A Study to Compare Antigen-based Enzyme-linked Immunosorbent Assay, Rapid Method, and Microscopy for Detection of Malaria in Blood Donors to prevent Transfusion-transmitted Malaria

Abstract

Abstract Introduction: In malaria-endemic countries, blood donors with low parasitemia may be missed at the time of screening of blood units leading to the consequences like hemolysis, morbidity, and even mortality in nonimmune transfusion recipient. This study aimed to compare peripheral blood smear (microscopy), rapid diagnostic test (RDT), and antigen detection enzyme-linked immune sorbent assay (ELISA) for the detection of Plasmodium spp. in blood donors to prevent transfusion-transmitted malaria (TTM). Materials and methods: Samples from 100 eligible blood donors coming to donate blood at the Bhopal Memorial Hospital & Research Center blood bank were collected in ethylenediaminetetraacetic acid vial. Light microscopic examination on both thin and thick smears, RDT, and PAN-specific lactate dehydrogenase antigen detection ELISA were performed on the blood samples and the results were compared. Results: None of the blood smears or samples from the 100 blood donors screened showed malarial parasitemia or positive result. Conclusion: In India, the current strategy of testing blood donors is mainly restricted to microscopy and some blood banks have adapted rapid methods for antigen detection. A larger study on large sample size should be conducted to determine the most appropriate and effective malarial screening test in blood donors and, most importantly, to suggest a workable national screening policy for prevention of TTM in transfusion recipients. Clinical significance: For screening blood units for malaria, currently available testing methodologies need to be studied in comparison with the assays with better sensitivity for increasing blood safety and reducing the complications of transmission of malaria to patients through blood transfusions.