title: Transfusion practice and knowledge in Mozambique.
abstract: BACKGROUND
  In Mozambique, there is a limited supply of blood and elevated risks for transmission of infections. Prior studies have documented that many transfusions in Mozambique are potentially avoidable. Transfusion training workshops with a survey and exam were held for providers to understand their perceptions and to improve knowledge and clinical practice.
  
  
  METHODS
  Health care providers completed a survey and a knowledge assessment. The Wilcoxon signed rank test was utilized to compare the relative importance of each factor in the survey, and pre- and posttraining exam scores were compared using Fisher's exact test.
  
  
  RESULTS
  A total of 216 health care providers participated; the majority worked in a referral hospital (74%) and reported transfusing blood at least once per week (56%). Most acknowledged the limited blood supply and transfusion risks. Providers rated low hemoglobin (Hb) levels and pallor as significantly important indications for transfusion (p < 0.001). They were more likely to transfuse with age under 5 years when compared to other ages (p < 0.01). The three most potentially influential factors for transfusion practice were increased reliability of the blood supply, education about transfusion indications, and assessment of perfusion. Before training, the majority of participants identified an incorrect Hb threshold for preoperative or critically ill patients. Overall exam scores improved from a mean of 58% to 74% (p < 0.001).
  
  
  CONCLUSIONS
  Mozambican providers were knowledgeable about the risks of blood transfusions. Preoperative patients, the critically ill, and children appear to be at highest risk for receiving an avoidable blood transfusion. These results will help guide planning for future provider training.
authors: UCLA Center for World Health, Los Angeles, California.
authors: Emily
authors: E
authors: Hartford
authors: Mozambique Ministry of Health.
authors: Olegario
authors: O
authors: Muanantatha
authors: Hospital Central De Maputo, Universidade Eduardo Mondlane Faculdade De Medicina, Maputo, Mozambique.
authors: Valigy Ismael
authors: VI
authors: Valigy
authors: Hospital Central De Maputo, Universidade Eduardo Mondlane Faculdade De Medicina, Maputo, Mozambique.
authors: Sara
authors: S
authors: Salimo
authors: UCLA Division of Transfusion Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors: Alyssa
authors: A
authors: Ziman
authors: UCLA Center for World Health, Los Angeles, California.
authors: Daniel A
authors: DA
authors: DeUgarte
mesh_terms: D001782:Blood Donors / Q000600:supply & distribution*; D001803:Blood Transfusion / Q000592:standards*; D004502:Education, Medical, Continuing / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D009073:Mozambique; D011795:Surveys and Questionnaires
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