Are some blood transfusions avoidable? A hospital record analysis in Mwanza Region, Tanzania

Records of 497 patients who received a blood transfusion in Mwanza Region, Tanzania, were analyzed in order to estimate the proportion of avoidable blood transfusions. This was part of a more comprehensive study which aims at the reduction of transfusion-associated HIV transmission. Blood transfusion recipients were divided into the following groups: operated patients (12%), pregnant women (8%), under-fives (62%), children aged 5-14 years (5%) and adults (13%). Two sets of criteria were applied to estimate the number of avoidable blood transfusions. The total proportion of avoidable blood transfusions using these criteria were 32 and 56%, respectively. If the strictest criteria were applied the proportion of avoidable blood transfusions in operated patients was 44%, in pregnant women with chronic anaemia 18%, in under-fives 62%, in children 31% and in adults 51%. It was concluded that a major reduction in the number of blood transfusions could be achieved, in particular in under-fives.