Meza Benjamin P L, Lohrke Britta, Wilkinson Robert, Pitman John P, Shiraishi Ray W, Bock Naomi, Lowrance David W, Kuehnert Matthew J, Mataranyika Mary, Basavaraju Sridhar V
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.
Blood Transfusion Service of Namibia, Windhoek, Namibia.
Blood Transfus. 2014 Jul;12(3):352-61. doi: 10.2450/2013.0143-13. Epub 2013 Nov 15.
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.
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.
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.
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.
急性输血反应在撒哈拉以南非洲地区可能很常见，但输血反应监测系统尚未广泛建立。2008年，纳米比亚输血服务中心实施了全国急性输血反应监测系统，但怀疑存在大量漏报情况。我们估计了纳米比亚温得和克发生的急性输血反应的实际患病率和发生率。
计算导致报告急性输血反应的输血事件百分比。通过查阅温得和克99%以上血液输注来自的六家医院的患者记录，估计每1000个输注单位的急性输血反应实际百分比和发生率。随机选择了2011年1月1日至12月31日期间发生的1162例输血事件的患者记录。提取临床和人口统计学信息，并应用疾病控制和预防中心国家医疗安全网络标准对急性输血反应进行分类。
2011年1月1日至12月31日，选定医院发生了3697例输血事件（涉及10338个血液单位）。监测系统报告了8例（0.2%）急性输血反应。在选定的1162例输血事件中，分析了785例输血事件的病历，检测到28例急性输血反应，其中只有1例也报告给了监测系统。估计温得和克3.4%（95%置信区间[CI]：2.3 - 4.4）的输血事件导致急性输血反应，估计每1000个输注单位中有11.5例（95%CI：7.6 - 14.5）急性输血反应。
急性输血反应的估计实际发生率高于向国家血液监测系统报告的发生率。纳米比亚需要加强监测和干预措施，以降低与输血相关的发病率和死亡率。
