A New Simple And Cheap Method For The Eradication Of Transfusion — Induced Malaria In Sudan

Abstract

ABSTRACT Background: Transmission of malaria through blood transfusion is a genuine problem for the capability of plasmodia to survive in stored blood and the weakness of transfused patients. Systemic screening of blood donors is not a practical solution of the problem even by using an advanced technique as well as treatment of transfused patients after transfusion and/or prospective donors before donation. Therefore, an ideal way for such prevention could be to kill the parasite in donors’ blood before transfusion. Objective: To select the antimalarial drug of choice that can be routinely added to donors’ blood in vitro to kill malaria parasites within maximum three days. Material and Methods: Donors’ blood which was collected from 4484 blood donors has been screened for malaria parasite microscopically using Giemsa’ staining technique. Of these samples, only 30 (500ml of blood each) satisfied the inclusion criteria of this study. Each of these blood samples was subdivided equally into ten sub-samples to obtain a total of 300 sub- specimens. Three concentrations of each antimalarial drug (chloroquine, fansidar and quinine) were added to 30 specimens while 30 specimens (control) were lefi without adding antimalarial drug. Blood specimens were tested for parasite culture, platelets count, total leucocyte count, packed cell volume, lysis percentage, osmotic fragility, prothrombin time, activated partial

thromboplastin time, sodium and potassium serum levels simultaneously on the day of collection. Thereafter, it was stored in the blood bank refrigerator (4°-6°C) and tested after 24 & 48 hours by the same laboratory procedures. Results: The reduction of malaria parasites numbers was found to be proportional to the concentrations of chloroquine, fansidar and quinine added to donors’ blood and to the storage period. Whereas, the control donors’ blood samples (without antimalarials) revealed stable number of the parasites even after 48 hours storage. Fansidar was highly effective afler 24 hours storage followed by quinine and 48 hours storage revealed high effectiveness of fansidar followed by quinine and chloroquine. The optimal doses of the applied antimalarial drugs were generally safe to all constituents of the stored blood compared to the control blood samples. Conclusion and Recommendation: It was concluded that for eradication of transfusion induced malaria by in vitro processing of donors blood, fansidar is the best drug that can be used followed by quinine. So it was recommended to apply the optimal doses of these drugs to the components of the blood bags before phlebotomy.