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  • Title: Are some blood transfusions avoidable? A hospital record analysis in Mwanza Region, Tanzania.
    Author: Vos J, Gumodoka B, Ng'weshemi JZ, Kigadye FC, Dolmans WM, Borgdorff MW.
    Journal: Trop Geogr Med; 1993; 45(6):301-3. PubMed ID: 8116064.
    Abstract:
    Records of 497 patients who received a blood transfusion in Mwanza Region, Tanzania, were analyzed in order to estimate the proportion of avoidable blood transfusions. This was part of a more comprehensive study which aims at the reduction of transfusion-associated HIV transmission. Blood transfusion recipients were divided into the following groups: operated patients (12%), pregnant women (8%), under-fives (62%), children aged 5-14 years (5%) and adults (13%). Two sets of criteria were applied to estimate the number of avoidable blood transfusions. The total proportion of avoidable blood transfusions using these criteria were 32 and 56%, respectively. If the strictest criteria were applied the proportion of avoidable blood transfusions in operated patients was 44%, in pregnant women with chronic anaemia 18%, in under-fives 62%, in children 31% and in adults 51%. It was concluded that a major reduction in the number of blood transfusions could be achieved, in particular in under-fives. In the Mwanza Region, Tanzania, an analysis of evaluable, available records from 370 patients from the peripheral hospital and 127 patients from the referral hospital who received a blood transfusion during January-June 1990 was conducted to identify unnecessary blood transfusions. Guidelines the researchers used to determine whether or not a blood transfusion was avoidable were based on the hemoglobin (Hb) level (e.g. children under 5 years old = or Hb 4 g/dl for criteria A and 5 g/dl for criteria B). The blood transfusion could have been avoided in 44% of operated patients based on both sets of criteria. Two of the 11 blood transfusions given to pregnant women with chronic anemia were avoidable. Among the under 5 years olds, 62% of blood transfusions were avoidable based on criteria A and 35% were avoidable based on criteria B. 31% and 15% of blood transfusions among 5-14 year olds were avoidable based on criteria A and B, respectively. As for adults, 63% of blood transfusions were avoidable based on criteria A and 27% were avoidable based on criteria B. Overall, 32% of blood transfusions were avoidable based on criteria B and 56% based on criteria A. Since limitations undoubtedly existed for this retrospective study, the researchers have begun a prospective study. They will use the research findings to develop and implement blood transfusion guidelines in the region to reduce unnecessary blood transfusions in order to reduce transfer-associated HIV transmission.
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