Blood transfusion rate in Congolese patients with sickle cell anemia

The main objective of this study was to evaluate the rate of blood transfusion in African Sickle Cell Patients and the risks related to the use of total blood.

186 sickle cell patients (95 males and 91 females) aged 0-21 years were regularly followed over a 3 years period in Katanga province, DR Congo. Indications for blood transfusion were mainly based on clinical criteria and Hb level (less than 5g% ml or a drop of 2g% under the steady state value). All the subjects, who were transfused, wer screened for hepatitis B surface antigen (HBs Ag) and Human Immune deficit Virus (HIV).

Of 186 patients, 150 (80.6%) were transfused and the average blood transfusion requirement was 0.4 units per patient-year. According to the age of first transfusion, 75.3% (113/150) of them were transfused before the 6th year of life; but the frequency of transfusions seemed to decline in children aged more than 13 years. The risk of HIV infection from blood transfusion was estimated at 1 per 37.1 units or 26 per 1000 blood units. The hepatitis B surface antigen was detected in 15 cases (10%) and HIV serology was positive in 17 patients (11.3%).

Because of the complications related to blood transfusions in Africa, efforts are needed in order to reduce the frequency of transfusions, by preventive measures (early diagnosis, malarial and penicillin-prophylaxis) and to use more rational indications.