Gadji Macoura, Cobar Guéda, Thiongane Alioune, Senghor Alioune Badara, Seck Rose, Faye Blaise Félix, Seck Moussa, Guéye Youssou Bamar, Sy Diariétou, Sall Abibatou, Toure Awa Oumar, Diéye Tandakha Ndiaye, Diop Saliou
Service of Haematology and Oncology-Haematology (HBOH) Department of Biology and Applied Pharmaceutical Sciences Faculty of Medicine Pharmacy and Odonto-Stomatology (FMPOS) University Cheikh Anta Diop of Dakar (UCAD) Dakar Senegal.
National Centre of Blood Transfusion (CNTS) Dakar Senegal.
EJHaem. 2023 Feb 9;4(2):315-323. doi: 10.1002/jha2.645. eCollection 2023 May.
Blood transfusion support predisposes transfused children to the risk of erythrocyte alloimmunization in Sub-Saharan Africa. A cohort of 100 children receiving one to five blood transfusions were recruited for screening and identification of irregular antibodies using gel filtration technique. The mean age was 8 years and the sex-ratio at 1.2. The retrieved pathologies were: major sickle cell anaemia (46%), severe malaria (20%), haemolytic anaemia (4%), severe acute malnutrition (6%), acute gastroenteritis (5%), chronic infectious syndrome (12%) and congenital heart disease (7%). The children presented with haemoglobin levels ≤6 g/dl, and 16% of them presented positive irregular antibodies directed against the Rhesus (30.76%) and Kell (69.24%) blood group systems. A literature review shows that irregular antibody screenings vary from 17% to 30% of transfused paediatric patients in Sub-Saharan Africa. These alloantibodies are in particular directed against the Rhesus, Kell, Duffy, Kidd and MNS blood group and generally found in sickle cell disease and malaria. This study highlights the urgent need of extended red blood cell phenotyping including typing for C/c, E/e, K/k, and Fya/Fyb, and if possible Jka/Jkb, M/N, and S/s for children before transfusion in Sub-Saharan Africa.
在撒哈拉以南非洲地区，输血支持使接受输血的儿童面临红细胞同种免疫的风险。招募了100名接受1至5次输血的儿童队列，采用凝胶过滤技术进行不规则抗体的筛查和鉴定。平均年龄为8岁，性别比为1.2。检索到的病症有：重度镰状细胞贫血（46%）、重症疟疾（20%）、溶血性贫血（4%）、重度急性营养不良（6%）、急性肠胃炎（5%）、慢性感染综合征（12%）和先天性心脏病（7%）。这些儿童的血红蛋白水平≤6 g/dl，其中16%的儿童出现针对恒河猴（30.76%）和凯尔（69.24%）血型系统的阳性不规则抗体。文献综述表明，在撒哈拉以南非洲地区，输血的儿科患者中不规则抗体筛查的比例在17%至30%之间。这些同种抗体尤其针对恒河猴、凯尔、达菲、基德和MNS血型，并且通常在镰状细胞病和疟疾中发现。这项研究强调了在撒哈拉以南非洲地区，在儿童输血前迫切需要进行扩展的红细胞表型分析，包括C/c、E/e、K/k和Fya/Fyb分型，以及如果可能的话进行Jka/Jkb、M/N和S/s分型。
