Innocent lives lost and saved: the importance of blood transfusion for children in sub-Saharan Africa

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Abstract

Severe anemia in children is a leading indication for blood transfusion worldwide. Severe anemia, defined by the World Health Organization as a hemoglobin level <5 g/dL, is particularly common throughout sub-Saharan Africa. Analysis of data from the Fluid Expansion as Supportive Therapy (FEAST) trial offers new insights into the importance of blood transfusion for children with severe anemia. The principal findings of this analysis include the observations that life-threatening anemia in children is a frequent presenting condition in East Africa; that delays in transfusion therapy are lethal; and that inadequate transfusion is probably more common than currently recognized. The findings of this new study highlight the need for changes in blood inventory management in sub-Saharan hospitals and the need for more research on transfusion therapy for children in peril.

Please see related article: http://dx.doi.org/10.1186/s12916-014-0246-7

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Inter-Relationships of Cardinal Features and Outcomes of Symptomatic Pediatric Plasmodium falciparum Malaria in 1,933 Children in Kampala, Uganda

Christine Cserti-Gazdewich, Aggrey Dhabangi, Charles Musoke … (2013)

Malaria remains a challenging diagnosis with variable clinical presentation and a wide spectrum of disease severity. Using a structured case report form, we prospectively assessed 1,933 children at Mulago Hospital in Kampala, Uganda with acute Plasmodium falciparum malaria. Children with uncomplicated malaria significantly differed from those with severe disease for 17 features. Among 855 children with severe disease, the case-fatality rate increased as the number of severity features increased. Logistic regression identified five factors independently associated with death: cerebral malaria, hypoxia, severe thrombocytopenia, leukocytosis, and lactic acidosis. Cluster analysis identified two groups: one combining anemia, splenomegaly, and leukocytosis; and a second group centered on death, severe thrombocytopenia, and lactic acidosis, which included cerebral malaria, hypoxia, hypoglycemia, and hyper-parasitemia. Our report updates previous clinical descriptions of severe malaria, quantifies significant clinical and laboratory inter-relationships, and will assist clinicians treating malaria and those planning or assessing future research (NCT00707200) (www.clinicaltrials.gov).

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The future of transfusion and Africa.

Shannon Delaney, W Dzik (2014)

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Author and article information

Contributors

Walter H Dzik: sdzik@partners.org

Journal

Journal ID (nlm-ta): BMC Med

Journal ID (iso-abbrev): BMC Med

Title: BMC Medicine

Publisher: BioMed Central (London )

ISSN (Electronic): 1741-7015

Publication date (Electronic): 2 February 2015

Publication date PMC-release: 2 February 2015

Publication date Collection: 2015

Volume: 13

Issue: 1

Electronic Location Identifier: 22

Affiliations

Blood Transfusion Service, Massachusetts General Hospital, Boston, MA 02114 USA

Article

Publisher ID: 248

DOI: 10.1186/s12916-014-0248-5

PMC ID: 4313467

PubMed ID: 25640864

SO-VID: 4b1b3860-3df9-4de3-aed1-1c6a5a11cfe8

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 8 December 2014

Date accepted : 8 December 2014

Custom metadata

ScienceOpen disciplines: Medicine

Keywords: transfusion,sub-saharan africa,severe anemia

Data availability:

ScienceOpen disciplines: Medicine

Keywords: transfusion, sub-saharan africa, severe anemia

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