The Role of Blood Operators and Transfusion Services in Preventing and Responding to Transfusion-transmitted Malaria

Program Chair(s)

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  Steven Drews, PhD FCCM D(ABMM) (he/him/his)

  Associate Director, Microbiology, Canadian Blood Services
  Donation Policy and Studies, Canadian Blood Services; Professor, Division of Diagnostic and Applied Microbiology, University of Alberta, Edmonton, AB, Canada.
  Edmonton, Alberta, Canada

  Disclosure(s): Abbott: Grant/Research Support (Terminated, March 30, 2022); Danaher/Cepheid: Honoraria (Ongoing); Roche: Consultant/Advisory Board (Terminated, March 30, 2023)

Speaker(s)

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  Susan Nahirniak, MD, FRCPC (she/her/hers)

  Medical Director & Professor
  Transfusion and Transplantation Medicine, Alberta Precision Laboratories & Laboratory Medicine & Pathology, University of Alberta
  Edmonton, Alberta, Canada

  Disclosure(s): No financial relationships to disclose

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  Rita Reik, MD FCAP (she/her/hers)

  Chief Medical Officer
  OneBlood
  Fort Meade, Florida, United States

  Disclosure(s): Creative Testing Solutions: Consultant/Advisory Board (Ongoing); OneBlood, Inc.: Full-time/Part-time Employee or Owner (Ongoing)

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Session Desription: Malaria is caused by intra erythrocytic parasites from the genus Plasmodium. In the natural world, Plasmodium is transmitted to humans via the bite of an infected female Anopheles mosquito. Autochthonous cases occur sporadically in Europe and the United States, yet malaria in Western countries usually occurs after travel/residence in an endemic region. Asymptomatic blood donors are a source of Plasmodium infected erythrocytes- leading to transfusion-transmitted malaria (TTM)- usually from whole blood, and red blood cell concentrates (RBC). TTM is rare yet lead to more severe disease/death than natural infection if not timely managed.
Global climate change and shifting malaria epidemiology challenges blood operators and transfusion medicine practitioners. In non-endemic regions, TTM can be overlooked by clinicians and laboratorians. Blood donor screening questions focussed on malaria disease have poor sensitivity/specificity. Serologic donor testing has strengths and weaknesses and only modest uptake worldwide. Most industrialized countries lack regulator-approved Plasmodium nucleic acid screening tests (NAT). Questions exist on whether NATs can detect the lowest infectious dose of Plasmodium in blood products. Clinicians may lack strategies on managing healthy donors with Plasmodium positive test results from a blood operator.
The session will provide unique perspectives from a blood operator working in a region with re-emergent endemic malaria and a transfusion medicine specialist investigating a pediatric TTM in a non-emergent region. Attendees will be engaged using polling questions and a Q&A period. Response to polling questions and general comments will be documented used in other knowledge translation activities. Attendees will develop insights on how to plan for changing malaria epidemiology, evaluate malaria transfusion-transmission risk mitigation options, and educate the broader medical/scientific community on transfusion-transmitted malaria.