Objective: To assess the effectiveness of blood transfusions in a hospital of north-eastern Democratic Republic of the Congo.
Methods: Prospective study of children admitted for severe anaemia. During admission, data were collected on clinical condition and haemoglobin levels, before and after blood transfusion. A linear regression model was built to explore factors associated with haemoglobin level after transfusion. Risk factors for mortality were explored through multivariate logistic regression.
Results: Haemoglobin level (Hb) was below 4 g/dl in 35% (230/657), between 4 and 6 g/dl in 58% (348/657) and at least 6 g/dl in another 6% (43/657) of the transfused children. A transfusion of 15 ml/kg of whole blood increased the Hb from 4.4 to 7.8 g/dl. Haemoglobin level after transfusion was associated with baseline Hb, quantity of delivered blood and history of previous transfusions. Overall case-fatality rate was 5.6% (37/657). Risk factors for deaths were co-morbidities such as chest infection, meningitis or malnutrition, Hb ≥ 6 g/dl, impaired consciousness or jugular venous distention on admission, and provenance.
Conclusion: Transfusion was a frequent practice, the use of which could clearly have been rationalised. While indications should be restricted, quantities of transfused blood should be adapted to needs.
Keywords: Democratic Republic of the Congo; RDC; República Democrática del Congo; blood transfusion; facteurs de risque; factores de riesgo; mortalidad; mortality; mortalité; paediatric; pediatría; pédiatrique; risk factors; transfusion sanguine; transfusión de sangre.
© 2012 Blackwell Publishing Ltd.