Prevalence and specificity of red blood cell antibodies in patients transfused in tertiary hospitals in Burkina Faso.

BACKGROUND: Sub-Saharan African countries face the challenge of immunological transfusion safety that puts many patients at risk of post-transfusion hemolytic reactions. This is because pre-transfusion testing for irregular/unexpected antibodies that helps to prevent these risks are neither universally available nor accessible. The aim of our study was to determine the prevalence of red blood cell alloantibodies and their specificity in patients transfused in Burkina Faso. MATERIALS AND METHODS: This was a cross-sectional study including patients who had received at least one blood transfusion. Indirect antiglobulin testing using LISS-enhanced medium gel column agglutination technique was used for antibodies screening and identification. Enzymatic technique with papain-treated red cell reagent was performed in attempt to solve some difficulties if necessary as well as auto-control test and RH-KEL phenotyping when possible to help antibodies identification. RESULTS: A total of 832 patients were included, 51.6% of whom were female, and the median (IQR) age was 34 (20-49) years. Of these, 43.7% had chronic kidney disease and 20.4% were sickle cell patients. The median (IQR) number of immunisation episodes (blood transfusion and pregnancies) was 3 (2-6) with the median (IQR) number of blood units received per patient of 2 (1-5). The proportion of patients with RBCs antibodies was 6.4% (53/832), with mainly anti-Rh antibodies. A combination of 2 antibodies was found in 7 patients and a combination of 3 antibodies in one patient. Antibodies of unknown specificity (AUS) were encountered in 29%. Independent factors associated with antibody positivity were age (OR = 1.02; p = 0.026), sickle cell disease (OR = 3.23; p = 0.017) and receiving more than 10 blood units (OR = 7.33; p = 0.01). CONCLUSION: In this study, the proportion of patients with RBC antibodies was quite similar to that observed in Sub-Saharan African countries. However, the availability and accessibility of pre-transfusion compatibility tests as well as the quality of methods used should be improved to ensure the safety of blood transfusions.

Traceability of Blood Transfusions and Reporting of Adverse Reactions in Developing Countries: A Six-Year Postpilot Phase Experience in Burkina Faso.

Traceability is an essential tool for haemovigilance and transfusion safety. In Burkina Faso, the implementation of haemovigilance has been achieved as part of a pilot project from 2005 to 2009. Our study aims to evaluate the traceability of blood transfusions and reporting of adverse reactions over the 6-year postpilot phase. A cross-sectional study including all blood units ordered between 2010 and 2015 has been conducted in public and private health care facilities supplied with blood products by the transfusion center of Bobo-Dioulasso. The complete traceability was possible for 83.5% of blood units delivered. Adverse reactions were reported in 107 cases representing 2.1/1,000 blood units per annum. Transfusions of wrong blood to wrong patient were reported in 13 cases. Our study shows that the haemovigilance system in Burkina Faso must be improved. Healthcare workers have to be sensitized on how traceability and haemovigilance could impact the quality of care provided to patients.

Epidemiological and clinical aspects of urogenital schistosomiasis in women, in Burkina Faso, West Africa.

BACKGROUND: Because infections with Schistosoma Haematobium usually peak in childhood, the majority of studies on schistosomiasis have focused on school-aged children. This study aimed to assess the epidemiological and clinical aspects of urogenital schistosomiasis in women in Burkina Faso, West Africa. METHODS: A cross-sectional study was conducted in a mesoendemic region (Kombissiri) and a hyperendemic region (Dori) for schistosomiasis in Burkina Faso. A total of 287 females aged 5 to 50 years were included in the study. S. haematobium infection was assessed using the urine filtration method and dipsticks were used for the detection of hematuria. Interviews were conducted to identify clinical aspects and risk factors related to urogenital schistosomiasis. RESULTS: The overall prevalence of S. haematobium infection in Dori was 21.3 %, where as Kombissiri was less affected with a prevalence of 4.6 %. The most affected age group was the 10- to 14-year-olds (41.2 %), followed by the 15- to 19-year-olds (26.3 %). Risk factors significantly associated with schistosomiasis (P <0.05) were place of residence, age, contact with open water in the past year, and distance of home to open water. The percentage of participants who had contact with open water was significantly higher among the women living in Dori compared to Kombissiri. Females over 15 years of age showed a significant higher rate of water contact compared to the 5- to 15-year-olds. A significant correlation between schistosomiasis and hematuria was established. Microhematuria showed a sensitivity of 80.6 %, a specificity of 92.7 %, and a positive predictive value of 61.7 %, whereas macrohematuria had a sensitivity of 47.2 %, a specificity of 99.2 %, and a positive predictive value of 89.5 %. The mass distribution of praziquantel in Burkina Faso is well established. However, over half of the participants with schistosomiasis in this study said they took praziquantel in the past 6 months, which indicates a high reinfection rate. This may be associated with a lack of knowledge about the transmission of schistosomiasis. Only 6 % of the participants in Kombissiri and 1.5 % in Dori knew about the correct mode of transmission. CONCLUSIONS: The results of our study indicate that distribution campaigns should be extended from school-aged children to young women. Our data also demonstrate the necessity of combining already established mass distribution campaigns with information campaigns, so that long-term elimination, or at least reduction, of schistosomiasis can be achieved.