Differentiation of cases of TTM from natural infections is very
difficult in endemic areas as malaria occurring post-transfusion
can be the result of natural infection via a mosquito bite,
rather than from the transfusion received. Furthermore, in
endemic areas, many of the donors and patients are already
infected with, or are at high risk of, malaria infection.
Identifying low-risk individuals is virtually impossible.
One approach is to use Giemsa-stained thick films or rapid
diagnostic tests (RDTs) for malarial antigen to identify those
donors with higher levels of parasitaemia