Anaemia and blood transfusion in African children presenting to hospital with severe febrile illness.

Sarah Kiguli; Kathryn Maitland; Elizabeth C. George; Peter Olupot-Olupot; Robert Opoka; Charles Engoru; Samuel O. Akech; Richard Nyeko; George Mtove; Hugh Reyburn

doi:10.1186/s12916-014-0246-7

Anaemia and blood transfusion in African children presenting to hospital with severe febrile illness.

Sarah Kiguli, Kathryn Maitland, Elizabeth C. George, Peter Olupot-Olupot, Robert Opoka, Charles Engoru, Samuel O. Akech, Richard Nyeko, George Mtove, Hugh Reyburn

Medical College, East Africa

Research output: Contribution to journal › Article

75 Citations (Scopus)

Abstract

Background

Severe anaemia in children is a leading cause of hospital admission and a major cause of mortality in sub-Saharan Africa, yet there are limited published data on blood transfusion in this vulnerable group.

Methods

We present data from a large controlled trial of fluid resuscitation (Fluid Expansion As Supportive Therapy (FEAST) trial) on the prevalence, clinical features, and transfusion management of anaemia in children presenting to hospitals in three East African countries with serious febrile illness (predominantly malaria and/or sepsis) and impaired peripheral perfusion.

Results

Of 3,170 children in the FEAST trial, 3,082 (97%) had baseline haemoglobin (Hb) measurement, 2,346/3,082 (76%) were anaemic (Hb Conclusions

Severe anaemia complicates one third of childhood admissions with serious febrile illness to hospitals in East Africa, and is associated with increased mortality. A high proportion of deaths occurred within 2.5 hours of admission, emphasizing the need for rapid recognition and prompt blood transfusion. Adherence to current WHO transfusion guidelines was poor. The high rates of re-transfusion suggest that 20 mL/kg whole blood or 10 mL/kg packed cells may undertreat a significant proportion of anaemic children. Future evaluation of the impact of a larger volume of transfused blood and optimum transfusion management of children with Hb of

Original language	Undefined/Unknown
Journal	Paediatrics and Child Health, East Africa
DOIs	https://doi.org/10.1186/s12916-014-0246-7
Publication status	Published - 2 Feb 2015

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s12916-014-0246-7Licence: Unspecified

http://ecommons.aku.edu/eastafrica_fhs_mc_paediatr_child_health/387

Cite this

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title = "Anaemia and blood transfusion in African children presenting to hospital with severe febrile illness.",

abstract = "Background Severe anaemia in children is a leading cause of hospital admission and a major cause of mortality in sub-Saharan Africa, yet there are limited published data on blood transfusion in this vulnerable group. Methods We present data from a large controlled trial of fluid resuscitation (Fluid Expansion As Supportive Therapy (FEAST) trial) on the prevalence, clinical features, and transfusion management of anaemia in children presenting to hospitals in three East African countries with serious febrile illness (predominantly malaria and/or sepsis) and impaired peripheral perfusion. Results Of 3,170 children in the FEAST trial, 3,082 (97\%) had baseline haemoglobin (Hb) measurement, 2,346/3,082 (76\%) were anaemic (Hb Conclusions Severe anaemia complicates one third of childhood admissions with serious febrile illness to hospitals in East Africa, and is associated with increased mortality. A high proportion of deaths occurred within 2.5 hours of admission, emphasizing the need for rapid recognition and prompt blood transfusion. Adherence to current WHO transfusion guidelines was poor. The high rates of re-transfusion suggest that 20 mL/kg whole blood or 10 mL/kg packed cells may undertreat a significant proportion of anaemic children. Future evaluation of the impact of a larger volume of transfused blood and optimum transfusion management of children with Hb of ",

author = "Sarah Kiguli and Kathryn Maitland and George, \{Elizabeth C.\} and Peter Olupot-Olupot and Robert Opoka and Charles Engoru and Akech, \{Samuel O.\} and Richard Nyeko and George Mtove and Hugh Reyburn",

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doi = "10.1186/s12916-014-0246-7",

language = "Undefined/Unknown",

journal = "Paediatrics and Child Health, East Africa",

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TY - JOUR

T1 - Anaemia and blood transfusion in African children presenting to hospital with severe febrile illness.

AU - Kiguli, Sarah

AU - Maitland, Kathryn

AU - George, Elizabeth C.

AU - Olupot-Olupot, Peter

AU - Opoka, Robert

AU - Engoru, Charles

AU - Akech, Samuel O.

AU - Nyeko, Richard

AU - Mtove, George

AU - Reyburn, Hugh

PY - 2015/2/2

Y1 - 2015/2/2

N2 - Background Severe anaemia in children is a leading cause of hospital admission and a major cause of mortality in sub-Saharan Africa, yet there are limited published data on blood transfusion in this vulnerable group. Methods We present data from a large controlled trial of fluid resuscitation (Fluid Expansion As Supportive Therapy (FEAST) trial) on the prevalence, clinical features, and transfusion management of anaemia in children presenting to hospitals in three East African countries with serious febrile illness (predominantly malaria and/or sepsis) and impaired peripheral perfusion. Results Of 3,170 children in the FEAST trial, 3,082 (97%) had baseline haemoglobin (Hb) measurement, 2,346/3,082 (76%) were anaemic (Hb Conclusions Severe anaemia complicates one third of childhood admissions with serious febrile illness to hospitals in East Africa, and is associated with increased mortality. A high proportion of deaths occurred within 2.5 hours of admission, emphasizing the need for rapid recognition and prompt blood transfusion. Adherence to current WHO transfusion guidelines was poor. The high rates of re-transfusion suggest that 20 mL/kg whole blood or 10 mL/kg packed cells may undertreat a significant proportion of anaemic children. Future evaluation of the impact of a larger volume of transfused blood and optimum transfusion management of children with Hb of

AB - Background Severe anaemia in children is a leading cause of hospital admission and a major cause of mortality in sub-Saharan Africa, yet there are limited published data on blood transfusion in this vulnerable group. Methods We present data from a large controlled trial of fluid resuscitation (Fluid Expansion As Supportive Therapy (FEAST) trial) on the prevalence, clinical features, and transfusion management of anaemia in children presenting to hospitals in three East African countries with serious febrile illness (predominantly malaria and/or sepsis) and impaired peripheral perfusion. Results Of 3,170 children in the FEAST trial, 3,082 (97%) had baseline haemoglobin (Hb) measurement, 2,346/3,082 (76%) were anaemic (Hb Conclusions Severe anaemia complicates one third of childhood admissions with serious febrile illness to hospitals in East Africa, and is associated with increased mortality. A high proportion of deaths occurred within 2.5 hours of admission, emphasizing the need for rapid recognition and prompt blood transfusion. Adherence to current WHO transfusion guidelines was poor. The high rates of re-transfusion suggest that 20 mL/kg whole blood or 10 mL/kg packed cells may undertreat a significant proportion of anaemic children. Future evaluation of the impact of a larger volume of transfused blood and optimum transfusion management of children with Hb of

U2 - 10.1186/s12916-014-0246-7

DO - 10.1186/s12916-014-0246-7

M3 - Article

JO - Paediatrics and Child Health, East Africa

JF - Paediatrics and Child Health, East Africa

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