Clinical Indications of Blood Transfusion at the Yaoundé University Teaching Hospital and the Cité Verte District Hospital

Asanghanwa Carlson Mathias Ngwabifu (carlsonngwa@yahoo.com)
Microbiology, Haematology and Cancerology, University of Yaounde I
July, 2013
 

Abstract

Abstract
Objectives: This study aimed to examine the pattern of usage of blood and blood products in a tertiary and a District hospital of Yaoundé; the major clinical indications, the various types of blood and blood products prescribed and their appropriateness.
Methodology: This was a cross-sectional descriptive study in the Yaoundé University Teaching Hospital (YUTH) and the Cité Verte District Hospital from November 2012 to April 2013. Consenting transfused patients were recruited. A complete medical interview was conducted and information concerning the indications for blood transfusion and the underlying diagnoses were noted. The type of blood product prescribed and its appropriateness was evaluated based on the World Health Organisation (WHO) manual for the use of blood and blood products and the National guidelines for blood transfusion in Cameroon.
Results: Of the 169 patients transfused during the study period, 11.83% were from the Cité Verte District Hospital and 88.07% were from YUTH. A total of 179 patient episodes were recorded. The blood recipients were predominantly females (52.66%) and the mean age was 37.71 ± 21.04 years (range: 7 days to 82 years). The prevalence of the different ABO blood groups in the study population was 48.5%, 28.9%, 17.7% and 4.7% for the O, A, B and AB groups respectively. The prevalence of the Rhesus antigen was 97.04%. Most of our patients (79.9%) were symptomatic at the time of transfusion. The most common indications of blood transfusion were elective transfusion for anaemia (29.05%), overt haemorrhage (23.46%), and severe anaemia (20.11%). Anaemia due to chronic renal failure, severe HIV infection and gynaeco-obstetric haemorrhage were the major provisional diagnoses provided for transfusion. About 90.6% of the 426 units of blood ordered in both institutions were at the YUTH. Whole blood was the most prescribed blood type (58.89%) followed by red cell concentrate (32.22%). Transfusion rates were significantly higher at the YUTH (6.09%) than the Cité Verte District hospital (2.00%), p < 0.05. Our study showed that appropriateness in blood prescription was 63.7% with a significant difference between the YUTH and the Cité Verte District Hospital, p = 0.0013.
Conclusion: This study highlights anaemia as the major indication for transfusion, with whole blood predominantly used in both institutions. Furthermore, the appropriateness in blood usage is still low within the different grade hospitals in our milieu, suggesting that the guidelines for blood transfusion in Cameroon are not well implemented in routine transfusion practice.
Key words: blood transfusion, anaemia, patient episode, appropriateness.


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