Barriers to Effective Transfusion Practices in Limited-Resource Settings: From Infrastructure to Cultural Beliefs.

World Journal of Surgery
Alhassan Datti MohammedAna Maria Crawford

Abstract

Surgery and anesthesia are indivisible parts of health care, but safe and timely care requires more than operating rooms and skilled providers. One vital component of a functional surgical system is reliable blood transfusion. While almost half of all blood is donated in high-income countries (HICs), over eighty percent of the global population lives outside of these countries. High-income countries have on average 30 donations per 1000 people, and the average age of transfusion recipient is over 65. Most low-income countries (LICs) have fewer than five donations per 1000 people, where maternal hemorrhage and childhood anemia are the most common indications for transfusion. In LICs, greater than 50% of blood is administered to children under 5 years of age. This study aims to snapshot, by survey, available resources for transfusion and then discusses the infrastructure and cultural barriers to optimal transfusion practice. In January 2019, a 10-question survey was sent electronically to physician anesthesiologists working in low- and middle-income countries to examine resources and practice patterns for blood transfusion. Subsequent discussions illustrate obstacles contributing to low availability of blood products and illumina...Continue Reading

References

May 28, 2011·The New England Journal of Medicine·Kathryn MaitlandUNKNOWN FEAST Trial Group
Feb 20, 2014·Pakistan Journal of Medical Sciences·Mukhtiar BaigRiyadh G Makki
Mar 21, 2017·Asian Journal of Transfusion Science·John C Aneke, Chide E Okocha
Mar 23, 2017·The Journal of Trauma and Acute Care Surgery·Yann DanielChristophe Martinaud
Apr 28, 2017·British Journal of Haematology·Imelda BatesTonderai Mapako
May 18, 2018·Anesthesia and Analgesia·Evan G PivalizzaBryan A Cotton
Dec 21, 2018·MMWR. Morbidity and Mortality Weekly Report·Udhayashankar KanagasabaiDejana Selenic

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