Determining the efficiency of malaria rapid diagnostic test to diagnose post transfusion malaria in children under five years old at Komfo Anokye Teaching Hospital

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Malaria associated with blood transfusion in malaria-endemic countries has until recently been a neglected area. Malaria prophylaxis has however been consistently used for the management of transfusion transmitted malaria (TTM). Current recommendations from World Health Organization (WHO) state that, the diagnosis of malaria must be confirmed before initiation of therapy. It is therefore important to establish which of the current routine test methods, is most appropriate for use. Malaria RDTs are now supplementing microscopy in the diagnosis of malaria in many endemic countries. However their efficiency as a screening tool for the detection of malaria in donors or in transfusion recipients has not been well evaluated. The aim of this study was to determine the efficiency of malaria RDT in the detection of post transfusion malaria in children under five years old at Komfo Anokye Teaching Hospital (KATH), Kumasi. The study took place between November 2014 and April 2015. Blood samples from 179 patients and their corresponding donors were tested for Plasmodium parasitaemia using RDT and microscopy. The recipients’ blood samples were obtained within 48hours after transfusion for malaria diagnosis. To determine the incidence of post transfusion malaria, 32 patients were purposefully selected. Their pre-transfusion, post transfusion and donor blood samples were tested for malaria using PCR. Majority (52%) of the study population was between the ages of 0 - < 1 year. Prevalence of malaria in blood donors was 27% by RDT and 7% by microscopy. Prevalence at pre transfusion, was 34% by RDT and 13% by microscopy. Prevalence at post transfusion was 59% by RDT and 4% by microscopy. Incidence of post transfusion malaria by PCR was 57%. The sensitivity of RDT in detecting malaria at post transfusion was 100%. Efficiency of malaria RDT as a tool for malaria diagnosis at post transfusion, among children under five years old is good. Clinicians should consider implementing the use of malaria RDT at post transfusion.
A thesis submitted to the Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirement for the degree of MASTER OF SCIENCE ,School of Medical Sciences, College of Health Sciences.