|Year : 2017 | Volume
| Issue : 1 | Page : 52-55
Blood transfusion request pattern in a medical center in Northwestern Nigeria
Ibrahim Aliyu1, Godpower Michael2, Haliru Ibrahim3, Zainab F Ibrahim4, Goni Aliyu5, Ajayi T Isaiah5
1 Department of Paediatrics, Aminu Kano Teaching Hospital/Bayero University, Kano, Nigeria
2 Department of Family Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
3 Department of Medicine, Federal Medical Centre, Birnin Kudu, Jegawa, Nigeria
4 Department of Nursing, Aminu Kano Teaching Hospital, Kano, Nigeria
5 Department of Haematology, Federal Medical Centre, Birnin Kudu, Jegawa, Nigeria
|Date of Web Publication||22-Mar-2017|
Department of Paediatrics, Aminu Kano Teaching Hospital/Bayero University, Kano
Source of Support: None, Conflict of Interest: None
Introduction: Nigeria has a national policy on blood services, however, most medical facilities find difficulties in establishing a viable, efficient blood banking system; therefore, it becomes necessary to ensure judicious utilization of this scarce commodity. Therefore, this study hopes to determine the pattern of demand for blood transfusion in our institution. Materials and Methods: This study was a 1-year retrospective analysis of the request for blood transfusion. Results: There were 1958 blood requests, consisting of 554 for males (28.3%) and 1404 for females (71.7%) with male:female ratio of 1:2.5. The obstetrics and gynecology department (52.3%) had the highest request for blood transfusion, while medicine had the least (9.3%). Whole blood was the most common form of blood product requested (87.3%) while only two (0.1%) request for plasma was made. The most common indication for blood transfusion was anemia (52.2%), followed by the need for blood transfusion during surgery (30.4%); however, exchange blood transfusion was the least with only 16 requests (0.8%). A total of 3766.4 pints of blood were requested during the study period; however, obstetrics and gynecology had the highest request of 2350 pints (62.4%) while pediatrics had the least request of 255.4 pints (6.8%). Over 90% of requested blood and blood products were dispatched. The months of August, September, and October recorded the highest need for blood transfusion whereas January and February recorded the least. Conclusion: The obstetrics and gynecology department had the highest request for blood transfusion; this demand was experienced mostly toward the last quarter of the year, and most requests were dispatched, and there was judicious utilization of blood donated.
Keywords: Blood request, blood transfusion, seasonal variation
|How to cite this article:|
Aliyu I, Michael G, Ibrahim H, Ibrahim ZF, Aliyu G, Isaiah AT. Blood transfusion request pattern in a medical center in Northwestern Nigeria. Glob J Transfus Med 2017;2:52-5
|How to cite this URL:|
Aliyu I, Michael G, Ibrahim H, Ibrahim ZF, Aliyu G, Isaiah AT. Blood transfusion request pattern in a medical center in Northwestern Nigeria. Glob J Transfus Med [serial online] 2017 [cited 2020 Aug 6];2:52-5. Available from: http://www.gjtmonline.com/text.asp?2017/2/1/52/202720
| Introduction|| |
Blood transfusion is an important part of patient care, especially during resuscitation; to ensure an adequate supply of this vital product, the Federal Government in Nigeria has developed a national blood service policy. Despite that, most medical facilities still find difficulty in establishing viable, efficient blood banking system; therefore, it becomes necessary to ensure judicious utilization of this scarce commodity in our health facilities. Efforts have been made to encourage voluntary blood donation; however, medical centers at times resort to other measures such as replacement and autologous donations to replenish their stock. Various studies have shown variable distribution in demand for blood and its component,,,,, but none had looked at any variability in the request pattern for blood and its product. Therefore, this study hopes to determine blood request pattern witnessed and if any, periodic variation in demand for blood transfusion. This will assist in effective planning; ensuring adequate provision in the blood bank at all times.
| Materials and Methods|| |
Blood donated is routinely screened for blood-transmissible pathogens (HIV, hepatitis B surface antigen, and hepatitis C virus antibodies) and those deemed fit for use are then grouped and labeled. Various forms of blood donations are practiced such as voluntary, replacement, and autologous.
This study was a retrospective analysis of the request for blood transfusion in Federal Medical Centre, Birnin Kudu, over a year period from January 1, 2011, to December 31, 2011. Relevant information was extracted from the blood bank register, such as the age/sex of the blood transfusion recipients, number of blood pints requested, number of pints dispatched, types of blood product requested (whole blood, packed red blood cell, and other component transfusion), the department requesting blood for transfusion, and common comorbidities associated with recipients. Permission to conduct this study was obtained from the Institution's Ethics Committee.
Statistical Package for the Social Sciences (SPSS Inc., Chicago, Illinois, USA) for Windows, version 19 software was used to analyze this data. Frequency distribution of variables was presented, and Fisher's exact test for judging any statistical significance of qualitative variables was explored with P< 0.05 quoted as being statistically significant.
| Results|| |
There was 1958 blood request within the study period consisting of 554 males (28.3%) and 1404 females (71.7%) with male:female ratio of 1:2.5. Replacement blood donation constituted 97.5% while 2% and 0.5% were from voluntary and autologous donors.
The obstetrics and gynecology department (52.3%) had the highest request for blood transfusion, while medicine had the least (9.3%). Whole blood was the most common form of blood product requested (87.3%) while only two (0.1%) request for plasma was made. The most common indication for blood transfusion was anemia (52.2%), followed by the need for blood transfusion during surgery (30.4%); however, exchange blood transfusion was the least with only 16 requests (0.8%) [Table 1].
|Table 1: Frequency distribution of departments, types of blood and blood products, and common indications for transfusion|
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A total of 3766.4 pints of blood were requested during the study period; however, obstetrics and gynecology had the highest request of 2350 pints (62.4%) while pediatrics had the least request of 255.4 pints (6.8%) [Table 2]. Over 90% of requested blood and blood products were dispatched. The average cross-match/transfusion (C/T) ratio was 1.0 while medicine had 1.1, other departments had a C/T ratio of 1.0.
|Table 2: Blood transfusion request and dispatch according to departments|
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Whole blood was mostly requested by surgery, obstetrics and gynecology, and medicine departments whereas pediatrics had more of packed cells [Table 3]. The only request of plasma was also from pediatrics department. These findings were observed to be statistically significant (Fisher's exact test 854.85; P = 0.00).
|Table 3: The relationship of the requested blood type and the departments|
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Anemia as an indication for blood transfusion was mostly seen in the pediatrics and medicine departments [Table 4]; bleeding and surgery as indications for transfusion were seen mostly in obstetrics and gynecology and surgery departments; however, anemia also constituted 46.9% in O and G cases; while only 16(4.2%) exchange blood transfusions were recorded from the pediatrics department. These observations were noted to be statistically significant (Fisher's exact test = 810.3; P- 0.00).
|Table 4: Common indications for blood transfusion according to the respective departments|
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Infection-related illnesses were most common among the individuals (28.0%), followed by (14.6%); however, bleeding from fibroid was less common (4.1%) [Table 5].
The months of March, August, September, October, and November recorded higher blood transfusion rate followed by the months of April, May, June, July, and December whereas the months of January and February recorded the least [Figure 1].
|Figure 1: Monthly blood transfusion request. 1 = January (108), 2 = February (117), 3 = March (152), 4 = April (141), 5 = May (141), 6 = June (181), 7 = July (142), 8 = August (204), 9 = September (212), 10 = October (221), 11 = November (194), 12 = December (145)|
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| Discussion|| |
This study showed a blood transfusion request of 1958 which was higher than 1066 reported by Kagu et al. but lower than 1703 reported by Musa et al. over a 3-month period. Females constituted the highest recipients of blood transfusion in this study which is similar to other reports.,, While replacement donation was the most common form of blood donation which was similar to the previous reports,,, though this was higher than the 47.3% reported by Kagu et al. However, no case of paid donor was documented.
The obstetrics and gynecology department had the highest request for blood transfusion (52.3%) which is similar to the previous reports,,, however, this figure is higher than that reported by Musa et al. (42.7%) but lower than (70.4%) that reported by Emeribe et al., furthermore, medicine had the least request for blood transfusion which was similar to that reported by Musa et al., this differences may be related to the fact that most obstetrics and gynecological events may be bleeding related such as those witnessed in abortion, ante- and post-partum bleeding, anemia in pregnancy, and delivery.
Whole blood was the most common form of transfusion requested, with only two request for plasma; this is similar to other reports in most resource-limited settings;,, nonavailability of facilities limits the practice of component transfusion as witnessed in most developed centers.,,,
The average C/T ratio of 1.0 observed in this study is indicative of efficient and effective utilization of this scarce product; this is commendable when compared to other studies with C/T ratios >2;,, therefore, a proper patient review, especially by senior colleagues coupled with patient-specific blood donation ordering  which was the practiced, significantly eliminated any wastage, and unnecessary cross-matching.
Anemia was the most common indication for blood transfusion in this study, most especially among the pediatric, obstetrics and gynecology, and medicine patient populations; this is similar to the previous report by Okpe et al., Furthermore, infection-related illnesses were most associated with individuals requiring blood transfusion. Birnin Kudu lies within the Sudan savannah with an endemic pattern of malaria transmission. Therefore, high burden of malaria infection and malnutrition among children and child-bearing mothers which is the case in most developing countries increases the prevalence of anemia in children and pregnancy, respectively. The World Health Organization estimates that the prevalence of anemia in pregnancy is 56% among Africans and up to 75% among Asians., This is worrisome; therefore, effective policies on the implementation of the use of insecticide-treated nets and intermittent malaria prophylaxis should be intensified.
The months of March, August, September, October, and November recorded higher transfusion rate. However, this did not show an established pattern; overall, the transfusion ranged from 5% to 10%.
| Conclusion|| |
The obstetrics and gynecology department had the highest request for blood transfusion, while the medicine department had the least; however, this demand was experienced mostly toward the last quarter of the year, and most of the requests were dispatched and there was judicious utilization of donated blood.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]