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Strategy to improve malaria surveillance system preventing transfusion-transmitted malaria in blood banks using molecular diagnostic

By Pierre Bush, PhD Moderator | 03 Oct, 2018

Dear Colleagues,
Surveillance is an important component of the elements required in the implementation of the strategies for the control, and the elimination of malaria. One way malaria parasites are transmitted is by transfusion of infected Red Blood Cells from an asymptotic donor. How effective is the program for screening donors' Red Blood Cells for transfusion at your institutions (or your suppliers)?

Attached is an example of how it's done by molecular techniques on Mitochondrial DNA (mtDNA) using real time Polymerase Chain Reaction (mt-qPCR) in some blood banks in Brazil (Batista-dos-Santos et al. (2018). https://doi.org/10.1186/s12936-018-2486-z
Highest Regards,

Abstract
Background
Malaria can be transmitted by blood transfusion through donations collected from asymptomatic or parasitic donors. The parasites are released into the bloodstream during its life cycle and will therefore be present in donated blood by infected individuals. All cases of transfusion-transmitted malaria (TTM) notified since 2005 in Brazil were fatal. A good screening tool for Plasmodium spp. detection in blood units must have a high detection threshold, and the prevention of TTM relies entirely on the exclusion of potentially infected donors. However, in Brazilian blood banks, the screening test relies on blood thick smears examination.

Methods
The molecular diagnostic based on mitochondrial DNA (mtDNA) using real time PCR (mt-qPCR) was improved to detect Plasmodium falciparum, Plasmodium vivax, and standardized for use in Plasmodium malariae. The analytic sensitivity of this mt-qPCR methodology was performed using a sample of P. vivax.

Results
The mt-qPCR was highly efficient, and the analytic sensitivity for P. vivax was determined (0.000006 parasites/µL). This method was tested to detect P. vivax and P. falciparum in individuals from two malaria-endemic areas in Brazil, Amazon region (Pará and Rondônia states), the samples were collected in 10 reference units of two blood banks (Pará/nine cities and Rondônia/Porto Velho), and parasites mtDNA were detected in 10 of 2224 potential blood donors (0.45%). In all 10 positive samples, only P. vivax was detected.

Conclusion
Molecular diagnostic using mt-qPCR was effective in revealing infected potential donors with good perspectives to be applied as screening routine of asymptomatic carriers for preventing transfusion-transmitted malaria in blood banks.

Attached resource:
 

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