Changes in blood transfusion practices after the introduction of consensus guidelines in Mwanza region, Tanzania

J, Vos; Gumodoka, Balthazar; Ha, van Asten; Za, Berege; Wm, Dolmans; Mw, Borgdorff

doi:10.1097/00002030-199408000-00016

Cited by 24 publications

(46 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All studies stated criteria for classifying transfusions. While the majority of these studies based their criteria on British or American guidelines, one study used local consensus guidelines that differed significantly from the rest 10 . This study identified avoidable transfusions in adults as those occurring in individuals with Hb greater than 50 g per L and no evidence of congestive heart failure.…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of interventions to reduce physician's levels of inappropriate transfusion: what can be learned from a systematic review of the literature

et al. 2002

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

The effectiveness of interventions to reduce physician's levels of inappropriate transfusion: what can be learned from a systematic review of the literature

et al. 2002

View full text Add to dashboard Cite

“…An effective blood transfusion committee and strict adherence to guidelines for the prescription of blood transfusion can reduce blood usage by up to 75%. 56 In Ghana, predonation screening for serological markers of HIV, hepatitis B and hepatitis C reduced wastage of blood bags, 57 which are the most expensive component of a hospital-based transfusion service. 58 Costly hepatitis C tests were conserved in Namibia by restricting their use to first time donors, 59 and in Malawi the order of five screening tests was adjusted so that the cheapest test was used first, thereby restricting expensive tests to samples that were negative for other tests.…”

Section: Conserving Transfusion Resourcesmentioning

confidence: 99%

Maternal mortality in sub‐Saharan Africa: the contribution of ineffective blood transfusion services

Bates

Chapotera

McKew

et al. 2008

BJOG

175

168

View full text Add to dashboard Cite

In sub-Saharan Africa, where blood supply is critically inadequate, severe haemorrhage is a leading cause of maternal deaths. The aim of this review was to estimate the impact of lack of blood on maternal deaths and identify reasons and potential solutions. Databases and websites from 1970 to 2007 were searched for information concerning maternal deaths and near misses due to haemorrhage in sub-Saharan Africa. Original studies that provided qualitative or quantitative information about blood transfusion services in relation to obstetric deaths or near misses were included. Data about maternal haemorrhage deaths associated with lack of blood for transfusion and reasons for blood shortages were extracted from the full text of articles by two independent reviewers using predesigned, piloted forms. Twenty of 37 selected studies described a direct association between maternal deaths and lack of blood transfusions. Five of 37 provided quantitative information which showed that overall 26% (16-72%) of maternal haemorrhage deaths were due to lack of blood. Reasons included nonaffordability of blood, lack of blood donors, unwillingness of relatives to donate and inadequate supplies and transport. Lack of blood for emergency transfusions is a major, but poorly quantified and under-researched cause of maternal deaths in sub-Saharan Africa. Potential solutions include more blood donations, better financing mechanisms and more efficient management systems. Complementary approaches to prevent severe anaemia and treat hypovolaemia are important to reduce use of transfusions.

show abstract

“…Nevertheless, evidence is lacking regarding which hemoglobin threshold criteria, volume and timing of transfusion intervention are associated with optimal survival outcomes. Consequently adherence to the current guidelines is poor [7,8]. Children with severe anemia have high rates of in-hospital mortality (9% to 10%) [9], suggesting that the current recommendations are not optimal.…”

Section: Introductionmentioning

confidence: 99%

Phase II trial of standard versus increased transfusion volume in Ugandan children with acute severe anemia

Engoru

Thompson

Nteziyaremye

et al. 2014

BMC Med

View full text Add to dashboard Cite

BackgroundSevere anemia (SA, hemoglobin <6 g/dl) is a leading cause of pediatric hospital admission in Africa, with significant in-hospital mortality. The underlying etiology is often infectious, but specific pathogens are rarely identified. Guidelines developed to encourage rational blood use recommend a standard volume of whole blood (20 ml/kg) for transfusion, but this is commonly associated with a frequent need for repeat transfusion and poor outcome. Evidence is lacking on what hemoglobin threshold criteria for intervention and volume are associated with the optimal survival outcomes.MethodsWe evaluated the safety and efficacy of a higher volume of whole blood (30 ml/kg; Tx30: n = 78) against the standard volume (20 ml/kg; Tx20: n = 82) in Ugandan children (median age 36 months (interquartile range (IQR) 13 to 53)) for 24-hour anemia correction (hemoglobin >6 g/dl: primary outcome) and 28-day survival.ResultsMedian admission hemoglobin was 4.2 g/dl (IQR 3.1 to 4.9). Initial volume received followed the randomization strategy in 155 (97%) patients. By 24-hours, 70 (90%) children in the Tx30 arm had corrected SA compared to 61 (74%) in the Tx20 arm; cause-specific hazard ratio = 1.54 (95% confidence interval 1.09 to 2.18, P = 0.01). From admission to day 28 there was a greater hemoglobin increase from enrollment in Tx30 (global P <0.0001). Serious adverse events included one non-fatal allergic reaction and one death in the Tx30 arm. There were six deaths in the Tx20 arm (P = 0.12); three deaths were adjudicated as possibly related to transfusion, but none secondary to volume overload.ConclusionA higher initial transfusion volume prescribed at hospital admission was safe and resulted in an accelerated hematological recovery in Ugandan children with SA. Future testing in a large, pragmatic clinical trial to establish the effect on short and longer-term survival is warranted.Trial registrationClinicalTrials.Gov identifier: NCT01461590 registered 26 October 2011.Please see related commentary article http://www.biomedcentral.com/1741-7015/12/68/abstract.

show abstract

Changes in blood transfusion practices after the introduction of consensus guidelines in Mwanza region, Tanzania

Cited by 24 publications

References 0 publications

The effectiveness of interventions to reduce physician's levels of inappropriate transfusion: what can be learned from a systematic review of the literature

The effectiveness of interventions to reduce physician's levels of inappropriate transfusion: what can be learned from a systematic review of the literature

Maternal mortality in sub‐Saharan Africa: the contribution of ineffective blood transfusion services

Phase II trial of standard versus increased transfusion volume in Ugandan children with acute severe anemia

Contact Info

Product

Resources

About