title: Estimation of the prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia.
abstract: BACKGROUND
  Acute transfusion reactions are probably common in sub-Saharan Africa, but transfusion reaction surveillance systems have not been widely established. In 2008, the Blood Transfusion Service of Namibia implemented a national acute transfusion reaction surveillance system, but substantial under-reporting was suspected. We estimated the actual prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia.
  
  
  METHODS
  The percentage of transfusion events resulting in a reported acute transfusion reaction was calculated. Actual percentage and rates of acute transfusion reactions per 1,000 transfused units were estimated by reviewing patients' records from six hospitals, which transfuse >99% of all blood in Windhoek. Patients' records for 1,162 transfusion events occurring between 1(st) January - 31(st) December 2011 were randomly selected. Clinical and demographic information were abstracted and Centers for Disease Control and Prevention National Healthcare Safety Network criteria were applied to categorize acute transfusion reactions.
  
  
  RESULTS
  From January 1 - December 31, 2011, there were 3,697 transfusion events (involving 10,338 blood units) in the selected hospitals. Eight (0.2%) acute transfusion reactions were reported to the surveillance system. Of the 1,162 transfusion events selected, medical records for 785 transfusion events were analysed, and 28 acute transfusion reactions were detected, of which only one had also been reported to the surveillance system. An estimated 3.4% (95% confidence interval [CI]: 2.3-4.4) of transfusion events in Windhoek resulted in an acute transfusion reaction, with an estimated rate of 11.5 (95% CI: 7.6-14.5) acute transfusion reactions per 1,000 transfused units.
  
  
  CONCLUSIONS
  The estimated actual rate of acute transfusion reactions is higher than the rate reported to the national haemovigilance system. Improved surveillance and interventions to reduce transfusion-related morbidity and mortality are required in Namibia.
authors: HIV Prevention Branch, Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States of America The CDC Experience Applied Epidemiology Fellowship, Scientific Education and Professional Development Program Office, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
authors: Benjamin P L
authors: BP
authors: Meza
authors: Blood Transfusion Service of Namibia, Windhoek, Namibia.
authors: Britta
authors: B
authors: Lohrke
authors: Blood Transfusion Service of Namibia, Windhoek, Namibia.
authors: Robert
authors: R
authors: Wilkinson
authors: Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Windhoek, Namibia.
authors: John P
authors: JP
authors: Pitman
authors: Epidemiology and Strategic Information Branch, Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
authors: Ray W
authors: RW
authors: Shiraishi
authors: HIV Prevention Branch, Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
authors: Naomi
authors: N
authors: Bock
authors: Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Windhoek, Namibia.
authors: David W
authors: DW
authors: Lowrance
authors: Office of Blood, Organ, and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
authors: Matthew J
authors: MJ
authors: Kuehnert
authors: Namibia Ministry of Health and Social Services, Directorate for Clinical Support Services, Windhoek, Namibia.
authors: Mary
authors: M
authors: Mataranyika
authors: HIV Prevention Branch, Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
authors: Sridhar V
authors: SV
authors: Basavaraju
mesh_terms: D000293:Adolescent; D000328:Adult; D058731:Blood Safety; D001803:Blood Transfusion / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008297:Male; D008499:Medical Records; D009276:Namibia / Q000453:epidemiology; D015995:Prevalence