One in six blood donors in Cameroon carries Plasmodium infection, meta-analysis finds

Photo by CDC / Unsplash

PLoS neglected tropical diseases Published May 30, 2026 Medically reviewed May 30, 2026 Study authors: Malieuze Nanfah Megane D, Binam Nkot Verónica M, Yop Kite Michel M, Beack Bayengue Sandrine S, Tcham… PubMed ↗ DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider that neglected transfusion-transmitted infections, especially Plasmodium, are prevalent in Cameroonian blood donors, warranting updated screening policies.

This systematic review and meta-analysis pooled data from 18 studies involving approximately 12,500 blood donations across three regions of Cameroon (Littoral, Northwest, Centre) to estimate the prevalence of neglected transfusion-transmitted infections. The primary outcome was the pooled proportion of Plasmodium spp., Loa loa, and SARS-CoV-2 in blood donors.

Key findings include a pooled Plasmodium spp. prevalence of 16.6%, SARS-CoV-2 prevalence of 17.7%, and Loa loa prevalence of 0.5%. The authors note that no evidence of SARS-CoV-2-associated transfusion-transmitted infections has been documented to date. Secondary outcomes regarding clinical impact (immunoglobulin E and albumin levels) were limited by a paucity of studies.

Limitations include significant publication bias for Plasmodium studies (p=0.004), most studies originating from only three regions, and a lack of robust clinical impact data. The authors emphasize that these are pooled proportions from a meta-analysis with noted bias, and no causal inferences can be drawn.

Practice relevance: The findings highlight the need to include neglected pathogens in blood safety guidelines in Cameroon, though the evidence is associative and not definitive.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

PMID42189856

View Original Abstract ↓

BACKGROUND: Blood supply is a public health challenge in African countries. In Cameroon, blood selection guidelines focus on four viral and bacterial pathogens (HIV, hepatitis B and C viruses, Treponema pallidum) associated with transfusion-transmitted infections (TTIs). Other pathogens, often endemic (e.g., Plasmodium spp.), are not routinely screened in blood banks and are not included in blood safety guidelines or surveillance, despite their potential for transfusion transmission. MATERIALS AND METHODS: Here, we conducted a systematic review and meta-analysis of prevalence, determinants, and clinical impact of 'neglected' pathogens, defined as pathogens not included in national blood safety guidelines (e.g., filaria, dengue virus, Toxoplasma gondii), in blood banks. Additionally, we identified the most urgent challenges and proposed actionable solutions to guide blood safety guidelines in the country. RESULTS: A total of 18 studies, covering ~12,500 donations, were included, with the bulk coming from donors living in three regions (Littoral, Northwest, Centre). Plasmodium parasite (68.4%) was the major studied pathogen, even though an evident publication bias was found (p = 0.004). The other pathogens included dengue virus (5.3%), T. gondii (5.3%), and HTLV-1 (5.3%). The filarial parasite Loa loa was consistently accidentally found. Even though there is no evidence of SARS-CoV-2-associated TTIs till now, the pooled proportion of this virus was 17.7%. The pooled proportions of infection in blood donors were 16.6% for Plasmodium spp. and 0.5% for Loa loa. There is a paucity of clinical impact studies on these 'neglected' TTIs, and the available literature suggests impaired levels of immunoglobulin E and albumin. We identified urgent challenges, including awareness among healthcare providers and policymakers, diagnostic and logistical constraints, and low microbial density infections, associated with neglected pathogen-related blood safety. CONCLUSION: We opine that providing more epidemiological evidence is crucial to address the above-mentioned challenges for guiding and guaranteeing blood safety in Cameroon.