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Lendabo F, Srinivasan V, Rather RA. Prevalence of ABO and Rhesus (D) Blood Group and Allelic Frequency at Blood Bank of Nigist Eleni Mohammed Hospital, Ethiopia. BIOMED RESEARCH INTERNATIONAL 2024; 2024:5353528. [PMID: 38628500 PMCID: PMC11019571 DOI: 10.1155/2024/5353528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 12/06/2023] [Accepted: 03/12/2024] [Indexed: 04/19/2024]
Abstract
Background The purpose of this cross-sectional study was to determine the pattern of the ABO and rhesus D (RhD) blood group distribution among voluntary blood donors attending five blood donation centers at Nigist Eleni Mohammed General Hospital in Hossana, Ethiopia. Methods A total of 1,120 participants who fulfilled the "who can give blood" criteria of the World Health Organization were selected randomly. Blood samples were collected, transported to the laboratory, and analyzed for ABO and RhD typing. The data was analyzed using descriptive statistics and chi-square correlation analysis. Results The study found that the O blood group was the most prevalent (39.0%), followed by A (32.2%), B (22.5%), and AB (6.4%). When considering both the ABO and Rh blood groups together, 92.9% of blood donors were RhD positive, while only 7.1% were RhD negative. The distribution pattern of the ABO blood groups in Gurage Zone, Hadiya Zone, Kembata Zone, and Silte Zone showed that the O blood group was the most prevalent, followed by A, B, and AB, in that order. Conversely, the ABO blood group distribution pattern in Halaba Zone was A > O > B > AB. Civil servants from different occupational statuses were the most dominant voluntary blood donors, accounting for 53.2%, followed by students from different high schools and universities (41.9%), self-employed individuals (4.1%), and others (0.7%). The ABO blood group system had observed allele frequencies significantly different from the expected frequencies (p = 0.007), while the RhD system did not (p = 0.037). Allele frequencies for A, B, and O in the ABO system were 0.3531, 0.2576, and 0.3893, respectively. Observed frequencies for RhD-positive and RhD-negative alleles were 0.9647 and 0.0531, respectively. Conclusion This study highlights the regional ABO and RhD blood group variations in Ethiopia, noting disparities from expected ABO allele frequencies, and identifies the O blood group predominance among donors with a high RhD-positive prevalence.
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Affiliation(s)
- Fekadu Lendabo
- Department of Biotechnology, College of Natural and Computational Science, Wachemo University, Hossana, Ethiopia
| | | | - Riyaz Ahmad Rather
- Department of Biotechnology, College of Natural and Computational Science, Wachemo University, Hossana, Ethiopia
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Chisele S, Mwanahamuntu M, Kamfwa P, Kalima-Munalula M, Fundafunda S, Chanda K, Hicks MM, Pinder LF, Pfaendler KS, Parham GP, Hicks ML. Gynaecologic oncology surgical cancellations in Zambia. Ecancermedicalscience 2023; 17:1617. [PMID: 38414948 PMCID: PMC10898890 DOI: 10.3332/ecancer.2023.1617] [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: 06/22/2023] [Indexed: 02/29/2024] Open
Abstract
Introduction Cancellations of elective surgery in low-and middle-income countries (LMIC) are common and a major hindrance for patients who are in need of surgical therapeutic modalities. This is especially important in the context of scaling up needed surgical interventions for gynaecological cancer care. There is a knowledge gap in the literature related to cancellation of gynaecologic oncology surgeries in LMIC, where there is enormous need for this specific cancer surgical capacity. We report in an observational descriptive fashion, our experience at the UTH/CDH in Lusaka, Zambia, on the causes of surgical cancellations in gynaecologic oncology. Methods From January 1, 2021 through June 31, 2023, we retrospectively evaluated the surgical registry for gynaecologic oncology at the UTH/CDH in Lusaka, Zambia to assess the number and causes of surgical cancellations. Results There were a total of 66 (16.96%) surgical cancellations out of 389 scheduled gynaecologic oncology cases. Lack of available blood and/or low haemoglobin was the most frequent cause of surgical cancellations, 27 cases (40.90%). Conclusion We highlight in our series that the lack of blood, leading to surgical cancellations was the most frequent impediment related to performing scheduled gynaecologic oncology surgical procedures. As gynaecologic oncology services scale up in LMIC, given the radical nature of surgery and its association with blood loss, it is incumbent on the entire clinical ecosystem to address this issue and to develop mitigating strategies, specific to their respective resource setting.
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Affiliation(s)
- Samson Chisele
- Department of Obstetrics and Gynecology, University Teaching Hospital - Women and Newborn Hospital, Lusaka 10101, Zambia
| | - Mulindi Mwanahamuntu
- Department of Obstetrics and Gynecology, University Teaching Hospital - Women and Newborn Hospital, Lusaka 10101, Zambia
| | - Paul Kamfwa
- Cancer Diseases Hospital, Lusaka, 10101, Zambia
| | - Mukatimui Kalima-Munalula
- Department of Obstetrics and Gynecology, University Teaching Hospital - Women and Newborn Hospital, Lusaka 10101, Zambia
| | | | - Kenneth Chanda
- Department of Obstetrics and Gynecology, University Teaching Hospital - Women and Newborn Hospital, Lusaka 10101, Zambia
| | - Maya M Hicks
- Anne Arundel Medical Center, Department of Obstetrics and Gynecology, 2000 Medical Pkwy, Belcher Pavilion, Ste 309, Annapolis, MD 21401, USA
| | - Leeya F Pinder
- University of Cincinnati College of Medicine, Ob/Gyn, Cincinnati, OH 45267, USA
| | - Krista S Pfaendler
- Department of Obstetrics and Gynecology, West Virginia University School of Medicine, 64 Medical Center Drive, Morgantown, WV 26506, USA
| | - Groesbeck P Parham
- Department of Obstetrics and Gynecology, University Teaching Hospital - Women and Newborn Hospital, Lusaka 10101, Zambia
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514, USA
| | - Michael L Hicks
- Department of Obstetrics and Gynecology, University Teaching Hospital - Women and Newborn Hospital, Lusaka 10101, Zambia
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514, USA
- St. Joseph Mercy Oakland Cancer Center, Michigan Cancer Institute, 44405 Woodward Ave, Suite 202, Pontiac, MI 48324, USA
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Mohammed KAS, Hameed MM, Mousa AH, Saleh AT. Prevalence and trends of transfusion transmissible infections among blood donors in Basra, Iraq. BMJ Open Gastroenterol 2023; 10:e000968. [PMID: 37487649 PMCID: PMC10373717 DOI: 10.1136/bmjgast-2022-000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/17/2022] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Despite saving millions of lives through blood transfusion, transfusion-transmissible infections (TTIs) still threaten the lives of patients requiring blood transfusion. Hence, screening blood donors and studying the prevalence of TTIs among blood donors may display the burden of these diseases among our population. The aim of this study was to assess the seroprevalence rates of transfusion transmitted infections among blood donors in Basra, Iraq from 2019 to 2021 as groundwork for providing safe blood transfusion in Iraq. METHODS A cross-sectional study was carried out in the blood banks in Basra, Iraq from 1 January 2019 to 31 December 2021. A total of 197 898 samples were collected and screened for hepatitis B surface antigen (HBsAg), anti-hepatitis B core (HBc), anti-hepatitis C virus (HCV) and syphilis immunologically. RESULTS The prevalence rates of seropositive of viral hepatitis for the year 2019, 2020, 2021 were as following: hepatitis B virus (HBV) rates 1.54%, 1.45% and 1.14% with significant declined trend by 26%; anti-HCV rates were 0.14, 0.12 and 0.11% with significant declined trend by 21.4%; and the syphilis rates were 0.38, 0.47, 0.36 with marked declined trend 5.3%, respectively.Of those donors showed HBV positive, 2503 (1.26%) had positive anti-HBc results, while only 173 (0.0874) showed positive test results for both anti-HBc and HBsAg. CONCLUSION Prevalence rates of viral hepatitis and syphilis showed a steady decline between 2019 and 2021, and these rates were much lower in Basra than in other parts of Iraq and neighbouring countries. The importance of using the anti-HBc test in the screening of blood donors was indicated in this study. These findings would contribute in improving the understanding of TTIs epidemiology and supporting health authorities controlling bloodborne diseases.
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Osei-Boakye F, Nkansah C, Appiah SK, Derigubah CA, Mensah K, Apandago AA, Boateng VA, Norsi OG, Kogh-Nuu D. Seroprevalence, trends, and risk factors of hepatitis B and C among family replacement blood donors; a 7-year retrospective study at Sunyani Municipal Hospital, Ghana. J Immunoassay Immunochem 2023; 44:162-175. [PMID: 36656031 DOI: 10.1080/15321819.2023.2168555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Hepatitis B and C cause chronic infections which develop into liver-related sequelae, like cirrhosis and liver carcinoma. This study determined the seroprevalence, trends, and risk factors of HBV and HCV among family replacement donors. A retrospective review of primary data on blood donors screened between January 2015 and December 2021 was conducted at Sunyani Municipal Hospital. The data were assessed for seroprevalence, trends, and odds ratios using SPSS. Of 6847 donors, the majority were males (88.1% [6033]), ≤24 years (27.4% [1874]), O blood type (69.8% [4776]), and Rh-positive (89.9% [6154]). The seroprevalences of HBV and HCV were 3.2% and 1.9%, respectively, with more males infected with HBV and HCV (3.4% vs 2.0%). Males were 2.842 times (p = .001) and 2.399 times (p = .025) more susceptible than females to HBV and HCV, respectively. In the rainy season, donors were 1.489 times (p = .041) more susceptible to HCV. HBV and HCV seroprevalence declined over the period (slope: -0.5464, p ≤ .001 vs slope: -0.6179, p ≤ .001). Male gender and rainy season were significant determinants of both infections. The seroprevalence of HBV was higher than HCV despite the significant decline in both infections. We, recommend health authorities intensify health education among males and during the rainy season.
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Affiliation(s)
- Felix Osei-Boakye
- Department of Medical Laboratory Technology; Department of Pharmaceutical Sciences, Sunyani Technical University, Sunyani, Ghana
| | - Charles Nkansah
- Department of Haematology, University for Development Studies, Tamale, Ghana
| | - Samuel Kwasi Appiah
- University for Development Studies, Department of Biomedical Laboratory Science, School of Allied of Health Sciences, Tamale, Ghana
| | | | - Kofi Mensah
- Department of Haematology, University for Development Studies, Tamale, Ghana
| | | | - Vida Animah Boateng
- Department of Pharmaceutical Sciences, Sunyani Technical University, Sunyani, Ghana
| | - Obed Gadufia Norsi
- Department of Pharmaceutical Sciences, Sunyani Technical University, Sunyani, Ghana
| | - Dominic Kogh-Nuu
- Department of Pharmaceutical Sciences, Sunyani Technical University, Sunyani, Ghana
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Idris E, Yadeta E, Debella A, Tamiru D, Atnafe G, Arkew M, Teklemariam Z. Blood donation practice and its predictors among undergraduate college students in Harari Regional State, Eastern Ethiopia. SAGE Open Med 2023; 11:20503121231159344. [PMID: 36993777 PMCID: PMC10041578 DOI: 10.1177/20503121231159344] [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: 12/28/2022] [Accepted: 02/06/2023] [Indexed: 03/31/2023] Open
Abstract
Objectives The main objective of this study was to assess blood donation practice and its associated factors among undergraduate college students in Harari Region, Eastern Ethiopia. Methods An institutional-based cross-sectional study was employed among 518 college students selected by using a simple random sampling technique. Data was collected using pretested structured self-administered questionnaire. The collected data was entered into Epi-data 3.41 and exported to Statistical Package for Social Science version 22 for analysis. Bivariate and multivariable logistic regressions were utilized to identify factors associated with blood donation practice. p-Values of 0.05 or less was used to declare statistical significance. Results In this study, the overall blood donation practice was 35.7% (95% confidence interval: 31.6, 39.8). Students studying health sciences were more likely than non-health sciences students (53.5%) to donate blood. Having positive knowledge about blood donation (adjusted odds ratio = 4.17; 95% confidence interval: 2.50, 6.92), being male (adjusted odds ratio = 0.57; 95% confidence interval: 0.38, 0.87), being student of midwifery department (adjusted odds ratio = 2.16; 95% confidence interval: 1.07, 4.36) and nursing department (adjusted odds ratio = 2.42; 95% confidence interval: 1.18, 4.98) were significantly associated with blood donation practice. Conclusion Practice of blood donation among college students in the study is relatively low. Knowledge about blood donation, male sex and being a nursing and midwifery student were independently associated with blood donation practice. Therefore, the Regional Health Bureau and Blood Bank in collaboration with college administrators should design and implement appropriate strategies to improve blood donation practice.
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Affiliation(s)
- Elias Idris
- School of Medical Laboratory Sciences, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Elias Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Elias Yadeta, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Tamiru
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Genanaw Atnafe
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mesay Arkew
- School of Medical Laboratory Sciences, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Zelalem Teklemariam
- School of Medical Laboratory Sciences, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
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Amenge J, Scherphof S, Osemwengie D, Nierich A, Lagerberg JW. Comparison of Washing Efficiency and Recovery of Blood Cells Between Centrifugation, Coarse Filtration and Microfiltration Techniques to Prepare Autologous Blood for Transfusion. J Blood Med 2022; 13:549-558. [PMID: 36204560 PMCID: PMC9531611 DOI: 10.2147/jbm.s367918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Cell salvage is the process by which blood lost in surgery is collected and washed or filtered to produce autologous blood for re-transfusion to the patient. Cell salvage aims to reduce the need for donor blood. Centrifugal cell salvage washing technique is a preferred medical treatment in order to retain lost red blood cells (RBCs) without contaminants. Although this technology very efficiently collects and washes shed blood, it is costly and often impractical or unavailable, especially in middle- or low-income countries. This study assessed two innovative filter devices as an alternative to centrifugal cell salvage technology: a coarse collection filter device (Hemafuse) and a microfiltration device (HemoClear). In contrast to centrifugal technology, both filter devices do not require electricity, nor costly equipment and extensive training. We compared the effectiveness of these filtration technologies to remove plasma constituents and recover and concentrate the cellular components with centrifugal technology (autoLog® device). Methods Whole blood was processed with each technology according to the device manufacturer’s instructions. Before and after processing, the blood products were analyzed for supernatant solutes and cellular composition. Results The centrifugal technology confirmed its efficacy to remove potentially harmful solutes and capture red blood cells. The microfiltration technology (HemoClear) reached comparable levels of removal of solutes, with a potential advantage over centrifugal technology in the ability to also recover platelets. The coarse filtration technology (Hemafuse) had no washing capacity but, like the microfiltration technology, has the advantage of recovering platelets. Conclusion Innovative filtration devices represent an alternative to centrifugal technology in the preparation of autologous blood for reinfusion. The HemoClear technology for the first time enables the recovery of washed platelets and red blood cells. Clinical trials will have to be performed to investigate the clinical value of this new autologous blood product.
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Affiliation(s)
- James Amenge
- Department of Obstetrics and Gynaecology, Kenyatta National Hospital, Nairobi, Kenya
| | | | | | - Arno Nierich
- Clinical Department, HemoClear BV, Zwolle, the Netherlands
- Department of Anaesthesiology & Intensive Care, Isala Clinics, Zwolle, the Netherlands
- Correspondence: Arno Nierich, Clinical Department, HemoClear BV, Dokter Stolteweg 70, Zwolle, 8025 AZ, the Netherlands, Tel +31 0 38 303 26 30, Email
| | - Johan W Lagerberg
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, the Netherlands
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Oreh A, Bozegha T, Ihimekpen A, Biyama F, Irechukwu C, Aliu S, Oshiame D, Nnabuihe A, Ndanitsa A, Nnachi O, Ogbenna A, Abubakar S, Olupitan F, Akinkunmi A, Ogunlade C, Abayomi T, Omokaro U, Sylvester C, Igiebor U, Wokoma B, Ebophni S, Adewuyi B, Dachi R, Muhammad H, Abubakar M, Mgbang J, Chineke A, Ogbuabor O, Fakai G, Hashim B, Adeluwoye N, Olanrewaju D, Agahiu E, Etim E, Alabi S, Akinbola I, Anibueze C, Awogbami O, Edowhorhu G, Adekoya-Benson T, Bello S, Ojuade Y, Amedu O. Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria - A multi-facility study of 34 tertiary hospitals. Niger J Clin Pract 2022; 25:786-793. [PMID: 35708419 DOI: 10.4103/njcp.njcp_1437_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
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.
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Affiliation(s)
- A Oreh
- National Blood Service Commission, Abuja, Nigeria
| | - T Bozegha
- National Blood Service Commission; National Hospital, Abuja; Federal Medical Centre, Asaba; Delta State University Teaching Hospital, Nigeria
| | - A Ihimekpen
- National Blood Service Commission, Abuja, Nigeria
| | - F Biyama
- National Blood Service Commission, Abuja, Nigeria
| | - C Irechukwu
- National Blood Service Commission, Abuja, Nigeria
| | - S Aliu
- National Blood Service Commission, Abuja, Nigeria
| | - D Oshiame
- National Blood Service Commission, Abuja, Nigeria
| | - A Nnabuihe
- National Blood Service Commission, Abuja, Nigeria
| | - A Ndanitsa
- National Blood Service Commission, Abuja, Nigeria
| | - O Nnachi
- Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - A Ogbenna
- University of Lagos Teaching Hospital (LUTH), Nigeria
| | | | - F Olupitan
- Lagos State University Teaching Hospital (LASUTH), Nigeria
| | - A Akinkunmi
- National Orthopaedic Hospital Dala, Kano, Nigeria
| | - C Ogunlade
- National Orthopaedic Hospital Igbobi, Lagos, Nigeria
| | - T Abayomi
- Federal Medical Centre, Owo, Nigeria
| | - U Omokaro
- University of Benin Teaching Hospital, Nigeria
| | - C Sylvester
- National Blood Service Commission, Abuja; Prof. Kelsey Harrison Hospital Port Harcourt, Nigeria
| | - U Igiebor
- Igbinedion University Teaching Hospital, Okada, Nigeria
| | - B Wokoma
- National Blood Service Commission, Abuja; University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - S Ebophni
- Braithwaite Memorial Specialist Hospital, Port Harcourt, Nigeria
| | - B Adewuyi
- Olabisi Onabanjo University Teaching Hospital, Nigeria
| | - R Dachi
- Abubakar Tafawa Balewa University Teaching Hospital, Nigeria
| | - H Muhammad
- University of Maiduguri Teaching Hospital, Nigeria
| | - M Abubakar
- Federal Medical Centre, Birnin Kudu, Jigawa, Nigeria
| | - J Mgbang
- National Blood Service Commission, Abuja; University of Uyo Teaching Hospital; University of Calabar Teaching Hospital; Federal Medical Centre, Yenagoa, Nigeria
| | - A Chineke
- Enugu State University Teaching Hospital, Parklane Enugu, Nigeria
| | - O Ogbuabor
- Enugu State University Teaching Hospital, Parklane Enugu, Nigeria
| | - G Fakai
- National Blood Service Commission, Abuja; Ahmadu Bello University Teaching Hospital; Usman Dan Fodio University Teaching Hospital, Nigeria
| | - B Hashim
- Federal Medical Centre, Birnin Kebbi, Nigeria
| | - N Adeluwoye
- National Blood Service Commission, Abuja; Bowen University Teaching Hospital, Ogbomoso, Nigeria
| | - D Olanrewaju
- Ambrose Alli University, Ekpoma; Irrua Specialist Hospital, Nigeria
| | - E Agahiu
- Nisa Premier Hospital, Abuja, Nigeria
| | - E Etim
- Federal Medical Centre, Yola, Nigeria
| | - S Alabi
- University of Ilorin Teaching Hospital, Nigeria
| | - I Akinbola
- Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Ogbomoso, Nigeria
| | - C Anibueze
- University of Abuja Teaching Hospital, Gwagwalada, Nigeria
| | - O Awogbami
- National Blood Service Commission, Abuja; Ekiti State University Teaching Hospital, Nigeria
| | - G Edowhorhu
- Bowen University Teaching Hospital, Ogbomoso, Nigeria
| | | | - S Bello
- National Blood Service Commission, Abuja; Ekiti State University Teaching Hospital, Nigeria
| | - Y Ojuade
- National Hospital, Abuja, Nigeria
| | - O Amedu
- National Blood Service Commission, Abuja, Nigeria
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Tsilingiris D, Nasiri-Ansari N, Spyrou N, Magkos F, Dalamaga M. Management of Hematologic Malignancies in the Era of COVID-19 Pandemic: Pathogenetic Mechanisms, Impact of Obesity, Perspectives, and Challenges. Cancers (Basel) 2022; 14:2494. [PMID: 35626099 PMCID: PMC9139192 DOI: 10.3390/cancers14102494] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/14/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic brought about an unprecedented societal and healthcare system crisis, considerably affecting healthcare workers and patients, particularly those with chronic diseases. Patients with hematologic malignancies faced a variety of challenges, pertinent to the nature of an underlying hematologic disorder itself as well as its therapy as a risk factor for severe SARS-CoV-2 infection, suboptimal vaccine efficacy and the need for uninterrupted medical observation and continued therapy. Obesity constitutes another factor which was acknowledged since the early days of the pandemic that predisposed people to severe COVID-19, and shares a likely causal link with the pathogenesis of a broad spectrum of hematologic cancers. We review here the epidemiologic and pathogenetic features that obesity and hematologic malignancies share, as well as potential mutual pathophysiological links predisposing people to a more severe SARS-CoV-2 course. Additionally, we attempt to present the existing evidence on the multi-faceted crucial challenges that had to be overcome in this diverse patient group and discuss further unresolved questions and future challenges for the management of hematologic malignancies in the era of COVID-19.
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Affiliation(s)
- Dimitrios Tsilingiris
- First Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, 17 St Thomas Street, 11527 Athens, Greece
| | - Narjes Nasiri-Ansari
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
| | - Nikolaos Spyrou
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Faidon Magkos
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, DK-2200 Frederiksberg, Denmark
| | - Maria Dalamaga
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
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Abstract
INTRODUCTION Globally, haemorrhage is the leading cause of both maternal mortality and preventable trauma death. For patients suffering from haemorrhage, prompt blood transfusion can be life-saving; however, safe and sufficient blood is often lacking in low-resource settings (LRS). Autotransfusion (AT), in which the patient's own blood is collected and transfused back, is an established alternative to donor blood transfusions, although one that is primarily performed with advanced AT systems. Research on basic AT in LRS is scarce. Therefore, we aimed to consolidate all available information on the current use of basic AT in LRS and to identify AT techniques and devices described for use in such settings. DESIGN Scoping review. METHODS We systematically searched four key databases: PubMed, Web of Science, Global Health and Cochrane Library as well as several grey literature databases and databases of relevant organisations. The final search was conducted on 22 April 2019. We included all types of studies referring to any information on basic AT used or sought to be used in LRS, published in English and dated after 31 December 2008. We synthesised the data from the included studies, results were charted or summarised narratively. RESULTS Some 370 records were reviewed, yielding 38 included documents. We found a paucity of scientific evidence as well as contradictory information on the extent of AT use and that AT use is largely undocumented. The most commonly described indications were haemoperitoneum (primarily among obstetric patients) and haemothorax. We identified three AT techniques used in LRS. Additionally, two new devices and one filter are described for potential use in LRS. CONCLUSIONS Basic AT is practiced for certain obstetric and trauma indications. However, context-specific studies are needed to determine the technique's safety and effectiveness. Extent of use is difficult to assess, but our results indicate that basic AT is not a widely established practice in LRS. Future research should address the bottlenecks hampering basic AT availability. New AT devices for use in LRS are described, but their utility and cost-effectiveness remain to be assessed.
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Affiliation(s)
- Maria Palmqvist
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Johan Von Schreeb
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Älgå
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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10
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Boumbaly S, Balde TAL, Semenov AV, Ostankova YV, Serikova EN, Naidenova EV, Valutite DE, Shchemelev AN, Zueva EB, Esaulenko EV, Totolian AA. [Prevalence of viral hepatitis B markers among blood donors in the Republic of Guinea]. Vopr Virusol 2022; 67:59-68. [PMID: 35293189 DOI: 10.36233/0507-4088-92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The problem of transfusion safety in relation to parenteral viral hepatitis still remains relevant. Viral hepatitis B (HB) remains the most common viral infection transmitted through transfusion procedures. One of the natural phases of chronic hepatitis B (CHB) is occult hepatitis B infection (OBI), characterized by an undetectable HBsAg (regardless of the other serological markers content) in the presence of hepatitis B virus (HBV) DNA in the liver tissue and an extremely low, up to undetectable, level of viral load in the blood. In the Republic of Guinea, as in most countries on the continent, the prevention of HBV transmission through transfusion is still based on HBsAg serological testing of donors only. In this connection, OBI remains as a potential threat to blood transfusion safety. Detection of HBV DNA is a reliable preventive measure against transmission of the virus from donors with HBsAg-negative HBV infection, especially in highly endemic regions. In this regard, the study was conducted to substantiate recommendations for improving blood safety against the background of significant HBV prevalence in the Republic of Guinea.The aim of the work was the evaluation of serological and molecular markers of HBV infection in blood donors in the Republic of Guinea. MATERIAL AND METHODS We examined 250 blood samples obtained from donors living in Conakry, Republic of Guinea. Samples were tested for the presence of serological (surface antigen, HBsAg; antibodies (ABs) to surface (anti-HBs IgG) and core (anti-HBc IgG) antigens) and molecular (DNA) markers of HBV infection. RESULTS AND DISCUSSION The overall detection rate of hepatitis B markers was 83.2%; HBsAg was detected in 16.4% of all individuals. The high incidence of HBsAg in men (19.55%) compared to women (8.45%) was shown, the relative risk of HBV infection with the formation of HBsAg-positive chronic hepatitis B in males was also significantly higher. The prevalence of the HBV DNA in the study group was 30.4%, the OBI cases accounted for 15.6%. The prevalence of this form of the disease was shown in donors aged 30-49 years (24.78%), in the group of people younger than 30 years, the incidence was lower (8.73%), and at the age of over 50 years, OBI was not detected. Based on the phylogenetic analysis of 76 virus isolates, it was shown that genotype E prevails in the examined group (85.53%).Cases of pathogen DNA detection occurred in HBsAg-negative blood donors in the presence of anti-HBs IgG (n = 4), as well as in the simultaneous presence of ABs anti-HBs IgG and anti-HBc IgG (n = 7). The viral load exceeded 200 IU/ml in OBI samples. Escape mutations were detected by sequencing in each OBI sample, contributing to the virus escaping from diagnostic based on screening for HBsAg. CONCLUSION Assessment of the prevalence viral hepatitis B markers in blood donors, determination of genotypes and clinically significant mutations of virus variants are necessary to ensure safe medical manipulations, control and prevention of the spread of this infectious agent.
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Affiliation(s)
- S Boumbaly
- International Tropical Infections Research Center; Research Institute of Applied Biology of Guinea
| | - T A L Balde
- Research Institute of Applied Biology of Guinea
| | - A V Semenov
- FSBI State Scientific Center of Virology and Biotechnology «Vector» of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
| | - Yu V Ostankova
- FBSI «Saint Petersburg Pasteur Research Institute of Epidemiology and Mictobiology» of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor)
| | - E N Serikova
- FBSI «Saint Petersburg Pasteur Research Institute of Epidemiology and Mictobiology» of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor)
| | - E V Naidenova
- FSHI Russian Research Anti-Plague Institute «Microbe» of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor)
| | - D E Valutite
- FBSI «Saint Petersburg Pasteur Research Institute of Epidemiology and Mictobiology» of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor)
| | - A N Shchemelev
- FBSI «Saint Petersburg Pasteur Research Institute of Epidemiology and Mictobiology» of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor)
| | - E B Zueva
- FBSI «Saint Petersburg Pasteur Research Institute of Epidemiology and Mictobiology» of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor)
| | - E V Esaulenko
- FBSI «Saint Petersburg Pasteur Research Institute of Epidemiology and Mictobiology» of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor)
| | - Areg A Totolian
- FBSI «Saint Petersburg Pasteur Research Institute of Epidemiology and Mictobiology» of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor)
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Ozioko O, Ozioko U, Iyidobi E, Ozor I, Abireh I, Mbaeze C, Okolo P. Surgeons' disposition on the use of autologous blood transfusion in tertiary hospitals in Enugu, Nigeria. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_55_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Othman M, Mahmud K, Mohammed R, Mohd Noor SNF, Tuan Din SA, Zabidi MA. Encapsulation of hemoglobin within mPEG- b-PCL micelle for development of artificial oxygen carrier. INT J POLYM MATER PO 2021. [DOI: 10.1080/00914037.2021.1915782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Mislia Othman
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Khadijah Mahmud
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Rafeezul Mohammed
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Siti Noor Fazliah Mohd Noor
- Biomaterial and Craniofacial Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Sharifah Azdiana Tuan Din
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Muhammad Azrul Zabidi
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
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Aziz Ali S, Feroz A, Abbasi Z, Aziz Ali S, Allana A, Hambidge KM, Krebs NF, Westcott JE, McClure EM, Goldenberg RL, Saleem S. Perceptions of women, their husbands and healthcare providers about anemia in rural Pakistan: Findings from a qualitative exploratory study. PLoS One 2021; 16:e0249360. [PMID: 33905421 PMCID: PMC8078764 DOI: 10.1371/journal.pone.0249360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 03/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Pakistan, there is a dearth of literature on the perceptions of anemia among women of reproductive age (WRA). This study was undertaken to explore the perceptions of women, their husbands, and healthcare providers about anemia, its possible causes, and how anemia impacts maternal and child health in Thatta, Pakistan. METHODS A qualitative study was conducted in Thatta, Pakistan from September to December 2018. Using a pre-tested semi-structured interview (SSI), we collected data to understand their definitions of anemia through ten focus group discussions (FGDs) with women and their partners and ten primary informant interviews (KIIs) with healthcare providers. We identified six major themes: (I) Knowledge and awareness of anemia, (II) Causes and consequences of Anemia, (III) Dietary practices, (IV) Knowledge and practices regarding the use of iron-folic acid supplements, (V) Factors influencing prevention and control of anemia and (VI) Women's health behavior. We analyzed the data through thematic analysis using NVivo 10 software. RESULTS Most community members were not aware of the term anemia but described anemia as a condition characterized by 'blood deficiency' in the body. All study participants perceived anemia as an important health problem tending to cause adverse outcomes among WRA and their children. Study participants perceived gutka (chewable tobacco) consumption as an important cause of anemia. Healthcare providers identified short inter-pregnancy intervals, lack of family planning, poor health-seeking behavior, and consumption of unhealthy food as causes of anemia in the district. Consumption of unhealthy food might not be related to related to a poorer knowledge of iron-deficient foods, but economic constraints. This was further endorsed by the healthcare providers who mentioned that most women were too poor to afford iron-rich foods. All men and women were generally well versed with the sources of good nutrition to be consumed by WRA to prevent anemia. CONCLUSION The findings suggest that the government should plan to develop strategies for poverty-stricken and vulnerable rural women and plan health awareness programs to improve dietary practices, compliance with supplements, and health-seeking behavior among women of reproductive age. There is a need to develop effective counseling strategies and context-specific health education sessions to improve the health-seeking behavior of women and men in the Thatta district of Pakistan. Besides, there is need to address social determinants of health such as poverty that pushes women of poorer socioeconomic strata to eat less nutritious foods and have more anaemia. Therefore, a comprehensive and robust strategic plan need to be adopted by government that focuses not only on the awareness programs, but also aim to reduce inequities that lead to pregnant women eat iron-poor foods, which, in turn, forces them to become anemic.
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Affiliation(s)
- Sumera Aziz Ali
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, United States of America
| | - Anam Feroz
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Zahid Abbasi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Savera Aziz Ali
- Department of Nursing, University of Alberta, Edmonton, Canada
| | - Ahreen Allana
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - K. Michael Hambidge
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Nancy F. Krebs
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Jamie E. Westcott
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Elizabeth M. McClure
- Regional Triangulate Institute International, Research Triangle Park, North Carolina, United States of America
| | - Robert L. Goldenberg
- Department of Obstetrics and Gynecology, Columbia University, New York City, New York, United States of America
| | - Sarah Saleem
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
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Wulff I, Duah HO, Oteng-Yeboah A, Tutu HO, Yankey KP, Essel AS, Akoto H, Boachie-Adjei O. The efficacy and safety of intraoperative acute normovolaemic haemodilution in complex spine surgery in a private surgical facility in Ghana. Ghana Med J 2021; 55:2-8. [PMID: 38322383 PMCID: PMC10665271 DOI: 10.4314/gmj.v55i1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Objectives To assess the safety and clinical benefits of intraoperative acute normovolaemic haemodilution (ANH) in complex spine surgery. Design Prospective comparative cohort study. Setting A private orthopaedic hospital in Ghana. Patients Seventy-six patients who underwent complex spine deformity surgery. Interventions Patients were randomly assigned to two groups. 45 patients to the acute normovolaemic haemodilution (ANH) or Group 1 and 31patients to the non-ANH or Group 2. Following anesthetic administration and before incision, autologous blood was collected from patients in Group1 and was reinfused during/shortly after surgery while patients in Group2 were transfused with compatible allogeneic blood intraoperatively. Main Outcome Measures Changes in haemodynamic parameters and incidence of allogeneic transfusions and related complications. Results The mean age (years), gender ratio, deformity size and aetiology, fusion levels, and operative times were similar in both groups. Blood loss (ml) of patients in groups 1 and 2 were 1583ml± 830.48 vs 1623ml ± 681.34, p=0.82, respectively. The rate of allogeneic blood transfusion in groups 1 and 2 were 71% vs 80.65%, p=0.88, respectively. Haemoglobin levels (g/dL) in groups 1 and 2 were comparable in both groups at Post-operative Day (POD) 0 and POD 1. Incidence of minor allogeneic transfusion reaction was 1/45 vs 1/31, p=0.80, group-1 and group-2, respectively. Conclusion Acute normovolaemic haemodilution can be safely performed in complex spine surgery in underserved regions. However, its use does not obviate allogeneic transfusion in patients with complex spine deformities in whom large volumes of blood loss is expected. Funding None declared.
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Affiliation(s)
- Irene Wulff
- FOCOS Orthopaedic Hospital, No. 8 Teshie Street, Pantang, Accra. P. O. Box KD 779, Accra-Ghana
| | - Henry O Duah
- FOCOS Orthopaedic Hospital, No. 8 Teshie Street, Pantang, Accra. P. O. Box KD 779, Accra-Ghana
| | | | - Henry O Tutu
- FOCOS Orthopaedic Hospital, No. 8 Teshie Street, Pantang, Accra. P. O. Box KD 779, Accra-Ghana
| | - Kwadwo P Yankey
- FOCOS Orthopaedic Hospital, No. 8 Teshie Street, Pantang, Accra. P. O. Box KD 779, Accra-Ghana
| | - Aba S Essel
- FOCOS Orthopaedic Hospital, No. 8 Teshie Street, Pantang, Accra. P. O. Box KD 779, Accra-Ghana
| | - Harry Akoto
- Korle-Bu Teaching Hospital, P. O. Box KB 77, Accra-Ghana
| | - Oheneba Boachie-Adjei
- FOCOS Orthopaedic Hospital, No. 8 Teshie Street, Pantang, Accra. P. O. Box KD 779, Accra-Ghana
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15
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Blood Donation Practice and Associated Factors in Ethiopia: A Systematic Review and Meta-analysis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8852342. [PMID: 33294457 PMCID: PMC7714580 DOI: 10.1155/2020/8852342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 12/20/2022]
Abstract
Background Blood donation is a novel act to save the lives of people who face serious medical and surgical conditions. Since the demand for blood supply is too high, there is a shortage of blood which causes significant morbidity and mortality. To increase blood supply and maintain adequate quantity of blood, regular and volunteer blood donation practice is needed, which meets the increased demand for blood. Therefore, this systematic review and meta-analysis was aimed at assessing the prevalence of blood donation practices and associated factors in Ethiopia. Method PubMed/MEDLINE, HINARI, Embase, Scopus, Google Scholar, African Journals Online (AJOL), and published and unpublished articles from the Ethiopian University repository were searched to find articles. Cochrane I 2 statistics and Egger's test with funnel plots were done to check heterogeneity and publication bias, respectively. Subgroup analysis by region, study subjects, study setting, and sample size was done due to heterogeneity, as well as sensitivity analysis. Result Twenty studies from different regions with a total study subject of 8546 were included in the final review. The pooled prevalence of blood donation practice in Ethiopia was 25.82% (95% CI: 21.45-30.19). Having good knowledge of blood donation (AOR = 2.85; 95% CI: 2.33-3.48) and favorable attitude (AOR = 4.35; 95% CI: 2.93-6.45) were factors associated with blood donation practice in Ethiopia. Conclusion The pooled prevalence of blood donation practices in Ethiopia was short of the demand for blood due to the increase in serious medical conditions and road traffic accidents. Knowledge and attitude towards blood donation were significantly associated with blood donation practice. Therefore, awareness creation and health education programs targeting blood donation practice should be strengthened.
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Ugwu NI, Uneke CJ, Ugwu CN, Oti WJO, Agbo UN, Akamike IC. Effect of Blood Donor Educational intervention on the knowledge and Attitude towards Voluntary Blood Donation among Medical Students at a Nigerian University. Niger Med J 2020; 61:163-168. [PMID: 33100469 PMCID: PMC7547758 DOI: 10.4103/nmj.nmj_177_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 04/15/2020] [Accepted: 05/19/2020] [Indexed: 11/06/2022] Open
Abstract
Background: Blood is a veritable tool in many life-saving situations. Despite the increased demand for blood, the supply of safe blood has been inadequate. This study was aimed to determine the effect of educational intervention on the knowledge and attitude of medical students of a Nigerian University to voluntary blood donation. Materials and Methods: This was a cross-sectional study involving 158 undergraduate medical students of Ebonyi State University in South-East Nigeria. Participants were recruited by stratified sampling technique. A pretested semi-structured participant administered questionnaire was used to baseline knowledge and attitude to voluntary blood donation. This was followed by educational intervention in the form of a workshop by experts in blood transfusion medicine. Then, postintervention assessment was done using the initial questionnaire 30 days later. The study was approved by the Research and Ethics Committee of Ebonyi State University, Abakaliki. Data obtained were analyzed using SPSS 20 software, and P value was set at ≤0.05. Results: Of the 158 medical students who participated in the study, there were 90 (57%) males and 68 (43%) females. Baseline proportion of the participants who had good knowledge was high (72.8%), while baseline attitude of the participants was positive to most aspects of voluntary blood donation. Post intervention, the level of knowledge about voluntary blood donation increased to 99.4%, and similarly attitude to voluntary blood donation improved. Conclusion: Educational intervention was effective in improving the knowledge and attitude towards voluntary blood donation among medical students. Continuous enlightenment will influence potential blood donors to have better knowledge and positive attitude toward voluntary blood donation.
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Affiliation(s)
- Ngozi Immaculata Ugwu
- Department of Haematology and Immunology, Faculty of Clinical Medicine, College of Health Sciences, Ebonyi State University, Abakaliki, Nigeria
| | - Chigozie Jesse Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Nigeria
| | - Collins Nwachi Ugwu
- Department of Internal Medicine, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria
| | - Wilberforce John Otu Oti
- Department of Industrial Chemistry, Faculty of Sciences, Ebonyi State University, Abakaliki, Nigeria
| | - Urudinachi Nnenne Agbo
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Ifeyinwa Chizoba Akamike
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
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A Last Resort When There is No Blood: Experiences and Perceptions of Intraoperative Autotransfusion Among Medical Doctors Deployed to Resource-Limited Settings. World J Surg 2020; 44:4052-4059. [PMID: 32856098 PMCID: PMC7599148 DOI: 10.1007/s00268-020-05749-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Four and a half million people die globally every year due to traumatic injuries. One major cause of preventable death is bleeding. Blood for transfusion is often unavailable in resource-limited settings, where a majority of trauma deaths occur. Intraoperative autotransfusion (IAT) has been proposed as a safe and feasible lifesaving alternative to allogeneic blood transfusion. However, there is limited knowledge regarding its use among doctors working for international non-governmental organisations (INGOs) in resource-limited settings. The aim of this study was to explore the experiences and perceptions of IAT among INGO-affiliated medical doctors with clinical experience in resource-limited settings. METHODS We conducted semi-structured interviews via telephone or Skype with 12 purposefully sampled surgeons and anaesthesiologists. The interviews were recorded, transcribed verbatim, and analysed using content analysis. RESULTS We identified three main themes relating to IAT and bottlenecks preventing the scale-up of its use: variation in techniques and systems, contextual factors, and individual medical doctor factors. The participants gave detailed reports of missed opportunities for usage of IAT in resource-limited settings. Bottlenecks included the lack of simple and cost-effective products, limited availability of protocols in the field, and insufficient knowledge and experience of IAT. CONCLUSIONS The participants found that simple IAT is under-utilised in resource-limited settings. Missed opportunities to use IAT were mainly associated with armed conflict settings and obstetrical emergencies. In order to meet the need for IAT in resource-limited settings, we suggest further consideration of the identified bottlenecks.
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Wise RD, de Vasconcellos K, Gopalan D, Ahmed N, Alli A, Joubert I, Kabambi KF, Mathiva LR, Mdladla N, Mer M, Miller M, Mrara B, Omar S, Paruk F, Richards GA, Skinner D, von Rahden R. Critical Care Society of Southern Africa adult patient blood management guidelines: 2019 Round-table meeting, CCSSA Congress, Durban, 2018. SOUTHERN AFRICAN JOURNAL OF CRITICAL CARE 2020; 36:10.7196/SAJCC.2020.v36i1b.440. [PMID: 37415775 PMCID: PMC10321416 DOI: 10.7196/sajcc.2020.v36i1b.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 07/08/2023] Open
Abstract
The CCSSA PBM Guidelines have been developed to improve patient blood management in critically ill patients in southern Africa. These consensus recommendations are based on a rigorous process by experts in the field of critical care who are also practicing in South Africa (SA). The process comprised a Delphi process, a round-table meeting (at the CCSSA National Congress, Durban, 2018), and a review of the best available evidence and international guidelines. The guidelines focus on the broader principles of patient blood management and incorporate transfusion medicine (transfusion guidelines), management of anaemia, optimisation of coagulopathy, and administrative and ethical considerations. There are a mix of low-middle and high-income healthcare structures within southern Africa. Blood products are, however, provided by the same not-for-profit non-governmental organisations to both private and public sectors. There are several challenges related to patient blood management in SA due most notably to a high incidence of anaemia, a frequent shortage of blood products, a small donor population, and a healthcare system under financial strain. The rational and equitable use of blood products is important to ensure best care for as many critically ill patients as possible. The summary of the recommendations provides key practice points for the day-to-day management of critically ill patients. A more detailed description of the evidence used to make these recommendations follows in the full clinical guidelines section.
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Affiliation(s)
- R D Wise
- Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - K de Vasconcellos
- Department of Critical Care, King Edward VIII Hospital, Durban; Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - D Gopalan
- Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - N Ahmed
- Surgical ICU, Tygerberg Academic Hospital; Department of Surgical Sciences and Department of Anaesthesiology and Critical Care, Stellenbosch University, Cape Town, South Africa
| | - A Alli
- Department of Anaesthesia, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - I Joubert
- Division of Critical Care, Department of Anaesthesia and Perioperative Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - K F Kabambi
- Department of Anaesthesia and Critical Care, Nelson Mandela Academic Hospital, Mthatha; Department of Surgery, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - L R Mathiva
- Intensive Care Unit, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - N Mdladla
- Dr George Mukhari Academic Hospital; Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - M Mer
- Department of Medicine, Divisions of Critical Care and Pulmonology, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - M Miller
- Department of Anaesthesia and Peri-operative Medicine, Division of Critical Care, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - B Mrara
- Anaesthesia Department, Walter Sisulu University, Mthatha, South Africa
| | - S Omar
- Department of Critical Care, Chris Hani Baragwanath Academic Hospital and School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - F Paruk
- Department of Critical Care, Steve Biko Academic Hospital and Critical Care, School of Medicine, University of Pretoria, South Africa
| | - G A Richards
- Department of Critical Care, Charlotte Maxeke Johannesburg Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - D Skinner
- Department of Critical Care, King Edward VIII Hospital, Durban; Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - R von Rahden
- Private practice (Critical Care), Rodseth and Partners, Pietermaritzburg, South Africa
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Hossain Parash M, Suki N, Shimmi S, Hossain A, Murthy K. Examining students’ intention to perform voluntary blood donation using a theory of planned behaviour: A structural equation modelling approach. Transfus Clin Biol 2020; 27:70-77. [PMID: 32139133 DOI: 10.1016/j.tracli.2020.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/05/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE This study aims to examine the behavioural intention of students to make voluntary blood donations. Moreover, it uses a theory of planned behaviour as its guiding principle and does so within the context of Malaysia, a developing nation. METHODS Data were collected via a self-administered questionnaire from a sample of 500 students at a public higher learning institution in Malaysia. Structural equation modelling approach (SEM) was performed to assess the strength of the hypothesized relationships of the proposed model simultaneously via the two-stage model-building process. RESULTS The SEM approach revealed that knowledge was the most influential predictor of students' intention to make a voluntary blood donation. With the knowledge that the more blood they donate, the more lives will be saved, the inclination to donate blood is intensifying among students. Moreover, all of the TPB constructs applied were also seen to significantly influence students' response to voluntary blood donation. CONCLUSIONS The nexus of attitude, subjective norm, perceived behavioural control, and knowledge about students' intention to perform voluntary blood donation are evidenced in a developing nation. The implications of the study and directions for future research are provided.
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Ddungu H, Krantz EM, Kajja I, Naluzze S, Nabbanja H, Nalubwama F, Phipps W, Orem J, Wald A, Kiwanuka N. Transfusion Challenges in Patients with Hematological Malignancies in Sub-Saharan Africa: A Prospective Observational Study from the Uganda Cancer Institute. Sci Rep 2020; 10:2825. [PMID: 32071350 PMCID: PMC7028934 DOI: 10.1038/s41598-020-59773-y] [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] [Received: 09/06/2019] [Accepted: 02/03/2020] [Indexed: 12/03/2022] Open
Abstract
Blood transfusion is fundamental in managing hematologic malignancies. We sought to evaluate the need and availability of blood products for patients with hematological malignancies at Uganda Cancer Institute. We prospectively studied the demand and supply of blood for patients with thrombocytopenia (platelet count ≤50 × 109/L), anemia (hemoglobin ≤10 g/dL), and bleeding (WHO grade ≥2). We used Poisson generalized estimating equation regression models for longitudinal binary outcomes. Among 91 patients, the median age was 26 years (IQR, 11–47). Thrombocytopenia occurred on ≥1 day in 58% of patients and on 49% of hospital days. Platelets were transfused to 39% of patients. The mean number of platelet units requested per day was 16.2 (range 0–30); 5.1 (range 0–15) were received. Anemia occurred on ≥1 day in 90% of patients; on 78% of days; and 68% received at least one blood transfusion. The mean number of blood units requested was 36.3 (range 8–57) units per day; 14 (range 0–30) were received. Bleeding occurred on ≥1 day in 19% of patients on 8% of hospital days. Thrombocytopenia and anemia were common, but product availability was substantially below that requested. We recommend increased blood collection and adherence to strict transfusion triggers as strategies to improve blood availability.
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Affiliation(s)
- Henry Ddungu
- Uganda Cancer Institute, Kampala, Uganda. .,School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Elizabeth M Krantz
- Vaccines and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Isaac Kajja
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | | | | | - Warren Phipps
- Vaccines and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Anna Wald
- Vaccines and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Medicine, University of Washington, Seattle, WA, USA.,Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Noah Kiwanuka
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
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21
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Enawgaw B, Yalew A, Shiferaw E. Blood donors' knowledge and attitude towards blood donation at North Gondar district blood bank, Northwest Ethiopia: a cross-sectional study. BMC Res Notes 2019; 12:729. [PMID: 31694710 PMCID: PMC6836355 DOI: 10.1186/s13104-019-4776-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/01/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Blood transfusion saves millions of lives. But, the need and the actual number of donations are not balanced in Ethiopia. The actual reason is not clearly assessed; however, level of knowledge and attitude may be the main contributing factors. Thus, the current study aimed to assess blood donors' knowledge and attitude towards blood donation at North Gondar district blood bank. RESULTS Of 401 blood donors, 142 (35.4%) and 379 (94.5%) were had adequate knowledge and positive attitude towards blood donation, respectively. About 343 (85.5%) of study participants had no previous experience of blood donation. Perceptions of fear of pain, medically unfitness to donate and lack of information on when, where and how to donate blood were mentioned as a reason for not donating blood. Educational status and residence were significantly associated with knowledge of blood donors. On the other hand, participants with secondary and higher education were more likely to have good attitude towards blood donation. Thus, blood banks should design strategies for health education about blood donation and transfusion.
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Affiliation(s)
- Bamlaku Enawgaw
- Department of Hematology& Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Aregawi Yalew
- Department of Hematology& Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Elias Shiferaw
- Department of Hematology& Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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22
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Ling G, Draghic N. Aerial drones for blood delivery. Transfusion 2019; 59:1608-1611. [PMID: 30980745 DOI: 10.1111/trf.15195] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/12/2018] [Accepted: 10/13/2018] [Indexed: 11/26/2022]
Abstract
Aerial drone technology is now in use to improve medical care, especially blood delivery. The use of aerial drones is broader than just this and includes aerial photography, express shipping and delivery, disaster management, search and rescue operations, crop monitoring, weather tracking, law enforcement, and structural assessment. This wide use promises to accelerate and, ideally, reduce the cost of technological advances of drones. By doing so, drone use offers the opportunity of improving health care, particularly in remote and/or underserved environments by decreasing lab testing turnaround times, enabling just-in-time lifesaving medical supply/device delivery, and reducing costs of routine prescription care in rural areas.
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Affiliation(s)
- Geoffrey Ling
- Division of Neurosciences Critical Care, Departments of Neurology, Neurosurgery and Anesthesiology-Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland.,Department of Clinical Neurosciences, Inova Fairfax Hospital, Falls Church, Virginia
| | - Nicole Draghic
- Department of Clinical Neurosciences, Inova Fairfax Hospital, Falls Church, Virginia
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23
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Tigabu A, Engda T, Mekonnen F. Seroprevalence of transfusion transmissible viral infections (HIV, HBV and HCV) among voluntary blood donors at University of Gondar Comprehensive Specialized Hospital, Gondar; Northwest Ethiopia. BMC Infect Dis 2019; 19:393. [PMID: 31068138 PMCID: PMC6507054 DOI: 10.1186/s12879-019-3950-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/03/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus, hepatitis B virus and hepatitis C virus are among the greatest threats to blood safety for the recipient. They are also the leading cause of death, chronic and life-threatening abnormalities. Therefore, this study was aimed to assess the Sero-prevalence of HIV, Hepatitis B and C virus among blood donors at the University of Gondar Comprehensive Specialized Hospital. METHODS A retrospective cross-sectional study was used to estimate the seroprevalence of HIV, Hepatitis B and C virus among blood donors at the University of Gondar Comprehensive Specialized Hospital from May-July 2018. Screening of HIV, HBV, and HCV was done by using the Enzyme-Linked ImmunoSorbent Assay. Records of 5983 first time blood donors were collected and reviewed by using a checklist from registration book. Data was entered in statistical package EP Info version 3.5.1, and data cleaned and analyzed using the statistical package SPSS version 16.0. RESULTS Of 5983 blood donors, 85.5% (5118/5983) donors were males and 14.5% (865/5983) were females. The median age was 27 years and the highest blood donations age category was between 20 to 51.2% (29/5983) followed by 30 to 39 years of age, 21.6% (1295/5983). The prevalence of HIV, HBV and HCV infections were 2.5% (95% CI: 1.07-2.398), 4.1% (95% CI: 0.461-1.053) and 1.6% (95% CI: 0.845-3.354), respectively. HIV infection was significantly associated with gender (p = 0.021, x2 = 5.358) and HCV infection with age group (p = 0.003, x2 = 17.673). Of all donated blood, 8.2% (489/5983) had serological evidence for at least one of the screened pathogens and 58 (0.96%) of them had multiple infections. CONCLUSIONS This study showed a significant prevalence of HIV, HBV, and HCV among blood donors, 2.5% (147/5983), 4.1% (244/5983) and 1.6% (98/5983), respectively. Therefore, strict selection of blood donors with an emphasis on getting voluntary blood donors, and highly sensitive and specific tests for screening of blood donors for HIV, HBV, and HCV using standard methods are highly recommended to ensure the safety of blood for the recipient.
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Affiliation(s)
- Abiye Tigabu
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P O.box: 196, Gondar, Ethiopia.
| | - Tigist Engda
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P O.box: 196, Gondar, Ethiopia
| | - Feleke Mekonnen
- Department of Medical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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24
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Reid ME. Hydroxyurea for Primary Stroke Prevention: The time draweth nigh. Pediatr Blood Cancer 2019; 66:e27536. [PMID: 30426675 DOI: 10.1002/pbc.27536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/07/2018] [Accepted: 10/10/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Marvin E Reid
- Tropical Metabolism Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Jamaica
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25
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How low can you go: What is the safe threshold for platelet transfusions in patients with hematologic malignancy in sub-Saharan Africa. PLoS One 2019; 14:e0211648. [PMID: 30726290 PMCID: PMC6364911 DOI: 10.1371/journal.pone.0211648] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 01/17/2019] [Indexed: 01/19/2023] Open
Abstract
Background Despite the importance of platelet transfusions in treatment of hematologic cancer patients, the optimal platelet count threshold for prophylactic transfusion is unknown in sub-Saharan Africa. Methods We followed patients admitted to the Uganda Cancer Institute with a hematological malignancy in 3 sequential 4-month time-periods using incrementally lower thresholds for prophylactic platelet transfusion: platelet counts ≤ 30 x 109/L in period 1, ≤ 20 x 109/L in period 2, and ≤ 10 x 109/L in period 3. Clinically significant bleeding was defined as WHO grade ≥ 2 bleeding. We used generalized estimating equations (GEE) to compare the frequency of clinically significant bleeding and platelet transfusions by study period, adjusting for age, sex, cancer type, chemotherapy, baseline platelet count, and baseline hemoglobin. Results Overall, 188 patients were enrolled. The median age was 22 years (range 1–80). Platelet transfusions were given to 42% of patients in period 1, 55% in period 2, and 45% in period 3. These transfusions occurred on 8% of days in period 1, 12% in period 2, and 8% in period 3. In adjusted models, period 3 had significantly fewer transfusions than period 1 (RR = 0.6, 95% CI 0.4–0.9; p = 0.01) and period 2 (RR = 0.5, 95% CI 0.4–0.7; p<0.001). Eighteen patients (30%) had clinically significant bleeding on at least one day in period 1, 23 (30%) in period 2, and 15 (23%) in period 3. Clinically significant bleeding occurred on 8% of patient-days in period 1, 9% in period 2, and 5% in period 3 (adjusted p = 0.41). Thirteen (21%) patients died in period 1, 15 (22%) in period 2, and 11 (19%) in period 3 (adjusted p = 0.96). Conclusion Lowering the threshold for platelet transfusion led to fewer transfusions and did not change the incidence of clinically significant bleeding or mortality, suggesting that a threshold of 10 x 109/L platelets, used in resource-rich countries, may be implemented as a safe level for transfusions in sub-Saharan Africa.
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26
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Chambers TM, Kahan S, Camanda JF, Scheurer M, Airewele GE. Intermittent or uneven daily administration of low-dose hydroxyurea is effective in treating children with sickle cell anemia in Angola. Pediatr Blood Cancer 2018; 65:e27365. [PMID: 30051651 DOI: 10.1002/pbc.27365] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 05/30/2018] [Accepted: 06/18/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although hydroxyurea is proven effective in treatment of sickle cell anemia (SCA) and is widely prescribed in high-income countries, due to questions about feasibility of treating large numbers of patients in resource-limited health systems, its use is limited in sub-Saharan Africa (SSA), where most children with SCA live. We assessed hematological response and toxicity of hydroxyurea treatment for SCA in Angola. METHODS Retrospective study of children with SCA (not selected for clinical severity) treated on a fixed dose of hydroxyurea for at least 6 months. Because only the 500 mg capsule was available, dose was averaged weekly. We evaluated toxicity events and magnitude of hydroxyurea-induced changes in blood counts and compared patients who received a uniform daily dose to those prescribed intermittent or uneven daily doses. RESULTS Only 13% of 303 patients received a uniform dose of hydroxyurea daily. Dose ranged from 16.5 to 22.8 mg/kg/day. Hydroxyurea increased HGB and mean cell volume values by 0.5 g/dL (P < 0.0001) and 8 fL (P < 0.0001), while ANC, PLT, and ARC decreased 1.1 × 109 /L (P < 0.0001), 34 × 109 /L (P = < 0.0001), and 19 × 109 /L (P = 0.0008), respectively. There were no differences in magnitude of hydroxyurea-induced changes between patients prescribed intermittent or uneven doses and uniform daily doses, or between those treated in the lower and higher dose quartiles. Hematological toxicity events were mild and reversible. CONCLUSION Intermittent or uneven daily dosing of hydroxyurea is as effective as fixed daily doses in treating SCA. This strategy may enable treatment of additional children with SCA in SSA.
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Affiliation(s)
- Tiffany M Chambers
- Department of Pediatrics-Section of Hematology and Oncology, Baylor College of Medicine, Houston, Texas
| | - Silvina Kahan
- Global Health Corps, Baylor College of Medicine, Houston, Texas
| | - Joao F Camanda
- Faculty of Medicine, Universidade 11 de Novembro, Cabinda, Angola
| | - Michael Scheurer
- Department of Pediatrics-Section of Hematology and Oncology, Baylor College of Medicine, Houston, Texas
| | - Gladstone E Airewele
- Department of Pediatrics-Section of Hematology and Oncology, Baylor College of Medicine, Houston, Texas
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27
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Utilisation of blood and blood products during open heart surgery in a low-income country: our local experience in 3 years. Cardiol Young 2018; 28:1289-1294. [PMID: 30070188 DOI: 10.1017/s1047951118001269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND In Nigeria, access to open heart surgery (OHS) is adversely affected by insufficient blood and blood products, including the challenges because of the lack of patient-focused blood management strategies owing to the absent requisite point-of-care tests in the operating theatre (OR)/ICU. In addition, the limited availability of altruistic blood donors including the detection of transfusion transmitted infections more commonly among non-altruistic blood donors is another burden affecting the management of excessive bleeding during and after open heart surgery in our country. OBJECTIVE The objective of this study was to review our local experience in the use of blood and blood products during open heart surgery and compare the same with the literature.Materials and methodsIn a period of 3 years (March, 2013-February, 2016), we performed a retrospective review of those who had open heart surgery in our institution. The data were obtained from our hospital health information technology department. The data comprised demography, types of operative procedures and units of blood and blood products transfused per procedure, including the details regarding the usage of the cell saver, as well as those who had severe bleeding requiring excessive blood transfusion. RESULTS During the study period, 102 patients had open heart surgery, an average of 34 cases in a year. Among them, there were 75 (73.53%) males and 37 (36.27%) females, giving a ratio of 2:1. The ages of the patients were from 0.6 (7/12) to 74 years. Mitral valve procedure was the most common (n=22, 21.6%) surgery type. Transfusion requirements averaged 1.9 units of fresh frozen plasma, 0.36 units of platelet concentrate, and 1.68 units of packed cells per procedure. The least common surgical procedure was common atrium repair (n=1, 0.01%). CONCLUSION Open heart procedure is a very complex procedure requiring cardiopulmonary bypass with associated severe perioperative bleeding. The attendant blood loss and haemostatic challenges are combated by intricate and selective transfusions of allogeneic blood and or blood products.
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Barro L, Drew VJ, Poda GG, Tagny CT, El-Ekiaby M, Owusu-Ofori S, Burnouf T. Blood transfusion in sub-Saharan Africa: understanding the missing gap and responding to present and future challenges. Vox Sang 2018; 113:726-736. [DOI: 10.1111/vox.12705] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 08/05/2018] [Accepted: 08/06/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Lassina Barro
- International Ph.D. Program in Biomedical Engineering; College of Biomedical Engineering; Taipei Medical University; Taipei Taiwan
- Centre National de Transfusion Sanguine; Ouagadougou Burkina Faso
| | - Victor J. Drew
- International Ph.D. Program in Biomedical Engineering; College of Biomedical Engineering; Taipei Medical University; Taipei Taiwan
| | | | - Claude T. Tagny
- Faculty of Medicine and Biomedical Sciences; University of Yaounde I; Yaoundé Cameroon
| | | | | | - Thierry Burnouf
- International Ph.D. Program in Biomedical Engineering; College of Biomedical Engineering; Taipei Medical University; Taipei Taiwan
- Graduate Institute of Biomedical Materials and Tissue Engineering; College of Biomedical Engineering; Taipei Medical University; Taipei Taiwan
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Misener R, Allenby MC, Fuentes-Garí M, Gupta K, Wiggins T, Panoskaltsis N, Pistikopoulos EN, Mantalaris A. Stem cell biomanufacturing under uncertainty: A case study in optimizing red blood cell production. AIChE J 2018; 64:3011-3022. [PMID: 30166646 PMCID: PMC6108044 DOI: 10.1002/aic.16042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 11/08/2017] [Indexed: 12/12/2022]
Abstract
As breakthrough cellular therapy discoveries are translated into reliable, commercializable applications, effective stem cell biomanufacturing requires systematically developing and optimizing bioprocess design and operation. This article proposes a rigorous computational framework for stem cell biomanufacturing under uncertainty. Our mathematical tool kit incorporates: high‐fidelity modeling, single variate and multivariate sensitivity analysis, global topological superstructure optimization, and robust optimization. The advantages of the proposed bioprocess optimization framework using, as a case study, a dual hollow fiber bioreactor producing red blood cells from progenitor cells were quantitatively demonstrated. The optimization phase reduces the cost by a factor of 4, and the price of insuring process performance against uncertainty is approximately 15% over the nominal optimal solution. Mathematical modeling and optimization can guide decision making; the possible commercial impact of this cellular therapy using the disruptive technology paradigm was quantitatively evaluated. © 2017 American Institute of Chemical Engineers AIChE J, 64: 3011–3022, 2018
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Affiliation(s)
- Ruth Misener
- Dept. of Computing; Imperial College London; South Kensington London SW7 2AZ U.K
| | - Mark C. Allenby
- Dept. of Haematology; Imperial College London; Harrow London HA1 3UJ U. K
| | - María Fuentes-Garí
- Dept. of Haematology; Imperial College London; Harrow London HA1 3UJ U. K
| | - Karan Gupta
- Dept. of Haematology; Imperial College London; Harrow London HA1 3UJ U. K
| | - Thomas Wiggins
- Dept. of Haematology; Imperial College London; Harrow London HA1 3UJ U. K
| | - Nicki Panoskaltsis
- Artie McFerrin Dept. of Chemical Engineering; Texas A&M University; College Station TX 77843
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30
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Siraj N, Achila OO, Issac J, Menghisteab E, Hailemariam M, Hagos S, Gebremeskel Y, Tesfamichael D. Seroprevalence of transfusion-transmissible infections among blood donors at National Blood Transfusion Service, Eritrea: a seven-year retrospective study. BMC Infect Dis 2018; 18:264. [PMID: 29879912 PMCID: PMC5992706 DOI: 10.1186/s12879-018-3174-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 05/30/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Blood transfusion is associated with several risks particularly exposure to blood transfusion-transmissible infections (TTI), including: Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human immunodeficiency virus (HIV) and Syphilis, among others. The threat posed by these blood-borne pathogens is disproportionately high in Sub-Saharan Africa (SSA). This fact underscores the need for continuous surveillance of TTIs in the region. Therefore, the study objectives were to evaluate the prevalence of TTIs and donor characteristics associated with positivity for TTIs at the National Blood Transfusion Center (NBTC) in Asmara, Eritrea. METHODS A retrospective analysis of blood donors' records covering the period from January 2010 to December 2016 was undertaken. The records were analyzed to evaluate the annualised cumulative prevalence of TTIs. Chi-square test (χ2) or Fisher's exact test was used to evaluate the relationship between serological positivity and particular donor characteristics. Logistic regression was fitted to identify factors associated with cumulative TTIs positivity. A P-value < 0.05 was considered statistically significant. RESULT A total of 60,236 consecutive blood donors were screened between 2010 and 2016. At least 3.6% of donated blood was positive for at least one TTI and 0.1% showed evidence of multiple infections. The sero-prevalence of HBV, HCV, HIV, syphilis and co-infection was 2.0, 0.7, 0.3 and 0.6%, respectively. Sex, type of donor and region were associated with TTI positivity. Except for donation frequency, there was a significant relationship (P < 0.005) between HBV, HCV, HIV and syphilis sero-positivity and other donor characteristics evaluated in the study. CONCLUSION The result demonstrates that Eritrea has relatively low TTI prevalence compared to other countries in Sub-Saharan Africa. However, the prevalence, particularly that of HCV, increased significantly in 2016. Enhancing donor screening and additional research utilizing nucleic acid based techniques should therefore be prioritized.
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Affiliation(s)
- Nejat Siraj
- Department of Clinical Laboratory Science, Asmara College of Health Sciences, P.O. Box 8566, Asmara, Eritrea
| | - Oliver Okoth Achila
- Department of Clinical Laboratory Science, Asmara College of Health Sciences, P.O. Box 8566, Asmara, Eritrea
| | - John Issac
- Department of Clinical Laboratory Science, Asmara College of Health Sciences, P.O. Box 8566, Asmara, Eritrea
| | - Efrem Menghisteab
- Department of Clinical Laboratory Science, Asmara College of Health Sciences, P.O. Box 8566, Asmara, Eritrea
| | - Maedn Hailemariam
- Department of Clinical Laboratory Science, Asmara College of Health Sciences, P.O. Box 8566, Asmara, Eritrea
| | - Semere Hagos
- Department of Clinical Laboratory Science, Asmara College of Health Sciences, P.O. Box 8566, Asmara, Eritrea
| | - Yosan Gebremeskel
- Department of Clinical Laboratory Science, Asmara College of Health Sciences, P.O. Box 8566, Asmara, Eritrea
| | - Daniel Tesfamichael
- Data Mangement Unit, National Blood Transfusion Service (NBTS), Asmara, Eritrea
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31
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Appiah B, Burdine JN, Aftab A, Asamoah-Akuoko L, Anum DA, Kretchy IA, Samman EW, Appiah PB, Bates I. Determinants of Intention to Use Mobile Phone Caller Tunes to Promote Voluntary Blood Donation: Cross-Sectional Study. JMIR Mhealth Uhealth 2018; 6:e117. [PMID: 29728343 PMCID: PMC5960044 DOI: 10.2196/mhealth.9752] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 02/14/2018] [Accepted: 02/23/2018] [Indexed: 12/03/2022] Open
Abstract
Background Voluntary blood donation rates are low in sub-Saharan Africa. Sociobehavioral factors such as a belief that donated blood would be used for performing rituals deter people from donating blood. There is a need for culturally appropriate communication interventions to encourage individuals to donate blood. Health care interventions that use mobile phones have increased in developing countries, although many of them focus on SMS text messaging (short message service, SMS). A unique feature of mobile phones that has so far not been used for aiding blood donation is caller tunes. Caller tunes replace the ringing sound heard by a caller to a mobile phone before the called party answers the call. In African countries such as Ghana, instead of the typical ringing sound, a caller may hear a message or song. Despite the popularity of such caller tunes, there is a lack of empirical studies on their potential use for promoting blood donation. Objective The aim of this study was to use the technology acceptance model to explore the influence of the factors—perceived ease of use, perceived usefulness, attitude, and free of cost—on intentions of blood or nonblood donors to download blood donation-themed caller tunes to promote blood donation, if available. Methods A total of 478 blood donors and 477 nonblood donors were purposively sampled for an interviewer-administered questionnaire survey at blood donation sites in Accra, Ghana. Data were analyzed using descriptive statistics, exploratory factor analysis, and confirmatory factory analysis or structural equation modeling, leading to hypothesis testing to examine factors that determine intention to use caller tunes for blood donation among blood or nonblood donors who use or do not use mobile phone caller tunes. Results Perceived usefulness had a significant effect on intention to use caller tunes among blood donors with caller tunes (beta=.293, P<.001), blood donors without caller tunes (beta=.165, P=.02, nonblood donors with caller tunes (beta=.278, P<.001), and nonblood donors without caller tunes (beta=.164, P=.01). Attitudes had significant effect on intention to use caller tunes among blood donors without caller tunes (beta=.351, P<.001), nonblood donors with caller tunes (beta=.384, P<.001), nonblood donors without caller tunes (beta=.539, P<.001) but not among blood donors with caller tunes (beta=.056, P=.44). The effect of free-of-cost caller tunes on the intention to use for blood donation was statistically significant (beta=.169, P<.001) only in the case of nonblood donors without caller tunes, whereas this path was statistically not significant in other models. Conclusions Our results provide empirical evidence for designing caller tunes to promote blood donation in Ghana. The study found that making caller tunes free is particularly relevant for nonblood donors with no caller tunes.
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Affiliation(s)
- Bernard Appiah
- Research Program on Public and International Engagement for Health, Department of Environmental and Occupational Health, Texas A&M School of Public Health, Texas A&M University, College Station, Texas, TX, United States.,Centre for Science and Health Communication, Accra, Ghana
| | - James N Burdine
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, Texas A&M University, College Station, Texas, TX, United States
| | - Ammar Aftab
- Department of Health Policy and Management, Texas A&M School of Public Health, Texas A&M University, College Station, Texas, TX, United States
| | - Lucy Asamoah-Akuoko
- Centre for Science and Health Communication, Accra, Ghana.,Research and Development, National Blood Service Ghana, Accra, Ghana.,Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - David A Anum
- Centre for Science and Health Communication, Accra, Ghana
| | - Irene A Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Legon, Accra, Ghana
| | - Elfreda W Samman
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, Texas A&M University, College Station, Texas, TX, United States
| | | | - Imelda Bates
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Tanywe A, Matchawe C, Fernandez R, Lapkin S. Perceptions of blood donation among people in Africa: a qualitative systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2018; 16:648-652. [PMID: 29521865 DOI: 10.11124/jbisrir-2017-003473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The aim of this review is to synthesize the best available evidence on the perceptions of blood donation among people living in Africa.
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Affiliation(s)
- Asahngwa Tanywe
- The Cameroon Center for Evidence Based Health Care: a Joanna Briggs Institute Centre of Excellence
| | | | - Ritin Fernandez
- Institute of Medical Research and Medicinal Plan Studies (IMPM), Yaounde, Cameroon, Africa
- Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Institute Centre of Excellence, University of Wollongong, Wollongong
- St George Hospital, Sydney, New South Wales, Australia
| | - Samuel Lapkin
- Institute of Medical Research and Medicinal Plan Studies (IMPM), Yaounde, Cameroon, Africa
- Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Institute Centre of Excellence, University of Wollongong, Wollongong
- St George Hospital, Sydney, New South Wales, Australia
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33
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Saha S, Chandra B. Understanding the underlying motives and intention among Indian blood donors towards voluntary blood donation: A cross-sectional study. Transfus Clin Biol 2018; 25:109-117. [PMID: 29472138 DOI: 10.1016/j.tracli.2018.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 01/24/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The present study aims to fill the gap in the literature by conducting a comprehensive research on Indian donor's intention towards voluntary blood donation in India. The study attempts to conceptualize and validate an integrative framework incorporating voluntary function inventory (VFI) in the theory of planned behaviour (TPB) model with the purpose tomeasure the voluntary blood donation intention. MATERIAL AND METHODS Structural equation modeling (SEM) has been used to rigorously test the hypothesized interrelationships among the underlying motives influencing voluntary blood donation intention. A self-administered questionnaire was used to collect data from a sample of respondents selected conveniently from selct locations in India. Total 450 completed questionnaires were received out of 1000 distributed. RESULTS The study develops a final conceptual framework that determines the drivers of blood donor's intention towards voluntary donation. The components of theory of planned behavior (TPB) model which include 'attitude', 'subjective norms' (SN), and 'perceived behavioral control' (PBC) along with modified volunteer functions namely 'value', 'social', 'career' and 'enhancement' were found significantly explaining the donation intention in the model. CONCLUSION The model achieves robustness with respect to predicting Indian donor's intention towards the voluntary donation of blood. The proposed model in this study advances the theory and research on thevolunteering motives towards blood donation. The study would provide a comprehensiveunderstanding of donors' intention to the practitioners, policy makers and Non-Government Organization (NGO), helping them to frame a calibrated strategydirected towards facilitating healthy blood donation practices.
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Affiliation(s)
- S Saha
- School of Business, Lovely Professional University, Phagwara, Punjab-144411, India.
| | - B Chandra
- Department of Management Studies, Indian Institute of Technology (Indian School of Mines), 826004 Dhanbad, Jharkhand, India.
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Apata IW, Drammeh B, De AK, Bjork A, Pathak S, Lyimo M, Juma A, Kutaga R, Mahmoud M, Nkya E, Kuehnert M, Marfin A. Diagnoses and ordering practices driving blood demand for treatment of anemia in Tanzania. Transfusion 2018; 58:379-389. [PMID: 29350415 DOI: 10.1111/trf.14461] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 10/19/2017] [Accepted: 10/19/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Resource-limited countries in Africa experience blood shortages. Understanding clinical drivers of blood demand can inform strategies to increase blood availability. STUDY DESIGN AND METHODS From a national representative sample of 42 hospitals in Tanzania, patient records and requests for whole blood (WB) and red blood cells (RBCs) to treat anemia were analyzed using data collected prospectively from June through September 2013. Abstracted data included cause of anemia, number of requested units, clinical signs, and pretransfusion hemoglobin (Hb) levels. Weighted projections of nationwide drivers of blood demand for the year, 2013, were calculated. Mean posttransfusion Hb levels were estimated, and blood requests were assessed for clinical appropriateness. RESULTS Malaria was the leading driver of blood demand for anemia among children, accounting for 67% (55,949 units; standard deviation [SD], 1911 units) of projected units requested for children in 2013. Maternal hemorrhage was the leading driver of blood demand for anemia among adults, accounting for 21% (31,321 units; SD, 963 units) of projected units requested. Seventeen percent (26,133 units; SD, 1013 units) of projected requested units were deemed inappropriate. Adults with severe anemia had a mean Hb level of 3.7 g/dL and a mean of 1.6 WB or RBC units per request, resulting in an estimated mean posttransfusion Hb level of 5.3 g/dL. CONCLUSIONS Strategies to prevent and treat underlying causes of anemia and decrease inappropriate blood requests will likely increase blood availability. Restrictive blood ordering practices seen in adults with severe anemia suggests undertreatment of anemia and may result in an underestimation of the national blood demand.
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Affiliation(s)
- Ibironke W Apata
- Epidemic Intelligence Service.,Division of Global HIV/AIDS and Tuberculosis (DGHT), Centers for Disease Control and Prevention
| | - Bakary Drammeh
- Division of Global HIV/AIDS and Tuberculosis (DGHT), Centers for Disease Control and Prevention
| | - Anindya K De
- Division of Global HIV/AIDS and Tuberculosis (DGHT), Centers for Disease Control and Prevention
| | - Adam Bjork
- Division of Global HIV/AIDS and Tuberculosis (DGHT), Centers for Disease Control and Prevention
| | | | | | | | | | | | | | - Matthew Kuehnert
- Division of Global HIV/AIDS and Tuberculosis (DGHT), Centers for Disease Control and Prevention
| | - Anthony Marfin
- Division of Global HIV/AIDS and Tuberculosis (DGHT), Centers for Disease Control and Prevention
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Jahanpour O, Pyuza JJ, Ntiyakunze EO, Mremi A, Shao ER. ABO and Rhesus blood group distribution and frequency among blood donors at Kilimanjaro Christian Medical Center, Moshi, Tanzania. BMC Res Notes 2017; 10:738. [PMID: 29246245 PMCID: PMC5732446 DOI: 10.1186/s13104-017-3037-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/30/2017] [Indexed: 12/20/2022] Open
Abstract
Objective This study aims to determine the distribution of blood groups and the demographic background of blood donors in a referral hospital in Northern Tanzania. Results The most common blood group was O (52.3%) and the least common was AB (3.18%). 97.7% of the blood donors were Rh positive and the rest were Rh negative. Most donors were young adults, representing the age group of 19–29. The majority of donors were male (88.1%) and the majority (90.8%) were replacement while the remainder was voluntary donors.
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Affiliation(s)
- Ola Jahanpour
- School of Public Health, Kilimanjaro Christian Medical University College, P.O. Box, 2240, Moshi, Kilimanjaro, Tanzania.,Department of Clinical Pathology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Kilimanjaro, Tanzania.,School of Public Health, Catholic University of Health and Allied Sciences, Bugando Area, P.O. Box 1464, Mwanza, Tanzania
| | - Jeremia J Pyuza
- Kilimanjaro Christian Medical University College, P.O.Box 2240, Moshi, Tanzania
| | - Ernest O Ntiyakunze
- School of Public Health, Kilimanjaro Christian Medical University College, P.O. Box, 2240, Moshi, Kilimanjaro, Tanzania.,Department of Clinical Laboratory, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Kilimanjaro, Tanzania
| | - Alex Mremi
- Department of Clinical Pathology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Kilimanjaro, Tanzania
| | - Elichilia R Shao
- School of Public Health, Kilimanjaro Christian Medical University College, P.O. Box, 2240, Moshi, Kilimanjaro, Tanzania. .,Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Longuo B, Sokoine Road, P.O. Box, 3010, Moshi, Kilimanjaro, Tanzania. .,Better Human Health Foundation, P.O. Box 1348, Moshi, Kilimanjaro, Tanzania.
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In Pursuit of Solving a Global Health Problem: Prototype Medical Device for Autotransfusing Life-Threatening Postpartum Hemorrhage in Resource-Limited Settings. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2017. [DOI: 10.1007/s13669-017-0213-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abera B, Mohammed B, Betela W, Yimam R, Oljira A, Ahmed M, Tsega W, Mulu W, Yizengaw E. Knowledge, attitude, and practice towards blood donation among health care providers in hospitals at Bahir Dar City, Ethiopia. Transfus Apher Sci 2017; 56:434-438. [PMID: 28515024 DOI: 10.1016/j.transci.2017.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 04/11/2017] [Accepted: 04/18/2017] [Indexed: 11/17/2022]
Abstract
Like other sub-Saharan Africa, in Ethiopia there is a shortage of adequate and safe blood supplies. Health care providers are potential resource and promoter of voluntary blood donation. This study was conducted to determine the knowledge, attitude and practice towards blood donation among health care providers in Bahir Dar City, Ethiopia. Paper based questionnaire was distributed to 276 health care providers from May 01 to June 30, 2016. Overall, 42.8% had donated blood at least once. Of these, males accounted for 60%. The median age of blood donors was 26 years. Voluntary-unpaid donation was 21.2%. Overall, 75.5% health care providers were knowledgeable. The levels of knowledge were significantly different among different disciplines (One-way ANOVA; F=69.7; P=0.004). Males were more knowledgeable than females (P<0.05). The overall favorable attitude was 78.6%. Previous practice of blood donation determined the odds of favorable attitude to be a future regular voluntary-unpaid blood donor (OR: 5.7, 95% CI: 3.2-10.4). Majority of health care providers had adequate knowledge and favorable attitude. However, voluntary-unpaid donation practice (21.1%) was lower compared to 100% target of voluntary-unpaid donation. There should be motivation packages to enhance voluntary-unpaid blood donation among health care professionals.
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Affiliation(s)
- Bayeh Abera
- Department of Medical Microbiology, Immunology and parasitology, College of Medicine and Health Sciences, Bahir Dar Univerity, Ethiopia.
| | - Beyan Mohammed
- School of Medicine, College of Medicine and Health Sciences, Bahir Dar Univerity, Ethiopia
| | - Wendmagegn Betela
- School of Medicine, College of Medicine and Health Sciences, Bahir Dar Univerity, Ethiopia
| | - Reshid Yimam
- School of Medicine, College of Medicine and Health Sciences, Bahir Dar Univerity, Ethiopia
| | - Adam Oljira
- School of Medicine, College of Medicine and Health Sciences, Bahir Dar Univerity, Ethiopia
| | - Merhab Ahmed
- School of Medicine, College of Medicine and Health Sciences, Bahir Dar Univerity, Ethiopia
| | - Wubet Tsega
- School of Medicine, College of Medicine and Health Sciences, Bahir Dar Univerity, Ethiopia
| | - Wondemagegn Mulu
- Department of Medical Microbiology, Immunology and parasitology, College of Medicine and Health Sciences, Bahir Dar Univerity, Ethiopia
| | - Endalew Yizengaw
- Department of Medical Microbiology, Immunology and parasitology, College of Medicine and Health Sciences, Bahir Dar Univerity, Ethiopia
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Kouriba B, Diarra AB, Douyon I, Diabaté DT, Kamissoko F, Guitteye H, Baby M, Guindo MA, Doumbo OK. P. falciparum malaria prevalence among blood donors in Bamako, Mali. Transfus Clin Biol 2017; 24:62-67. [PMID: 28434852 DOI: 10.1016/j.tracli.2017.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 03/20/2017] [Indexed: 01/18/2023]
Abstract
AIM Malaria parasite is usually transmitted to humans by Anopheles mosquitoes but it can also be transmitted through blood transfusion. Usually malaria transmission is low in African urban settings. In West Africa where the P. falciparum is the most predominant malaria species, there are limited measures to reduce the risk of blood transfusion malaria. The aim of this study was to evaluate the prevalence of P. falciparum malaria carriage among blood donors in the National Blood Center of Bamako, capital city of Mali. METHODS The study was conducted using a random sample of 946 blood donors in Bamako, Mali, from January to December 2011. Screening for malaria was performed by thick smear and rapid diagnostic test (RDT). Blood group was typed by Beth-Vincent and Simonin techniques. RESULTS The frequency of malaria infection was 1.4% by thick smear and 0.8% by the RDT. The pick prevalence of P. falciparum malaria was in rainy season, indicating a probable high seasonal risk of malaria by blood transfusion, in Mali. The prevalence of P. falciparum infection was 2% among donors of group O the majority being in this group. CONCLUSION There is a seasonal prevalence of malaria among blood donors in Bamako. A prevention strategy of transfusion malaria based on the combination of selection of blood donors through the medical interview, promoting a voluntary low-risk blood donation and screening all blood bags intended to be transfused to children under 5, pregnant women and immune-compromised patients during transmission season using thick smear will reduce the risk of transfusion malaria in Mali.
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Affiliation(s)
- B Kouriba
- Département d'épidémiologie des affections parasitaires, malaria research and training center, faculty of medicine and pharmacy, BP 1805, Bamako, Mali; Centre National de transfusion sanguine du Mali, Ministère de la santé et de l'hygiène publique, BP E344, Bamako, Mali.
| | - A B Diarra
- Département d'épidémiologie des affections parasitaires, malaria research and training center, faculty of medicine and pharmacy, BP 1805, Bamako, Mali
| | - I Douyon
- Département d'épidémiologie des affections parasitaires, malaria research and training center, faculty of medicine and pharmacy, BP 1805, Bamako, Mali
| | - D T Diabaté
- Département d'épidémiologie des affections parasitaires, malaria research and training center, faculty of medicine and pharmacy, BP 1805, Bamako, Mali
| | - F Kamissoko
- Département d'épidémiologie des affections parasitaires, malaria research and training center, faculty of medicine and pharmacy, BP 1805, Bamako, Mali
| | - H Guitteye
- Département d'épidémiologie des affections parasitaires, malaria research and training center, faculty of medicine and pharmacy, BP 1805, Bamako, Mali
| | - M Baby
- Département d'épidémiologie des affections parasitaires, malaria research and training center, faculty of medicine and pharmacy, BP 1805, Bamako, Mali
| | - M A Guindo
- Centre National de transfusion sanguine du Mali, Ministère de la santé et de l'hygiène publique, BP E344, Bamako, Mali
| | - O K Doumbo
- Centre National de transfusion sanguine du Mali, Ministère de la santé et de l'hygiène publique, BP E344, Bamako, Mali
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Al-Ghumlas AK, Al Momen AK, Badri M, Abdel Gader AG. Long-term audit of platelet consumption in a university hospital. Transfus Clin Biol 2017; 24:68-75. [PMID: 28434851 DOI: 10.1016/j.tracli.2017.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/14/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To determine the long-term trend in platelet consumption in a university hospital. MATERIALS AND METHODS The annual consumption of platelets concentrate (PC) was analyzed over 23 years (1985-2007) in King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia. RESULTS The total 23 years consumption was 100,466 units of PC. Consumption went through 3 phases: the first, 1985-1994: the annual consumption increased from 1706 to 5912 which coincided with the increase in the number of patient admissions; the second, 1994-2003:featured a remarkable drop (48.9%) in annual consumption while patient admission remained stable. There was a concurrent decline in platelet consumption and all-cause mortality/patient. Third phase: 2003-2007, the consumption increased to reach 5642 units/year in 2007. The Department of Medicine consumed (52%), followed by Pediatrics (21%), and General Surgery (16%). CONCLUSION This audit uncovered evidence of inappropriate platelet consumption that reached 48.9% in the period 1994 to 2003, which coincided with widely publicized HIV scare that dominated blood transfusion during that period. We also found evidence suggesting that reducing platelet transfusion could improve patient outcome.
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Affiliation(s)
- A K Al-Ghumlas
- The Coagulation Research Laboratory, Department of Physiology, College of Medicine, King Khalid University Hospital, King Saud University, P.O. Box 2925, 11461 Riyadh, Saudi Arabia.
| | - A K Al Momen
- The Blood Bank, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - M Badri
- Department of Statistics, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - A G Abdel Gader
- The Blood Bank, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
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Abstract
The attainment of blood transfusion safety in Nigeria (and probably the rest of Sub-Saharan Africa) remains an uphill task due to a number of factors, ranging from shortage of blood, poor implementation of blood transfusion guidelines, infrastructural deficits to high prevalence of transfusion-transmissible infections (TTIs), particularly hepatitis and human immune deficiency viruses. We reviewed available data on blood transfusion practices and safety in Nigeria using the PubMed, PubMed Central, Google Scholar, and African Index Medicus search engines, through a combination of word and phrases relevant to the subject. The World Health Organization has been in the forefront of efforts to establish safe, available, and affordable blood transfusion services in most parts of Africa through encouraging adequate blood donor recruitment, donor blood testing, and collection as well developing strategies for the rational use of blood. Even though modest improvement has been recorded, particularly with regards to donor blood screening for common TTIs, considerable efforts are needed in the form of robust public enlightenment campaigns (on blood donation) and continuous system improvement to drive the current transfusion practices in the country toward safety and self-sustenance.
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Affiliation(s)
- John C Aneke
- Department of Haematology and Blood Transfusion, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria
| | - Chide E Okocha
- Department of Haematology and Blood Transfusion, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria
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Totino PRR, Daniel-Ribeiro CT, Ferreira-da-Cruz MDF. Evidencing the Role of Erythrocytic Apoptosis in Malarial Anemia. Front Cell Infect Microbiol 2016; 6:176. [PMID: 28018860 PMCID: PMC5145864 DOI: 10.3389/fcimb.2016.00176] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 11/21/2016] [Indexed: 01/06/2023] Open
Abstract
In the last decade it has become clear that, similarly to nucleated cells, enucleated red blood cells (RBCs) are susceptible to programmed apoptotic cell death. Erythrocytic apoptosis seems to play a role in physiological clearance of aged RBCs, but it may also be implicated in anemia of different etiological sources including drug therapy and infectious diseases. In malaria, severe anemia is a common complication leading to death of children and pregnant women living in malaria-endemic regions of Africa. The pathogenesis of malarial anemia is multifactorial and involves both ineffective production of RBCs by the bone marrow and premature elimination of non-parasitized RBCs, phenomena potentially associated with apoptosis. In the present overview, we discuss evidences associating erythrocytic apoptosis with the pathogenesis of severe malarial anemia, as well as with regulation of parasite clearance in malaria. Efforts to understand the role of erythrocytic apoptosis in malarial anemia can help to identify potential targets for therapeutic intervention based on apoptotic pathways and consequently, mitigate the harmful impact of malaria in global public health.
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Affiliation(s)
- Paulo R R Totino
- Laboratory of Malaria Research, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz Rio de Janeiro, Brazil
| | - Cláudio T Daniel-Ribeiro
- Laboratory of Malaria Research, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz Rio de Janeiro, Brazil
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Hepatitis B, HIV, and Syphilis Seroprevalence in Pregnant Women and Blood Donors in Cameroon. Infect Dis Obstet Gynecol 2016; 2016:4359401. [PMID: 27578957 PMCID: PMC4992796 DOI: 10.1155/2016/4359401] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/12/2016] [Indexed: 01/30/2023] Open
Abstract
Objectives. We estimated seroprevalence and correlates of selected infections in pregnant women and blood donors in a resource-limited setting. Methods. We performed a cross-sectional analysis of laboratory seroprevalence data from pregnant women and voluntary blood donors from facilities in Cameroon in 2014. Rapid tests were performed to detect hepatitis B surface antigen, syphilis treponemal antibodies, and HIV-1/2 antibodies. Blood donations were also tested for hepatitis C and malaria. Results. The seroprevalence rates and ranges among 7069 pregnant women were hepatitis B 4.4% (1.1–9.6%), HIV 6% (3.0–10.2%), and syphilis 1.7% (1.3–3.8%) with significant variability among the sites. Correlates of infection in pregnancy in adjusted regression models included urban residence for hepatitis B (aOR 2.9, CI 1.6–5.4) and HIV (aOR 3.5, CI 1.9–6.7). Blood donor seroprevalence rates and ranges were hepatitis B 6.8% (5.0–8.8%), HIV 2.2% (1.4–2.8%), syphilis 4% (3.3–4.5%), malaria 1.9%, and hepatitis C 1.7% (0.5–2.5%). Conclusions. Hepatitis B, HIV, and syphilis infections are common among pregnant women and blood donors in Cameroon with higher rates in urban areas. Future interventions to reduce vertical transmission should include universal screening for these infections early in pregnancy and provision of effective prevention tools including the birth dose of univalent hepatitis B vaccine.
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Tissot JD, Danic B, Cabaud JJ, Garraud O. [Ethical issues in transfusion medicine]. Transfus Clin Biol 2016; 23:119-26. [PMID: 27443188 DOI: 10.1016/j.tracli.2016.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Ethics is on the cross road of off values that are present along the ways of transfusion medicine. This is an important tool to afford opinions as well as debates that always emerge when discussing transfusion medicine. The wording is particularly important; this was one among several others that characterized the soul of Jean-Jacques Lefrère when he opened the doors of the ethical issues of transfusion medicine.
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Affiliation(s)
- J-D Tissot
- Transfusion interrégionale, Croix-Rouge suisse, 1066 Épalinges, Suisse
| | - B Danic
- Établissement français du sang Bretagne, 35016 Rennes, France
| | - J-J Cabaud
- Institut national de la transfusion sanguine, Paris, France
| | - O Garraud
- Institut national de la transfusion sanguine, Paris, France; Université de Lyon/Saint-Étienne, faculté de médecine, 42023 Saint-Étienne cedex 02, France.
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Knowledge, Attitude, and Practice of Adult Population towards Blood Donation in Gondar Town, Northwest Ethiopia: A Community Based Cross-Sectional Study. JOURNAL OF BLOOD TRANSFUSION 2016; 2016:7949862. [PMID: 27516920 PMCID: PMC4969535 DOI: 10.1155/2016/7949862] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/23/2016] [Indexed: 11/17/2022]
Abstract
Background. Though World Health Organization recommends 100% voluntary blood donation, the percentage of blood collected from voluntary blood donors and the average annual blood collection rate are extremely low in Ethiopia. The role of adults is crucial to meet the demand of safe blood. Thus, this study aimed to assess knowledge, attitude, and practice of adult population towards blood donation in Gondar town, Northwest Ethiopia. Method. A community based cross-sectional study was conducted among 768 adults. Multistage sampling technique together with simple random and systematic random sampling technique was employed. Bivariate and multivariate logistic regression analysis and bivariate correlation analysis were done. Result. About 436 (56.8%), 630 (82%), and 141 (18.4%) study participants had adequate knowledge, good attitude, and experience of blood donation, respectively. Secondary and higher educational statuses were significantly associated with adequate knowledge towards blood donation. Participants who were protestant by religion were more likely to have good attitude towards blood donation. Age, self-perceived health status, and religion were significantly associated with blood donation practice. Conclusion. Knowledge and attitude towards blood donation are high. However, the level of practice is low. District and national blood banks and transfusion agency should design strategies that promote and motivate the communities to donate blood.
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Abstract
Maternal and perinatal morbidity and mortality remain major challenges in the delivery of safe maternity care worldwide. Anaemia in pregnancy is an important contributor to this dismal picture, especially where blood transfusion services are poorly developed. An early diagnosis and treatment of iron deficiency anaemia in pregnancy using the new generation dextran-free parenteral iron preparations can save lives and reduce morbidity in selected pregnancies. It is time to cast aside the fears associated with the use of the old parenteral iron preparations which were associated a high incidence of anaphylaxis, and embrace the use of new parenteral iron products which have better side effect profiles and can deliver total dose infusions without the need for test dosing. In selected women, the benefits of this treatment far outweigh any disadvantages.
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Affiliation(s)
- Umo I Esen
- a Department of Obstetrics & Gynaecology , South Tyneside NHS Foundation Trust, South Shields , Tyne and Wear , UK
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Hussein J, Hirose A, Owolabi O, Imamura M, Kanguru L, Okonofua F. Maternal death and obstetric care audits in Nigeria: a systematic review of barriers and enabling factors in the provision of emergency care. Reprod Health 2016; 13:47. [PMID: 27102983 PMCID: PMC4840864 DOI: 10.1186/s12978-016-0158-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/04/2016] [Indexed: 01/23/2023] Open
Abstract
Background Maternal death reviews and obstetric audits identify causes and circumstances related to occurrence of a maternal death or serious complication and inform improvements in quality of care. Given Nigeria’s high maternal mortality, the lessons learned from past experiences can provide a good evidence base for informed decision making. We aimed to synthesise findings from maternal death reviews and other obstetric audits conducted in Nigeria through a systematic review, seeking to identify common barriers and enabling factors related to the provision of emergency obstetric care. Methods We searched for maternal death reviews and obstetric care audits reported in the published literature from 2000–2014. A ‘best-fit’ framework approach was used to extract data using a structured data extraction form. The articles that met the inclusion criteria were assessed using a nine point quality score. Results Of the 1,841 abstracts and titles at initial screening, 329 full text articles were reviewed and 43 papers fulfilled the inclusion criteria. Four types of barriers were reported related to: transport and referral; health workers; availability of services; and organisational factors. Three elements stand out in Nigeria as contributing to maternal mortality: delays in Caesarean section, unavailability of magnesium sulphate and lack of safe blood transfusion services. Conclusions Obstetric care reviews and audits are useful activities to undertake and should be promoted by improving the processes used to conduct them, as well as extending their implementation to rural and basic level health facilities and to the community. Urgent areas for quality improvement in obstetric care, even in tertiary and teaching hospitals should focus on organisational factors to reduce delays in conducting Caesarean section and making blood and magnesium sulphate available for all who need these interventions.
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Affiliation(s)
- Julia Hussein
- Immpact, University of Aberdeen, Health Sciences Building, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, Scotland.
| | - Atsumi Hirose
- Immpact, University of Aberdeen, Health Sciences Building, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, Scotland
| | - Oluwatoyin Owolabi
- Women's Health and Action Research centre (WHARC), KM 11 Benin-Lagos Expressway, Igue-Iheya, Benin City, Edo State, Nigeria
| | - Mari Imamura
- Immpact, University of Aberdeen, Health Sciences Building, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, Scotland
| | - Lovney Kanguru
- Immpact, University of Aberdeen, Health Sciences Building, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, Scotland
| | - Friday Okonofua
- Women's Health and Action Research centre (WHARC), KM 11 Benin-Lagos Expressway, Igue-Iheya, Benin City, Edo State, Nigeria
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Ngoma AM, Mutombo PB, Ikeda K, Nollet KE, Natukunda B, Ohto H. Red blood cell alloimmunization in transfused patients in sub-Saharan Africa: A systematic review and meta-analysis. Transfus Apher Sci 2016; 54:296-302. [DOI: 10.1016/j.transci.2015.10.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 10/07/2015] [Accepted: 10/28/2015] [Indexed: 01/20/2023]
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Mafirakureva N, Nyoni H, Nkomo SZ, Jacob JS, Chikwereti R, Musekiwa Z, Khoza S, Mvere DA, Emmanuel JC, Postma MJ, van Hulst M. The costs of producing a unit of blood in Zimbabwe. Transfusion 2015; 56:628-36. [DOI: 10.1111/trf.13405] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 09/23/2015] [Accepted: 09/29/2015] [Indexed: 12/18/2022]
Affiliation(s)
- Nyashadzaishe Mafirakureva
- Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy; University of Groningen; Groningen the Netherlands
- National Blood Service Zimbabwe
| | | | | | | | | | | | - Star Khoza
- Department of Clinical Pharmacology; University of Zimbabwe; Harare Zimbabwe
| | | | | | - Maarten J. Postma
- Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy; University of Groningen; Groningen the Netherlands
- Institute of Science in Healthy Aging & healthCare (SHARE)
- Department of Epidemiology; University Medical Center Groningen (UMCG)
| | - Marinus van Hulst
- Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy; University of Groningen; Groningen the Netherlands
- Department of Clinical Pharmacy and Toxicology; Martini Hospital; Groningen the Netherlands
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Kerkhoff AD, Lawn SD, Schutz C, Burton R, Boulle A, Cobelens FJ, Meintjes G. Anemia, Blood Transfusion Requirements and Mortality Risk in Human Immunodeficiency Virus-Infected Adults Requiring Acute Medical Admission to Hospital in South Africa. Open Forum Infect Dis 2015; 2:ofv173. [PMID: 26730391 PMCID: PMC4693115 DOI: 10.1093/ofid/ofv173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/05/2015] [Indexed: 12/19/2022] Open
Abstract
Background. Morbidity and mortality remain high among hospitalized patients infected with human immunodeficiency virus (HIV) in sub-Saharan Africa despite widespread availability of antiretroviral therapy. Severe anemia is likely one important driver, and some evidence suggests that blood transfusions may accelerate HIV progression and paradoxically increase short-term mortality. We investigated the relationship between anemia, blood transfusions, and mortality in a South African district hospital. Methods. Unselected consecutive HIV-infected adults requiring acute medical admission to a Cape Town township district hospital were recruited. Admission hemoglobin concentrations were used to classify anemia severity according to World Health Organization/AIDS Clinical Trials Group criteria. Vital status was determined at 90 days, and Cox regression analyses were used to determine independent predictors of mortality. Results. Of 585 HIV-infected patients enrolled, 578 (98.8%) were included in the analysis. Anemia was detected in 84.8% of patients and was severe (hemoglobin, 6.5–7.9 g/dL) or life-threatening (hemoglobin, <6.5 g/dL) in 17.3% and 13.3%, respectively. Within 90 days of the date of admission, 13.5% (n = 78) patients received at least 1 blood transfusion with red cell concentrate and 77 (13.3%) patients died. In univariable analysis, baseline hemoglobin and receipt of blood transfusion were associated with increased mortality risk. However, in multivariable analysis, neither hemoglobin nor receipt of a blood transfusion were independently associated with greater mortality risk. Acquired immune deficiency syndrome-defining illnesses other than tuberculosis and impaired renal function independently predicted mortality. Conclusions. Newly admitted HIV-infected adults had a high prevalence of severe or life-threatening anemia and blood transfusions were frequently required. However, after adjustment for confounders, blood transfusions did not confer an increased mortality risk.
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Affiliation(s)
- Andrew D Kerkhoff
- Department of Medicine, University of California San Francisco School of Medicine; Department of Global Health, Academic Medical Center, Amsterdam Institute for Global Health and Development, University of Amsterdam, The Netherlands; Faculty of Health Sciences, The Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa
| | - Stephen D Lawn
- Faculty of Health Sciences, The Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom; Department of Medicine, Faculty of Health Sciences, University of Cape Town
| | - Charlotte Schutz
- Department of Medicine, Faculty of Health Sciences, University of Cape Town; Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town
| | - Rosie Burton
- Department of Medicine, Faculty of Health Sciences, University of Cape Town; Khayelitsha District Hospital, Cape Town
| | - Andrew Boulle
- Faculty of Health Sciences, Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town; Department of Health, Provincial Government of the Western Cape, South Africa
| | - Frank J Cobelens
- Department of Global Health, Academic Medical Center, Amsterdam Institute for Global Health and Development, University of Amsterdam, The Netherlands; KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - Graeme Meintjes
- Department of Medicine, Faculty of Health Sciences, University of Cape Town; Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town; Department of Medicine, Imperial College, London, United Kingdom
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Pruett CR, Vermeulen M, Zacharias P, Ingram C, Tayou Tagny C, Bloch EM. The use of rapid diagnostic tests for transfusion infectious screening in Africa: a literature review. Transfus Med Rev 2014; 29:35-44. [PMID: 25447555 DOI: 10.1016/j.tmrv.2014.09.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 09/09/2014] [Accepted: 09/16/2014] [Indexed: 12/22/2022]
Abstract
Infectious risk associated with blood transfusion remains a major public health challenge in Africa, where prevalence rates of the major transfusion-transmissible infections (ie, hepatitis B, hepatitis C, human immunodeficiency virus, and syphilis) are among the highest in the world. Resource-limited blood services often operate with minimal predonation screening safeguards, prompting exclusive reliance on laboratory testing to mitigate infectious risk. Transfusion screening with rapid diagnostic tests (RDTs) has been adopted in areas that lack the capacity to support the routine use of more sophisticated technologies. However, uncertainty surrounding the performance of some RDTs in the field has spurred debate regarding their application to blood donation screening. Our review of the literature identified 17 studies that evaluated RDTs for the infectious screening of blood donors in Africa. The review highlights the variable performance of available RDTs and the importance of their use in a quality-assured manner. Deficiencies in performance observed with some RDTs underscore the need to validate test kits prior to use under field conditions with locally acquired samples. Suboptimal sensitivities of some available tests, specifically hepatitis B virus rapid assays, question their suitability in single-test algorithms, particularly in high-prevalence regions. Although RDTs have limitations, many of which can be addressed through improved training and quality systems, they are frequently the only viable option for infectious screening in resource-poor African countries. Therefore, additional studies and specific guidelines regarding the use of RDTs in the context of blood safety are needed.
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Affiliation(s)
| | - Marion Vermeulen
- South African National Blood Service, Johannesburg, South Africa
| | | | - Charlotte Ingram
- South African National Blood Service, Johannesburg, South Africa
| | | | - Evan M Bloch
- Blood Systems Research Institute, San Francisco, CA; University of California San Francisco, San Francisco, CA
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