Transfusional malaria in the neonatal period in Lagos, South-West Nigeria

Abstract

Background and objectivesSick neonates in malaria endemic areas are frequently transfused with donor blood unscreened for malaria parasite. Consequently, they are at risk of transfusional malaria which can lead to increased neonatal mortality. The study aimed to determine the burden of transfusional malaria in neonates to help in policy formulation on prevention of transfusional malaria.Materials and methodsOne hundred and sixty four neonates admitted into the neonatal unit of a tertiary hospital over a 10 month period who were scheduled for blood transfusion were screened for malaria parasites pre-transfusion, at three and 14 days post transfusion using Giemsa stained thick and thin films. Donor blood was screened for malaria parasites at the point of transfusion. Neonates who developed malaria parasitaemia post transfusion were followed up for signs of malaria.ResultsAll recruited neonates tested negative to malaria parasite pre- transfusion. One hundred and twenty (73.2%) were term neonates with 94(57.3%) aged 1-7days. Four (2.4%) neonates developed malaria parasitaemia three days post transfusion and all four developed fever that resolved on treatment for malaria. Three (1.8%) of 164 donor blood samples had malaria parasitaemia and all three (100%) neonates who were transfused with the infected donor blood developed malaria parasitaemia post transfusion. However, one neonate who developed malaria parasitaemia post transfusion was transfused with non-infected donor blood.ConclusionsThe prevalence of transfusional malaria in this study is low (2.4%). However, 100% of neonates who received malaria infected donor blood developed transfusional malaria. We therefore recommend routine screening of donor pre-transfusion, testing of neonates who develop fever post transfusion and treatment of those who test positive to malaria.

Transfusional Malaria and Associated Factors at the National Blood Transfusion Center of Niamey-Niger

“…Currently this strategy is the most used in developing countries because it has the best cost-benefit ratio. Finally, posttransfusion screening of transfused patients can be used during clinical investigations to assess the extent of transfusion-transmitted malaria [26].…”

Opportunities and challenges of pharmacovigilance in special populations: a narrative review of the literature

“…This group can be further divided into several subgroups, including neonates (0-28 days old), infants (0-3 years old), those in early childhood (1-7 years old), and juveniles (7-14 years old). [17][18][19][20][21] For children, it is not sufficient to simply regard them as miniature adults [Figure 1(a)]. Drug pharmacokinetics (PK) and pharmacodynamics (PD) observed in children are different from those observed in adults.…”

Malaria

“…Einige aktuellere Studien haben sich mit der transfusionsassoziierten Malaria in endemischen, vor allem afrikanischen Ländern beschäftigt [82][83][84][85][86][87][88]88]. Die molekulare Typisierung der Parasiten in einer dieser Studien zeigte, dass die wahre Inzidenz der transfusionsassoziierten Malaria wahrscheinlich deutlich geringer ist als eine nachgewiesene Parasitämie bei der Empfängerin oder dem Empfänger [87].…”