ArticleBMC health services research2018
High rate of inappropriate blood transfusions in the management of children with severe anemia in Ugandan hospitals.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Facilitators and barriers to blood and blood product accessibility and use in sub-Saharan Africa: a systematic review.Frontiers in health services · 2026Pooled it
- Use of point-of-care haemoglobin tests to diagnose childhood anaemia in low- and middle-income countries: A systematic review.Tropical medicine & international health : TM & IH · 2024Pooled it
- Transfusion management of severe anaemia in African children: a consensus algorithm.British journal of haematology · 2021Trial
- Immediate Transfusion in African Children with Uncomplicated Severe Anemia.The New England journal of medicine · 2019Trial
- Timeliness of blood transfusion among children admitted with severe anaemia in a tertiary hospital in Eastern Uganda: a prospective cohort study.Scientific reports · 2026Article
- Restrictive vs. liberal blood transfusion strategies in Africa: clinical outcomes, resource stewardship, and future directions.Frontiers in medicine · 2026Review
- Effect of corticosteroids on haemoglobinuria resolution among children with blackwater fever at Soroti regional referral hospital, Uganda: a retrospective cohort study.Malaria journal · 2025Article
- Article
- Clinicians in low- and middle-income settings need better access to point-of-care haemoglobin tests for identifying and managing children and pregnant women with severe anaemia.Tropical medicine & international health : TM & IH · 2025Article
- Article
- Red blood cell alloantibodies in paediatric transfusion in sub-Saharan Africa: A new cohort and literature review.EJHaem · 2023Article
- Overuse of medications in low- and middle-income countries: a scoping review.Bulletin of the World Health Organization · 2023Article
- Incidence and predictors of hospital readmission in children presenting with severe anaemia in Uganda and Malawi: a secondary analysis of TRACT trial data.BMC public health · 2021Article
- Doctors' practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study.African journal of primary health care & family medicine · 2021Article
- Point-of-care haemoglobin testing in African hospitals: a neglected essential diagnostic test.British journal of haematology · 2021Review
- Socio-emotional and adaptive behaviour in children treated for severe anaemia at Lira Regional Referral Hospital, Uganda: a prospective cohort study.Child and adolescent psychiatry and mental health · 2020Article
- AnemoCheck-LRS: an optimized, color-based point-of-care test to identify severe anemia in limited-resource settings.BMC medicine · 2020Article
- Neurodevelopmental performance among pre-schoolers treated for severe anaemia at Lira Regional Referral Hospital, Uganda.PloS one · 2020Article
- Informing thresholds for paediatric transfusion in Africa: the need for a trial.Wellcome open research · 2019Article
- Severe childhood anemia and emergency blood transfusion in Gadarif Hospital, eastern Sudan.PloS one · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundSevere anaemia (SA) is a common reason for hospitalisation of children in sub-Saharan Africa but the extent to which blood transfusion is used appropriately in the management of severe anemia has hitherto remained unknown. We report on the use of blood transfusion in the management of anemic children in two hospitals in Uganda.
methodsInpatient records of children 0-5 years of age admitted to Lira and Jinja regional referral hospitals in Uganda were reviewed for children admitted on selected days between June 2016 and May 2017. Data was extracted on the results, if any, of pre-transfusion hemoglobin (Hb) level, whether or not a blood transfusion was given and inpatient outcome for all children with a diagnosis of 'severe anemia'. Qualitative data was also collected from health workers to explain the reasons for the clinical practices at the two hospitals.
resultsOverall, 574/2275 (25.2%) of the children admitted in the two hospitals were assigned a diagnosis of SA. However 551 (95.9%) of children assigned a diagnosis of SA received a blood transfusion, accounting for 551/560 (98.4%) of the blood transfusions in the pediatric wards. Of the blood transfusions in SA children, only 245 (44.5%) was given appropriately per criteria (Pre-transfusion Hb ≤ 6 g/dL), while 306 (55.5%) was given inappropriately; (pre-transfusion Hb not done, n = 216, or when a transfusion is not indicated [Hb > 6.0 g/dl], n = 90). SA children transfused appropriately per Hb criteria had lower inpatient mortality compared to those transfused inappropriately, (7 (2.9%) vs. 22 (7.2%), [OR 0.4, 95% CI 0.16, 0.90]). Major issues identified by health workers as affecting use of blood transfusion included late presentation of SA children to hospital and unreliable availability of equipment for measurement of Hb.
conclusionMore than half the blood transfusions given in the management of anemic children admitted to Lira and Jinja hospitals was given inappropriately either without pre-transfusion Hb testing or when not indicated. Verification of Hb level by laboratory testing and training of health workers to adhere to transfusion guidelines could result in a substantial decrease in inappropriate blood transfusion in Ugandan hospitals.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.