Mem Inst Oswaldo Cruz, Rio de Janeiro, VOLUME 119 | 2024
Research Articles

Molecular test for screening malaria-infected blood donors to maximise recipient safety in Acre State, a Brazilian endemic area

Thereza Cristina Picado Pinheiro1,5,+, Sabrina Silva Santos1,2, Fernanda Moura El Bayet Simião3, Aline Rosa de Lavigne Mello4, Cinara de Barros Pimentel5, Leonardo Assad Lomonaco1, Patrícia Alvarez6, Cláudio Tadeu Daniel-Ribeiro4, Rosalina Jorge Koifman1,2, Maria de Fátima Ferreira-da-Cruz4,+

1Universidade Federal do Acre, Programa de Pós-Graduação em Saúde Coletiva, Rio Branco, AC, Brasil
2Fundação Oswaldo Cruz-Fiocruz, Escola Nacional de Saúde Pública Sérgio Arouca, Rio de Janeiro, RJ, Brasil
3Centro de Hematologia e Hemoterapia do Acre, Hemonúcleo de Cruzeiro do Sul, AC, Brasil
4Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Pesquisa em Malária / Centro de Pesquisa, Diagnóstico e Treinamento em Malária, Laboratório de Referência do Ministério da Saúde para Diagnóstico de Malária na Região Extra-Amazônica, Rio de Janeiro, RJ, Brasil
5Centro de Hematologia e Hemoterapia do Acre, Hemoacre, Rio Branco, AC, Brasil
6Fundação Oswaldo Cruz-Fiocruz, Instituto de Tecnologia em Imunobiológicos, Bio-Manguinhos, Rio de Janeiro, RJ, Brasil

DOI: 10.1590/0074-02760240109
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ABSTRACT

BACKGROUND Although blood transfusion is an essential therapeutic procedure, it can present risks, including transmitting infectious diseases, such as malaria. In Acre, the thick blood smear microscopic examination (TBS) is used to screen infected malaria blood donors. However, TBS has low sensitivity for detecting Plasmodium in situations of low parasitaemia, such as those presented by asymptomatic clinically healthy individuals.
OBJECTIVES To investigate the pertinence of using polymerase chain reaction (PCR) to detect malarial infection for screening blood donors in Cruzeiro do Sul, Acre, an endemic high-risk malaria area in the Legal Amazon.
METHODS A cross-sectional study was conducted among individuals eligible and ineligible to be blood donors, according to clinical and epidemiological criteria. Besides the mandatory screening of HCV, HBV, and HIV tests, malaria PCR and TBS were also carried out on all blood donor candidates who attended the Cruzeiro do Sul Blood Centre from July to September 2022.
FINDINGS Of the 230 participants, 209 (91%) were eligible for blood donation by clinical-epidemiological screening. Surprisingly, no blood donor candidate reported a history of malaria. All TBS microscopic tests were negative at the time of recruitment. However, samples from four blood donor candidates (two eligible by clinical and epidemiological malaria criteria and two ineligible by hypertension and recent tattoo) were positive by Plasmodium and P. vivax molecular tests.
MAIN CONCLUSIONS Malaria molecular techniques for screening blood donors should be introduced in the Brazilian Blood Centres to maximise recipient safety. Furthermore, selecting zero-risk donors could pave the way to build a transmissible malaria-free environment in the blood bank context in the near future.

key words: malaria blood donors P. vivax P. falciparum malaria diagnosis
REFERENCES
01. ANVISA - Agência Nacional de Vigilância Sanitária. Produção hemoterápica no Brasil. Dados do Sistema de Informação e Produção Hemoterápica (Hemoprod) de 2020. Brasília. Junho de 2022. Available from: https://app.powerbi.com/view?r=eyJrIjoiMWM4MDQzNDMtYjZjZC00ZTBhLWFkOTctODdiZjE2ODQ4 YTJkIiwidCI6ImI2N2FmMjNmLWMzZjMtNGQzNS04MGM3LWI3MDg1ZjVlZGQ4MSJ9.
02. ANVISA - Agência Nacional de Vigilância Sanitária. 7º Boletim de produção hemoterápica. Hemoprod 2018. Brasília. Janeiro de 2020. Available from: https://www.gov.br/anvisa/pt-br/arquivosnoticias- anvisa/961json-file-1.
03. ANVISA - Agência Nacional de Vigilância Sanitária. Resolução da Diretoria Colegiada 34, de 11 de junho de 2014. Dispõe sobre as Boas Práticas do Ciclo do Sangue. Diário Oficial da União 16 de junho de 2014. Available from: https://inc.saude.gov.br/download/ resolucao-rdc-n-34-de-11-de-junho-de2014.pdf#:~:text=os%20 requisitos%20de%20boas%20pr%C3%A1ticas%20para.
04. MS - Ministério da Saúde. Portaria de Consolidação nº 5, de 28 de setembro de 2017. Consolidação das normas sobre as ações e os serviços de saúde do Sistema Único de Saúde. Diário Oficial da União 03 mai 2021. Available from: http://www.portalsinan. saude.gov.br/images/documentos/Legislacoes/Portaria_Consolidacao_ 5_28_SETEMBRO_2017.pdf.
05. Wu D, Feng F, Wang X, Wang D, Hu Y, Yu Y, et al. The impact of nucleic acid testing to detect human immunodeficiency virus, hepatitis C virus, and hepatitis B virus yields from a single blood center in China with 10-years review. BMC Infect Dis. 2022; 22(1): 279.
06. Batista- dos-Santos SA, Freitas DRC, Raiol M, Cabral GF, Feio AC, Póvoa MM, et al. Strategy to improve malaria surveillance system preventing transfusion-transmitted malaria in blood banks using molecular diagnostic. Malar J. 2018; 17(1): 344.
07. Mpina M, Stabler TC, Schindler T, Raso J, Deal A, Pupu LA, et al. Diagnostica performance and comparison of ultrasensitive and conventional rapid diagnostic test, thick blood smear and quantitative PCR for detection of low density Plasmodium falciparum infections during a controlled human malaria infection study in Equatorial Guinea. Malar J. 2022; 21(1): 99.
08. Rocha D, Melo GC, Carneiro JMH, Ribeiro M, Ribeiro S, Godoy DT, et al. Use of a NAT-based assay to improve the surveillance system and prevent transfusion-transmitted malaria in blood banks. Malar J. 2020; 19(1): 275.
09. Alho RM, Machado KVA, Val FFA, Fraiji NA, Alexandre MAA, Melo GC, et al. Alternative transmission routes in the malaria elimination era: an overview of transfusion-transmitted malaria in the Americas. Malar J. 2017; 16(1): 78.
10. Gama BE, Silva-Pires FES, Lopes MNR, Cardoso MAB, Britto C, Torres KL, et al. Real-time PCR versus conventional PCR for malaria parasite detection in low-grade parasitemia. Exp Parasitol. 2007; 116(4): 427-32.
11. Almeida-de-Oliveira NK, Moreira OC, Lavigne AR, Mendonça- Lima L, Werneck GL, Daniel-Ribeiro CT, et al. Analytical validation of real-time quantitative PCR assays for optimum diagnosis of vivax malaria. Mem Inst Oswaldo Cruz. 2019; 114: e180350.
12. Zalis MG, Ferreira-da-Cruz MF, Balthazar-Guedes HC, Banic DM, Alecrim W, Souza JM, et al. Malaria diagnosis: standardization of a polymerase chain reaction for the detection of Plasmodium falciparum parasites in individuals with low-grade parasitemia. Parasitol Res. 1996; 82(7): 612-6.
13. Snounou G, Singh B. Nested PCR Analysis of Plasmodium Parasites. Methods Mol Med. 2002; 72: 189-203.
14. Abdullah S, Karunamoorthi K. Malaria and blood transfusion: major issues of blood safety in malaria-endemic countries and strategies for mitigating the risk of Plasmodium parasites. Parasitol Res. 2016: 115(1): 35-47.
15. Kitchen AD, Chiodini PL. Malaria and blood transfusion. Vox Sang. 2006: 90(2): 77-84.
16. Verra F, Angheben A, Martello E, Giorli G, Perandin F, Bisoffi Z. A systematic review of transfusion-transmitted malaria in nonendemic areas. Malar J. 2018; 17(1): 36.
17. MS - Ministério da Saúde. Situação epidemiológica da malária [acess 27 mar 2024]. Available from: https://www.gov.br/saude/ptbr/ assuntos/saude-de-a-a-z/m/malaria/situacao-epidemiologicada- malaria#:~:text=No%20Brasil,%20a%20regi%C3%A3o%20 amaz%C3%B4nica%20%C3%A9.
18. MS/SVS - Ministério da Saúde/Secretaria de Vigilância em Saúde. Malária 2020. Boletim Epidemiológico. Available from: file:///C:/ Users/682751/Downloads/boletim_especial_malaria_1dez20_final. pdf.
19. Costa KMM, Almeida WAF, Magalhães IB, Montoya R, Moura MS, Lacerda MVG. Malária em Cruzeiro do Sul (Amazônia Ocidental brasileira): análise da série histórica de 1998 a 2008. Rev Panam Salud Publica. 2010; 28(5): 353-60.
20. Lapouble OMM, Santelli ACFS, Muniz-Junqueira MM. Situação epidemiológica da malária na região amazônica brasileira, 2003 a 2012. Rev Panam Salud Publica. 2015; 38(4): 300-6.
21. Silva RSU, Carvalho FT, Santos AB, Ribeiro ES, Cordeiro KM, Melo GIB, et al. Malária no Município de Cruzeiro do Sul, Estado do Acre, Brasil: aspectos epidemiológicos, clínicos e laboratoriais. Rev Pan-Amaz Saude. 2012; 3(1): 45-54.
22. Anand A, Mace KE, Towsend RL, Madison-Antenucci S, Grimm KE, Espina N, et al. Investigation of a case of suspected transfusion- transmitted malaria. Transfusion. 2018: 58(9): 2115-21.
23. WHO - World Health Organization. World Malaria Report 2020: 20 years of global progress and challenges. Available from: file:///C:/Users/682751/Downloads/9789240015791-eng.pdf.

Financial support: CNPq, Department of Science and Technology in Health/Ministry of Health (DECIT/MS), FIOCRUZ, FAPERJ, UFRR.
MFFC and CTD-R are supported by CNPq, Brazil, through a Research Productivity Grant, and are “Cientistas do Nosso Estado” by FAPERJ.
+ Corresponding authors: therezapicado1@gmail.com / mffcruz@ioc.fiocruz.br
ORCID https://orcid.org/0000-0002-7031-4510
ORCID https://orcid.org/0000-0003-3522-3792
Received 22 May 2024
Accepted 30 September 2024

HOW TO CITE
Pinheiro TCP, Santos SS, Simião FMB, Mello ARL, Pimentel CB, Lomonaco LA, et al. Molecular test for screening malaria-infected blood donors to maximise recipient safety in Acre State, a Brazilian endemic area. Mem Inst Oswaldo Cruz. 2024; 119: e240109.

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