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Harley RJ, Tonetti L. Transfusion-Transmitted Malaria: Two Pediatric Cases Reinforce the Need for Hemovigilance in a Globalized World. J Pediatric Infect Dis Soc 2022; 11:119-120. [PMID: 34939653 DOI: 10.1093/jpids/piab101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/13/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Robert J Harley
- Donor and Product Safety Policy Unit, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
| | - Laura Tonetti
- Scientific Affairs, American Red Cross, Rockville, Maryland, USA
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Thompson JM, Eick SM, Dailey C, Dale AP, Mehta M, Nair A, Cordero JF, Welton M. Relationship Between Pregnancy-Associated Malaria and Adverse Pregnancy Outcomes: a Systematic Review and Meta-Analysis. J Trop Pediatr 2020; 66:327-338. [PMID: 31598714 DOI: 10.1093/tropej/fmz068] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Pregnancy-associated malaria (PAM) has been associated with adverse pregnancy outcomes like preterm birth (PTB) and low birthweight (LBW), which are among the leading causes of infant mortality globally. Rates of PTB and LBW are high in countries with a high burden of malaria. PAM may be a contributing factor to PTB and LBW, but is not well understood. METHODS We conducted a systematic review and meta-analysis of studies examining the relationship between PAM and PTB or LBW using PubMed. The title and abstract of all studies were screened by two reviewers, and the full text of selected studies was reviewed to ensure they met inclusion criteria. Information regarding study characteristics and of PTB and LBW births among women with and without PAM was abstracted for included studies. RESULTS Our search terms yielded 2237 articles, of which 18 met our final inclusion criteria. Eight studies examined associations between PAM and PTB, and 10 examined associations between PAM and LBW (population size ranging from 35 to 9956 women). The overall risk of LBW was 63% higher among women with PAM compared with women without PAM (95% CI = 1.48-1.80) and the risk of PTB was 23% higher among women with PAM compared with women without PAM (95% CI = 1.07-1.41). CONCLUSIONS These results indicate that infection with PAM is associated with PTB and LBW. Further understanding of the pathogenesis of disease and the immunologic changes that occur during pregnancy is essential for reducing the disproportional effects this disease has on this vulnerable population.
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Affiliation(s)
- Julie M Thompson
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, 30605 Athens, GA, USA.,College of Veterinary Medicine, University of Georgia, 30602 Athens, GA, USA
| | - Stephanie M Eick
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Services, University of California, San Francisco, 94158 San Francisco, CA, USA
| | - Cody Dailey
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, 30605 Athens, GA, USA.,Odum School of Ecology, University of Georgia, 30602 Athens, GA, USA
| | - Ariella P Dale
- Colorado Department of Public Health & Environment, 80246 Denver, CO, USA
| | - Mansi Mehta
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, 30605 Athens, GA, USA
| | - Anjali Nair
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, 30605 Athens, GA, USA
| | - José F Cordero
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, 30605 Athens, GA, USA
| | - Michael Welton
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, 30605 Athens, GA, USA
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Makanjuola RO, Taylor-Robinson AW. Improving Accuracy of Malaria Diagnosis in Underserved Rural and Remote Endemic Areas of Sub-Saharan Africa: A Call to Develop Multiplexing Rapid Diagnostic Tests. SCIENTIFICA 2020; 2020:3901409. [PMID: 32185083 PMCID: PMC7060414 DOI: 10.1155/2020/3901409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/04/2020] [Indexed: 06/10/2023]
Abstract
Clinical infection with malaria, caused by parasites of the genus Plasmodium, is considered a serious medical condition with the potential to become a life-threatening emergency. This is especially relevant to low-income countries in tropical and subtropical regions of the world where high rates of malaria-related morbidity and mortality are recorded. As a means to combat this major global public health threat, rapid and effective diagnosis remains the frontline action to initiate a timely and appropriate medical intervention. From all the approaches to parasite detection, rapid diagnostic tests, so-called RDTs, are the easiest to use and most cost-effective. However, some of the limitations inherent in this methodology could hinder effective patient treatment. A primary drawback is that the vast majority of commercially available RDTs detect only one of the five species of human malaria, P. falciparum. While this is the main cause of infection in many areas, it excludes the possibility of infection with another parasite (P. vivax, P. ovale, P. malariae, and P. knowlesi) or of mixed infections containing different species. Hence, a diagnosis of non-P. falciparum malaria is missed. In turn, in resource-constrained settings where optimal microscopy is not available, a misdiagnosis of bacterial infection based on signs and symptoms alone often results in an inappropriate prescription of antibiotics. Here, we discuss how effective diagnosis of malaria and indiscriminate use of antibiotics in sub-Saharan Africa, a hot spot for P. falciparum transmission, may both be addressed by the development of innovative multiplexing RDTs that detect two or more species of Plasmodium.
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Affiliation(s)
- Rasheed O. Makanjuola
- Department of Biology and Biotechnology, University of Pavia, Lombardy, Italy
- Department of Microbiology, Edo University, Iyamho, Edo State, Nigeria
| | - Andrew W. Taylor-Robinson
- Infectious Diseases Research Group, School of Health, Medical & Applied Sciences, Central Queensland University, Brisbane, Australia
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Faddy HM, Rooks KM, Irwin PJ, Viennet E, Paparini A, Seed CR, Stramer SL, Harley RJ, Chan HT, Dennington PM, Flower RLP. No evidence for widespread Babesia microti transmission in Australia. Transfusion 2019; 59:2368-2374. [PMID: 31070793 DOI: 10.1111/trf.15336] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND A fatal case of autochthonous Babesia microti infection was reported in Australia in 2012. This has implications for Australian public health and, given that babesiosis is transfusion transmissible, has possible implications for Australian blood transfusion recipients. We investigated the seroprevalence of antibodies to B. microti in Australian blood donors and in patients with clinically suspected babesiosis. STUDY DESIGN AND METHODS Plasma samples (n = 7,000) from donors donating in at-risk areas and clinical specimens from patients with clinically suspected babesiosis (n = 29) were tested for B. microti IgG by immunofluorescence assay (IFA). IFA initially reactive samples were tested for B. microti IgG and IgM by immunoblot and B. microti DNA by polymerase chain reaction. RESULTS Although five donors were initially reactive for B. microti IgG by IFA, none was confirmed for B. microti IgG (zero estimate; 95% confidence interval, 0%-0.05%) and all were negative for B. microti DNA. None of the patient samples had B. microti IgG, IgM, or DNA. CONCLUSIONS This study does not provide evidence for widespread exposure to B. microti in Australian blood donors at local theoretical risk, nor does it provide evidence of B. microti infection in Australian patients with clinically suspected babesiosis. Given that confirmed evidence of previous exposure to B. microti was not seen, these data suggest that transmission of this pathogen is currently uncommon in Australia and unlikely to pose a risk to transfusion safety at present.
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Affiliation(s)
- Helen M Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia.,School of Biomedical Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Kelly M Rooks
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Peter J Irwin
- Murdoch University, Perth, Western Australia, Australia
| | - Elvina Viennet
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | | | - Clive R Seed
- Clinical Services and Research, Australian Red Cross Blood Service, Perth, Western Australia, Australia
| | - Susan L Stramer
- American Red Cross Scientific Affairs, Gaithersburg, Maryland
| | - Robert J Harley
- Clinical Services and Research, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Hiu-Tat Chan
- Clinical Services and Research, Australian Red Cross Blood Service, Melbourne, Victoria, Australia
| | - Peta M Dennington
- Clinical Services and Research, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
| | - Robert L P Flower
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
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Portugal-Calisto D, Ferreira AR, Silva MS, Teodósio R. Post-exposure serological responses to malaria parasites in potential blood donors. Malar J 2016; 15:548. [PMID: 27829450 PMCID: PMC5103439 DOI: 10.1186/s12936-016-1586-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/28/2016] [Indexed: 11/29/2022] Open
Abstract
Background Cases of transfusion-transmitted malaria have been described around the world and highlighted in some studies. Semi-immune individuals are more likely to transmit malaria as they may be asymptomatic. Some countries allow blood donations only based on epidemiological criteria while others reinforce their criteria with serological tests. However, little is known about the longevity of anti-Plasmodium spp. antibodies and its meaning in blood donation. Therefore, this study aims to assess the longevity of different subclasses of anti-Plasmodium spp. antibodies in individuals with previous stays in endemic areas, as well as to assess how those antibodies are related to personal features and travel characteristics. Based on those results, the suitability of the Portuguese blood donors screening method was addressed, i.e. the method to search for an eventual risk of transfusion–transmitted malaria among the population studied. Results Statistical associations were found between the presence of total anti-Plasmodium spp. antibodies and some travel characteristics, namely to be born in endemic area versus non endemic and previous episodes of malaria. The intersection between seropositive results and the last year of stay in endemic areas showed a longer longevity of anti-Plasmodium spp. antibodies than previously reported. Those results represented a considerable portion of the individuals having returned from their last stay in endemic areas more than 10 years before enrolment in this study. Considering the study population as potential blood donors, serological results also indicated that if epidemiological criteria alone were applied to screen blood donors, an important percentage of seropositive individuals would be approved for blood donation. Because the nature and meaning of those antibodies in the blood donation context is still not understood, those approved individuals could represent a risk for blood transfusion safety. Conclusions The place of birth and past episodes of malaria seem to be related to the serological outcome. Epidemiological criteria to screen potential blood donors are insufficient to guarantee the safety of the blood, if applied alone. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1586-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniela Portugal-Calisto
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008, Lisbon, Portugal
| | - Ana Raquel Ferreira
- Instituto Português do Sangue e da Transplantação, Parque de Saúde de Lisboa, Av. do Brasil, 53-Pav. 17, 1749-005, Lisbon, Portugal
| | - Marcelo Sousa Silva
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008, Lisbon, Portugal. .,Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Universidade Federal do Rio Grande do Norte, Campus Universitário Lagoa Nova, Natal, 59078-970, Brazil. .,Programa de Pós-graduação em Bioquímica, Universidade Federal do Rio Grande do Norte, Campus Universitário Lagoa Nova, Natal, 59078-970, Brazil.
| | - Rosa Teodósio
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008, Lisbon, Portugal.
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The Epidemiology of Imported Malaria and Transfusion Policy in 5 Nonendemic Countries. Transfus Med Rev 2015; 29:162-71. [PMID: 25933591 DOI: 10.1016/j.tmrv.2015.03.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/13/2015] [Accepted: 03/20/2015] [Indexed: 01/20/2023]
Abstract
Addressing risk of imported malaria is complicated by 5 human species of Plasmodium, semi-immunity in donors with long-term exposure, increasing travel and immigration, changing risk in endemic areas, and limitations of screening assays. To gain insight into policy formulation, we have compiled epidemiologic data from 5 countries with different policies involving either deferral (the United States and Canada) or selective testing (France, England, and Australia). The greatest risk is from semi-immune former residents of endemic areas, but the greatest impact on sufficiency (donor loss) is from low-risk short-term travel. France and the UK have the highest rates of travel to Africa where most malaria cases originate. The UK has substantial travel to the Indian subcontinent where Plasmodium vivax cases are more common, and Australia, to Southeast Asia and Papua New Guinea. In the United States and Canada, malaria risk travel is more often to lower risk areas such as Mexico and the Caribbean. Each country has imported cases, predominantly Plasmodium falciparum and P. vivax, although data are incomplete. Transfusion-transmitted malaria has been rare over the last 10 years, generally involving P. falciparum, but there were 2 US cases of Plasmodium malariae. Uncertainty due to limitations of epidemiologic data and reliance on donors' answers underpins much of the complexity of policy formulation. Variability in policies between countries reflects not only epidemiologic differences but also operational considerations, donor demographics, regulatory approaches, and public pressure to react to rare transfusion-transmitted malaria cases. Testing reduces the operational impact of addressing the very small risk from travelers and offers improvement over deferral by testing all former residents of endemic areas. Notwithstanding current international regulatory requirements, policies have "evolved" through a series of additions and revisions as concerns and issues arose, with resultant variability in donor selection criteria.
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Faddy HM, Prow NA, Fryk JJ, Hall RA, Keil SD, Goodrich RP, Marks DC. The effect of riboflavin and ultraviolet light on the infectivity of arboviruses. Transfusion 2014; 55:824-31. [PMID: 25370822 DOI: 10.1111/trf.12899] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 08/29/2014] [Accepted: 09/01/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Arboviruses are an emerging threat to transfusion safety and rates of infection are likely to increase with the increased rainfall associated with climate change. Arboviral infections are common in Australia, where Ross River virus (RRV), Barmah Forest virus (BFV), and Murray Valley encephalitis virus (MVEV), among others, have the potential to cause disease in humans. The use of pathogen reduction technology (PRT) may be an alternative approach for blood services to manage the risk of arboviral transfusion transmission. In this study, the effectiveness of the Mirasol PRT (Terumo BCT) system at inactivating RRV, BFV, and MVEV in buffy coat (BC)-derived platelets (PLTs) was investigated. STUDY DESIGN AND METHODS BC-derived PLT concentrates in additive solution (SSP+) were spiked with RRV, BFV, or MVEV and then treated with the Mirasol PRT system. The level of infectious virus was determined before and after treatment, and the reduction in viral infectivity was calculated. RESULTS Treatment with PRT (Mirasol) reduced the amount of infectious virus of all three arboviruses. The greatest level of inactivation was observed for RRV (2.33 log; 99.25%), followed by BFV (1.97 log; 98.68%) and then MVEV (1.83 log; 98.42%). CONCLUSION Our study demonstrates that treatment of PLT concentrates with PRT (Mirasol) reduces the infectious levels of RRV, BFV, and MVEV. The relevance of the level of reduction required to prevent disease transmission by transfusion has not been fully defined and requires further investigation. In the face of a changing climate, with its associated threat to blood safety, PRT represents a proactive approach for maintaining blood safety.
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Affiliation(s)
- Helen M Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Natalie A Prow
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jesse J Fryk
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Roy A Hall
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | | | | | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
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