Transfusion-transmitted malaria: case report of asymptomatic donor harboring Plasmodium malariae

Scuracchio, Patrícia; Vieira, Sérgio Domingos; Dourado, Denise Albuquerque; Bueno, Luciana Moro; Colella, Rafael; Ramos-Sanchez, Eduardo Milton; Lima, Giselle Fernandes Maciel de Castro; Inoue, Juliana; Sanchez, Maria Carmen Arroyo; Santi, Sílvia Maria Di

doi:10.1590/s0036-46652011000100010

Cited by 47 publications

(48 citation statements)

References 25 publications

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“…Transmission of autochthonous malaria in SP is characterised by sporadic outbreaks in the western region (Andrade et al 1986) and persistent transmission in the eastern region, which is home to the Atlantic Forest biome; here, oligosymptomatic or even asymptomatic cases occur with low levels of parasitaemia caused by P. vivax (Carvalho et al 1985, 1988, Barata 1995, Branquinho et al 1997, Couto et al 2010) and P. malariae (Scuracchio et al 2011). The primary vector in the western region is Anopheles of the subgenus Nyssorhynchus , whereas in the eastern region, transmission occurs mainly due to Anopheles (Kerteszia) cruzii .…”

Section: Malaria In the Extra-amazonian (Non-endemic) Regionmentioning

confidence: 99%

Malaria in Brazil: what happens outside the Amazonian endemic region

Pina-Costa

Brasil

Santi

et al. 2014

Mem. Inst. Oswaldo Cruz

137

172

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Brazil, a country of continental proportions, presents three profiles of malaria transmission. The first and most important numerically, occurs inside the Amazon. The Amazon accounts for approximately 60% of the nation’s territory and approximately 13% of the Brazilian population. This region hosts 99.5% of the nation’s malaria cases, which are predominantly caused by Plasmodium vivax (i.e., 82% of cases in 2013). The second involves imported malaria, which corresponds to malaria cases acquired outside the region where the individuals live or the diagnosis was made. These cases are imported from endemic regions of Brazil (i.e., the Amazon) or from other countries in South and Central America, Africa and Asia. Imported malaria comprised 89% of the cases found outside the area of active transmission in Brazil in 2013. These cases highlight an important question with respect to both therapeutic and epidemiological issues because patients, especially those with falciparum malaria, arriving in a region where the health professionals may not have experience with the clinical manifestations of malaria and its diagnosis could suffer dramatic consequences associated with a potential delay in treatment. Additionally, because the Anopheles vectors exist in most of the country, even a single case of malaria, if not diagnosed and treated immediately, may result in introduced cases, causing outbreaks and even introducing or reintroducing the disease to a non-endemic, receptive region. Cases introduced outside the Amazon usually occur in areas in which malaria was formerly endemic and are transmitted by competent vectors belonging to the subgenus Nyssorhynchus (i.e., Anopheles darlingi, Anopheles aquasalis and species of the Albitarsis complex). The third type of transmission accounts for only 0.05% of all cases and is caused by autochthonous malaria in the Atlantic Forest, located primarily along the southeastern Atlantic Coast. They are caused by parasites that seem to be (or to be very close to) P. vivax and, in a less extent, by Plasmodium malariae and it is transmitted by the bromeliad mosquito Anopheles (Kerteszia) cruzii. This paper deals mainly with the two profiles of malaria found outside the Amazon: the imported and ensuing introduced cases and the autochthonous cases. We also provide an update regarding the situation in Brazil and the Brazilian endemic Amazon.

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Section: Malaria In the Extra-amazonian (Non-endemic) Regionmentioning

confidence: 99%

Malaria in Brazil: what happens outside the Amazonian endemic region

Pina-Costa

Brasil

Santi

et al. 2014

Mem. Inst. Oswaldo Cruz

137

172

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“…Different tests have been used such as microscopy techniques, 50 or rapid antigen detection, 51 however, several reports have shown that PCR is, by far, the most powerful tool for such surveillance. 51,52 Such screening would prevent misdiagnoses of imported malaria cases leading to delayed treatment; would avoid unidentified reservoirs of malaria, which could contribute to local transmission and could also 53,54 avoid congenital, 55 transfusional, 56,57 or organ transplantation-associated transmission. 58,59 Our data found a prevalence of 4.6% among asymptomatic sub-Saharan Africans.…”

Section: Discussionmentioning

confidence: 99%

Screening of Imported Infectious Diseases Among Asymptomatic Sub-Saharan African and Latin American Immigrants: A Public Health Challenge

Monge‐Maíllo¹,

López‐Vélez²,

Norman³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Migrants from developing countries are usually young and healthy but several studies report they may harbor asymptomatic infections for prolonged periods. Prevalence of infections were determined for asymptomatic immigrants from Latin America and sub-Saharan Africa who ettended to a European Tropical Medicine Referral Center from 2000 to 2009. A systematic screening protocol for selected infections was used. Data from 317 sub-Saharan Africans and 383 Latin Americans were analyzed. Patients were mostly young (mean age 29 years); there were significantly more males among sub-Saharan Africans (83% versus 31.6%) and pre-consultation period was longer for Latin Americans (5 versus 42 months). Diagnoses of human immunodeficiency virus (HIV), chronic hepatitis B and C virus infection, and latent tuberculosis were significantly more frequent in sub-Saharan Africans (2.3% versus 0.3%; 14% versus 1.6%; 1.3 versus 0%; 71% versus 32.1%). There were no significant differences in prevalence for syphilis and intestinal parasites. Malaria and schistosomiasis prevalence in sub-Saharan Africans was 4.6% and 5.9%, respectively, and prevalence of Chagas disease in Latin Americans was 48.5%. Identifying and treating asymptomatic imported infectious diseases may have an impact both for the individual concerned and for public health. Based on these results, a systematic screening protocol for asymptomatic immigrants is proposed.

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“…Plasmodium transmission by transfusion usually occurs through whole blood and red blood cells and may occur less frequently through platelet concentrates, white blood cells, cryoprecipitate, and fresh frozen plasma [18,45]. The blood bank is therefore an important target for controlling undesirable Plasmodium transmission in endemic [38,46] and non-endemic regions [43,47]. …”

Section: Discussionmentioning

confidence: 99%

Detection of Plasmodium falciparum and Plasmodium vivax subclinical infection in non-endemic region: implications for blood transfusion and malaria epidemiology

Maselli

Levy

Laporta

et al. 2014

Malar J

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BackgroundIn Brazil, malaria is endemic in the Amazon River basin and non-endemic in the extra-Amazon region, which includes areas of São Paulo state. In this state, a number of autochthonous cases of malaria occur annually, and the prevalence of subclinical infection is unknown. Asymptomatic infections may remain undetected, maintaining transmission of the pathogen, including by blood transfusion. In these report it has been described subclinical Plasmodium infection in blood donors from a blood transfusion centre in São Paulo, Brazil.MethodsIn this cross-sectional study, representative samples of blood were obtained from 1,108 healthy blood donors at the Fundação Pró-Sangue Hemocentro de São Paulo, the main blood transfusion centre in São Paulo. Malaria exposure was defined by the home region (exposed: forest region; non-exposed: non-forest region). Real-time PCR was used to detect Plasmodium falciparum and Plasmodium vivax. Subclinical malaria cases were geo-referenced.ResultsEighty-four (7.41%) blood donors tested positive for Plasmodium; 57 of these were infected by P. falciparum, 25 by P. vivax, and 2 by both. The prevalence of P. falciparum and P. vivax was 5.14 and 2.26, respectively. The overall prevalence ratio (PR) was 3.23 (95% confidence interval (CI) 2.03, 5.13); P. falciparum PR was 16.11 (95% CI 5.87, 44.21) and P. vivax PR was 0.47 (95% CI 0.2, 1.12). Plasmodium falciparum subclinical malaria infection in the Atlantic Forest domain was present in the mountain regions while P. vivax infection was observed in cities from forest-surrounded areas.ConclusionsThe presence of Plasmodium in healthy blood donors from a region known as non-endemic, which is important in the context of transfusion biosafety, was described. Infected recipients may become asymptomatic carriers and a reservoir for parasites, maintaining their transmission. Furthermore, P. falciparum PR was positively associated with the forest environment, and P. vivax was associated with forest fragmentation.

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Transfusion-transmitted malaria: case report of asymptomatic donor harboring Plasmodium malariae

Cited by 47 publications

References 25 publications

Malaria in Brazil: what happens outside the Amazonian endemic region

Malaria in Brazil: what happens outside the Amazonian endemic region

Screening of Imported Infectious Diseases Among Asymptomatic Sub-Saharan African and Latin American Immigrants: A Public Health Challenge

Detection of Plasmodium falciparum and Plasmodium vivax subclinical infection in non-endemic region: implications for blood transfusion and malaria epidemiology

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