Risk factors of transfusion transmissible infections among blood donors at Karongi Regional Centre for blood transfusion in Rwanda

Background Blood transfusion saves human lives, but also it can be a route for TransfusionTransmissible Infections (TTIs) including Human Immuno-Deficiency Virus (HIV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), and syphilis. Objective This study aimed to explore the risk factors associated with TTIs among blood donors at Regional Centre for Blood Transfusion (RCBT) of Karongi, Rwanda. Methods This was a retrospective cross-sectional study design conducted among 36,708 blood donors from 2015 to 2019. Data were extracted from the system known as eProgesaused and the outcome variable were TTIs including HBV, HCV and HIV (measured using Enzyme Immuno-Assay/Chemiluminescence Immunoassay) and syphilis (determined by Rapid Reagin Plasma). Descriptive statistics was computed to describe the characteristics of the blood donors. Bivariate and multivariable logistic regression were performed to assess the risk factors associated with TTIs. P value less than 0.05 was considered statistically significant. Results The study found that the overall prevalence of TTIs was 2.1%, while the prevalences of HBV, HCV, HIV, and syphilis were 1.3%, 0.4%, 0.06%, and 0.34%, respectively. Multivariable analysis showed that the factors associated with HBV, HCV, HIV and syphilis were being male, age more than 25 years, being married, living in urban areas, first time blood donors and blood donors living in Rusizi, Rusizi, Nyamasheke and Karongi districts. Conclusion This study revealed that the most frequent TTI was HBV among blood donors and the main risk groups were males, age group of 26-35 years, married and first time donors. Hence, while developing health policies to reduce the effects of HBV infection on safe blood transfusion, these study findings should be taken into account.

Prevalence and factors associated with the severity of anaemia among patients on chronic haemodialysis in Lagos, Nigeria

Anaemia is a global public health problem with high mortality and morbidity. It is also a common consequence of chronic kidney disease (CKD). There is a paucity of data on the actual burden of anaemia among patients on chronic haemodialysis (CHD) in Lagos, Nigeria. Objectives: To determine the prevalence and factors associated with the severity of anaemia among Nigerian patients undergoing chronic haemodialysis. Methods: This was a retrospective analysis of adult patients with end-stage renal disease (ESRD) on maintenance haemodialysis at the Lagos State University Teaching Hospital, Ikeja, Lagos. The data extracted from the clinical case files included the bio-demographic and clinical parameters, including the treatment modalities. Results: A total of 92 patients comprising 69 (75%) males and 23 (25.0%) females with the overall mean age of 48.2±14.0 years were included. Hypertension was the commonest aetiology of CKD and the average duration of haemodialysis was 16.6 months. The commonest access route for haemodialysis was a central line while 96.7% and 81.5% received erythropoietin and intravenous iron sucrose respectively. Seventy-three (79.3%) patients have had intra-dialysis blood transfusions in the past. Mild, moderate, and severe anaemia were recorded in 17%, 67%, and 16% respectively. The use of erythropoietin, iron sucrose, and increased frequency of blood transfusions correlated with the severity of anaemia. Conclusion: Anaemia is highly prevalent among patients with CKD on chronic haemodialysis. Increased frequency of blood transfusions, inadequate utilization of erythropoietin, and iron sucrose administration are associated with anaemia severity.

Use of exchange blood transfusion in the management of severe COVID-19 infection in pregnancy: experience from Lagos, Nigeria

Coronavirus disease 2019 (COVID-19) presents with symptoms that may be mild or severe. The individual with the severe form of the disease usually presents with a constellation of respiratory symptoms typical of acute respiratory distress syndrome. In this report, we present our experience of the successful management of an oxygen-dependent pregnant woman with severe COVID-19 infection who had 2 sessions of partial exchange blood transfusion. We discussed the principles that informed this intervention and the need to adopt this novel approach in the care of severe COVID-19 infection.

Insuffisance rénale chronique: aspects épidémiologique, diagnostique, thérapeutique et évolutif au CHU de Bouaké de 2016 à 2020 / Epidemiological aspects, diagnosis features and therapeutic outcome of chronic kidney disease at the Teaching Hospital of Bouake from 2016 to 2020

Le profil épidémiologique de l'insuffisance rénale chronique (IRC) varie d'un pays à un autre et d'une région à une autre dans un même pays. L'objectif de la présente étude était de décrire les cas d'IRC observés dans la ville de Bouaké. Méthodes : il s'agissait d'une étude rétrospective réalisée dans le service de Médecine Interne du CHU de Bouaké durant la période allant du 1er Janvier 2016 au 31 Décembre 2020. L'IRC était définie par un DFG inférieur à 60 ml/minute évoluant depuis plus de trois mois et/ou une atrophie rénale. Résultats : nous avons recensé 150 cas donnant une prévalence hospitalière de 3,6%. L'âge moyen était de 38,8±10 ans avec une prédominance masculine. Les antécédents étaient dominés par l'automédication traditionnelle et l'hypertension artérielle dans 68% des cas chacun. Dans 91% des cas, l'IRC était classée grade 5. Les étiologies étaient dominées par l'hypertension artérielle (34%). Le traitement symptomatique était la transfusion dans 73% et l'usage des antihypertenseurs dans 73%. Le traitement de suppléance était indiqué dans 91% et réalisé dans 3%. La mortalité était de 25%. Les facteurs associés à la survenue du décès étaient une altération de l'état général, une hypercréatininémie, une hyperphosphorémie, des reins atrophiés et le recours à la transfusion sanguine. Conclusion: l'IRC était diagnostiquée à un stade sévère. La principale cause était l'hypertension artérielle. La mortalité demeure élevée, faute d'accès au traitement de suppléance. L'accent doit être mis sur la prévention de l'IRC au cours des pathologies à risque.

Background: The epidemiological profile of chronic kidney disease (CKD) varies from country to country and from region to region within, even in the same country. The objective of this study was to describe the cases of CKD found in the city of Bouake (Ivory Coast). Methods: We proceeded to a retrospective study carried out in the Internal Medicine department of the Bouake University Hospital from January 1, 2016 till December 31, 2020. CKD was defined by a GFR (Glomerular Filtration Rate) at less than 60 ml/ minute and small kidneys. Results: In all , we identified 150 cases corresponding to 3.6% as hospital prevalence . The mean age was 38 .8 ± 10 years with a male predominance. The history was dominated by traditional self-medication and high blood pressure (HBP) for respectively 68% of cases. In 91% of cases , the CKD was classified as grade 5. The etiologies were dominated by HBP (34%). The care was a symptomatic one using transfusion in 73% and antihypertensive medication was prescribed for 73% of the patients. The substitution treatment was indicated in 91% of cases and carried out in 3%. The rate of mortality was 25 % and factors associated with death were a deterioration of the general condition, increased of blood level of creatininemia, hyperphosphatemia, small size of kidneys and the use of blood transfusion. Conclusion: CKD was diagnosed at a severe stage. The main cause was high blood pressure. Mortality remains high due to lack of access to replacement therapy . Emphasis should be placed on the prevention of CKD in high-risk pathologies

Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria ­ A multi-facility study of 34 tertiary hospitals

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

Anémie chez les donneurs de sang volontaires après vérification de l'hémoglobine pré-don au Centre de Transfusion Sanguine de Libreville / Anemia in voluntary blood donors after verification of pre-donation hemoglobin at the Libreville Blood Transfusion Center

Introduction : La nécessité de disposer de produits sanguins labiles (PSL) de qualité est un impératif de la transfusion sanguine. Le don de sang n'est pas sans risque pour le donneur. Ce qui soulève la question de la perte de fer par spoliation sanguine. Ce constat a conduit à la réalisation de cette étude dans le but de rechercher l'anémie chez le donneur de sang volontaire jugé apte après évaluation de l'hémoglobine pré-don et d'en déterminer la cause. Patients et méthodes : Il s'agissait d'une étude transversale prospective réalisée au Centre National de Transfusion Sanguine (CNTS) de Libreville. La population d'étude était constituée de donneurs de sang, nouveaux ou anciens, volontaires en bonne santé chez qui les examens suivant ont été réalisés pour le diagnostic de l'anémie et celui de la carence en fer tout en excluant d'autre étiologies: l'hémogramme, le dosage de la Protéine C Réactive (CRP), le fer sérique, la ferritine, l'hepcidine et le test de diagnostic du paludisme (TDR).Résultats : Sur l'ensemble des deux cent quinze volontaires inclus, trente - quatre (15,8%) présentaient une anémie parmi lesquels douze femmes et vingt- deux hommes d'un âge moyen de 32,8 ±8,0. Le nombre de dons effectués était corrélé à la survenue de l'anémie selon le genre et l'âge du donneur. Il en a été de même pour les valeurs de la ferritine, du fer sérique.Conclusion : Le nombre important d'anémie est lié à un seuil bas de l'hémoglobine pré-don. Le caractère microcytaire hypochrome de l'anémie laisse supposer une origine ferriprive.

Introduction: The need to have quality labile blood products (LBP) is an imperative of blood transfusion. Blood donation is not without risk for the donor. This raises the question of the loss of iron by blood spoliation. This finding led to the realization of this study with the aim of looking for anemia in voluntary blood donors deemed suitable after evaluation of the pre-donation hemoglobin and to determine the cause.Patients and methods: This was a prospective cross-sectional study carried out at the National Blood Transfusion Center (CNTS) in Libreville. The study population consisted of blood donors, new or old, healthy volunteers in whom the following examinations were carried out for the diagnosis of anemia and that of iron deficiency while excluding other etiologies: blood count, C-Reactive Protein (CRP), serum iron, ferritin, hepcidin and malaria diagnostic test (RDT). Results: Of the two hundred and fifteen volunteers included, thirty-four (15.8%) presented anemia, including twelve women and twenty-two men with an average age of 32.8 ±8.0. The number of donations made was correlated with the occurrence of anemia according to the sex and age of the donor. It was the same for the values of ferritin, serum iron. Conclusion: The large number of anemia is linked to a low threshold of pre-donation hemoglobin. The hypochromic microcytic character of the anemia suggests an iron deficiency origin.

Transfusion, mortality and hemoglobin level: associations among emergency department patients in Kigali, Rwanda

Background: Studies from high-income countries (HIC) support restrictive blood transfusion thresholds in medical patients. In low- and middle-income countries (LMIC), the etiologies of anemia and baseline health states differ greatly; optimal transfusion thresholds are unknown. This study evaluated the association of packed red blood cell (PRBC) transfusion with mortality outcomes across hemoglobin levels amongst emergency center (EC) patients presenting with medical pathology in Kigali, Rwanda. Methods: This retrospective cohort study was performed using a random sample of patients presenting to the EC at the University Teaching Hospital of Kigali. Patients ≥15 years of age, treated for medical emergencies during 2013­16, with EC hemoglobin measurements were included. The relationship between EC PRBC transfusion and patient mortality was evaluated using logistic regression, with stratified analyses performed at hemoglobin levels of 7 mg/dL and 5 mg/dL. Results: Of 3609 cases sampled, 1116 met inclusion. The median age was 42 years (IQR 29, 60) and 45.2% were female. Transfusion occurred in 12.1% of patients. Hematologic (24.4%) and gastrointestinal pathologies (20.7%) were the primary diagnoses of those transfused. Proportional mortality was higher amongst those receiving transfusions, although not statistically significant (23.7% vs 17.0%, p=0.06). No significant difference in adjusted odds of overall mortality by PRBC transfusion was found. In stratified analysis, patients receiving EC transfusions with a hemoglobin >5.0 mg/dL, had 2.21 times the odds of mortality (95% CI 1.51­3.21) as compared to those ≤5.0 mg/dL. Conclusions: No association between PRBC transfusion and odds of mortality was observed amongst EC patients in this LMIC setting. An increased mortality association was found for patients receiving PRBC transfusions with an initial hemoglobin >5 mg/dL. Results suggest benefits from PRBC transfusion are limited as compared to HIC. Further research evaluating emergent transfusion thresholds for medical pathologies should be performed in LMICs to guide practice

Seroprevalence of transfusion-transmissible infections among blood donors in the Hohoe Municipality Hospital, Ghana: 2015-2016: a retrospective hospital-based cross-sectional study

Introduction: unsafe blood remains a major threat to the global spread of transfusion transmissible infections (TTIs). Blood is usually tested for four TTIs: Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Syphilis before transfusion. This study determined the trends of transfusion-transmissible infections among blood donors in the Hohoe Municipal Hospital, Ghana from 2015 to 2016. Methods: a total of 3,173 blood donor records were reviewed for the presence of anti-HIV 1/2 IgG/IgM, HBV, anti-HCV IgG/IgM, and anti-Treponema pallidum IgG/IgM/IgA, using commercial ELISA kits following standard protocols. Statistical analysis was performed using Stata version 14.0 at the level 0.05 Results: seroprevalence of HIV, HBV, HCV and Syphilis were 3.9% 5.0%, 4.2% and 5.2% respectively. Females were 30% less likely to be infected with Syphilis (OR=0.3; 95% CI: (0.15-0.69); p=0.004); donors aged 20-29 years were 60% less likely to be infected with HIV than those less than 20 years (OR=0.6; 95% CI: (0.04-0.99); p=0.049), while those aged 30-39 years were 90% more likely to be infected with Syphilis than those less than 20 years (OR=1.9; 95% CI: (1.23-3.20) p=0.005) and those aged 40-49 years were 2 times more likely to get infected with HBV than those less than 20 years (OR=2.2; 95% CI: (1.17-4.04)); p=0.013). Conclusion: males presented higher prevalence of Syphilis and all TTIs were recorded highest among young adults. It is important to continue screening donated blood with highly sensitive tests and to sensitize young adults, especially females on the importance of blood donation

Organisational management of hospital blood transfusion services in Nairobi County, Kenya: Evidence of implementation

Background: The World Health Organization in 2002 recommended implementation of a quality system for national blood programmes to ensure adequate and safe blood products to patients. Key elements of the quality system include organisational management, standards, documentation, training and assessment.Objectives: The aim of this study was to describe the extent to which organisational management, which is the first element of a quality system, has been implemented in hospitals in Nairobi County, Kenya.Methods: A descriptive, cross-sectional study design was used. Sixty health workers were selected as respondents from 15 hospitals that provide blood transfusion services in Nairobi County. The data collection period was from June to August 2015 and the data were analysed in 2016.Results: Faith-based hospitals had the lowest level of organisational management implementation (33.3%), private hospitals had 42.5%, whereas government hospitals had the highest implementation (60%). The extent of implementation was based on performance of the senior management team, overall rated by the respondents at 40.1%, establishment of hospital transfusion committees in nine (60%) of the hospitals and appointment of key staff ­ quality officers in three (20%) hospitals and blood transfusion specialists in six (40%) hospitals. These key staff were instrumental in steering the quality system and ensuring sound blood transfusion practices.Conclusion: The implementation of quality management systems in hospital blood transfusion services can be improved through commitment from senior management teams, who should provide the necessary resources for employment of key staff and establish and empower hospital transfusion committees to guide the blood transfusion services

Elevated unidentified antibodies in sickle cell anaemia patients receiving blood transfusions in Cape Town, South Africa

Background. Sickle cell disease (SCD) is an inherited haemoglobinopathy in which homozygous individuals suffer from numerous complications including vaso-occlusion, infection and haemolytic anaemia. Patients therefore often require blood transfusions, which may lead to elevated levels of allogeneic antibodies. In South Africa (SA), the number of patients with SCD has risen significantly owing to migration and changing demographics, leading to an increased need for blood products.Objectives. Against the above background, to determine the incidence of alloimmunisation and the presence of clinically significant antibodies in SCD patients requiring transfusions in Cape Town, SA.Methods. Information on SCD patients receiving blood products between 2010 and 2012, including demographics, number of units transfused and the presence and type of alloantibodies, was collected. The results were compared with those for non-SCD controls who had received a similar number of transfusions.Results. Of 182 patients analysed, 91 had SCD. Twenty-two percent of the SCD patients and 13.2% of the controls had become alloimmunised (p=0.12), while the proportions of those receiving transfusions and acquiring clinically significant antibodies were similar between the two groups (p=0.17 and p=0.19, respectively). However, the total number and amount of unidentified antibodies were significantly increased in patients with SCD (p=0.02 and p<0.001, respectively).Conclusions. This study concluded that patients with SCD develop increased numbers of unidentified antibodies, which may be important in the selection of suitable donors

Towards the future of blood transfusion ­ the South African national blood service's perspectives on cellular therapeutic services and products

Blood transfusion services are the cornerstone of the healthcare delivery system, and need to stay abreast of advances in technology to ensure relevance to the needs of the country. In this review, we examine the current status of blood transfusion systems and discuss their possible future role in cellular therapies

The use of locally fabricated compact fluorescent lamps (CFL) phototherapy devices in the management of significant neonatal hyperbilirubinaemia

Abstract: One of the challenges of managing significant neonatal hyperbilirubinaemia in resource-poor settings is limited access to effective phototherapy devices hence the need to try appropriate technologies. The objective was to assess the effectiveness of Compact Fluorescent Lamps phototherapy devices in the management of significant neonatal hyperbilirubinaemia in a resource-poor setting. A cohort of babies with significant hyperbilirubinaemia managed with locally fabricated Compact Fluorescent Lamps (CFL) phototherapy devices (2014-2016) were compared with historical controls managed with conventional imported phototherapy devices (2007-2010) for the severity of hyperbilirubinaemia and requirements for Exchange Blood Transfusion. A total of 96 babies in the subject group and 202 babies in the control group were studied. The proportion of babies with peak TSB >30mg/dl was significantly higher among the controls compared to the subjects (p < 0.001). The interval between the commencement of phototherapy and the peak TSB was greater than 1 day among 30.2% (29/96) subjects compared to 74.3% (150/202) babies in the control group (p < 0.001). The mean duration of phototherapy was significantly shorter for the subjects compared to the controls. EBT was performed for 38.5% of the subjects and 51.5% of the controls. Single sessions of EBT were required for 78.4% of the subjects compared to 45.2% of the controls (p = 0.001). In conclusion, the locally fabricated Compact Fluorescent Lamps phototherapy devices reduced EBT rate among babies with significant hyperbilirubinaemia

Toxicité hématologique sévère du linezolide au cours du traitement de la tuberculose pharmacorésistante : A propos de deux(2) cas au service de Pneumo-Phtisiologie du CHU de Conakry

Introduction : Le linezolide est un médicament potentiellement efficace pour le traitement des patients atteints de tuberculose pharmaco-résistante. En dépit de son efficacité et sa bonne biodisponibilité, il présente des toxicités, dont celle hématologique demeure l'une des plus graves. Nous rapportons deux cas de toxicité hématologique du linézolide au cours du traitement de la tuberculose pharmacorésistante. Le premier cas concernait un patient de 65 ans traité pour une tuberculose multi-résistante avec un schéma thérapeutique contenant du linézolide. L'évolution fut marquée par la survenue d'une pancytopénie avec anémie sévère à 5,4 g et un tableau d'insuffisance rénale. L'issue fut favorable après arrêt du médicament et transfusion sanguine. Le second cas concernait un patient de 33 ans, pré XDR qui lutte contre la tuberculose depuis 10 ans avec cinq cures de chimiothérapie antituberculeuse qui se sont soldées par des échecs et résistances. Au cours de son suivi, il a présenté une bonne évolution clinique et bactériologique initiale mais rapidement était survenue une anémie sévère à 5g/dl, à cette anémie était associées des neuropathies périphériques. Le Linezolide avait été retiré du schéma thérapeutique, suivi de transfusions sanguines. La suite avait été favorable sous traitement antituberculeux et le patient fut guéri de sa tuberculose. Conclusion Le linézolide est efficace dans le traitement de la tuberculose pharmacorésistante mais présente une toxicité hématologique

Medical selection effectiveness inassessing the risk of HIV transmission in blood transfusion in Antananarivo Madagascar

Un défi auquel fait face un centre de transfusion en Afrique consiste à assurer une sécurité transfusionnelle optimale. Il est estimé que 25% des dons de sang collectés en Afrique sub-saharienne francophone sont infectés par des agents viraux (HIV, HBV, HCV), parasitaires (Plasmodium spp., microfilaires) et bactériennes. Méthode : Il s'agit d'une étude rétrospective descriptive effectuée au CRTS Analamanga. L'étude concerne tous les dons enregistrés au CRTS Analamanga durant l'année 2013 et l'année 2014. La prévalence du VIH chez les donneurs de sang durant ces deux périodes a été comparée à celle rapportée dans la population générale. Nous avons comparé la prévalence du VIH au niveau du CRTS en utilisant le test de l'écart-réduit avec les données du SE/CNLS 2013 pour l'année 2013 et les données du SE/CNLS 2014 pour l'année 2014. Résultats: Le nombre de total de dons pour l'année 2013 était de 14316. La prévalence du VIH était de 0,78% (112/14316) (ℇ = 5,46). Pour l'année 2014, le nombre total de dons était de 16551 donnant une prévalence du VIH de 0,28% (472/16551) (ℇ = 0,31) Conclusion : La sélection médicale est le seul moyen le plus efficace pour la réduction des IT par le sang en transfusion en Afrique et à Madagascar. La sélection médicale du donneur avec le questionnaire actuel est inefficace pour diminuer le risque de la transmission du VIH par la transfusion sanguine. Une élaboration d'un nouveau questionnaire est urgente. L'adoption des stratégies adaptées aux réalités locales est bénéfique pour le pays

Profil épidémiologique, diagnostique, thérapeutique et évolutif des nouveau-nés de faible poids de naissance transfusés au Centre Hospitalier Universitaire de Bouaké (Côte d'Ivoire)

Introduction : La transfusion sanguine est une pratique fréquente en néonatalogie. Aucune étude n'a porté sur cette thérapeutique salvatrice chez le Faible Poids de Naissance (FPN) au CHU de Bouaké. L'objectif de cette étude était de décrire le profil épidémiologique, diagnostique, thérapeutique et évolutif du FPN transfusés pour l'amélioration du pronostic et de la pratique professionnelle. Méthodes : Il s'agissait d'une étude rétrospective, descriptive et analytique réalisée de janvier 2016 à décembre 2017 dans l'unité de néonatalogie du CHU de Bouaké. Etaient inclus tout nouveau-né transfusé quel que soit l'âge gestationnel. Les variables étudiées étaient, l'âge, le sexe, les signes cliniques, les étiologies, la transfusion et l'évolution. Résultats : Sur 1186 nouveau-nés de faibles poids de naissances hospitalisés, 121 (65 garçons, 56 filles) ont été transfusés soit 10,2%. Le nouveau-né, référé dans 78,2%, était prématuré dans 85 cas et hypertrophie dans 36 cas. La prématurité (42,9%), la souffrance néonatale (14,7%) et la difficulté respiratoire (11,4%) étaient les principaux motifs d'admission. Le taux d'hémoglobine médian était de 12,1g/dL. L'infection néonatale (56%) et la prématurité (19%) étaient les principales étiologies. Le culot globulaire érythrocytaire était utilisé dans tous les cas. La transfusion était efficace dans 94,3%. La polytransfusion, 7 cas (5,7%), était motivée par la persistance des signes de décompensation anémique. L'évolution des nouveau-nés était marquée par la guérison 51,2%, le décès 43% et la sortie contre avis médical 5,8%. Conclusion : La transfusion est fréquente chez le FPN au CHU de Bouaké. L'amélioration du pronostic nécessite une bonne collaboration entre le gynécologue-obstétricien, le Centre de Transfusion Sanguine et le pédiatre

Prevalence and associated risk factors of transfusion transmissible infections among blood donors at Regional Blood Transfusion Center Nakuru and Tenwek Mission Hospital, Kenya

Introduction: unsafe transfusion practices can put millions of people at risk of Transfusion Transmissible Infections (TTIs). In Kenya the current blood transfusion scheme involves screening of blood for HIV, Hepatitis B virus (HBV), Hepatitis C virus (HCV) and syphilis. Malaria is also a blood-borne disease which is not currently screened for. In Kenya blood donor selection criteria were reviewed in 2009. Regular review of effectiveness of donor selection criteria can help reduce TTIs prevalence amongst donors and thus make the blood supply safer.Methods: a cross sectional study was conducted between November 2011 to January 2012 among 594 blood donors in the Regional Blood Transfusion Center Nakuru and Tenwek Mission Hospital. Socio-demographic characteristics and associated risk factors were collected using a standard blood transfusion service questionnaire. Donors were obtained through systematic sampling. Each donor sample was screened, for HIV-1 and HIV-2, HBV, HCV, syphilis and malaria parasites.Results: the overall prevalence of TTIs was 14.1%, which ranged from 0.7% for malaria to 5.6% for HBsAg. Blood donors who were married (P=0.0057), had non-formal or just primary education (P=0.0262), had multiple sexual partners (P=0.0144) and in informal occupation (P=0.0176) were at higher risk of HIV positivity. History of blood transfusion/blood products (P=0.0055), being married (P=0.0053) were high risk factors associated with positive syphilis. Being male (P=0.0479) was a high risk factor to HBV infection. Conclusion: the prevalence of TTIs indicates a need to review the questionnaire and apply it strictly for donor selection. The 0.7% prevalence of malaria, poses a serious health risk to non-immune recipients of transfusion. Malaria should be included among mandatory TTI tests in Kenya

Knowledge and attitude of undergraduates towards blood donation: a cross sectional study of the University of Benin, Benin City

Background: Blood is an essential but scarce therapeutic element. The youth constitute an important age group that can contribute significantly to donor blood availability in health institutions. Their knowledge and attitude towards blood donation may influence their disposition to blood donation practices. Objective: The study seeks to determine the knowledge, attitude and blood donation practices among undergraduate students of the University of Benin. Methodolgy: This is a cross sectional study, conducted at the University of Benin, Benin City. Two hundred pretested questionnaires on knowledge, attitude and practice of blood donation were distributed among consenting undergraduate students across different faculties of the university. Data was analyzed with the statistical package for social science (SPSS IBM) version 20. Result: A total of 155 (79.5%) males and 40 (20.5%) females (M:F of approximately 3.8:1) completed the questionnaires. Their modal age group was 16 ­ 20 years. Sixty eight (34.9%) had good knowledge of blood donation process, 43 (22.1%) had average knowledge and 84 (43.0%) had poor knowledge. Repeat donation rate was 11.3% among the respondent. The practice of blood donation was significantly associated with good knowledge of blood donation process (p = 0.001). Blood donation was higher in those between the age groups of 21 ­ 25 years. Conclusion: Good knowledge of blood transfusion is below average. Blood donation practices is low among undergraduate students of the University of Benin and there is high disposition to family replacement donation

Red blood cell concentrate transfusion strategies utilised at a tertiary-level paediatric intensive care unit: A descriptive study on impact and cost

Background. Optimal haemoglobin threshold for red blood cell (RBC) transfusions in critically ill anaemic children in a paediatric intensive care unit (PICU) is uncertain.Objective. To describe outcomes and costs associated with different RBC transfusion strategies in anaemic patients admitted to a tertiary PICU in Durban, South Africa.Methods. Transfusion data gathered over a 1-year period were analysed retrospectively. RBC transfusion strategies were classified as restrictive, 'modified liberal' or mixed. The 'modified liberal' group was subdivided into haemodynamically stable or unstable clusters.Transfusion-related effects, comorbidities and mortality were described. Costs associated with RBC transfusions in the various strategy groups were analysed.Results. Over the 118 transfusion records analysed, a restrictive strategy was adopted in 27 cases (22.9%) and a modified liberal strategy was used in 68 cases (57.6%). A mixed strategy was followed in 23 (19.5%) cases. Although mortality was higher in the modified liberal group than in the restrictive group (27.9% v. 11.1%), the difference was not statistically different (p=0.09). There were no differences in the duration of intermittent positive pressure ventilation, length of PICU stay or post-transfusion effects between the restrictive and modified liberal transfusion strategies. A saving of R155 280.15 could have been realised if a restrictive transfusion strategy had been used for haemodynamically stable patients assigned to the modified liberal group. A further R28 988.67 was spent on avoidable after-hours transfusions levies.Conclusion. Adopting a restrictive daytime strategy for RBC transfusions at a PICU could introduceconsiderable cost savings without affecting outcomes

Intérêt du dosage de l'hémoglobine pré-don au Centre National de Transfusion Sanguine de Bamako

Le but de cette étude était d'évaluer la qualité de la sélection médicale des donneurs de sang par le dosage de l'hémoglobine pré-don.Nous avons mené de novembre 2012 à février 2013 une enquête transversale auprès de 2097 donneurs de sang du Centre National de Transfusion Sanguine de Bamako. L'hémoglobinomètre HemoCue® a été utilisé pour le dosage de l'hémoglobine pré-don et les infections par le VIH, le VHC, le VHB, le tréponème et le plasmodium ont été dépistées.Nos résultats ont montré que 10,3% des donneurs de sang avaient un taux d'hémoglobine inférieur à la normale et le don de sang de ces personnes a été ajourné.Au total, 543 donneurs ont été exclus dont 217 par le dosage pré-don de l'hémoglobine soit 39.97% des exclusions aux dons. L'anémie était plus présente chez les donneurs volontaires (12,5%) que les donneurs familiaux (9,2%), d'où la nécessité et l'importance d'effectuer le dosage de l'hémoglobine pré-don pour la sécurité des donneurs, en particulier pour les donneurs volontaires.Notre étude a montré clairement que la sélection des donneurs peut être mieux améliorée en faisant le dosage de l'hémoglobine pré-don qui permet d'assurer une bonne qualité des produits sanguins capables de corriger une anémie et garantir la sécurité transfusionnelle

Anémies décompensées et transfusion sanguine chez les enfants de 0 à 59 mois (RD. Congo)

Introduction: L'anémie est un problème de santé publique, surtout dans les pays en voie de développement et chez les enfants de moins de 5 ans etles femmes enceintes.L'objectif de ce travail a été de déterminer le profil des anémies décompensées et les indications de la transfusion sanguine dans les anémies chez les enfants de 0 à 59 mois.Méthodes : il s'agissait d'une étude rétrospective et descriptive réalisée au Centre de Santé de Référence Katele (Moba, RDC) de janvier à décembre 2014. Notre échantillon était constitué de 730 enfants.Résultats :30,4% cas d'anémies décompensées ont été évoqués. Les enfants de 13 à 36 mois et de sexe féminin (54,5%)ont été plus concernés. Les signes de décompensation étaient constitués de tachycardie (98,2%), altération de l'état général (97,7%), pâleur cutanéo-muqueuse (96,8%), dyspnée (96,4%), battement des ailes du nez (92,8%) et souffle cardiaque systolique (46,9%). 17 enfants (7,7%) étaient amenés au stade de coma anémique et en majorité c'étaient des cas de transfert. Dans 39,6% il y avait d'antécédents transfusionnels et l'Hb était ≤ 5 g/dl dans 56,8% de cas. Le paludisme (p 0,000) est de façon significative la principale indication (91,0%) de transfusion sanguine, suivi de la malnutrition. La transfusion avait concerné 98,2% enfants. 10,4% de décès ont été notés.Conclusion :le paludisme était la principale étiologie des anémies décompensées. Des mesures préventives et d'amélioration de la prise en charge doivent être entreprises pour lutter contre les étiologies incriminées et diminuer la mortalité en dessous de 1 %. Les indications de la transfusion devraient être revues dans notre pratique hospitalière et la formation du personnel en médecine transfusionnelle s'avère à cet effet très utile