title: Blood transfusion practice in a rural hospital in Northern Ghana, Damongo, West Gonja District.
abstract: BACKGROUND
  Blood transfusion in rural sub-Saharan Africa presents special challenges. Transfusions are primarily given for emergencies--life-threatening blood loss or anemia; blood is usually collected from family or replacement donors; and facilities to store an adequate reserve in a hospital bank are constrained. We report the everyday and organizational practices in a medium-sized district hospital in Northern Ghana.
  
  
  METHODS
  Information and data on blood transfusion practices at West Gonja Hospital, Damongo, were available from the laboratory reports, from day books and workbooks, and from direct observation in the following four areas: blood collection and blood donors; blood donation testing; blood storage and logistics; and clinical transfusion practice, adverse events, and follow-up.
  
  
  RESULTS
  The hospital serves a rural community of 86,000. In 2009, a total of 719 units of whole blood were collected, a rate of 8.36 units per 1000 population. All donors were family or replacement donors. Positivity rates for infectious disease markers were 7.5% (64/853) for hepatitis B surface antigen, 6.1% (50/819) for hepatitis C virus, 3.9% (33/846) for human immunodeficiency virus, and 4.7% (22/468) for syphilis. Supply of laboratory materials was sometimes problematic, especially for temperature-critical materials. Difficulties in sample labeling, storage of blood and laboratory supplies, and disposal of waste were also incurred by operational, material, and financial constraints. Follow-up for outcomes of transfusion is not currently feasible.
  
  
  CONCLUSIONS
  The operational, demographic, and financial environment pertaining in a rural hospital in Northern Ghana differs substantially from that in which much of current blood transfusion practice and technology evolved. Considerable effort and innovation will be needed to address successfully the challenges posed.
authors.affiliation: West Gonja Hospital, Damongo, Northern Region, Ghana.
authors.forename: Chrysantus
authors.initials: C
authors.lastname: Kubio
authors.forename: Geraldine
authors.initials: G
authors.lastname: Tierney
authors.forename: Theophilus
authors.initials: T
authors.lastname: Quaye
authors.forename: James Wewoli
authors.initials: JW
authors.lastname: Nabilisi
authors.forename: Callistus
authors.initials: C
authors.lastname: Ziemah
authors.forename: Sr Mary
authors.initials: SM
authors.lastname: Zagbeeb
authors.forename: Sandra
authors.initials: S
authors.lastname: Shaw
authors.forename: William G
authors.initials: WG
authors.lastname: Murphy
mesh_terms: D000328:Adult; D001771:Blood Banks / Q000458:organization & administration* / Q000706:statistics & numerical data; D001782:Blood Donors; D001793:Blood Preservation / Q000379:methods; D058731:Blood Safety; D001803:Blood Transfusion / Q000592:standards / Q000706:statistics & numerical data*; D002648:Child; D003906:Developing Countries; D004865:Equipment and Supplies, Hospital / Q000600:supply & distribution; D005260:Female; D005869:Ghana; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology; D006780:Hospitals, Rural / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control / Q000458:organization & administration / Q000592:standards; D007391:International Cooperation; D007494:Ireland; D008288:Malaria / Q000097:blood / Q000453:epidemiology; D008297:Male; D017744:Medical Waste Disposal / Q000379:methods; D010564:Personnel, Hospital / Q000706:statistics & numerical data; D006473:Postpartum Hemorrhage / Q000628:therapy; D011247:Pregnancy; D012698:Serologic Tests / Q000706:statistics & numerical data; D013587:Syphilis / Q000097:blood / Q000453:epidemiology; D013696:Temperature; D014766:Viremia / Q000453:epidemiology
chemical_list: D017744:Medical Waste Disposal