The acceptability to women in Mombasa, Kenya, of the donation and transfusion of umbilical cord blood for severe anaemia in young children

Abstract

Background and Objectives Severe anaemia, for which a blood transfusion can be life saving, is common in hospitalized children in sub-Saharan Africa but blood for transfusion is often in short supply. Umbilical cord blood is usually thrown away but could be a useful source of red cells for small volume transfusions in young children in this setting. The objective of this study was to evaluate the attitudes of women using the maternity services of the provincial hospital in Mombasa, Kenya, towards cord blood donation and transfusion, and essential aspects of this process including informed consent and the acceptability of screening for human immunodeficiency virus (HIV) infection. Materials and MethodsA structured questionnaire was developed based on data provided by focus group discussions with women attending the hospital's maternity unit and administered to women who had recently delivered at the hospital. ResultsOf the 180 women who completed a questionnaire, the donation and transfusion of cord blood were acceptable to 81% and 78%, respectively. Ninety per cent of women who supported cord blood donation were willing to undergo further HIV testing at the time of delivery. Seventy-seven per cent of women wanted informed consent to be sought for cord blood donation and 66% of these felt they could make this decision alone. ConclusionThe donation of umbilical cord blood and its transfusion are acceptable to the majority of women delivering at Coast Provincial General Hospital, Mombasa. Findings from the study will benefit the planned cord blood donation programme at this facility.

The acceptability of volunteer, repeat blood donations in a hospital setting in the Adamaoua region of Cameroon

“…The Cameroonian health care system, especially in rural areas relies to a large extent on family and replacement donors (Tagny et al , ; WHO, ). In line with previous findings, altruism, either personally motivated or prompted by religion, was an important reason for blood donation in this population (Agbovi et al , ; Hassall et al , ; Duboz et al , ). Most did not perceive remuneration as a prerequisite for blood donation; however, non‐cash compensation, such as beverages, could be expected.…”

“…Studies indicate that socio‐cultural beliefs and medical misconceptions represent important barriers to blood donations in Africa (Umeora et al , ; Agbovi et al , ; Duboz et al , ; Koster & Hassall, ; Salaudeen et al , ). Fear of learning HIV status and mistrust of confidentiality remain important obstacles to blood donation (Umeora et al , ; Agbovi et al , ; Hassall et al , ; Salaudeen et al , ). Barriers to and motivational factors for blood donation vary between cultures, and knowledge of local conditions is crucial for donor recruitment and the establishment of safe and sustainable blood transfusion services (Hassall et al , ).…”

“…Fear of learning HIV status and mistrust of confidentiality remain important obstacles to blood donation (Umeora et al , ; Agbovi et al , ; Hassall et al , ; Salaudeen et al , ). Barriers to and motivational factors for blood donation vary between cultures, and knowledge of local conditions is crucial for donor recruitment and the establishment of safe and sustainable blood transfusion services (Hassall et al , ).…”

The use of cord blood for transfusion purposes: current status

“…The use of UCB for small volume allogeneic transfusions in anaemic children in Africa or in malaria endemic areas has also been proposed [78]. A preclinical study showed that donation and transfusion of UCB would be acceptable to women living in Mombasa, Kenya [79]. Planning of cord blood donation programmes as suggested by Hassall et al.…”

The microbiologic safety of umbilical cord blood transfusion for children with severe anemia in Mombasa, Kenya

“…Consequently, clinical trials are urgently needed in sub‐Saharan Africa to establish the safety and efficacy of cord blood transfusion in children. We have established a cord blood program in Mombasa, Kenya, to test the feasibility of cord blood transfusion and have previously demonstrated the acceptability of cord blood donation and transfusion, the feasibility of an informed consent process for cord blood donation, and the quality of stored cord blood 11,12 . Before clinical trials are initiated the risk of harm associated with bacterial contamination and transfusion‐transmitted infection of cord blood must first be established and compared to current practice.…”