Alain M Ngoma1, Paulin B Mutombo2, Kazuhiko Ikeda3, Kenneth E Nollet4, Bernard Natukunda5, Hitoshi Ohto6. 1. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada. Electronic address: alain.ngoma@mail.mcgill.ca. 2. School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo. 3. Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan; Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan. 4. Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan; Radiation Medical Science Center, Fukushima Medical University, Fukushima, Japan. 5. Department of Hematology and Transfusion Medicine, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda. 6. Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan.
Abstract
BACKGROUND AND OBJECTIVES: Previous studies of Sub-Saharan Africans show significant alloimmunization to red blood cell (RBC) antigens, but country-specific data are limited. Thus, the aim of this study was to estimate, by meta-analysis, the overall proportion of red blood cell alloantibodies among transfused patients. METHODS: We systematically searched Medline, Embase, and the Africa-Wide Information database to identify relevant studies in any language. Case reports, comments, letters, conference abstracts, editorials, and review articles were excluded. Of the 269 potentially relevant articles, 11 studies fulfilled our selection criteria. RESULTS: Overall proportions of alloimmunization were 6.7 (95% CI: 5.7, 7.8) per 100 transfused patients. With regard to antibody specificity, among clinically significant antibodies, anti-E ranked as the most common, followed by anti-K, anti-C and anti-D. CONCLUSION: Meta-analysis of available literature quantifies and qualifies the clinical challenge of RBC alloimmunization among transfused patients in Sub-Saharan Africa. These results should drive policy decisions in favour of routine testing of RBC antigens and irregular antibodies for transfused patients as a standard of care throughout Sub-Saharan Africa.
BACKGROUND AND OBJECTIVES: Previous studies of Sub-Saharan Africans show significant alloimmunization to red blood cell (RBC) antigens, but country-specific data are limited. Thus, the aim of this study was to estimate, by meta-analysis, the overall proportion of red blood cell alloantibodies among transfused patients. METHODS: We systematically searched Medline, Embase, and the Africa-Wide Information database to identify relevant studies in any language. Case reports, comments, letters, conference abstracts, editorials, and review articles were excluded. Of the 269 potentially relevant articles, 11 studies fulfilled our selection criteria. RESULTS: Overall proportions of alloimmunization were 6.7 (95% CI: 5.7, 7.8) per 100 transfused patients. With regard to antibody specificity, among clinically significant antibodies, anti-E ranked as the most common, followed by anti-K, anti-C and anti-D. CONCLUSION: Meta-analysis of available literature quantifies and qualifies the clinical challenge of RBC alloimmunization among transfused patients in Sub-Saharan Africa. These results should drive policy decisions in favour of routine testing of RBC antigens and irregular antibodies for transfused patients as a standard of care throughout Sub-Saharan Africa.
Authors: B F Faye; D Sow; M Seck; N Dieng; S A Toure; M Gadji; A B Senghor; Y B Gueye; D Sy; A Sall; T N Dieye; A O Toure; S Diop Journal: Adv Hematol Date: 2017-05-11