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Umar G, Abdulqadir I, Ugwu N, Adeyemo T, Yau N, Hassan A, Olaniyi J, Musa A, Abubakar S, Ndakotsu M, James J, Uche C, Musa A, Ukoma C, Nwogoh B, David E, Ugwu A, Nwankwo C, Omokanye O, Abba A, Owojuyigbe T, Isyaku M, Obi E, Jatau E, Ekwere T, Oladosu-Olayiwola R, Isah H, Diggi S, Nwannadi A, Yuguda S, Iheanacho O, Tikau H, Adeleke I, Ekanem M, Madu A, Ikusemoro A, Chukwu C, Galadanci A, Bassey O, Otu T, Agwu O, Osho P, Gwarzo A, Hassan S, Majeed A, Umar A, Abubakar H, Gimba M, Ugbor M, Ali A, Ajuba C. Blood donation practices, processing and utilisation of blood components in government tertiary hospitals in Nigeria: a multicentre cooperative study. Int Health 2023:ihad105. [PMID: 37956086 DOI: 10.1093/inthealth/ihad105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/08/2023] [Accepted: 10/17/2023] [Indexed: 11/15/2023] Open
Abstract
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.
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Affiliation(s)
- Garba Umar
- Department of Haematology, Federal Medical Center, Birnin Kebbi, Kebbi State, Nigeria
| | - Ibrahim Abdulqadir
- Department of Haematology and Blood Transfusion, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Ngozi Ugwu
- Department of Haematology and Immunology, Ebonyi State University, Abakaliki, Nigeria
| | | | - Nabila Yau
- Department of Haematology, College of Health Sciences, Federal University, Dutse, Jigawa State, Nigeria
| | - Abdulazziz Hassan
- Department of Haematology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - John Olaniyi
- Department of Haematology, University College Hospital, Ibadan, Nigeria
| | - Abubakar Musa
- Department of Haematology, Federal Medical Center, Yola, Nigeria
| | - Sharafa Abubakar
- Department of Haematology, Federal Medical Center, Yola, Nigeria
| | | | - Jasini James
- Department of Haematology, Federal Medical Center, Yola, Nigeria
| | - Chika Uche
- Department of Haematology, Abia State University Teaching Hospital, Aba Abai State, Nigeria
| | - Awwal Musa
- Department of Haematology, Murtala Muhammad Specialist Hospital, Kano, Nigeria
| | - Chikadibia Ukoma
- Department of Haematology, Federal Medical Center, , Keffi, Nassarawa State, Nigeria
| | - Benedict Nwogoh
- Department of Haematology, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Ekaete David
- Department of Haematology, Natioanl Hospital, Abuja, Nigeria
| | - Angela Ugwu
- Department of Haematology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Chizoba Nwankwo
- Department of Haematology, Asokoro District Hospital, Abuja, Nigeria
| | - Olaitan Omokanye
- Department of Haematology, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Aisha Abba
- Department of Haematology, University of Maiduguri Teaching Hospital, Bornu State, Nigeria
| | - Temilola Owojuyigbe
- Department of Haematology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Mujtabba Isyaku
- Department of Haematology, Federal Medical Center, Yenagoa, Bayelsa State, Nigeria
| | - Esther Obi
- Department of Haematology, Federal Medical Center, Yenagoa, Bayelsa State, Nigeria
| | - Ezra Jatau
- Department of Haematology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Timothy Ekwere
- Department of Haematology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | | | - Hezekiah Isah
- Department of Haematology, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - Sirajo Diggi
- Department of Haematology, Sir Yahaya Memorial Hospital, Birnin Kebbi, Kebbi State, Nigeria
| | - Alexander Nwannadi
- Department of Haematology, Benue State University Teaching Hospital, Makurdi, Benue State, Nigeria
| | - Saleh Yuguda
- Department of Haematology, Federal Teaching Hospital, Gombe, Nigeria
| | - Obinna Iheanacho
- Department of Haematology, University of Calabar, Cross River State, Nigeria
| | - Hadiza Tikau
- Department of Haematology, Federal Medical Center, Nguru, Yobe State, Nigeria
| | - Ibijola Adeleke
- Department of Haematology, Federal Teaching Hospital, Ido Ekiti, Nigeria
| | - Mabel Ekanem
- Department of Haematology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Anazoeze Madu
- Department of Haematology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Augustina Ikusemoro
- Department of Haematology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
| | - Celestine Chukwu
- Department of Haematology, National Neuropsychiatric hospital, Benin City, Edo State, Nigeria
| | - Amal Galadanci
- Department of Haematology, National Neuropsychiatric hospital, Benin City, Edo State, Nigeria
| | - Okon Bassey
- Department of Haematology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria
| | - Theresa Otu
- Department of Haematology, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - Obineche Agwu
- Department of Haematology, Federal Teaching Hospital, Umuahia, Abia State, Nigeria
| | - Patrick Osho
- Department of Haematology, University of Medical Sciences Teaching Hospital, Ondo State, Nigeria
| | - Aisha Gwarzo
- Department of Haematology, National Neuropsychiatric hospital, Benin City, Edo State, Nigeria
| | | | - Adepoju Majeed
- Department of Haematology, Federal Medical Center, Gusau, Nigeria
| | - Anas Umar
- General Outpatient Clinic, Federal Medical Center, Birnin-Kudu, Nigeria
| | - Habib Abubakar
- Department of Haematology, Rasheed Shekoni Specialist Hospital, Dutse, Jigawa State, Nigeria
| | - Mohamed Gimba
- Federal Neuropsychiatric Hospital, Kware, Sokoto State, Nigeria
| | | | - Abdulmalik Ali
- Department of Haematology, Muhammad Abdullahi Wase Specialist Hospital, Kano, Nigeria
| | - Clara Ajuba
- Department of Haematology, Nnamdi Azikiwe University, Nnewi, Anambra State, Nigeria
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Berhan A, Solomon Y, Getie B, Damtie S, Legese B, Chanie A, Almaw A. The frequency of ABO and Rhesus(D) blood group antigens among blood transfused patients in Northern Ethiopia, 2023: Retrospective study. Heliyon 2023; 9:e22313. [PMID: 38045168 PMCID: PMC10692891 DOI: 10.1016/j.heliyon.2023.e22313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023] Open
Abstract
Background Data about the distribution of ABO and RhD blood groups is important for effective blood utilization, which is maintained by identifying the most clinically required blood type. However, there is a scarcity of data in Ethiopia about the distribution of ABO and RhD blood groups among blood-transfused patients, particularly in the study area. Objective To determine the frequency of ABO and RhD blood groups among blood transfused patients at Dessie Comprehensive Specialized Hospital, Northern Ethiopia, 2023. Method A hospital-based retrospective study was conducted from September 1 to September 30, 2022, to determine the frequency of ABO and RhD blood groups among blood-transfused patients at Dessie Comprehensive Specialized Hospital. The study was conducted on data from blood-transfused patients from October 2019 to June 2022. A total of 3762 blood transfused patients' data was collected from the blood transfusion log book records. The data were coded, entered, and cleaned using Epi-data version 4.6 and analyzed for descriptive statistics using Stata version 14.0. Result A total of 3762 blood-transfused patients were included in the study. Of those, females made up 57.3 % (2156/3762). Of 3762 blood transfused patients, the majority (33.9 %, 1277/3762) had ABO blood group B, and 81.3 % (3060/3762) of the blood transfused patients were RhD-positive. Eight thousand three hundred fifteen units of whole blood were transfused to 3762 patients, with a mean of 2.2 units of blood transfused per patient. Furthermore, the majority of the study participants 42.82 %, (1611/3762) were given two units of blood, and 8.77 % (330/3762) were given four units of blood. Conclusion Most of the study participants had B and RhD-positive blood groups. The majority of the blood transfused patients were females. Most of the blood was transfused in the medical ward, and whole blood was transfused for all patients.
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Affiliation(s)
- Ayenew Berhan
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yenealem Solomon
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Birhanu Getie
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Shewaneh Damtie
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Biruk Legese
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Awoke Chanie
- Dessie Compressive Specialized Hospital Laboratory, Dessie, Ethiopia
| | - Andargachew Almaw
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Mortazavi H, Mohammadi A, Sharifian E, Firouzeh N, van Belkum A, Ghasemzadeh-Moghaddam H. The effect of aging on the epidemiology of blood transfusions in North Khorasan province, Iran. AMERICAN JOURNAL OF BLOOD RESEARCH 2023; 13:44-52. [PMID: 36937460 PMCID: PMC10017592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/05/2023] [Indexed: 03/21/2023]
Abstract
PURPOSE Additional knowledge on the epidemiology and recipients of blood transfusions will help health-care managers to estimate the future needs. The study was performed to define the blood transfusion rate based on gender, sex, and clinical features of patients receiving blood products in all hospitals of the North Khorasan province of Iran. METHODS Data on blood transfusion implementation were extracted from blood bank documents. The data for all patients who received at least one blood product were collected from March 2018 to March 2019. RESULTS Among blood transfused patients, the highest transfusion rate was for packed red blood cells (PRBC) (47.7%). The two other most frequently used products were fresh frizzed plasma (FFP) (27.2%) and platelets (PLT) (21.9%). The patients in the age group of 51-80 years received the majority of PRBCs and FFPs. Patients aged 21-40 and 61-70 yrs had the highest transfusion rates for PLT. Elderly female patients (57.4%) received more blood products than their male counterparts. The highest blood transfusion rates were among patients with neoplasms, anemia, gastrointestinal bleeding, and gastric diseases. CONCLUSION The primary Iranian blood recipients were elderly patients. Population aging is associated with an increase in the number of blood recipients and simultaneously declines the blood donors pool. It highlights the need for optimizing the use of blood in hospitals and having better strategies for overcoming the shortage of blood.
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Affiliation(s)
- Hamed Mortazavi
- Department of Geriatric Nursing, Gerontological Care Research Center, School of Nursing and Midwifery, North Khorasan University of Medical SciencesBojnurd, Iran
| | - Akbar Mohammadi
- Department of Geriatric Nursing, Gerontological Care Research Center, School of Nursing and Midwifery, North Khorasan University of Medical SciencesBojnurd, Iran
| | - Elham Sharifian
- Department of Statistic and Epidemiology, North Khorasan University of Medical SciencesBojnurd, Iran
| | - Nima Firouzeh
- Vector-Borne Diseases Research Center, North Khorasan University of Medical SciencesBojnurd, Iran
| | - Alex van Belkum
- Open Innovation & Partnerships, BaseClearSylviusweg 74, 2333 BE Leiden, The Netherlands
| | - Hamed Ghasemzadeh-Moghaddam
- Vector-Borne Diseases Research Center, North Khorasan University of Medical SciencesBojnurd, Iran
- Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical SciencesBojnurd, Iran
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Tewabe H, Mitiku A, Worku H. Assessment of Blood Transfusion Utilization and Patient Outcomes at Yekatit-12 Hospital, Addis Ababa, Ethiopia. J Blood Med 2022; 13:171-180. [PMID: 35378868 PMCID: PMC8976520 DOI: 10.2147/jbm.s355178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background The goal of blood transfusion is to provide a safe, sufficient, and timely supply of blood components to the recipients by ensuring that donation is safe and no harm to the recipient. So the current study was aimed to assess blood transfusion utilization and its outcome in patients at Yekatit-12 Hospital, Addis Ababa, Ethiopia. Methods A cross-sectional study was conducted from May 01 to July 30, 2021, on 616 individuals who have requested blood transfusion at Yekatit-12 Hospital, Addis Ababa, Ethiopia. Information on blood and blood component utilization was collected by using a checklist. Finally, data were analyzed using SPSS version 21.0, and those variables in which P-value is less than 0.05 were considered statistically clinically significant. Results A total of 1540 cross-match units were requested for 616 (53.2% male) patients with a mean age of 43 years. Out of 1540 cross-matched blood units, 1498 units of blood were transfused for 615 individuals with a mean of 2.43 units. The most widely used blood component was whole blood 694 (46.3%) and 1252 (83.6%) of the blood unit were “RH” positive. From a total of 68 (11.1%) none improved reported cases, 48 (10.5%) were those transfused with whole blood transfusion. The proportion of improvement after transfusion according to the service ranged from 83.3.0% to 100% and no post-transfusion reactions were reported. A significant improvement was seen in the hematological profile (hemoglobin, red blood cells, hematocrit, platelets, and white blood cells) findings of the transfused individuals after blood unit transfusion (P < 0.05). Conclusion The overall utilization rate and improvement status after transfusion were high even if the utilization rate has some limitations. The overall ratios of cross-match to transfusion ratio, transfusion probability, and transfusion index were 1.03, 99.8%, and 0.97, respectively.
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Affiliation(s)
- Haymanot Tewabe
- Department of Medical Laboratory Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
- Correspondence: Haymanot Tewabe, Email
| | - Asaye Mitiku
- Department of Medical Laboratory Sciences, College of Health Science, Dilla University, Dilla, Ethiopia
| | - Habtamu Worku
- Department of Medical Laboratory Sciences, ECUSTA Health Science College, Addis Ababa, Ethiopia
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Haseeb Khan S, Ahmed Khan H, Ijaz Bhatti M, Mudasir Khan M. Profiles of Whole Blood Transfusion Recipients at a Teaching Hospital in Lahore, Pakistan. Cureus 2022; 14:e21728. [PMID: 35251802 PMCID: PMC8887547 DOI: 10.7759/cureus.21728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2022] [Indexed: 11/12/2022] Open
Abstract
Background Blood transfusion plays a vital role in medical practice. Evaluation of blood utilization in a blood bank is a crucial step in good transfusion practice. It is the inception towards assessing the present and future demands for blood and also avoiding unnecessary transfusions. Methods Retrospective analysis of one-year data, available in the blood bank of Gulab Devi Hospital Lahore, was done to study blood transfusion practice. Issue registers were accessed to retrieve the required information such as gender, age, blood group, pre-transfusion Hemoglobin level, ward, clinical diagnosis, and indication for the transfusion. The data was analyzed using SPSS version 20 software. Frequency and percentages were used to summarize categorical demographics and clinical variables. Results A total of 1181 units were requested from the hospital during our study period. Majority of the requests were for the female patients (69%) of the reproductive age group (21 to 30 years). Blood group B positive was most frequent in our study population. Maximum requests were from reproductive health departments (39.9%). Surgery was the major diagnostic category to require blood transfusions (31.8%). Elective surgery constituted the major indication requiring blood transfusion at our hospital (41.3%). Conclusion Blood utilization patterns vary significantly within geographical regions, hospital to hospital, and according to clinical practices as well as patients’ clinical findings. Moreover, diseases burden, level of organization, and advancement of healthcare facilities in various settings contribute to the significant contrast in blood utilization trends.
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Ogar CO, Okpokam DC, Okoroiwu HU, Okafor IM. Comparative analysis of hematological parameters of first-time and repeat blood donors: Experience of a blood bank in southern Nigeria. Hematol Transfus Cell Ther 2021; 44:512-518. [PMID: 34538762 PMCID: PMC9605908 DOI: 10.1016/j.htct.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/18/2021] [Accepted: 06/25/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction The safety of a blood transfusion practice is anchored on safe blood from a healthy donor, while further protecting the donor from future harm. This study aimed to evaluate the hematological parameters of blood donors in view of their donor category to aid in assessing the safety threshold in terms of donation frequency. Methods This study made use of the descriptive cross-sectional design. The blood donors were bled and their samples analyzed using a hematology autoanalyzer. Results A total of 178 male blood donors were recruited. Most of the donors were aged 18 to 39 years and were mostly students. A greater part of them were repeat donors who had donated blood more than four times. First- and second-time donors constituted the majority of the voluntary donors. While the total red cell count was significantly lower in repeat third-time donors, the hemoglobin and hematocrit of the first-time donors were significantly higher than those of the repeat fourth-time donors. The mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) of the first-time donors were significantly higher than those of the repeat fifth-time donors. The red cell distribution width (RDW) and mean platelet volume (MPV) were significantly lower in the first-time donors from those of the sixth- and seventh-time donors, respectively. Most of the fifth-time donors have subclinical anemia. There was more subclinical anemia in commercial donors than in voluntary donors. Conclusion Repeat donors more than fifth-time donors are at risk of donation-induced iron deficiency anemia.
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Obi E, Diette-spiff C, Omunakwe H. Knowledge and practices of physicians on blood component therapy: a cross-sectional study from two tertiary hospitals in Nigeria. Afr Health Sci 2021; 21:1230-1236. [PMID: 35222586 PMCID: PMC8843283 DOI: 10.4314/ahs.v21i3.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- Esther Obi
- Federal Medical Centre, Yenagoa, Haematology and Blood Transfusion
| | | | - Hannah Omunakwe
- Rivers State University Teaching Hospital, Dept of Pathology
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Adedayo T, O'Mahony D, Adeleke O, Mabunda S. Doctors' practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study. Afr J Prim Health Care Fam Med 2021; 13:e1-e8. [PMID: 34212740 PMCID: PMC8252156 DOI: 10.4102/phcfm.v13i1.2889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/28/2021] [Accepted: 04/01/2021] [Indexed: 01/28/2023] Open
Abstract
Background Unnecessary blood transfusion exposes recipients to potential harms. Aim The aim of this study was to describe blood transfusion practice and explore doctors’ attitudes towards transfusion. Setting A hospital providing level 1 and 2 services. Methods A mixed-methods study design was used. In the cross-sectional descriptive component, a sample was taken from patients transfused over a 2-month period. Blood use was categorised as for medical anaemia or haemorrhage, and appropriate or not. The qualitative component comprised a purposeful sample for focus group and individual semi-structured interviews. Results Of 239 patients sampled, 62% were transfused for medical anaemia and 38% for haemorrhage. In the medical anaemia group, compliance with age-appropriate transfusion thresholds was 69%. In medical anaemia and haemorrhage, 114 (77%) and 85 (93.4%) of recipients had orders for ≥ 2 red blood cell (RBC) units, respectively. In adults ≥ 18 years old with medical anaemia, 47.1% of orders would have resulted in a haemoglobin (Hb) > 8 g/dL. Six doctors participated in focus group and eleven in individual interviews. There was a lack of awareness of institutional transfusion guidelines, disagreement on appropriate RBC transfusion thresholds and comments that more than one RBC unit should always be transfused. Factors informing decisions to transfuse included advice from senior colleagues, relieving symptoms of anaemia and high product costs. Conclusion Most orders were for two or more units. In medical anaemia, doctors’ compliance with RBC transfusion thresholds was reasonable; however, almost half of the orders would have resulted in overtransfusion. The attitudes of doctors sampled suggest that their transfusion practice is influenced more by institutional values than formal guidelines.
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Affiliation(s)
- Temitope Adedayo
- Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha.
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Prin M, Mfune T, Njolomole S, Moore EE, Ginde A. For whole blood research, look to the whole world. Vox Sang 2021; 117:145. [PMID: 34081775 DOI: 10.1111/vox.13124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/01/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Meghan Prin
- Department of Anesthesiology, University of Colorado, Aurora, Colorado, USA
| | - Thomas Mfune
- Malawi Blood Transfusion Services, Lilongwe, Malawi
| | - Stephen Njolomole
- University of Malawi College of Medicine, Department of Pathology, Blantyre, Malawi
| | - Ernest Eugene Moore
- Department of Surgery, Ernest E Moore Shock and Trauma Center at Denver Health, Denver, Colorado, USA
| | - Adit Ginde
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
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Feyisa T, Tesfaye Kiya G, Maleko WA. Assessment of recipients' characteristics, transfusion appropriateness, and utilization pattern of blood and blood products in Jimma Medical Center, Jimma, Ethiopia. PLoS One 2021; 16:e0250623. [PMID: 33901253 PMCID: PMC8075257 DOI: 10.1371/journal.pone.0250623] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As blood transfusion remains life-saving and is being frequently prescribed, a greater number of its practice is unnecessary or inappropriate. This important clinical intervention is reported as one of the five overused medical treatments, with gross over-ordering and whole blood transfusions as the sole component being common in developing countries. Study of recipient's demographics, clinical conditions, appropriate blood utilization, and continuous clinical audits for quality assurance and service improvement plan are important factors to this practice. This study was designed to assess the recipient's characteristics, blood type distributions, appropriateness of blood transfusion, and utilization practice of the big medical center. METHODS Institution based cross-sectional study was conducted from February 1 to June 30, 2018. Data were collected using a structured data collection format prepared for this study. All transfusion prescriptions were followed from requisition up to completion. Patient's age, sex, requesting departments, hemodynamics, number and component of units requested and issued, and units transfused were collected. Transfusion appropriateness was assessed by a criterion-based method while blood utilization was calculated. RESULTS A total of 545 units of blood for 425 patients were cross-matched of the 809 units of total blood prescribed. The mean and median age of transfused individuals was found to be 27.47 ±15.28 years and 26 years respectively, and 65.4% females most in reproductive age groups. O and A Rhesus-positive blood types were the two major blood groups observed. Overall 82.1% of transfusions were appropriate; while only 27.8% of patients received appropriate components as 96.5% of individuals received a whole blood transfusion. Significant blood utilization was recorded with a C/T ratio of 1.05, TP% of 100%, and TI of 1.23. CONCLUSION Much of the transfusion recipients were relatively young aged and females, most in the reproductive age group. Although whole blood was used as a sole component, significant blood transfusion utilization and appropriateness were recorded; while appropriate component transfusion was recorded to be significantly low. Local transfusion guidelines and appropriate component preparation and utilization are required to improve the sub-optimal blood component transfusion practice.
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Affiliation(s)
- Tufa Feyisa
- Hematology Laboratory Unit of Jimma Medical Center, Jimma University, Jimma, Ethiopia
| | - Girum Tesfaye Kiya
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Wondimagegn Adissu Maleko
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
- Clinical Trial Unit, Jimma University, Jimma, Ethiopia
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Okoroiwu HU, Okafor IM, Asemota EA, Ogar CO, Uchendu IK. Coping with COVID-19 pandemic in blood transfusion services in West Africa: the need to restrategize. Hematol Transfus Cell Ther 2021; 43:119-125. [PMID: 33714719 PMCID: PMC8211632 DOI: 10.1016/j.htct.2021.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/13/2020] [Accepted: 01/07/2021] [Indexed: 02/07/2023] Open
Abstract
Introduction The West African region has been lagging in terms of the availability of, and accessibility to, safe blood. According to the 2016 World Health Organization (WHO) Global Status Report on Blood Safety and Availability, none of the West African countries met the WHO benchmark of 10 blood units per 1000 inhabitants. This study is aimed at discussing the blood transfusion status of West African countries in the pre-COVID-19 period and analyze the capacity to respond to the COVID-19 blood crisis, as well as to outline the panacea. Methods Secondary data were extracted from published reports, journal articles and web pages, reviewed and analyzed. Result All the West African countries have recorded confirmed COVID-19 cases and deaths. The confirmed cases have reached 55,697, with 1069 deaths and a fatality rate of 1.9%, as of June 17, 2020. The assessed countries lagged in most of the WHO benchmarks for effective blood transfusion services. Conclusion Blood transfusion services in the West African region lacked the basic benchmark practice and policy, are not coordinated and may find it hard to tackle the blood transfusion crisis created by the COVID-19 pandemic.
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Ogar CO, Okoroiwu HU, Obeagu EI, Etura JE, Abunimye DA. Assessment of blood supply and usage pre- and during COVID-19 pandemic: A lesson from non-voluntary donation. Transfus Clin Biol 2021; 28:68-72. [PMID: 33080420 PMCID: PMC7836417 DOI: 10.1016/j.tracli.2020.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/03/2020] [Accepted: 10/06/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Ensuring steady stream of safe blood is the ultimate goal of blood transfusion practice. The current COVID-19 pandemic has affected almost every part of life and economy. Consequently, this study sets off to assess the effect of the pandemic on blood supply and blood transfusion in the University of Calabar Teaching Hospital. METHODS Data from the Donor Clinic and Blood Group Serology Unit of the University of Calabar Teaching Hospital were retrospectively extracted to evaluate supply and use of blood before and during COVID-19 pandemic. RESULT A total of 1638 donors were recorded within the study period. Age range 15-29 and 30-44 years constituted majority of the subjects (58.9% and 33.4%, respectively). The donor pool were male-dominated. Commercial donors (61.7%) and family replacement donors (30.6%) constituted majority of the donor pool. Most of the donor pool were students (37.1%), public servants (22.8%) and artisans (18.6%). A concomitant decrease of 26.1% and 18.9% were recorded in blood donation and request during the COVID-19 pandemic. CONCLUSION Blood supply was not significantly affected in our study center as both requests and donations decreased. Consideration for improving family replacement donation was advised.
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Affiliation(s)
- C O Ogar
- Hematology Unit, Department of Medical Laboratory Science, University of Calabar, Nigeria
| | - H U Okoroiwu
- Hematology Unit, Department of Medical Laboratory Science, University of Calabar, Nigeria.
| | - E I Obeagu
- Department of Medical Laboratory Science, Imo State University, Nigeria
| | - J E Etura
- Hematology Unit, Department of Medical Laboratory Science, University of Calabar, Nigeria
| | - D A Abunimye
- Hematology Unit, Department of Medical Laboratory Science, University of Calabar, Nigeria
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Etura JE, Amaechi RA, Akpotuzor JO, Okoroiwu HU. Demographics of Rhesus Phenotype of Blood Donors in Calabar: A Case Study of University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria. Adv Hematol 2020; 2020:2659398. [PMID: 32908516 PMCID: PMC7474351 DOI: 10.1155/2020/2659398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 06/08/2020] [Accepted: 07/15/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Rhesus antigens have been documented to cause haemolytic disease of the newborn as well as acute and delayed transfusion reactions. This study was performed to evaluate the frequency of rhesus antigens (C, c, D, E, and e) in the studied population. METHOD This study was a cross-sectional study involving 130 prospective blood donors attending University of Calabar Teaching Hospital (UCTH) donor clinic. Donors were grouped for Rh antisera (anti-E, anti-e, anti-C, anti-c, and anti-D) using the standard serologic technique. RESULT The most prevalent Rh antigen was "c" (98.5%), followed by "D" (97.7%), while the least was "C" (30.7%). The most prevalent phenotype was cDe/cDe (R0R0). CONCLUSION This work therefore concludes that the most prevalent rhesus antigen and rhesus phenotype was c and cDe/cDe among blood donors in University of Calabar Teaching Hospital.
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Affiliation(s)
- Joyce Ezekiel Etura
- Haematology Unit, Department of Medical Laboratory Science, University of Calabar, Calabar, Nigeria
| | - Rose A. Amaechi
- Haematology Unit, Department of Medical Laboratory Science, Ambrose Alli University, Ekpoma, Edo State, Nigeria
| | - Josephine O. Akpotuzor
- Haematology Unit, Department of Medical Laboratory Science, University of Calabar, Calabar, Nigeria
| | - Henshaw Uchechi Okoroiwu
- Haematology Unit, Department of Medical Laboratory Science, University of Calabar, Calabar, Nigeria
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Blood component utilization before and after implementation of good transfusion practice measures in a pediatric emergency department. Transfus Apher Sci 2020; 59:102719. [PMID: 31953106 DOI: 10.1016/j.transci.2020.102719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/23/2019] [Accepted: 12/23/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVES We aimed to determine the pattern of blood component utilization in pediatric Emergency Department (ED) and compare the utilization rate before and after the implementation of simple good transfusion practice measures. MATERIAL AND METHODS This was a prospective pre/post interventional study conducted between February 2015 and April 2016. The study included 3 phases [1] Pre-intervention phase (6 weeks) consisting of baseline data collection [2] Intervention phase (3 months) involving education on transfusion triggers and periodic mailers about good practice and designated 'transfusion resident' for supervision. [3] Post- intervention phase (6 weeks) collecting data while continuing interventions. RESULTS During pre-intervention, 379 blood components [Packed red cells(PRBC) - 227, Platelet concentrate(PC) - 78, Fresh Frozen Plasma(FFP) - 74] were requested for 280 children; 195 were transfused with an overall utilization rate of 51.5 %. PRBC had the poorest utilization rate (30 %) followed by PC (72 %) and FFP (96 %). About 79 % of the requisitions sent by residents in first training year were not utilized before intervention. Indications such as anticipated surgery, congenital heart disease, pneumonia and sepsis had lower utilization rate. Post intervention, there was 14 % reduction in blood component requests (325 requests in 258 patients). Both overall utilization rate (56 %) and PRBC utilization (37.4 %) showed improvement but the difference was statistically not significant. CONCLUSIONS Red blood cells were the most frequently requested blood components yet poorly utilized in ED. Simple interventions targeting providers in early stages of training could potentially improve the blood component utilization and transfusion practices in busy emergency departments.
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The global need and availability of blood products: a modelling study. LANCET HAEMATOLOGY 2019; 6:e606-e615. [PMID: 31631023 DOI: 10.1016/s2352-3026(19)30200-5] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Blood transfusions are an important resource of every health-care system, with often limited supply in low-income and middle-income countries; however, the degree of unmet need for blood transfusions is often unknown. We therefore aimed to estimate the blood transfusion need and supply at national level to determine gaps in transfusion services globally. METHODS We did a modelling study involving 195 countries and territories. We used blood component preparation data from 2011-13 to estimate blood availability for 180 (92%) of 195 countries from the WHO Global Status Report on Blood Safety and Availability. We calculated disease-specific transfusion needs per prevalent case for 20 causes in the USA using the National (Nationwide) Inpatient Sample dataset between the years 2000 and 2014, and the State Inpatient Databases between 2003 and 2007 from the Healthcare Cost and Utilization Project. Using prevalence estimates for the USA from the Global Burden of Disease (GBD) 2017 study, we estimated the ideal disease specific-transfusion rate as the lowest rate from the years 2000 to 2014. We applied this rate to GBD prevalence results for 195 countries to estimate transfusion needs. Unmet need was the difference between the estimated supply and need. FINDINGS In 2017, the global blood need was 304 711 244 (95% uncertainty interval [UI] 293 064 637-314 049 479) and the global blood supply was 272 270 243 (268 002 639-276 698 494) blood product units, with a need-to-supply ratio of 1·12 (95% UI 1·07-1·16). Of the 195 countries, 119 (61%) did not have sufficient blood supply to meet their need. Across these 119 countries, the unmet need totalled 102 359 632 (95% UI 93 381 710-111 360 725) blood product units, equal to 1849 (1687-2011) units per 100 000 population globally. Every country in central, eastern, and western sub-Saharan Africa, Oceania, and south Asia had insufficient blood to meet their needs. INTERPRETATION Our data suggest that the gap between need and supply is large in many low-income and middle-income countries, and reinforce that the WHO target of 10-20 donations per 1000 population is an underestimate for many countries. A continuous expansion and optimisation of national transfusion services and implementation of evidence-based strategies for blood availability is needed globally, as is more government support, financially, structurally, and through establishment of a regulatory oversight to ensure supply, quality, and safety in low-income and middle-income countries. FUNDING National Institutes of Health.
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Okoroiwu HU, Asemota EA. Blood donors deferral prevalence and causes in a tertiary health care hospital, southern Nigeria. BMC Health Serv Res 2019; 19:510. [PMID: 31331326 PMCID: PMC6647304 DOI: 10.1186/s12913-019-4352-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 07/16/2019] [Indexed: 12/27/2022] Open
Abstract
Background Blood transfusion is a life-saving intervention. However, the safety of the donor and the recipient is paramount. This study was aimed at determining the blood donation deferral pattern of University of Calabar Teaching Hospital. Methods A retrospective analysis of the prospective donors’ data of University of Calabar Donor clinic within the period of March 2015 to February 2016 was conducted. Data were extracted from the donor register and analyzed. Prospective donors were screened and interviewed for causes of temporary and permanent deferrals. Result Out of the 1886 screened prospective donors, 164 (8.69%) were deferred. Though the minority of the donor population, female donors had the highest deferral rate (33.33%). There were 31.10 and 68.90% cases of temporary and permanent deferrals, respectively. Hepatitis B virus (HBV) was the highest (31.71%) cause of overall deferral as well as permanent deferral. Anemia was the major (21.95%) cause of temporary deferral as well as the second cause of overall deferrals. Commercial and replacement donors constituted 68.28 and 31.71% of the deferral cases, respectively. Conclusion HBV was found to be the overall leading cause of deferral in the studied area. This outcome poses a public health concern and should elicit measures to curb the infection rate.
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Affiliation(s)
- Henshaw Uchechi Okoroiwu
- Department of Medical Laboratory Science, Haematology Unit, University of Calabar, Calabar, Nigeria.
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Kipkulei JC, Buziba N, Mining S, Jepngetich H. Demographic and Clinical Profiles of Blood Transfusion Recipients at a Teaching and Referral Hospital in Kenya. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ojbd.2019.91004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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