Blood donation practices, processing and utilisation of blood components in government tertiary hospitals in Nigeria: a multicentre cooperative study.

BACKGROUND: Timely access to safe blood and blood components is still a challenge in Nigeria. This study aimed to determine blood donation practices, processing and utilization of blood components across government tertiary hospitals (THs) in Nigeria. METHODS: This was a descriptive cross-sectional study done in Nigeria in June-July 2020. Data were analysed with SPSS version 21.0. RESULTS: Data were collected from 50 THs. The majority (68%) of the THs lack facilities for blood component preparation and only 18% and 32% provide cryoprecipitate and platelet concentrate, respectively. Whole blood was most commonly requested (57.04%). All facilities tested blood for HIV, HBV and HCV, but the majority (23 [46%]) employed rapid screening tests alone and nucleic acid testing was not available in any hospitals. The manual method was the most common method of compatibility testing in 90% (45/50) and none of the THs routinely perform extended red cell typing. The average time to process routine, emergency and uncross-matched requests were a mean of 109.58±79.76 min (range 45.00-360.00), 41.62±25.23 (10.00-240.00) and 11.09±4.92 (2.00-20.00), respectively. CONCLUSION: Facilities for blood component preparation were not widely available. Concerned government authorities should provide facilities for blood component preparation.

Knowledge and practices of physicians on blood component therapy: a cross-sectional study from two tertiary hospitals in Nigeria.

INTRODUCTION: Comprehension of blood component therapy (BCT) has profound impact on transfusion outcomes. Variations from the standards in practices of BCT may jeopardize patient care. AIM: To assess the understanding and implementation of BCT by physicians. METHODS: The study was carried out at two tertiary health care centres. It was a descriptive cross-sectional study using a self-administered, questionnaire comprising of 30 questions. RESULT: A total of 265 physicians responded from various clinical specialties. Physicians studied showed remarkable knowledge (98%) of BCT. Nevertheless, 92.8% of the respondents' were inclined to prescribing whole blood and the commonest reason given was ready availability at the blood bank. More than half of the respondents' have prescribed BCT with sedimented red cells and platelet concentrates being the most frequently prescribed blood components. Non-availability of blood components and cost implications were some of the identified limitations to the use of BCT. CONCLUSION: Majority of the physicians have a good knowledge concerning BCT. Nonetheless, there was a knowledge-practice mismatch attributable to the unavailability of the various blood components limiting optimal practice of BCT. Strategies should be formulated to overcome these identified challenges to ensure quality transfusion services in our healthcare facilities.

Massive hemoperitoneum from hemorrhagic corpus luteum in a patient with acquired amegakaryocytic thrombocytopenic purpura.

Doctors should think of a spectrum of differential diagnoses in patients presenting with acute abdominal pain ranging from medical, surgical, and gynecological conditions. Proper laboratory and radiological tests including bone marrow study are advised.

Red blood cell alloimmunization in multi-transfused patients with chronic kidney disease in Port Harcourt, South-South Nigeria.

BACKGROUND: Serological safety is an integral part of overall safety for blood banks. OBJECTIVES: The aim of the study was to determine the prevalence and specificities of red blood cell alloimmunization in multi-transfused patients with chronic kidney disease (CKD). METHODS: A cross-sectional case-control study carried out at the University of Port Harcourt Teaching Hospital in which 186 patients with CKD were enrolled consecutively, 124 had received multiple transfusions (more than one unit of blood in one month, or at least 10 units within 3 months), while 62 had never been transfused. Antibody screen test was performed by the gel agglutination technique. RBC antibody identification was performed on the sera of those that tested positive to antibody screening test. RESULTS: Out of the 124 multi-transfused patients (total of 789 transfusions), 4 (3.2%) were alloimmunised. The alloimmunised patients received a higher mean number of 17.5 ± 12 blood units, compared to 6 ± 6 units by the non-alloimmunised multi-transfused patient (p= <0.001). Six clinically significant alloantibodies were identified with all of the alloimmunised patients forming more than one antibody. Anti-E was detected in all alloimmunised patients. CONCLUSION: The prevalence of RBC alloimmunisation in multi-transfused CKD patients was 3.2% with anti-E being the most frequently identified antibody.