Evaluating laboratory screening tests for malaria on blood donors candidates to reduce the risk of transfusion-transmitted malaria in an endemic area of Indonesia

  • Nethasia Louhenapessy Biomedical Science Institute, Transfusion Science Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0000-0001-6303-3123
  • Ria Syafitri Evi Gantini Biomedical Science Institute, Transfusion Science Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Central Blood Transfusion Services, Jakarta, Indonesia; Blood Bank Technology, Indonesian Red Cross, Jakarta, Indonesia
  • Susan Rahayu Integrated Laboratory Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0000-0002-9148-1086
  • Elisabeth Lilipory Provincial Health Office of Ambon City, Maluku, Indonesia
  • Heri Wibowo Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Yuyun Soedarmono Directorate General of Health Care, Ministry of Health, Jakarta, Indonesia
  • Inge Sutanto Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0000-0003-2488-5133
Keywords: blood donors, malaria, Indonesia
Abstract viewed: 1059 times
PDF downloaded: 564 times
HTML downloaded: 289 times
EPUB downloaded: 260 times


BACKGROUND Laboratory screening of blood donors for malaria has not been routinely performed in Indonesia. Current policy and practice simply exclude donors based on a history of active clinical malaria. This study was aimed to evaluate laboratory screening tests for malaria among blood donors in an endemic area of Indonesia.

METHODS The study was conducted on 550 consecutive blood samples withdrawn from volunteer donors at the Red Cross Blood Transfusion Unit in Ambon city using microscopic and rapid diagnostic tests for antigen as well as for antibody. Furthermore, 248 of those 550 samples were also tested for the presence of malaria DNA using 18S rRNA marker. Statistical analysis was done descriptively using SPSS software version 15 (SPSS Inc., USA).

RESULTS The overall malaria positivity rate among the donors was 4.5% (25/550). None of the specimens tested using microscopy or rapid test for malaria antigen assay were positive. However 22 (4.0%) samples were positive for malaria antibody against Plasmodium falciparum; while 3 (1.2%) were positive by PCR.

CONCLUSIONS Laboratory testing for blood donors may be used to prevent transfusiontransmitted malaria in an endemic area of Indonesia.


  1. Alho RM, Machado KV, Val FF, Fraiji NA, Alexandre MA, Melo GC, et al. Alternative transmission routes in the malaria elimination era: an overview of transfusion-transmitted malaria in the Americas. Malar J. 2017;16(1):78. https://doi.org/10.1186/s12936-017-1726-y

  2. Verra F, Angheben A, Martello E, Giorli G, Perandin F, Bisoffi Z. A systematic review of transfusion-transmitted malaria in nonendemic areas. Malar J. 2018:17(1):36. https://doi.org/10.1186/s12936-018-2181-0

  3. Chattopadhyay R, Majam VF, Kumar S. Survival of Plasmodium falciparum in human blood during refrigeration. Transfusion. 2011;51(3):630-5. https://doi.org/10.1111/j.1537-2995.2010.02872.x

  4. Bruce-Chwatt LJ. Transfusion malaria. Bull World Health Organ. 1974;50(3-4):337-46.

  5. Seed CR, Kitchen A, Davis TM. The current status and potential role of laboratory testing to prevent transfusion-transmitted malaria. Transfus Med Rev. 2005;19(3):229-40. https://doi.org/10.1016/j.tmrv.2005.02.004

  6. Mungai M, Tegtmeier G, Chamberland M, Parise M. Transfusiontransmitted malaria in the United States from 1963 through 1999. N Engl J Med. 2001;344(26):1973-8. https://doi.org/10.1056/NEJM200106283442603

  7. Hartopo AB, Wijisaksono DP. A lethal case of Plasmodium falciparum infection in a young patient with end-stage renal failure who underwent regular hemodialysis. Intern Med. 2010;49(17):1867-70. https://doi.org/10.2169/internalmedicine.49.3888

  8. O'Brien SF, Delage G, Seed CR, Pillonel J, Fabra CC, Davison K, et al. The epidemiology of imported malaria and transfusion policy in 5 nonendemic countries. Transfus Med Rev. 2015:29(3):162-71. https://doi.org/10.1016/j.tmrv.2015.03.004

  9. Owusu-Ofori AK, Parry C, Bates I. Transfusion-transmitted malaria in countries where malaria is endemic: a review of the literature from sub-Saharan Africa. Clin Infect Dis. 2010;51(10):1192-8. https://doi.org/10.1086/656806

  10. Elyazar IR, Gething PW, Patil AP, Rogayah H, Kusriastuti R, Wismarini DM, et al. Plasmodium falciparum malaria endemicity in Indonesia in 2010. PLoS One. 2011;6(6):e21315. https://doi.org/10.1371/journal.pone.0021315

  11. Elyazar IR, Gething PW, Patil AP, Rogayah H, Sariwati E, Palupi NW, et al. Plasmodium vivax malaria endemicity in Indonesia in 2010. PLoS One. 2012;7(5):e37325. https://doi.org/10.1371/journal.pone.0037325

  12. Peraturan Pemerintah Republik Indonesia Nomor 7 tahun 2011 tentang pelayanan darah.

  13. Pava Z, Burdam FH, Handayuni I, Trianty L, Utami RA, Tirta YK, et al. Submicroscopic and asymptomatic Plasmodium parasitaemia associated with significant risk of anaemia in Papua, Indonesia. PLoS One. 2016;11(10):e0165340. https://doi.org/10.1371/journal.pone.0165340

  14. Herdiana H, Cotter C, Coutrier FN, Zarlinda I, Zelman BW, Tirta YK, et al. Malaria risk factor assessment using active and passive surveillance data from Aceh Besar, Indonesia, a low endemic, malaria elimination setting with Plasmodium knowlesi, Plasmodium vivax, and Plasmodium falciparum. Malar J. 2016;15:468. https://doi.org/10.1186/s12936-016-1523-z

  15. Burdam FH, Hakimi M, Thio F, Kenangalem E, Indrawanti R, Noviyanti R, et al. Asymptomatic vivax and falciparum parasitaemia with helminth co-infection: major risk factors for anaemia in early life. PLoS One. 2016;11(8):e0160917. https://doi.org/10.1371/journal.pone.0160917

  16. Mohon AN, Elahi R, Podder MP, Mohiuddin K, Hossain MS, Khan WA, et al. Evaluation of the OnSite (Pf/Pan) rapid diagnostic test for diagnosis of clinical malaria. Malar J. 2012;11:415. https://doi.org/10.1186/1475-2875-11-415

  17. Kim SH, Nam MH, Roh KH, Park HC, Nam DH, Park GH, et al. Evaluation of a rapid diagnostic test specific for Plasmodium vivax. Trop Med Int Health. 2008;13(12):1495-500. https://doi.org/10.1111/j.1365-3156.2008.02163.x

  18. Cho SJ, Lee J, Lee HJ, Jo HY, Sinniah M, Kim HY, et al. A novel malaria Pf/Pv Ab rapid diagnostic test using a differential diagnostic marker identified by network biology. Int J Biol Sci. 2016;12(7):824-35. https://doi.org/10.7150/ijbs.14408

  19. Sambrook J, Fritsch ER, Maniatis T. Molecular cloning: a laboratory manual. 2nd ed. New York: Cold Spring Harbor Laboratory Press; 1989. p. 85, 159-61.

  20. Mangold KA, Manson RU, Koay ES, Stephens L, Regner M, Thomson RB Jr, et al. Real-time PCR for detection and identification of Plasmodium spp. J Clin Microbiol. 2005;43(5):2435-40. https://doi.org/10.1128/JCM.43.5.2435-2440.2005

  21. World Health Organization. Screening donated blood for transfusion-transmissible infections: recommendations. World Health Organization: Geneva; 2010. p. 38-9.

  22. Kwenti TE, Njunda LA, Tsamul B, Nsagha SD, Assob NJ, Tufon KA, et al. Comparative of a rapid diagnostic test, an antiboy ELISA, and a pLDH ELISA in detecting asymptomatic malaria parasitaemia in blood donors in Buea, Cameroon. Infect Dis Poverty. 2017;6(1):103. https://doi.org/10.1186/s40249-017-0314-2

  23. Lima GFMC, Arroyo Sanchez MC, Levi JE, Fujimori M, da Cruz Caramelo L, Sanchez AR, et al. Asymptomatic infections in blood donors harbouring Plasmodium: an invisible risk detected by molecular and serological tools. Blood Tranfus. 2018;16(1):17-25.

  24. Mangano VD, Perandin F, Tiberti N, Guerriero M, Migliaccio F, Prato M, et al. Risk of transfusion-transmitted malaria: evaluation of commercial ELISA kits for the detection of anti-Plasmodium antibodies in candidate blood donors. Malar J. 2019;8(1):17. https://doi.org/10.1186/s12936-019-2650-0

  25. Haura AA. Screening of malaria parasites among blood donors in blood donors unit of Padang Indonesian Red Cross Society, Sumatera Barat [thesis]. [Padang]: Universitas Andalas; 2016.

  26. Nugroho DK. Sensitivity of the malaria rapid diagnostic test in blood donors smear [master's thesis]. [Yogyakarta]: Universitas Gadjah Mada; 2014.

How to Cite
Louhenapessy N, Gantini RSE, Rahayu S, Lilipory E, Wibowo H, Soedarmono Y, Sutanto I. Evaluating laboratory screening tests for malaria on blood donors candidates to reduce the risk of transfusion-transmitted malaria in an endemic area of Indonesia. Med J Indones [Internet]. 2021Oct.10 [cited 2023Sep.28];30(3):191-7. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/5491
Basic Medical Research

Most read articles by the same author(s)