Impact of Asymptomatic Malaria and Microfilaria Infections on Serum Iron and Transferrin Levels: Implications for Blood Donor Screening in Southwestern Nigeria

Abstract

Aims: The study aims to determine the prevalence of asymptomatic malaria and microfilaria infection among prospective blood donors and to evaluate the impact of these infections on serum iron and transferrin levels, with implications for blood donor screening policy in southwestern Nigeria. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Blood Bank Unit, Department of Haematology, University College Hospital (UCH), Ibadan, Oyo State, Nigeria, between February and April. Methodology: Three hundred apparently healthy prospective blood donors were recruited using a structured questionnaire. Thick and thin Giemsa-stained blood films were examined for malaria parasites, and Knott's concentration technique was used to detect microfilariae. Serum iron was measured by a FerroZine-based colourimetric assay and serum transferrin by immunoturbidimetric assay on the Roche/Hitachi Cobas C system. Data were analysed using SPSS version 20; independent-samples t-tests and chi-square tests were applied, with P < .05 considered statistically significant. Results: Malaria parasitaemia was detected in 51 donors (17.0%) and microfilariae in 4 donors (1.3%). Mean serum iron was significantly lower in malaria-positive donors (10.3±3.4 µmol/L) than malaria-negative donors (14.3±4.8 µmol/L; t = 6.907, P < .001) and in microfilaria-positive donors (12.5±0.37 µmol/L) than microfilaria-negative donors (13.6±4.9 µmol/L; t = 3.142, P = .004). Serum transferrin was significantly lower in malaria-positive donors (2.15±0.27 g/L) than malaria-negative donors (2.35±0.77 g/L; t = 3.328, P < .001) but did not differ significantly by microfilaria status. Abnormal serum iron was significantly associated with malaria positivity (χ² = 14.400, P < .001) but not with microfilaria status. Conclusion: Asymptomatic malaria and, to a lesser extent, microfilaria infection meaningfully disrupt serum iron and transferrin homeostasis among donor-eligible individuals who pass current clinical screening. Incorporating haemoparasite screening into donor selection algorithms could improve both transfusion safety and donor iron-health monitoring in malaria-endemic settings such as southwestern Nigeria.