Four-year, 800% increase in malaria deferrals sparks change to make
better use of donor's gift and increase efficiency
OTTAWA, March 15 /CNW Telbec/ - As thousands of Canadians travel to
warmer climates for Spring Break, Canadian Blood Services is asking
vacationers to think about donating blood before they leave the country.
That's because April 2, 2007, Canadian Blood Services is changing the way it
manages donations from people who have been exposed to malaria risks.
Travel or geography-related deferrals as a result of malaria risks are
not new. Canadian Blood Services recognizes over 100 countries around the
world which pose a malaria risk (see list at www.blood.ca). However, in recent
years, the addition of popular Canadian tourist destinations such as certain
parts of Mexico, the Dominican Republic and Jamaica has had a significant
impact on our ability to collect blood. From 2002 to 2006, the number of
people who were temporarily ineligible to donate blood due to potential
malaria exposure jumped from 5,000 per year to 40,000 per year. As a result of
this 800% increase in malaria deferrals, the not-for-profit organization has
to make changes in order to make the best use of each donation and of its
The new policy
Beginning April 2, 2007:
- People who spend less than six consecutive months in malaria-risk zone
(these represent 87% of malaria deferrals) will be temporarily
ineligible to donate blood for one year following the departure from
the malaria-risk zone.
- People who spend six or more consecutive months in a malaria-risk zone
will be temporarily deferred for three years after they leave the
- People who have had malaria: will no longer be able to donate blood.
What has changed?
Previously, individuals were permitted to donate blood six months after
returning from a malaria-risk zone or six months after recovering from
malaria. However, only one out of three parts of their blood could be used:
the plasma. The other two parts - red cells and platelets - could not be used
since they were at risk of carrying the malaria parasite, and therefore had to
be removed. For people who spent time in a malaria risk zone, this removal
process was temporary (one to three years, depending on the length of stay).
For people who had malaria, this process was permanent.
Why the change?
Collecting and processing blood when only one of the three parts can be
used requires the same amount of time, energy and resources from both the
donor and the organization, as if we were able to use all three parts.
"When the number of malaria-risk deferrals was much lower, this was a
manageable way to build up our supply of plasma products for patients in
need," says Ian Mumford, Chief Operating Officer. "However with the growth
rate of malaria deferrals, this practice has become unsustainable. We are now
developing more efficient ways to safely meet the need for plasma products in
Therefore, beginning April 2, 2007, Canadian Blood Services will only
collect blood from people who have been exposed to malaria risk when
sufficient time has passed that all three components of their blood can safely
This is the first major change to donor selection criteria made by
Canadian Blood Services for operational efficiency rather than safety reasons.
"When Canadian Blood Services first took over operation of the country's
blood system nine years ago, our sole priority was making the blood supply
safe" says Mumford. "That we can now expand our focus to deliver operational
improvements that make better use of each donation and of our limited
resources shows how stable the blood system is, and how we have matured as an
Don't screen yourself out
Determining eligibility and exposure to malaria risk can be complex. For
instance, in some countries, only specific regions or territories are at risk,
while others are not. Rather than making assumptions about their eligibility,
Canadian Blood Services strongly encourages blood donors and potential blood
donors to consult our website at www.blood.ca, or speak with one of our nurses
at 1 888 2 DONATE (1-888-236-6283) to find out more information about this
policy change and how it relates to them and their travel plans. A greater
risk than malaria entering the blood system is that too many Canadians will
unnecessarily screen themselves out as blood donors, resulting in challenges
to providing a stable supply of blood for patients in need.
About Canadian Blood Services
Canadian Blood Services is a national, not-for-profit charitable
organization that manages the blood supply in all provinces and territories
outside of Quebec and oversees the country's Unrelated Bone Marrow Donor
Registry. A dedicated team of about 4,500 staff and 17,000 volunteers enable
us to operate 41 permanent collection sites and more than 19,000 donor clinics
annually. Canadian Blood Services is a non-governmental organization, however
the Provincial and Territorial Ministers of Health provide operational
funding, and the federal government, through Health Canada, is responsible for
regulating the blood system.
MALARIA DEFERRAL CHANGE BACKGROUNDER
No testing available:
- No test is currently available in Canada to detect malaria in donated
- In the absence of a test, donor selection criteria and health screening
of donors is our primary line of defence against transmission of
malaria via blood transfusion.
- Donated blood is separated into three components: red blood cells,
platelets and plasma.
- Red blood cells and platelets are at risk of being exposed to the
harmful effects of the malarial parasite.
- Plasma extracted from whole blood donations, and destined for
fractionation (a manufacturing process to turn the plasma into various
life-saving protein products) is "heat-treated", which neutralizes the
malaria parasite and makes the product safe.
- Therefore, if a donor has had malaria or spends time in a malaria-risk
zone, only their plasma can be used - and the red blood cells and
platelets must be removed from the donation. This removal process must
always be done for people who have had malaria. For people who spend
time in a malaria-risk zone, it is done for a temporary period of time.
- The difficulty in collecting only plasma from a blood donation is that
the same time, energy and resources are required to collect and process
the blood as if we were able to use all three components.
- As a not-for-profit organization that is funded by provincial and
territorial governments, Canadian Blood Services has an obligation to
manage the blood system in a financially prudent manner.
- With limited resources, each time we collect a unit of blood where only
one out of three parts can be used, it is a lost opportunity to collect
a donation where all three parts can be used.
- More efficient ways of collecting plasma for the needs of Canadian
patients are currently being developed.
- As a result, we will only collect blood from people who have been in
malaria-risk zones when sufficient time has passed that we can safely
use all three components of their blood.
- This also means we will no longer collect blood from individuals who
have had malaria.
By the numbers:
- Number of countries recognized as malaria-risk zones: over 100
- Active blood donors in Canada (2006 total): Approx. 400,000
- Blood donors deferred for malaria-risk in 2006: Approx. 40,000
- People who spent less than six months in a malaria-risk zone:
- People who spent six or more consecutive months in a malaria-risk
- People who have had malaria: 970
- Number of malaria-type donations made in 2006 where only one of three
components could be used: 26,000
- Cost of collecting and processing those 26,000 units: upwards of
$4.5 million annually
- Cost of alternate strategies to collect same volume of plasma: approx.
$1.5 million annually
- Savings to the healthcare system: approx. $3 million annually
- "Time cost" for donors who make a "one-out-of-three" blood donation:
Approx. 1 hour
- ...and a "three-out-of-three" blood donation: same, Approx. 1 hour
For more information on the deferral criteria or for a list of the 100+
malaria-risk zones, visit www.blood.ca or call 1 888 2 DONATE
For further information:
For further information: Media: Anne Trueman, Manager Media Relations,
Canadian Blood Services, (Work) (613) 739-2538, (Cell) (613) 295-5622