Professional Documents
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CARE HOSPITALS
INTRODUCTION:
pathogen that can be transmitted in donated blood through transfusion to a recipient. Malaria
is a protozoan parasitic infection of humans resulting from one or more of the five species of
transfusion of cellular blood components and it is undoubtedly responsible for the majority of
Screening for transfusion transmissible infections (TTIs) ensures that blood transfusion is
safe. Unsafe blood transfusion is damaging from both a human and an economic point of
view. Each unit of blood transfused potentially carries 1% risk of transfusion related
problems, including TTIs such as human immunodeficiency virus (HIV), hepatitis C virus
(HCV), hepatitis B virus (HBV), syphilis and malaria. In Pakistan, with an only nascent
culture of voluntary donations, a strong dependence on replacement and paid donors and the
lack of systematic screening strategy. The infection risks are formidable since the
commercially remunerated blood donors and family replacement donors are more
likely to transmit TTIs as compared to the voluntary donors. The morbidity and mortality,
resulting from transfusion of infected blood, have far reaching consequences for the
There has been a paucity of information concerning the distribution and potential role of the
different Plasmodium species in transfusion-related malaria cases, and the clinical impact of
parasitaemic blood in recipients, particularly young children and pregnant women who are
the highest consumers of blood transfusions in Pakistan. Transfusion malaria is fairly
common in endemic areas. Following an attack of malaria, the donor may remain infective
for years (1-3 years in P. falciparum, 3-4 years in P. vivax, and 15-50 years in P. malariae.)
Most infections occur in cases of transfusion of blood stored for less than 5 days and it is rare
in transfusions of blood stored for more than 2 weeks. Frozen plasma is not known to
transmit malaria(3).
progress rapidly and may lead to significant morbidity and mortality, specifically when
endemic country with a National API averaging at 1.08 (MIS, 2015) and wide diversity
within and between the provinces and districts. Plasmodium Vivax and Plasmodium
Falciparum are the only prevalent species of parasites detected so far, with P.vivax being the
major parasite species responsible for >80% reported confirmed cases in the country.
Transfusion-transmitted malaria occurs at an estimated rate of 0.25 cases per 1 million blood
units collected(4).
The prevalence of malaria parasitaemia among consenting 308 blood donors in Ilorin was
27.3%(5). Similarly a study published in 2016, carried out at Kaduna, Nigeria reported 27
(7.5%) positive cases of malarial parasites among the blood donors(6). Total 300 blood donors
from Jamila Sultana Foundation Rawalpindi were studied and screened for the prevalence of
infectious disease. Out of these donors 4 were infected with malaria (1.6%)(7).
Keeping in view the above mentioned facts and figures I have designed my study to
determine the magnitude of malarial parasites in our local population coming to donate blood
at tertiary care hospital. The donors who are deferred due to presence of malarial parasites in
their blood will be counselled that malaria is a treatable cause and then they will be referred
to physicians for treating the parasite. Pakistan is a developing country and its dealing with a
lot of other health issues, so we have to take proper precautions to make blood transfusion
safe and uneventful in regards to malarial parasite. The result of this study will also be shared
with other professionals to aware them regarding current situation so they can plan their
OBJECTIVES:
Operational Definition:
Malaria Infection:
100.4 F - 105 F) and sweating, caused by a protozoan of the genus Plasmodium in red blood
cells, diagnosis depends primarily on the identification of Plasmodium in thick and thin blood
smears and is transmitted to humans by the bite of an infected female anopheles mosquito.
BLOOD DONOR:
A person who gives his or her blood to be used for transfusion for the first time.
Study Design:
Setting:
Sampling Technique:
Sample Size: Sample size will be 218 with 95% confidence interval, 3.5% margin of error
and keeping 7.5% proportion of Malaria in donors 7 under WHO sample size calculator.
Inclusion criteria:
1. Either gender
3. Blood Donor
Exclusion criteria:
Study will be approved by CPSP. All the individuals presenting with the primary intention of
donating blood without compensation will be interviewed by me in the Blood Bank unit of
haematology Department. The purpose and procedure of the study will be explained and an
informed consent will be obtained from the blood donor justifying the inclusion criteria and
allotted a donor ID number which will be noted.03 ml venous blood of the donor will be
collection. The complete blood count will be obtained with the help of Cell dyn ruby
analyser. Giemsa stained thick and thin blood films will be made from each donor blood and
will be examined under x100 objective lens (immersion oil) using a light microscopy to
identify and detect Plasmodium parasites (trophozoites, schizontes, gametocytes, and malarial
pigment in neutrophils and monocytes) demographic and clinical data of all patients
including age, gender, address, occupation and malarial parasite present or absent will be
STATISTICAL ANALYSIS
The study will be analyzed using SPSS version 17 for windows. The frequency and
percentages will be calculated for the categorical variables such as gender, marital status,
dwelling, education, occupation, history of blood transfusion, history of fever in past six
months and history of travel in past six months while the numerical variable such as age and
frequency of blood transfusion will be presented with mean +SD. Malaria will be stratified
among age, gender, history of blood transfusion, dwelling, education, occupation, history of
fever in past six months and history of travel in past six months to see the effect modification.
Post stratification chi-square test will be applied keeping p-value ≤ 0.05 as significant. All the
REFERENCES
1. Munir MA, Qureshi H, Safdar N. Malaria indicator survey in 38 high risk districts of
Pakistan - Pakistan Medical Research Council, Ministry of Health, Government of
Pakistan MIS Report 2013-2014.
2. Gharehbaghian A. An estimate of transfusion-transmitted infection prevalence in
general populations. Hepat Mon. 2011;11(12):1002.
3. Attaullah S, Khan S, Khan J. Trend of transfusion transmitted infections frequency in
blood donors: provide a road map for its prevention and control. J Transl Med.
2012;10(1):20.
4. Amer A, Al Malki A, Yousef B, Al Mutawa H. Improved screening of donor’s blood
for malaria: A qatari experience. Qatar Med J. 2005;2005(2):9.
5. Olawumi HO, Fadeyi A, Babatunde SK, Akanbi II AA, Babatunde AS, Sani MA, et al.
Malaria parasitaemia among blood donors in Ilorin, Nigeria. African J Infect Dis.
2015;9(1):10–3.
6. Garba D, Ameh J, Whong C, Mukhtar M.
Prevalence of malaria parasites among blood donors in Kaduna, Nigeria Int J Res Med
Sci. 2016;6(4):2114.
7. Kamran M, Mahmood RT, Khan MA, Mehmood A, Nisar L, Asad MJ.
Prevalence of transfusion transmitted infections among blood donors; a prospective
study. Am J Phytomed Clin Theur. 2014;2(4):540–3.
BLOOD TRANSFUSION SERVICES
DEPARTMENT OF PATHOLOGY
PESHAWAR
Name:_________________________ Age:______
Occupation:________________________________
Education: _________________________________