Severe Childhood Anaemia and Blood Transfusion in a Nigerian Secondary Level Facility

Abstract

This study aimed to describe the pattern and immediate outcome of severe childhood anaemia requiring blood transfusion at a secondary level of care in Nigeria. A cross-sectional survey of children hospitalized in a secondary health facility in Ogun State, Nigeria, with packed cell volume <20% and who received blood transfusion was done. Of the 253 children admitted between March 2013 and June 2014, 79 (31.2%) had severe anaemia and were transfused with blood. Two-thirds had multiple transfusions. Higher rates of blood transfusion were obtained among underweight children. Fever (98.7%), hypoglycaemia (65.8%) and tender liver (54.4%) were the leading co-morbidities. The case fatality rate was 21.5%. Respiratory distress, convulsions and altered sensorium were significantly associated with mortality. In conclusion, severe anaemia was associated with major morbidities and mortality at the secondary level of paediatric care in Nigeria.

Blood use in sub‐Saharan Africa: a systematic review of current data

“…Blood use among the other patient populations of pediatrics, obstetrics and gynecology, cesarean section births, and newborns are shown in Appendices S3.3 through S3.7. The studies among pediatric patients showed that 64% (2810 of 4387) of blood products were transfused for malaria. Postpartum hemorrhage (PPH) at 24% (524 of 2228) and cesarean sections at 22% (485 of 2228) were the most transfused diagnostic categories among the obstetrics and gynecology patients, with abortions and cancer accounting for only 10% and 8% of transfusions, respectively.…”

“…These 10 studies were used for the primary outcome calculation. The rest of the studies evaluated blood use among specific patient groups: nine studies among pediatric patients only; five on obstetrics and gynecology patients; three among cesarean section deliveries; three among newborn babies; two among elective surgical operations; two exclusively on the use of platelets; two on the use of autologous blood; and one among hepatogastroenterology patients . Most studies made a clear distinction between the number of patients transfused and the number of blood products used for transfusion.…”

“…We found parallel patterns both for the individual hospital wards, with most products being given to the pediatric ward, and for subgroup patient populations. In the pooled analysis of the nine studies that included only children, it was found that 64% of blood products were used for children with severe malaria. Similarly, from the five pooled studies in obstetrics and gynecology, over one‐half (54%) of blood products were used for obstetric hemorrhage (represented here by the diagnostic categories of PPH, antepartum hemorrhage, and cesarean deliveries).…”

Etiology of Severe Anemia in Children at a Tertiary Care Hospital.

“…In developing countries of Africa malaria (95%), IDA (36.7%), and sickle cell anemia(31.7%) were the predominant causes indicating significant regional differences in the etiology of severe anemia. [26,27] China has lesser rates of anemia(24.4%) compared to India. [28] India has the highest IDA in comparison to rest of the world.…”

Transfusional malaria in the neonatal period in Lagos, South-West Nigeria

“…It is a common procedure in hospitalized children under the age of five years in malaria endemic countries because of their vulnerability to severe anaemia. [ 1 ] Other groups of children often transfused are those with hematological conditions, cancers and sick neonates. Sick neonates are intensively transfused due to common underlying conditions such as severe unconjugated hyper bilirubinaemia, neonatal sepsis, bleeding disorder, prematurity and anaemia from other causes.…”