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 Table of Contents  
SHORT COMMUNICATION
Year : 2016  |  Volume : 1  |  Issue : 2  |  Page : 75-77

Daycare transfusion service: Two-year experience in a daycare transfusion unit of a licensed private blood transfusion center in Dhaka City of Bangladesh


Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

Date of Web Publication6-Sep-2016

Correspondence Address:
Md. Ashadul Islam
Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka
Bangladesh
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2455-8893.189850

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  Abstract 


Background: Establishment of daycare blood transfusion service in a licensed blood transfusion center of Dhaka city for patients needed blood transfusion is a milestone for improving blood service of Bangladesh.
Aim: The aim of this study is to assess the daycare blood transfusion service of a licensed blood transfusion center in Dhaka city and evaluation of patients receiving blood transfusion and to determine the pattern of blood groups of the patients.
Materials and Methods: This cross-sectional study was done in a licensed blood transfusion center in Dhaka city. The study reveals that 383 patients of various modalities of ailments had their blood transfusion from August 2012 to January 2014. The patient age, sex, diagnosis, and levels of hemoglobin were taken into consideration. The patterns of their blood groups were determined for the study.
Results: This cross-sectional study revealed that among 383 patients, 148 were male and 235 were female. With the age range of 14–80 years, mean age was 53.9 ± 2.77 years. Among them, most (148) were in the age range of 55–64 years. Among the patients, 47.00% (180) were suffering from anemia according to severe, moderate, and mild anemia with various diseases. Out of 383 patients, 31.33% (120) were suffering from carcinomas. Among those carcinomas, breast, colon, lung, larynx, tongue, stomach, and esophagus carcinoma and cholangiocarcinoma were prevalent. Others such as chronic kidney disease and leukemia 7.31% (28) were next to take transfusion. Maximum of them, i.e. 235 (61.36%), were in the hemoglobin range of 5.81–7.80 g/dl range and 60 (15.67%) had their hemoglobin level at 3.81–5.80 g/dl range. Out of them, 160 were of A group, 106 were B group, 88 were O group, and 29 were AB group.
Conclusion: Although daycare transfusion centers are very few in licensed blood transfusion centers, the need for daycare transfusion is increasing gradually. We recommend establishing more daycare transfusion services for the transfusion needed patients.

Keywords: Daycare, outcome, private blood bank


How to cite this article:
Islam M, Quader M, Islam KA, Khatun A, Biswas J. Daycare transfusion service: Two-year experience in a daycare transfusion unit of a licensed private blood transfusion center in Dhaka City of Bangladesh. Glob J Transfus Med 2016;1:75-7

How to cite this URL:
Islam M, Quader M, Islam KA, Khatun A, Biswas J. Daycare transfusion service: Two-year experience in a daycare transfusion unit of a licensed private blood transfusion center in Dhaka City of Bangladesh. Glob J Transfus Med [serial online] 2016 [cited 2022 May 26];1:75-7. Available from: https://www.gjtmonline.com/text.asp?2016/1/2/75/189850




  Introduction Top


Blood transfusion is one of the important services of health care delivery system for critical patients who require blood for life-saving purpose. Blood transfusion service in Bangladesh started in 1950 in Dhaka Medical College Hospitals. Later, the service expanded to other medical college hospitals as well as started in the Institute of Post Graduate Medicine and Research (IPGM and R) on October 8, 1972. There was no daycare transfusion service in any of the blood transfusion centers of Bangladesh till 1990. In early 1990, the authorities of the IPGM and R, Dhaka, Bangladesh, established the Daycare Transfusion Unit within the Department of Blood Transfusion aiming to provide transfusion therapy to patients who are waiting for long period in hospital beds and desperately need one or two units of blood transfusion for their treatment.[1] Here, a patient does not require admission to the hospital rather receive blood and blood products as an outdoor patient. Transfusion of one unit of blood or blood product requires at best 3 or 4 h.[2]

The government started National Safe Blood Transfusion Programme (SBTP) for restructuring of blood transfusion services in 2000 with programmatic approach for introduction of mandatory blood screening for five transfusion transmissible infections (human immunodeficiency virus/acquired immune deficiency syndrome, hepatitis B virus, hepatitis C virus, syphilis, and malaria). For supply of safe blood and blood products, expansion of blood transfusion centers as well as capacity development is ongoing in government and private sectors. This makes blood transfusion affordable and accessible to all. National SBTP is supported through an act of parliament, “Safe Blood Transfusion Act of 2002.” The enforcement of this Law started from August 1, 2004 and rules developed in 2004 and Statutory Regulatory Order issued on June 17, 2008. Government also approved and published a National Blood Policy in 2013. As per the Safe Blood Transfusion Act, the Safe Blood Transfusion Rules, and the National Blood Policy, all government and licensed blood transfusion centers have to establish outpatient department and daycare transfusion service. As a part of this, there are some licensed blood transfusion centers running daycare transfusion services in Dhaka city.[3]

Blood transfusion services are undergoing a period of significant changes as a result of National Blood Policy. Government hospital based transfusion services and licensed private blood transfusion centers along with Thalassemia Foundation, Haemophilia Foundation, and Ashik Foundation are meeting transfusion needs. One licensed private blood transfusion center is providing daycare transfusion service and is governed by some eminent transfusion specialists. Daycare transfusion centers play the most vital role of providing blood transfusions and monitoring children suffering from thalassemia major. Children who are registered with daycare centers expect to receive comprehensive treatment in a systemic manner.[4] In such centers, they will not have to go through the procedure of getting admitted to the hospital and waiting for blood units to be made available.

The objective of this study was to assess and evaluate the disease modalities of patients that required blood transfusion in a private blood transfusion center.


  Materials and Methods Top


For this retrospective, cross-sectional study, one licensed private blood transfusion center running with daycare transfusion service in Dhaka city was selected. This study was conducted from August 10, 2012, to January 9, 2014. Registration books of the patients were scrutinized and essential parts of the data were collected. This includes age, sex, diagnosis, hemoglobin level and blood group of the patients which were analyzed. ABO blood grouping of the patient or blood recipients were determined by the standard method with autocontrol.

Various disease modalities which caused the patients to take transfusion and their hemoglobin level which compelled them to take transfusion were considered. Transfusion therapy of each patient was carefully monitored by clinical doctor working in the daycare transfusion service. Every patient was briefed after each transfusion session and supplied with a future transfusion regimen and follow-up schedule.

Data were entered into the spreadsheet. Simple descriptive statistics were expressed as mean ± standard deviation, and qualitative data were expressed as percentage.


  Results Top


In total, 383 patients who needed blood transfusions in the daycare center from August 2012 to January 2014 were analyzed. Among them, 148 were male and 235 were female patients.

The age range of the patients was from 14 years to 80 years, with a mean age of 53.9 (±2.77) years.

All the patients needed blood transfusion and suffered from various diseases. Most of them, i.e., 180 (47.00%), suffered from anemia of various types (severe, moderate, mild). Totally, 120 (31.33%) patients suffered from carcinomas of various kinds. These included carcinoma of breast, colon, lung, larynx, tongue, stomach, and esophagus and cholangiocarcinoma with intracranial metastasis. Patients suffering from chronic kidney disease 28 (7.31%) and leukemia 28 (7.31%), cardiovascular disease 14 (3.66%), systemic lupus erythematosus 9 (2.35%), bone fracture 4 (1.04%) accounted for the remaining cases.

Hemoglobin level considered for transfusion shows that maximum patients (235, 61.36%) had the range of 5.81–7.80 g/dl. Hemoglobin ranged from 3.81 to 5.80 g/dl in 60 (15.67%) patients who were transfused. Sixty-nine (18.01%) patients were in the 7.81–9.80 g/dl range, who needed blood.


  Discussion Top


Daycare transfusion centers set up for those patients who require blood transfusion regularly for their treatment purpose.

The thalassemia patients and other patients suffering from aplastic anemia, hemophilia, leukemia, hematological diseases, or disorders need repeated transfusion of blood and blood products at regular intervals. Our study is based mainly on reviewing clinical records and analyzing the practical management of those patients with blood and blood components.

One study on daycare blood transfusion by Kashem et al.[5] at IPGM and R, Dhaka, showed that out of 104 patients getting transfusion, 76 were ß thalassemia hemoglobin E and 13 were aplastic anemia. There were six leukemia patients also. In this study, majority of the patients were of anemia of various types (180, 47.00%) and carcinoma of different categories (120, 31.33%).

As thalassemia is an early childhood disease, so the age limit was 1–20 years of the study done by Kashem et al.[5] However, in this present study, the age limit was 14–80 years with mean age of 53.9 (±2.77) years. The variation may be due to difference of disease modality.

The study done by Shil et al.[2] also provided blood transfusion in different clinical conditions of patients in their daycare facility.

In our country, due to an adverse economic and social background, it is not possible to provide complete management facilities for such large numbers of patients as in case of developed countries. A long-term community-oriented program would be desirable at national levels for setting up more daycare transfusion unit where necessary. This will provide them with adequate facilities for regular transfusion therapy. This is essential for patients suffering from those debilitating disease require transfusion therapy to attend the daycare transfusion centers at regular interval and reduce complication with transfusion therapy when necessary. A combined effort from government and philanthropic organization is required to set up more daycare transfusion centers both in government and licensed private blood transfusion centers in different parts of the country to provide comprehensive therapy. In addition, international involvement can certainly complement and accelerate the national initiatives.


  Conclusion Top


Daycare transfusion service facility is very few in the private sector in our country. The study was done in one private daycare blood transfusion service. Hence, we recommend establishing more daycare facility both in public and private blood transfusion centers to help and build hope for those distressed patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Haque KM, Kobir KM, Sultan M. Current management situation of transfusion dependent thalassemia patients in Bangladesh: Experience of a day care transfusion unit. Transfus Today 1995;23:1015-6.  Back to cited text no. 1
    
2.
Shill N, Biswas J, Islam A, Khatun A. Day care transfusion therapy-one year experiences in a day care transfusion unit of transfusion medicine department in a tertiary care hospital. Bangladesh J Med 2005;16:83-6.  Back to cited text no. 2
    
3.
Safe Blood Transfusion Programme, Director General of Health Services (DGHS), MoH and FW. Dhaka, Bangladesh; 2008.  Back to cited text no. 3
    
4.
Calvo CL, Sherrick B. Orientation to the modern blood bank laboratory. In: Harmening DM, editor. Modern Blood Banking and Transfusion Practice. India: Jaypee Brothers; 2008. p. 283-92.  Back to cited text no. 4
    
5.
Kashem MA, Huda KM, Islam MA. Disease pattern of blood recipient in a day care transfusion centre – A prospective study in a day care transfusion centre of blood transfusion department of BSMMU, Dhaka, Bangladesh. Sir Salimullah Med Coll J 2000;8:83-5.  Back to cited text no. 5
    




 

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Introduction
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