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Background <p>The World Health Organization malaria burden estimates produced from incomplete clinical case reporting and often outdated household asymptomatic parasitaemia surveys in children &lt; 5&#xa0;years old, are unreliable. Surveillance target groups need to be expanded in line with the epidemiological shift in malaria-eliminating countries towards adults, and particularly men. Furthermore, new tools that can provide granular and timely data, critical to understanding geographic heterogeneity and enabling timely decision-making at the operational level, are needed. This prospective study aimed to demonstrate that blood donor malaria screening could serve as a time-sensitive complementary source of highly detailed malaria surveillance data.</p> Methods <p>Consecutive blood donations received from 16 August 2023 to 31 August 2024 at the Ouagadougou and Bobo-Dioulasso Regional Blood Transfusion Centres in Burkina Faso, covering 5 of 13 regions, were screened for malaria using the Sysmex XN-31 automated analyser. XN-31 results, donor age, sex, place of residence, collection date, were analysed using descriptive statistics, chi-squared, and logistic regression tests. Seasonal malaria patterns were compared with publicly available rainfall data.</p> Results <p>Donor malaria prevalence was 5.91% (3164/53575) overall. Key predictors of malaria identified were age ≤ 30&#xa0;years (odds ratio (OR) 2.85, <i>p</i> &lt; 0.001), male sex (OR 1.47, <i>p</i> &lt; 0.001) and rural residency (OR 2.40, <i>p</i> &lt; 0.001), with regional location having a strong influence on the latter. Strong seasonal variability, mirroring that of rainfall with a 3-month lag, was observed with different peak periods and rate of change over time at provincial level. Hot-spots were observed within both Bobo-Dioulasso and Ouagadougou. There were no age or sex-based differences in parasite density or gametocyte carriage, and both measures were directly proportional to malaria prevalence. Only males showed striking seasonal variability in gametocyte carriage (low season 1.39%, 14/1006; high season 4.42%, 66/1494; <i>p</i> &lt; 0.001).</p> Conclusions <p>The large data set and spatiotemporal malaria prevalence information, not possible with episodic household malaria surveys, facilitated highly granular analysis and demonstrated the potential to provide dynamic real-time information on the malaria burden using automated XN-31 blood donor malaria screening.</p>

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Blood donors as a sentinel population for real-time malaria surveillance using the Sysmex XN-31: a one-year review from the National Blood Transfusion Centre in Burkina Faso

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  • 发表日期：

    2025年9月23日

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  • Salam Sawadogo,
  • Talent Hwandih,
  • Jarob Saker,
  • Thérèsa L. Coetzer,
  • Anna Paszkowska,
  • Sidzabda C. B. Kompaoré,
  • Marion Münster

摘要

Background

The World Health Organization malaria burden estimates produced from incomplete clinical case reporting and often outdated household asymptomatic parasitaemia surveys in children < 5 years old, are unreliable. Surveillance target groups need to be expanded in line with the epidemiological shift in malaria-eliminating countries towards adults, and particularly men. Furthermore, new tools that can provide granular and timely data, critical to understanding geographic heterogeneity and enabling timely decision-making at the operational level, are needed. This prospective study aimed to demonstrate that blood donor malaria screening could serve as a time-sensitive complementary source of highly detailed malaria surveillance data.

Methods

Consecutive blood donations received from 16 August 2023 to 31 August 2024 at the Ouagadougou and Bobo-Dioulasso Regional Blood Transfusion Centres in Burkina Faso, covering 5 of 13 regions, were screened for malaria using the Sysmex XN-31 automated analyser. XN-31 results, donor age, sex, place of residence, collection date, were analysed using descriptive statistics, chi-squared, and logistic regression tests. Seasonal malaria patterns were compared with publicly available rainfall data.

Results

Donor malaria prevalence was 5.91% (3164/53575) overall. Key predictors of malaria identified were age ≤ 30 years (odds ratio (OR) 2.85, p < 0.001), male sex (OR 1.47, p < 0.001) and rural residency (OR 2.40, p < 0.001), with regional location having a strong influence on the latter. Strong seasonal variability, mirroring that of rainfall with a 3-month lag, was observed with different peak periods and rate of change over time at provincial level. Hot-spots were observed within both Bobo-Dioulasso and Ouagadougou. There were no age or sex-based differences in parasite density or gametocyte carriage, and both measures were directly proportional to malaria prevalence. Only males showed striking seasonal variability in gametocyte carriage (low season 1.39%, 14/1006; high season 4.42%, 66/1494; p < 0.001).

Conclusions

The large data set and spatiotemporal malaria prevalence information, not possible with episodic household malaria surveys, facilitated highly granular analysis and demonstrated the potential to provide dynamic real-time information on the malaria burden using automated XN-31 blood donor malaria screening.