A new blood treatment that combines UV radiation and vitamin B could minimise the risk of malaria infection following blood transfusions.
Clinicians behind the new therapy, which was revealed for the first time last night (21 April, 2016), believe it will be of particular benefit to children who undergo blood transfusions in sub-Saharan Africa because they are at high risk of transfusion-transmitted malaria.
Professor Jean-Pierre Allain, lead author from the University of Cambridge, England, whose study is published in The Lancet, said it is the first study to look at the potential of pathogen-reduction technology in a real-world treatment setting.
“In many countries in sub-Saharan Africa where malaria is endemic, a high proportion of the population carry the parasite but do not show any clinical symptoms,” he said.
“This is particularly problematic when it comes to donated blood transfusions as it puts the recipients at high risk of infection if no blood treatment procedure is provided.
“Testing for parasites such as malaria is expensive and until now, there have been no technologies capable of treating whole blood, which is most commonly used in transfusions in sub-Saharan Africa.”
Donated blood is not tested in most developing countries because of a lack of resources and while there are pathogen reduction technologies that treat blood components about 70% of blood transfusions in developing countries are of whole blood.
Detecting Plasmodium in donated blood is very difficult, with microscopes being the only existing, affordable option, – this is unreliable, the researchers say.
In this study, which is published ahead of World Malaria Day (25 April, 2016), researchers examined the effectiveness and safety of a new pathogen reduction technology that uses UV light and vitamin B2 (riboflavin) to reduce the levels of the parasite in donated whole blood.
The double blind randomised study follows earlier research that found the technology could inactivate Plasmodium and other pathogens, including HIV, hepatitis C, and hepatitis B virus in vitro.
A total of 223 adult patients from the Komfo Anokye Teaching Hospital in Kumasi, Ghana, took part in the study, and the research team analysed blood samples for all of the transfusion recipients on the day of the transfusion and one, three, seven and 28 days later to examine the sequences of Plasmodium genes in the blood.
Of the cohort, 65 patients did not previously carry the parasite and half received parasite-treated blood, and the other half received parasite untreated blood.
The researchers found that 35% – 13 out of the 37 – who received untreated blood later tested positive for malaria parasite. This compared with just 10% – three out of 28 – who received treated blood.
Coagulation parameters, platelet counts and haemostatic status were similar among all patients, regardless of whether or not they received treated or untreated blood.
The researchers also discovered that the technology did not affect the coagulation properties of the blood, while patients who received the treated blood had slightly fewer allergic reactions to those who received the untreated blood.
Further studies in larger population groups, particularly among at risk populations such as young children and pregnant mothers are now needed, add the authors.
Allain JP, Owusu-Ofori A, Assennato S et al. Effect of Plasmodium inactivation in whole blood on the incidence of blood transfusion-transmitted malaria in endemic regions: the African Investigation of the Mirasol System (AIMS) randomised controlled trial. Lancet 2016. 387: 1753–61, April 21, 2016.
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