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

Background: Data on the use of blood products in sub-Saharan Africa (SSA) are scarce. A systematic review of published data on blood utilization according to diagnosis in SSA was performed. Study design and methods: Studies published from January 2000 to June 2018 were searched in PubMed, Embase and African Index Medicus. Data were extracted and synthesized. The proportion of blood products used for different diagnostic categories is presented. Results: 37 studies representing 159,746 transfusions to 96,690 patients from 14 countries in SSA were included. Data from six of 37 studies were pooled to determine blood product use according to diagnosis. The primary diagnostic categories were pediatric malaria (20%), sickle cell anemia [SCA] (18%), obstetric hemorrhage (16%), and other causes of bleeding (16%). About 8%, 6% and 2% of products were used for other infections, cancer treatment, and surgery respectively. Overall, 58.5% of the products transfused were red blood cells, 31.7 % whole blood, 7.2% fresh frozen plasma, and 2.6% as platelets. Estimated blood product use per population in SSA was 5.3 transfusions per 1000 people, compared with 52 and 34 per thousand for Australia and United States respectively. Conclusion: This study provides a systematic attempt to quantify blood utilization for SSA. Blood products in SSA are used primarily for pediatric malaria, SCA, obstetric hemorrhage and other causes of bleeding. Studies such as this represent an important early step towards improving hemovigilance in SSA

Paradigm Shift in HIV Testing; Getting Along or Getting Behind?

In the last twenty five years, the Human Immunodeficiency Virus (HIV), the causative organism of the Acquired Immune Deficiency Syndrome (AIDS) has assumed a frontline position worldwide in health discourse. In the early days of the characterization of the clinical spectrum caused by infection with this virus, screening was an exception rather than the rule. This article reviews the landmarks attained till date in the all important issue of screening for HIV and concludes that Nigeria can not afford to be left behind in the major policy issue changes currently occupying the front burner globally. Keywords: HIV testing; exceptionalism; universal testing.Nigerian Medical Journal Vol. 48 (2) 2007: pp. 39-4

Allergic transfusion reactions in a tertiary hospital in southwest Nigeria

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Survival in primary a plastic anaemia; experience with 20 cases from a tertiary hospital in Nigeria

Background: Aplastic anaemia is a condition characterized by pancytopenia and unexplained bone marrow hypocellularity. Without treatment, it is invariably fatal. However with the currently available treatment options, patient survival is improving in the developed countries. Methods: The study is a retrospective study. We reviewed the cases of primary aplastic anaemia managed in our hospital over a period of fifteen years. Results: A total of twenty five cases were seen; out of which twenty had complete analyzable data. Management consisted of transfusion support with packed red cells, platelet concentrates and freshly collected unbanked blood; immunosuppressive therapy was with methyl prednisolone. None of the patients had the benefit of bone marrow/stem cell transplantation. Overall median survival was 6.5 weeks. Conclusions: There is a clear need to ensure the availability of proven therapeutic options for patients such as bone marrow/stem cell transplantation and drugs such as cyclosporine and antithymocyte globulin to improve on the present situation