Project Details

Prevalence, Indications, and Care Integration of Transfused Dependent Pediatric Patients in Primary Centers

Emmanuela Ambrose, MD

Summary

BACKGROUND: Anaemia is common in sub-Saharan Africa, especially among children, and undiagnosed sickle cell anaemia (SCA) can cause recurrent severe anemia. Blood transfusion is a critical, life-saving intervention with limited availability, and recurrent transfusions for undiagnosed SCA not only strain limited blood supplies but also increase the risk of alloimmunization. Identification of severe, acute anemia requiring transfusion is a valuable opportunity to diagnose SCA and link patients to disease-modifying care, so that future transfusion needs are reduced GAP: Indications for pediatric transfusions in sub-Saharan Africa, the burden of undiagnosed SCA, and the impact of a linkage-to-care on transfusion are especially important in areas of high SCA prevalence, but often unknown. HYPOTHESIS: We hypothesize that (1) over 10% of pediatric admissions at district hospitals require transfusions; (2) SCA and malaria will jointly account for ≥60% of transfusions, with SCA alone contributing over 40%; and (3) more than 70% of newly diagnosed SCA patients will attend a follow-up clinic visit post-enrollment in a structured care program. METHODS: Children who attend district hospitals in four districts in northwest Tanzania and require blood transfusion will be screened for SCA and malaria using point-of-care tests and confirmed with lab based testing. SCA patients will be enrolled into a regional follow-up clinic at Bugando Medical Center. RESULTS: Pending. IMPACT: This study may significantly improve early SCA diagnosis, optimize transfusion practices, and enhance pediatric chronic disease management in underserved settings. This work supports chronic disease management and capacity building in Tanzania by strengthening pediatric hematology care and serving as foundational data for broader implementation and future funding efforts.