[Transfusion-induced malaria: risks, prevention and cost (1 year's experience)].
Three cases of transfusion induced paludism have been seen in Rouen since 1976. Two of them were due to Plasmodium falciparum and the third to Plasmodium malariae. In order to improve the prevention of this disease, a survey was carried out in 1980 which concerned 51,000 blood samples, 1,020 blood donors were selected because they had lived in a malarial endemic zone. Among them, 92 subjects were detected by an indirect immunofluorescence reaction as having a titer exceeding 1: 20 and their blood was kept aside any transfusional use. These results were studied according to the geographical area concerned, the ethnical origin, the time elapsed since the return and whether or not a chemoprophylaxis had been used. The present study gives further evidence of the risk linked to a stay in Africa. But neither the time since the return, nor the use or not of a chemoprophylaxis seemed to influence the serological results. The five years exclusion rule, used up until now, came to be at the same time too much and insufficiently limitative, since it would have eliminated 1.4% blood donors while the serological controls would eliminate only 0.18%. On the other hand, 14 blood donors, who were back in France for more than 5 years and presented with a positive serology, would have been considered as normal. In the light of these results, a practical line is given based on the association of a simple inquiry to a malarial serology.