Malaria and blood donation
Frequently asked questions
I recently travelled to a malaria-endemic region, where preventative medications are recommended. I used medications and mosquito repellants — do I still have to wait to donate blood products?
Most likely, yes. Even if prevention methods such as anti-malarial drugs, topical mosquito repellant or insecticide treated bed nets were used during your travels, the chances of exposure to malaria cannot be eliminated.
Your waiting period to donate whole blood or platelets will depend on the length of your stay in certain regions. This is because the chance of having a new or previously unrecognized infection diminishes over time.
- If your stay was less than one day, you may be able to donate depending on where you were.
- If your stay was less than six (6) months, you will need to wait three (3) months from the date you left a malaria-endemic region.
- If your stay was six (6) months or more, you will need to wait three (3) years.
If your visit lasted less than 24 hours, please call us at 1 888 2 DONATE (1 888 236-6283) to discuss your eligibility.
I have fully recovered from malaria. Can I donate blood?
The parasites that cause malaria can lie dormant for decades. This means that no matter how much time has passed, there remains a small chance that someone who has had a malaria infection at some point in their lives may still carry malaria parasites in their blood. Even just one malaria parasite in donated blood can lead to malaria being transmitted to the blood recipient, which could cause severe illness and even death.
For this reason, people who have had malaria are not eligible to donate whole blood or platelets. However, they may be able to donate plasma used to manufacture lifesaving medications, stems cells, organs and/or tissues (see below for more information).
We know that these deferrals may cause hurt and frustration for those who are unable to donate in the way that is most meaningful to them. We are committed to deepening our learning, continuing to review scientific data, and actively engaging with communities affected by these policies to advance inclusive practices, while ensuring the safety and sufficiency of Canada’s blood supply.
Aren’t all blood donations tested? Why would someone be deferred from donating prior to testing?
Canada’s blood supply is recognized as one of the safest in the world. One reason we have such a safe blood system, is because of the layering of a donor screening questionnaire with donation testing. Every donation is tested for an array of infections that could be transmitted by blood transfusion. But no test is perfect, and there are some infections for which there is no test.
Unfortunately, at this time, there is no suitable, Health Canada-approved screening test available that can adequately screen blood donors for malaria. In the absence of an available test in Canada, we rely on thorough donor eligibility assessments based on possible exposures.
Of note, there is a significant difference between the blood screening tests (licensed by Health Canada) that we use at Canadian Blood Services to detect transfusion-transmitted infectious agents, and the diagnostic tests that are used in hospitals to establish the presence (or absence) of disease. Unlike diagnostic tests, blood screening tests administered by Canadian Blood Services and other blood operators around the world, do not provide a comprehensive diagnostic assessment. This is because blood screening tests are designed to screen a generally healthy population, not a patient with symptoms.
Why can people who have recovered from malaria donate source plasma but not whole blood?
People who have recovered from malaria more than six months ago may be eligible to donate source plasma, which is used to make lifesaving medications. Plasma contains important substances, including proteins that are vital for our immune systems, and for healing and blood clotting.
When plasma is collected, red blood cells are removed. Malaria parasites infect red blood cells, so their removal during the plasma collection process also reduces the risk of transmission. Subsequently, when the collected plasma is treated and processed to make valuable medications, infectious agents that cause malaria (including parasites) are inactivated.
Becoming a plasma donor can make a lifesaving difference for patients across Canada who depend on medicines made from donated plasma. These specialized medicines help treat a variety of rare, life-threatening conditions. Learn more about how your donated plasma touches the lives of patients and their families.
If you are interested in making a source plasma donation or have any questions about your eligibility to donate, please call us 1 888 2 DONATE (1 888 236-6283) for more information.
Why can people who have recovered from malaria donate stem cells?
Bone marrow is where our body makes blood. Stem cells in the bone marrow make all types of blood and immune cells. For some blood diseases and disorders, including blood cancers (leukemia) and other red cell diseases like sickle cell anemia and thalassemia, a stem cell transplant can offer a cure, or be a lifesaving therapy. A stem cell donation from a healthy donor gives the recipient’s body the ability to make new immune and blood cells, allowing them to recover. For many recipients, a stem cell transplant may be their best and only hope of returning to good health.
When a stem cell donor who has fully recovered from malaria is matched to a specific patient requiring a stem cell transplant, the donor is asked to complete an extensive health history form. This form includes questions about travel, history of residence and history of malaria. This information is then provided to the hospital-based stem cell transplant team, who independently assesses the eligibility of each donor (this includes an in-person assessment with a physician). Based on these assessments, the recipient and their transplant team will then be able to weigh the risks and benefits of receiving lifesaving stem cells.
Why can people who have recovered from malaria donate organs and tissues but not whole blood?
As malaria parasites can lay dormant for extended periods of time within blood cells and the liver, the risk of malaria transmission will be different for each organ/tissue. The recipient and their transplant team will weigh the risks and benefits of receiving organs and tissues.
Like the process for stem cell donation, organ and tissue donors are assessed independently by a transplant team. The assessment process involves extensive screening questions and an in-person assessment with a physician. Each situation is different, and the final decision on suitability is made in consultation with the attending physician and the recipient.
Why are the donor screening criteria for malaria different in different countries?
Canadian Blood Services looks at patterns of disease and risk specific to Canada.
To ensure the safety of the blood supply, each country and jurisdiction around the world makes region-specific decisions about the risks and benefits of various criteria, based on their local context. There is no uniform approach to malaria screening amongst blood operators around the world. Our blood donor eligibility criteria are developed within a strict, evidence-informed regulatory framework that focuses on product quality and recipient safety.
Why do the criteria for malaria seem to disproportionately defer people from African, South Asian and South American countries?
Safeguarding against transfusion-transmitted infections starts with a deep, research-informed understanding of how an illness occurs, which includes geographical distribution patterns. Every time someone donates blood, we ask about where they may have previously lived or travelled. This is because the places someone has lived in, or travelled to, can increase their chances of exposure to infectious agents that may be transmitted to recipients through blood transfusions.
Canadian Blood Services uses the United States Centers for Disease Control (CDC) malaria information to determine which regions have occurrences of malaria that are high enough to require medications to prevent infection. Based on CDC publications, we know that malaria transmission occurs disproportionately in certain regions within sub-Saharan Africa, South Asia and South America. Unfortunately, this means that donor deferrals for malaria disproportionately impact people who have travelled to, or lived in, these regions. The list of regions where the chances of acquiring malaria may be greatest can be found here.
We truly empathize that being turned away from donating blood may leave donors with a sense of frustration and disappointment.
As our testing platforms and research into various diseases continues to advance, we remain committed to continuously reviewing and updating our eligibility criteria and removing existing barriers to donation. This includes evaluating possible alternatives to deferral, based on risk assessment.
What is Canadian Blood Services doing to make donation more equitable for people who have lived in, or travelled to, malaria-endemic regions?
We understand there are lasting consequences of past and current eligibility criteria, and we are undertaking work to further understand and address the impact of these criteria on people from regions where malaria is endemic.
This engagement work involves addressing barriers to donation and building relationships based on trust and reciprocity. We know this is complex work that will take many years, but we are committed to fostering more positive and inclusive donation experiences for all donors.
Additionally, as the patterns of disease, testing platforms and research continue to advance, we also continuously review and update our eligibility criteria and risk management strategies. This includes evaluating possible alternatives to deferrals, based on risk assessment.
What is Canadian Blood Services doing to address barriers to donation more broadly?
Our diversity, equity and inclusion (DEI) team is leading critical work to build a culture of psychologically safe and racially-just environments at Canadian Blood Services for equity-deserving groups. This work involves establishing culturally-safe policies, procedures, and other institutional practices to address existing barriers to donation at Canadian Blood Services. Importantly, these efforts involve working closely with internal and external stakeholders to co-create equity-based strategies that will maximize donor and registrant inclusion.
You can learn more at blood.ca/DEI.