Pediatric blood transfusion practices at a regional referral hospital in Kenya

• DOI: 10.1111/trf.13774
• Publication Date: 2016-09-09T15:15:41Z
• Authors: Helen M. Nabwera; Greg Fegan; Jay Shavadia; Douglas Denje; Kishor Mandaliya; Imelda Bates; Kathryn Maitland; Oliver W. Hassall
• Keywords: Interquartile range; Medical record; McNemar's test

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