Africa Sanguine. Vol 21, No 1 (2019):18-21

Transfusion transmitted Malaria in the Western Cape, South Africa
C.J. Sims, T Paarman

Background: The Western Province Blood Transfusion Service is situated in the non-endemic malaria province of the Western Cape in South Africa.Transfusion Transmitted Malaria (TTM) is uncommon in the Western Cape with only three cases having been reported to date.Objective: The objective of this presentation is to report on three cases of TTM that have occurred in the Western Cape, and to describe the look-back processes that were involved in the diagnosis, and resolution of the cases.Case reviews: In 2001, a 35-year-old male patient tested positive for Plasmodium falciparum malaria post red cell concentrate transfusion. The second case occurred in 2010 when Plasmodium falciparum malaria was transmitted via a platelet transfusion. The donors involved in these cases of TTM had both originated from malaria endemic countries outside South Africa. In December 2012, the third case of TTM was reported. An 81-year-old female patient with an unexplained febrile illness tested positive for Plasmodium malariae after transfusion. The red cell donor had left his country of origin Nigeria in 2007.Conclusion: Despite revised deferral strategies, there still remains a risk of TTM as people infected with Plasmodium malariae and Plasmodium falciparum may remain asymptomatic carriers longer than the three year deferral period. Consequently, TTM must always be considered as a differential diagnosis in any patient with an unexplained febrile illness following transfusion.Keywords: Malaria, transfusion-transmitted infection, platelet, deferral, South Africa

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