Malaria

Must not donate if:
a) The mother has ever had malaria.

b) The mother has had an undiagnosed fever (that could have been malaria) while abroad or within four months of leaving a malaria endemic area.

c) The mother has lived in any malarial endemic area for a continuous period of six months or more at any time of life.

d) Less than 12 months after last leaving a malaria endemic area.

1a) Mothers who have had malaria diagnosed in the past:
If more than three years have passed since anti-malaria therapy has been completed and symptoms caused by malaria have resolved and a validated test for malaria antibody is negative, accept.

If the donor (with a history of malaria) has revisited a malaria endemic area and at least four months have passed since return and a validated test for malaria antibody is negative, accept.

1b) Mothers who have EVER had an undiagnosed fever that could have been malaria while in a malaria area or within four months of leaving a malaria endemic area:
If at least four months have passed since the donor returned from the malaria endemic area, or from the date of recovery from symptoms (undiagnosed fever) that may have been caused by malaria, whichever is later, and a validated test for malaria antibody is negative, accept.

1c) Mothers who have EVER been resident in a malaria endemic area for six months or more:
If at least four months have passed since the date of the last potential exposure to malaria, and a validated test for malaria antibody is negative, accept.

1d) For all other mothers:
If at least four months and less than 12 months have passed since return from a malaria endemic area, and a validated test for malaria antibody is negative, accept.

If travel to a malaria endemic area is more than 12 months prior to donation and the mother has never been diagnosed with malaria, has never had an undiagnosed fever while abroad or within four months of leaving a malaria endemic area and has not lived in a malaria endemic area for a continuous period of six months or more at any time of life, the mother can be accepted without the need for malaria antibody testing.

1e) For all of the above (a-d):
If malaria antibody testing is indicated as outlined above and the result is inconclusive or positive, obtain details of exposure and treatment and discuss with the Designated Medical Officer. 

If the malaria antibody test is positive or inconclusive, additional nucleic acid testing (NAT) for malaria on a maternal and a cord blood sample may be utilised to determine the safety of the cord blood donation. In case of confirmed negative NAT results, a  risk assessment must be documented and, if accepted, the details must be discussed at selection with the transplant centre.

Geographical Disease Risk Index for countries with a current endemic malaria risk.

Cases of malaria transmission have occurred many years after the mother was last at risk of becoming infected with malaria. This is mainly a problem in people who have had repeated episodes of infection with malaria. This is uncommon, but before allowing someone who has had, or may have had malaria to give a donation, it is safer to test for malaria antibodies rather than to wait a specific length of time. Malaria may be fatal.

Some countries have malaria as well as tropical viral risk. Both risks have to be considered if the mother had symptoms after travel or stay.

The ‘Discretionary’ entry has been expanded to include information on the option for NAT testing if required.