Blood donation practices, processing and utilisation of blood components in government tertiary hospitals in Nigeria: a multicentre cooperative study.

BACKGROUND: Timely access to safe blood and blood components is still a challenge in Nigeria. This study aimed to determine blood donation practices, processing and utilization of blood components across government tertiary hospitals (THs) in Nigeria. METHODS: This was a descriptive cross-sectional study done in Nigeria in June-July 2020. Data were analysed with SPSS version 21.0. RESULTS: Data were collected from 50 THs. The majority (68%) of the THs lack facilities for blood component preparation and only 18% and 32% provide cryoprecipitate and platelet concentrate, respectively. Whole blood was most commonly requested (57.04%). All facilities tested blood for HIV, HBV and HCV, but the majority (23 [46%]) employed rapid screening tests alone and nucleic acid testing was not available in any hospitals. The manual method was the most common method of compatibility testing in 90% (45/50) and none of the THs routinely perform extended red cell typing. The average time to process routine, emergency and uncross-matched requests were a mean of 109.58±79.76 min (range 45.00-360.00), 41.62±25.23 (10.00-240.00) and 11.09±4.92 (2.00-20.00), respectively. CONCLUSION: Facilities for blood component preparation were not widely available. Concerned government authorities should provide facilities for blood component preparation.

Blood transfusion services for patients with sickle cell disease in Nigeria.

BACKGROUND: Safe, timely red blood cell transfusion saves lives and chronic transfusion therapy (CTT) prevents or limits morbidities such as stroke, therefore improving quality of life of patients with sickle cell disease (SCD). METHODS: This questionnaire-based study assessed the ability of sickle cell centers in Nigeria to provide safe blood to patients with SCD between March and August 2014. RESULTS: Out of the 73 hospitals contacted, responses were obtained from 31. Twenty four (78%) hospitals were unable to transfuse patients regularly due to blood scarcity. Packed red blood cells were available in 14 (45%), while only one provided leukocyte-depletion. Most centers assessed donor risk and screened for HIV in 30 (97%), hepatitis B in 31(100%) and hepatitis C in 27 (87%) hospitals. Extended phenotyping and alloantibody screening were not available in any center. A quarter of the hospitals could monitor iron overload, but only using serum ferritin. Access to iron chelators was limited and expensive. Seventeen (55%) tertiary hospitals offered CTT by top-up or manual exchange transfusion; previous stroke was the most common indication. CONCLUSION: Current efforts of Nigerian public hospitals to provide safe blood and CTT fall short of best practice. Provision of apheresis machines, improvement of voluntary non-remunerated donor drive, screening for red cell antigens and antibodies, and availability of iron chelators would significantly improve SCD care in Nigeria.

Lupus anticoagulant in Nigerian patients living with human immunodeficiency virus/acquired immunodeficiency syndrome.

BACKGROUND AND PURPOSE: Lupus anticoagulants (LACs) are frequently found in patients with human immunodeficiency virus (HIV). This study was designed to examine the prevalence of LACs and its significance in HIV-infected Nigerian patients. METHODS: LACs were assayed, and complete blood count and direct Coombs' test (DCT) were performed for 155 participants. Patients with other conditions known to be associated with LACs such as autoimmune disease, pregnancy, malignancies, and illegal drug use were excluded. There were 104 highly active antiretroviral therapy-naive patients with HIV and 51 HIV-negative control participants. RESULTS: The prevalences of LACs in HIV-infected patients and controls were 2.9% and 1.9%, respectively (p = 0.973). The majority of the patients (76%) had clinical and/or immunological acquired immunodeficiency syndrome. The mean (+/- standard deviation) hematocrit levels of patients (0.32 +/- 0.05) were significantly lower than those of the controls (0.40 +/- 0.04) [p <0.0001]. Although within the normal range, the platelet count of HIV-infected patients (180 +/- 667 x 10(9)/L) was significantly lower than that of the controls (213 +/- 80 x 10(9)/L) [p = 0.026]. None of the participants had neutropenia or DCT-positivity. There was no correlation between LAC and opportunistic illness, thrombosis, or cytopenia. CONCLUSIONS: The prevalence of LACs was low and was not associated with opportunistic illness, thrombosis, or cytopenia.