{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:56:23Z","timestamp":1790841383936,"version":"4.1.0"},"reference-count":62,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Blood donor deferral for malaria risk relies exclusively on responses to self\u2010reported questionnaires. This study evaluated the economic impact of introducing\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      nucleic acid testing (NAT) as a universal screening strategy in the United States.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>\n                      A budget impact analysis comparing scenarios with and without universal\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      NAT screening was conducted. In the testing scenario, question (Q) 29 on malaria risk was removed from the donor questionnaire. NAT was performed on mini\u2010pools of 16 donations, followed by individual testing of reactive pools. Clinical, epidemiological, and cost inputs were obtained through a targeted literature review. The analysis adopted the perspective of blood suppliers and included a 1\u2010to\u20103\u2010year projection with a one\u2010way sensitivity analysis. Costs were adjusted to 2021 USD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Universal\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      NAT screening is estimated to yield a net cost saving of 13,628,616 USD for US blood suppliers in the first year. While implementing NAT would add 4,443,286 USD in expenses, these costs would be offset by additional donations from donors previously deferred due to malaria risk identified by Q29 (266,438 extra blood products, resulting in 15,037,737 USD additional revenue), and labor savings of 3,034,165 USD from removing Q29, which is time\u2010consuming, labor\u2010intensive, and error\u2010prone. Assuming an annual average increase of 2.4% in donations, projected savings are 13,865,670 USD in year 2 and 14,108,893 USD in year 3.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Implementing universal\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      NAT screening could enhance the availability and safety of blood products in the United States while reducing labor costs and losses from collections from deferred donors.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70396","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:05:29Z","timestamp":1790838329000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Budget impact of implementing universal\n                    <scp>\n                      <i>Plasmodium<\/i>\n                      NAT\n                    <\/scp>\n                    screening in the blood transfusion system in the\n                    <scp>US<\/scp>"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8603-1520","authenticated-orcid":false,"given":"Cristina","family":"Coll\u2010Ortega","sequence":"first","affiliation":[{"name":"Grifols SA  Sant Cugat Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3253-0148","authenticated-orcid":false,"given":"Elisabet","family":"Viayna","sequence":"additional","affiliation":[{"name":"Grifols SA  Sant Cugat Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiani","family":"Zhou","sequence":"additional","affiliation":[{"name":"Grifols GSSNA  Clayton North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5865-6366","authenticated-orcid":false,"given":"Susan L.","family":"Stramer","sequence":"additional","affiliation":[{"name":"Infectious Disease Consultant  North Potomac Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2405313"},{"key":"e_1_2_12_3_1","unstructured":"World Health Organization (WHO).World malaria report 2024. [Accessed Nov 27 2025]. Available from:https:\/\/www.who.int\/teams\/global\u2010malaria\u2010programme\/reports\/world\u2010malaria\u2010report\u20102024"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.20-0186"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0235014"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-018-2226-4"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pt.2022.11.008"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-020-03344-z"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanmic.2025.101073"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss7108a1"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7318a2"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7236a1"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7241a3"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid3006.240336"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2006.00733.x"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-018-2181-0"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14778"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-016-1398-z"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejm200106283442603"},{"key":"e_1_2_12_20_1","unstructured":"US Food and Drug Administration.Recommendations to reduce the risk of transfusion\u2010transmitted malaria: guidance for industry. Center for Biologics Evaluation and Research. Available from:https:\/\/www.fda.gov\/regulatory-information\/search-fda-guidance-documents\/recommendations-reduce-risk-transfusion-transmitted-malaria"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2008.01825.x"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03158.x"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000525414"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.2450\/2022.0166-22"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.13748"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17612"},{"key":"e_1_2_12_27_1","unstructured":"US Food and Drug Administration.Recommendations to Reduce the Risk of Transfusion\u2010Transmitted Malaria: Guidance for Industry.2025Center for Biologics Evaluation and Research; [Accessed Nov 27 2025]. Available from:https:\/\/www.fda.gov\/regulatory\u2010information\/search\u2010fda\u2010guidance\u2010documents\/recommendations\u2010reduce\u2010risk\u2010transfusion\u2010transmitted\u2010malaria\u20100"},{"key":"e_1_2_12_28_1","unstructured":"Association for the Advancement of Blood and Biotherapies (AABB) America's Blood Centers (ABC) American Red Cross (ARC).Re: Docket No. FDA\u20102000\u2010D\u20100187 Recommendations To Reduce the Risk of Transfusion\u2010Transmitted Malaria; Draft Guidance for Industry.2025[Accessed Feb 23 2026]. Available from:https:\/\/americasblood.org\/wp\u2010content\/uploads\/2025\/03\/20250313\u2010AABB\u2010Joint\u2010Comments\u2010to\u2010FDA\u2010Jan2025\u2010Malaria\u2010Guidance.pdf"},{"key":"e_1_2_12_29_1","unstructured":"America's Blood Centers (ABC) The Association for Blood Donor Professionals (ADRP).U.S. Blood Donation Statistics and Public Messaging Guide (Version 2.0).2024[Accessed February 23 2026]. Available from:https:\/\/americasblood.org\/wp\u2010content\/uploads\/2024\/01\/U.S.\u2010Blood\u2010Donation\u2010Statistics\u2010and\u2010Public\u2010Messaging\u2010Guide\u2010Jan.\u20102024.pdf"},{"key":"e_1_2_12_30_1","volume-title":"Center for Biologics Evaluation and Research","author":"US Food and Drug Administration","year":"2024"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2018.1490301"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17279"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15118"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15620"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17509"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17951"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16778"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16005"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.2165\/11530740-000000000-00000"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16718"},{"key":"e_1_2_12_41_1","unstructured":"Salary.com. [Accessed Jun 29 2023] Available from:https:\/\/www.salary.com\/"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2013.08.2291"},{"key":"e_1_2_12_43_1","unstructured":"US Centers for Disease Control and Prevention (CDC).Clinical Testing Guidance for Blood Safety. Available from:https:\/\/www.cdc.gov\/blood-safety\/hcp\/diagnosis-testing\/index.html"},{"key":"e_1_2_12_44_1","unstructured":"International Trade Administration.US citizen travel to international regions.2023Available from:https:\/\/www.trade.gov\/us-international-air-travel-statistics-i-92-data"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2009.02290.x"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tracli.2019.12.001"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12855"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14028"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.3390\/v15091783"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12004"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.13705"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17740"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1159\/000491883"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-11-327361"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2012.11-0685"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0097398"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2015.03.004"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.18061"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-019-2650-0"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.13592"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1111\/voxs.12152"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.18431"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.70133"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70396","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.70396","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:05:33Z","timestamp":1790838333000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.70396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":62,"alternative-id":["10.1111\/trf.70396"],"URL":"https:\/\/doi.org\/10.1111\/trf.70396","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,1]]},"assertion":[{"value":"2026-03-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"trf.70396"}}