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The aim of this study was to measure the prevalence of social isolation in community-dwelling elderly and related factors based on household composition differences. Method: We used the six-item Lubben Social Network Scale to measure social isolation in 2,000 individuals. Multiple

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Sickle cell disease (SCD) is the most common monogenic disorder in sub-Saharan Africa (SSA). Blood transfusion to increase the oxygen carrying capacity of blood is vital in the management of many patients with SCD. However, red blood cell (RBC) alloimmunization is a major challenge to transfusions in these patients. Commonly in SSA, pre-transfusion tests only involve ABO D grouping and compatibility without RBC antibody testing. Data on the frequency of RBC alloimmunization in patients with SCD in SSA is limited. We performed a systematic review and meta-analysis on available data on alloimmunization in transfused patients with SCD to determine the published prevalence of RBC alloimmunization in SCD patients in SSA. Six databases were systematically searched to identify relevant studies, without year or language restrictions. In all, 249 articles were identified and 15 met our selection criteria. The overall proportion of alloimmunization was 7.4 (95% CI: 5.1-10.0), per 100 transfused patients. Antibodies against E, D, C and K antigens accounted for almost half of antibody specificities and antibodies to low and high frequency antigens were also common and represented almost 30% (20% to low frequency antigens and 9% to high frequency antigens) of specificities. Heterogeneity between studies was moderate and meta-analysis found region of Africa as the major contributor to the heterogeneity. We also observed inconsistencies across studies in reporting of factors that may influence alloimmunization. This review provides an overview of the extent of the alloimmunization problem in SSA and provides a baseline against which to compare the effect of any interventions to reduce the alloimmunization risk.