Between 1958 and 1998, the Centers for Disease Control recorded 103 cases of transfusion-transmitted malaria in the United States. Malaria is not endemic in North America, so these cases most likely were the result of blood donated by people who were asymptomatic carriers. In the United States, potential donors are screened by questionnaire and asked to refrain from giving blood until one year after visiting a malarial area, three years after completing treatment for malaria, or three years after living in an area where it is endemic. While very rare in the US, malaria is epidemic in tropical areas and causes serious health consequences, including death. There is no practical test available to screen donors. Table 7.5 illustrates that the US estimate of malaria contamination to the blood supply currently is small, at about just over 1/250,000 units with no fatalities. However, the problem is wholly different in tropical countries, particularly in sub Saharan Africa. Worldwide malaria is the most significant cause of death due to parasitic infection. The World Health Organization estimates there are at least 300 million acute cases of malaria each year globally, which lead to more than a million deaths. Probably 90 percent of the deaths occur in Africa, mostly in young children. Blood transfusion is used to treat life-threatening malaria in young children, but also poses the risk of acquiring HIV infection (Obonyo et al., 1998; WHO, 2006a).

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