Fourteen‐year experience of a tertiary hospital transfusion committee in <scp>W</scp>est <scp>A</scp>frica

Opare-Sem, Ohene; Bedu-Addo, George; Karikari, Patrick; Boateng, Peter Kojo; Sarkodie, Francis; Rahman, Rabiniatu; Asenso-Mensah, Kwame; Awuah, Baffour; Osei‐Akoto, Alex; Munin, S.A. Abdul; Mensah-Acheampong, Fred; Allain, Jean‐Pierre; Owusu‐Ofori, Shirley

doi:10.1111/trf.12690

Cited by 10 publications

(7 citation statements)

References 46 publications

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“…Alternatively, this discrepancy may be due to the fact that blood request procedures may not have been updated in line with the WHO guidelines and therefore blood is ordered in units and not in milliliters, therefore resulting in larger volumes being requested. Training of clinicians in the indications for blood transfusions in children and improved communication and working relations between clinicians and blood bank staff through a hospital transfusion committee might be a possible solution to this …”

Section: Discussionmentioning

confidence: 99%

“…Most of the children who were transfused received antimalarial therapy irrespective of blood film results. As donated blood was not routinely screened for malaria in Kenya at the time of the study, clinicians would have prescribed antimalarials in children receiving blood transfusions due to a perceived risk of transfusion‐induced malaria as recommended in the Kenyan blood transfusion guidelines . This practice although pragmatic, does not eliminate the risk of transfusion‐induced malaria .…”

Section: Discussionmentioning

confidence: 99%

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Pediatric blood transfusion practices at a regional referral hospital in Kenya

et al. 2016

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BACKGROUNDSevere anemia in children is a major public health problem in sub‐Saharan Africa. In this study we describe clinical and operational aspects of blood transfusion in children admitted to Coast Provincial General Hospital, Kenya.STUDY DESIGN AND METHODSThis was an observational study where over a 2‐year period, demographic and laboratory data were collected on all children for whom the hospital blood bank received a transfusion request. Clinical data were obtained by retrospective review of case notes over the first year.RESULTSThere were 2789 requests for blood for children (median age, 1.8 years; interquartile range [IQR], 0.6‐6.6 years); 70% (1950) of the samples were crossmatched with 85% (1663/1950) issued. Ninety percent (1505/1663) were presumed transfused. Median time from laboratory receipt of request to collection of blood was 3.6 hours (IQR, 1.4‐12.8 hr). Case notes of 590 children were reviewed and median pretransfusion hemoglobin level was 6.0 g/dL (IQR, 4.2‐9.1 g/dL). Ninety‐four percent (186) were transfused “appropriately” while 52% (120) were transfused “inappropriately.” There was significant disagreement between the clinical and laboratory diagnosis of severe anemia (exact McNemar's test; p < 0.0001). Antimalarials were prescribed for 65% (259) of children who received blood transfusions but only 41% (106) of these had a positive blood film.CONCLUSIONIn this setting, clinicians often order blood based on the clinical impression of “severe anemia.” This has implications for laboratory workload and the blood supply itself. However, the majority of children with severe anemia were appropriately transfused. The use of antimalarials with blood transfusions irrespective of blood film results is common practice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pediatric blood transfusion practices at a regional referral hospital in Kenya

et al. 2016

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“…The hospital transfusion committee was instrumental in initiating the new strategy, showing the critical role such committees can play in the implementation of evidence‐based measures to improve blood safety and availability even when resources are limited (Opare‐Sem et al , ).…”

Section: Discussionmentioning

confidence: 99%

A novel strategy for screening blood donors for syphilis at Komfo Anokye Teaching Hospital, Ghana

Sarkodie

Ullum

Owusu‐Dabo

et al. 2016

Transfusion Medicine

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Objective:To implement and describe a novel syphilis screening strategy for blood donors.Background: The seroprevalence of syphilis in blood donors is often high in low-and middle-income countries (LMIC) although the proportion of infectious donations is probably low. Syphilis screening may not happen at all; or the use of non-specific screening tests, which have high false positive rates, results in many donations being discarded unnecessarily. This can have a critical effect on already inadequate blood supplies.

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“…It was established 15 years ago and has helped increase the local blood supply, which now exceeds the WHO target of 10 donations per 1000 population. It has also managed research to identify the most accurate rapid tests available for HIV and hepatitis B and C screening, and has determined clinical policies for blood use based on input from local stakeholders . Similar benefits could be realized from an HTC at VRH, providing there is commitment from the relevant stakeholders, and support from hospital management in providing the necessary resources for the HTC to function.…”

Section: Discussionmentioning

confidence: 99%

Adherence to clinical guidelines for use of blood components at a tertiary hospital in Ghana

Dhariwal

Allotey

Fisher

et al. 2018

ISBT Science Series

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Background and objectives Guidelines for blood transfusions can help to ensure that blood is used appropriately, to avoid wastage and minimize risks, and are particularly important in sub‐Saharan Africa because chronic blood shortages are widespread. This study explored transfusion practices and guideline compliance among clinicians at a tertiary hospital in the Volta region of Ghana. Materials and methods Participants in this 3‐month study were clinicians from several hospital departments. The mixed methods study used a questionnaire to assess clinicians’ knowledge of transfusion. Retrospective data from hospital records were used to assess whether each transfusion given during the study period complied with recommendations in the national transfusion guidelines. Results Although 44/50 clinicians self‐rated their knowledge of transfusion in the questionnaire as good, only two were aware of the national transfusion guidelines, 48% listed incorrect indications for fresh frozen plasma (FFP) and there was considerable variation in haemoglobin thresholds they used to guide transfusion decisions. Of the 313 transfusions of whole blood/packed cells and FFP given during the study, 49% were not in accordance with the guidelines. For the 31 FFP transfusions, under‐dosing was common (87%) and 52% were not in accordance with the guidelines. 46/220 (21%) patients had no cause for anaemia documented during their admission. Conclusion There is a need to improve awareness of, and compliance with, national guidelines. A multi‐faceted approach including education, guideline dissemination, transfusion audits and oversight from a hospital transfusion committee could contribute to much more effective use of blood components.

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Fourteen‐year experience of a tertiary hospital transfusion committee in West Africa

Cited by 10 publications

References 46 publications

Pediatric blood transfusion practices at a regional referral hospital in Kenya

Pediatric blood transfusion practices at a regional referral hospital in Kenya

A novel strategy for screening blood donors for syphilis at Komfo Anokye Teaching Hospital, Ghana

Adherence to clinical guidelines for use of blood components at a tertiary hospital in Ghana

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