Prevalence and risk factors for red blood cell alloimmunisation among sickle cell patients in Mwanza City, Tanzania

• Main Authors: Erius Tebuka (Author), Mwesige Charles (Author), Jeffer O. Bhuko (Author)
• Format: Book
• Published: AOSIS, 2020-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2225-2002; 2225-2010; 10.4102/ajlm.v9i1.823
• Keywords: sickle cell disease; alloimmunisation; alloantibody; screening cells; bugando medical centre; catholic university of health and allied sciences; red blood cells; Public aspects of medicine; RA1-1270; Medicine (General); R5-920
• Source: African Journal of Laboratory Medicine, Vol 9, Iss 1, Pp e1-e5 (2020)

Background: Erythrocyte alloimmunisation can lead to complications such as delayed haemolytic transfusion reaction. Objective: This study investigated the prevalence of and risk factors for red blood cell alloimmunisation among multiply transfused sickle cell disease (SCD) patients in Mwanza City, Tanzania. Methods: From May 2017 to July 2017, this descriptive, cross-sectional, hospital-based study enrolled 200 participants with SCD who had received at least two units of blood in the previous year. Blood count was performed using a Sysmex haematology analyser. Antibody screening was done by the tube method using a panel of three screening cells with known antigenicity. Results: Of the 200 patients enrolled, 108 (54%) were female. The median age was 4.5 years (interquartile range [IQR] = 6), the median number of transfusions was 3 (IQR = 1), and the median pre-transfusion haemoglobin level was 6.6 g/dl (IQR = 2.7). Prevalence of alloimmunisation was 8.5% (17/200) with immunoglobulin G, and one patient developed cold immunoglobulin M antibodies. Blood groups reported were Rhesus C and E, Kell, Kidd and Duffy. There was no statistically significant association between the number of transfusions and the risk of alloimmunisation. Conclusion: The rate of alloimmunisation in multiply transfused SCD patients was 8.5% and higher than other studies in East Africa. Thus, there is a need for extensive red blood cell screening and matching to minimize alloimmunisation and risk of delayed haemolytic transfusion reaction, particularly in SCD and chronically transfused patients.