison SR. When is serum iron really a serum iron? A follow-up study on the status of iron measurements in serum. Clin Chem. 1996;45(9):1240-3.
12. Wick M, Pinggera W, Lehmann P. Metabolism, Diagnosis and Therapy of Anemias. 5th ed. Vienna: Springer; 1999. [Author note: insert URL and date accessed.]
13. Tangpukdee N, Duangdee C, Wilairatana P, Krudsood S. Malaria diagnosis: a brief review. Korean J Parasitol. 2009;47(2):93-102.
14. Chattopadhyay R, Majam VF, Kumar S. Survival of Plasmodium falciparum in human blood during refrigeration. Transfusion. 2011;51(3):630-5.
15. Contreras CE, De Donato M, Rivas MA, Rodulfo H, Mora R, Batista ME, et al. Malaria seroprevalence in blood bank donors from endemic and non-endemic areas of Venezuela. Mem Inst Oswaldo Cruz. 2011;106(2):123-9.
16. Kitchen AD, Barbara JA, Hewitt PE. Documented cases of post-transfusion malaria occurring in England: a review in relation to current and proposed donor-selection guidelines. Vox Sang. 2005;89(2):77-80.
17. Verra F, Angheben A. A systematic review of transfusion-transmitted malaria in non-endemic areas. Malar J. 2018;17:36.
18. Coura JR, Suárez-Mutis M, Ladeia-Andrade S. A new challenge for malaria control in Brazil: asymptomatic Plasmodium infection - a review. Mem Inst Oswaldo Cruz. 2006;101(3):229-37.
