Asymptomatic infections in blood donors harbouring Plasmodium: an invisible risk detected by molecular and serological tools

Author(s):Show less -

Lima, Giselle F. M. C. ^[1] ; Arroyo Sanchez, Maria C. ^[2] ; Levi, Jose E. ^[3] ; Fujimori, Mahyumi ^[2] ; Caramelo, Luiza da Cruz ^[2] ; Sanchez, Arianni Rondelli ^[2] ; Ramos-Sanchez, Eduardo M. ^[2] ; Inoue, Juliana ^[1] ; Costa-Nascimento, Maria de Jesus ^[4] ; Mendrone Junior, Alfredo ^[3] ; Di Santi, Silvia M. ^{[1, 4]}

Affiliation

^[1] Univ Sao Paulo, Fac Med, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Inst Trop Med, Sao Paulo - Brazil

^[3] Prosangue Blood Ctr Fdn, Sao Paulo - Brazil

^[4] Epidem Dis Control Unit, Sao Paulo - Brazil

• Document type: Journal article
• Source: BLOOD TRANSFUSION; v. 16, n. 1, p. 17-25, 2018.
• Web of Science Citations: 4

Abstract

Background. Transfusion-transmitted malaria due to asymptomatic Plasmodium infections is a challenge for blood banks. There is a lack of data on the prevalence of asymptomatic infected blood donors and the incidence of transfusion-transmitted malaria in low endemicity areas worldwide. We estimated the frequency of blood donors harbouring Plasmodium in an area in which asymptomatic infections have been reported. Material and methods. To estimate the frequency of blood donors harbouring Plasmodium we used microscopy and molecular tools. Serological tests were applied to measure the exposure of candidates to Plasmodium antigens. Venous blood was collected from 91 candidates attending the ``Pro-Sangue{''} Blood Centre Foundation in Sao Paulo, who lived in the municipality of Juquitiba, Sao Paulo, Brazil, where sporadic autochthonous cases of malaria have been described. Blood samples were used for parasitological, molecular and serological studies. Results. Among the 91 samples examined, rare Plasmodium forms were observed in two donors. Genus real-time polymerase chain reaction analysis demonstrated Plasmodium amplification in three candidates and species-specific nested polymerase chain reaction identified P. malariae in two. ELISA-IgG was reactive in 42.9% of samples for P. vivax (Pv-MSP1 19) and in 6.6% for P. falciparum (Pf-Zw). ELISA-IgM was reactive in 2.2% of samples for P. vivax and in 4.4% for P. falciparum. An indirect immunofluorescence assay was reactive for P. malariae in 15.4% of cases. Discussion. Reservoirs of Plasmodium represent a challenge for blood banks, since studies have shown that high levels of submicroscopic infections can occur in low transmission areas. The risk of transfusion-transmitted malaria presented here points to the need to conduct molecular investigations of candidate donors with any positive malarial antibody test. (AU)

• FAPESP's process: 12/18014-5 - Platform for malaria diagnosis applied to samples of blood donors from endemic and non-endemic Brazilian areas processed in pool: determination of the frequency of positivity using serological and molecular markers
• Grantee: Silvia Maria Fátima Di Santi
• Support Opportunities: Regular Research Grants
• FAPESP's process: 14/50093-8 - Prevention of transfusional transmitted malaria in São Paulo State
• Grantee: José Eduardo Levi
• Support Opportunities: Research Grants - Research in Public Policies for the National Health Care System (PP-SUS)