Should all blood donors be screened for Malaria? Cost analysis from a tertiary care hospital in North India.

BACKGROUND AND

OBJECTIVE

Transfusion-transmitted malaria (TTM) can lead to severe or fatal outcomes. With the declining prevalence of malaria in the general population, the relevance, effectiveness, and economic justification of universal malaria screening in blood donors have been increasingly questioned. The present study is a retrospective cost analysis of routine malaria screening among blood donors conducted at a tertiary care centre in Delhi, North India.

METHODS

Donor records at a Regional Blood Transfusion Centre over a six-year period were analysed and malaria seroprevalence noted. The cost incurred in testing as well as the person-time utilised were also calculated.

RESULTS

During the study period of six years (2019-2024), the Regional Blood Transfusion Centre recorded 141,206 blood donations. The overall seroprevalence of malaria in tested units was found to be 0.00% with no donor testing positive during six years. The total program cost over six years was approximately ₹4.73 million (₹33.24 per test), translating to an average cost of ₹33.53 per donor screened. The performance of tests through this six year period consumed 346.2 person days.

CONCLUSION

The current strategy of testing all blood donors for malaria has limited utility in regions with low seroprevalence and causes significant financial burden. The findings call for an alternative strategy that ensures supply of safe blood in a cost-effective and efficient manner. Since the results are from a single centre, low endemicity setting, further research on larger scale is needed to confirm these conclusions.