Original Research

Prevalence and risk factors for red blood cell alloimmunisation among sickle cell patients in Mwanza City, Tanzania

Erius Tebuka, Mwesige Charles, Jeffer O. Bhuko
African Journal of Laboratory Medicine | Vol 9, No 1 | a823 | DOI: https://doi.org/10.4102/ajlm.v9i1.823 | © 2020 Erius Tebuka, Mwesige Charles, Jeffer O. Bhuko | This work is licensed under Other
Submitted: 01 May 2018 | Published: 10 September 2020

About the author(s)

Erius Tebuka, Department of Pathology, Weill Bugando School of Medicine, Mwanza, United Republic of Tanzania; and, Bugando Medical Centre, Mwanza, Tanzania, United Republic of
Mwesige Charles, Central Pathology Laboratory, Bugando Medical Centre, Department of Hematology, Mwanza, Tanzania, United Republic of
Jeffer O. Bhuko, Department of Pathology, Weill Bugando School of Medicine, Mwanza, United Republic of Tanzania; and, Bugando Medical Centre, Mwanza, United Republic of Tanzania; and, Mwanza Region Health Center, Mwanza, Tanzania, United Republic of

Abstract

Background: Erythrocyte alloimmunisation can lead to complications such as delayed haemolytic transfusion reaction.

Objective: This study investigated the prevalence of and risk factors for red blood cell alloimmunisation among multiply transfused sickle cell disease (SCD) patients in Mwanza City, Tanzania.

Methods: From May 2017 to July 2017, this descriptive, cross-sectional, hospital-based study enrolled 200 participants with SCD who had received at least two units of blood in the previous year. Blood count was performed using a Sysmex haematology analyser. Antibody screening was done by the tube method using a panel of three screening cells with known antigenicity.

Results: Of the 200 patients enrolled, 108 (54%) were female. The median age was 4.5 years (interquartile range [IQR] = 6), the median number of transfusions was 3 (IQR = 1), and the median pre-transfusion haemoglobin level was 6.6 g/dl (IQR = 2.7). Prevalence of alloimmunisation was 8.5% (17/200) with immunoglobulin G, and one patient developed cold immunoglobulin M antibodies. Blood groups reported were Rhesus C and E, Kell, Kidd and Duffy. There was no statistically significant association between the number of transfusions and the risk of alloimmunisation.

Conclusion: The rate of alloimmunisation in multiply transfused SCD patients was 8.5% and higher than other studies in East Africa. Thus, there is a need for extensive red blood cell screening and matching to minimize alloimmunisation and risk of delayed haemolytic transfusion reaction, particularly in SCD and chronically transfused patients.


Keywords

sickle cell disease; alloimmunisation; alloantibody; screening cells; Bugando Medical Centre; Catholic University of Health and Allied Sciences; red blood cells

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