Prevalence of Malaria in blood donor population from a tertiary care centre and effective donor notification and counselling policy

Background and Objective Transfusion-transmitted malaria is of great concern in endemic countries. From 1940, the Drugs and Cosmetic Act in India mandates the testing of all blood donations for human immunodeficiency virus (HIV), hepatitis B surface antigen (HbsAg), hepatitis C virus (HCV), malaria and syphilis. The present study was undertaken to assess the prevalence of malaria among blood donors and to summarize our experience with the notification algorithm that was developed for infected donors. Materials and Methods Records of all eligible donors, which were collected between 2011 and 2015, were analysed for the prevalence of malaria. Malaria screening was performed using by WHO-approved immunochromatographic rapid diagnostic test (RDT) (Malascan®; Zephyr Biomedicals, India) for malarial antigen and confirmed by thick and thin blood smear. Those testing positive for malaria were called for post-test counselling. Results A total of 108184 blood donors donated during the analysed period. Twenty-six donors (0·024%) tested positive for malarial antigen by RDT. One (3·8%) of the 18 donors with double band on RDT showed the presence of mixed infection (Plasmodium vivax and Plasmodium falciparum). Fifteen (83·3%) donors were infected with P. falciparum. In the remaining two (11·1%) positive samples, further analysis by microscopy failed to find any evidence of malaria. There were eight non-falciparum cases of P. vivax. Twenty-one (80·8%) infected donations were avoided by post-test counselling strategy as these donors underwent treatment prior to scheduling their next blood donation. Conclusion Blood donors in our region have a 0·024% prevalence of malaria. With proper donor testing, notification and post-test counselling the rate of TTM can be further minimized.