Transfusion-transmitted Malaria in Sub-Saharan Africa

The World Health Organisation (WHO) recently reported that global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality rates in Africa alone by 49%. Despite these encouraging statistics, the burden of malaria in Africa remains high. One area of malaria control which has been neglected is malaria transmission through blood transfusion. In sub-Saharan African (SSA), little is known about the burden of transfusion transmitted malaria (TTM) and how it contributes to the overall burden of malaria. Most studies from SSA report on the prevalence rates of parasitaemia in blood donors, with some rates as high as 50%. Parasitaemia in donors may not necessarily translate to parasitaemia or clinical disease in semi-immune recipients living in endemic regions of malaria. Using molecular genotyping, two studies in Ghana recently determined the incidence of TTM to be 2% and 28% in adult populations. These incidence rates may not be representative of what occurs across the continent in view of the varied malaria endemicity and transmission intensity in different regions. This review will discuss the peculiarities of TTM in sub-Saharan Africa with the view to understand the risks and pathophysiology of the disease. The options of preventive strategies for TTM will also be considered.