Blood Transfusion Rate in Congolese Patients with Sickle Cell Anemia

Objective: 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.

Methods: 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).

Results: 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%).

Conclusion: 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.