Effectiveness of blood transfusions and risk factors for mortality in children aged from 1 month to 4 years at the Bon Marché Hospital, Bunia, Democratic Republic of the Congo.
OBJECTIVE
To assess the effectiveness of blood transfusions in a hospital of north-eastern Democratic Republic of the Congo.


METHODS
Prospective study of children admitted for severe anaemia. During admission, data were collected on clinical condition and haemoglobin levels, before and after blood transfusion. A linear regression model was built to explore factors associated with haemoglobin level after transfusion. Risk factors for mortality were explored through multivariate logistic regression.


RESULTS
Haemoglobin level (Hb) was below 4 g/dl in 35% (230/657), between 4 and 6 g/dl in 58% (348/657) and at least 6 g/dl in another 6% (43/657) of the transfused children. A transfusion of 15 ml/kg of whole blood increased the Hb from 4.4 to 7.8 g/dl. Haemoglobin level after transfusion was associated with baseline Hb, quantity of delivered blood and history of previous transfusions. Overall case-fatality rate was 5.6% (37/657). Risk factors for deaths were co-morbidities such as chest infection, meningitis or malnutrition, Hb ≥ 6 g/dl, impaired consciousness or jugular venous distention on admission, and provenance.


CONCLUSIONS
Transfusion was a frequent practice, the use of which could clearly have been rationalised. While indications should be restricted, quantities of transfused blood should be adapted to needs.
Epicentre, Paris, France  Médecins Sans Frontières, Geneva, Switzerland  National Program for Blood Transfusion, Bunia, Democratic Republic of the Congo.
Yolanda
Y
Mueller
Mathieu
M
Bastard
Geneviève
G
Ehounou
Jeff
J
Itama
Michel
M
Quéré
Roberto
R
de la Tour
Louis
L
Vala
Jean-François
JF
Etard
Marie-Claude
MC
Bottineau
D000740:Anemia / Q000401:mortality* / Q000628:therapy*; D001803:Blood Transfusion; D002675:Child, Preschool; D015897:Comorbidity; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D065227:Transfusion Reaction
D006454:Hemoglobins