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Blood transfusion practice in a rural hospital in Northern Ghana, Damongo, West Gonja District
Author(s) -
Kubio Chrysantus,
Tierney Geraldine,
Quaye Theophilus,
Nabilisi James Wewoli,
Ziemah Callistus,
Zagbeeb Sr Mary,
Shaw Sandra,
Murphy William G.
Publication year - 2012
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2012.03709.x
Subject(s) - medicine , blood transfusion , blood bank , syphilis , donation , rural area , population , anemia , emergency medicine , environmental health , medical emergency , human immunodeficiency virus (hiv) , family medicine , surgery , pathology , economics , economic growth
BACKGROUND: Blood transfusion in rural sub‐Saharan Africa presents special challenges. Transfusions are primarily given for emergencies—life‐threatening blood loss or anemia; blood is usually collected from family or replacement donors; and facilities to store an adequate reserve in a hospital bank are constrained. We report the everyday and organizational practices in a medium‐sized district hospital in Northern Ghana. STUDY DESIGN AND METHODS: Information and data on blood transfusion practices at West Gonja Hospital, Damongo, were available from the laboratory reports, from day books and workbooks, and from direct observation in the following four areas: blood collection and blood donors; blood donation testing; blood storage and logistics; and clinical transfusion practice, adverse events, and follow‐up. RESULTS: The hospital serves a rural community of 86,000. In 2009, a total of 719 units of whole blood were collected, a rate of 8.36 units per 1000 population. All donors were family or replacement donors. Positivity rates for infectious disease markers were 7.5% (64/853) for hepatitis B surface antigen, 6.1% (50/819) for hepatitis C virus, 3.9% (33/846) for human immunodeficiency virus, and 4.7% (22/468) for syphilis. Supply of laboratory materials was sometimes problematic, especially for temperature‐critical materials. Difficulties in sample labeling, storage of blood and laboratory supplies, and disposal of waste were also incurred by operational, material, and financial constraints. Follow‐up for outcomes of transfusion is not currently feasible. CONCLUSIONS: The operational, demographic, and financial environment pertaining in a rural hospital in Northern Ghana differs substantially from that in which much of current blood transfusion practice and technology evolved. Considerable effort and innovation will be needed to address successfully the challenges posed.