Blood and blood products usage in Maputo.

We studied retrospectively a sample of 521 order forms for blood and blood products transfusion, among the 25,845 requests sent to the Maputo Central Hospital's Blood Bank., from March 1992 to February 1993. The Paediatrics Department ordered nearly half (47.2 pc); Surgery ranked second (16.9 pc), followed by Gynaecology-Obstetrics (1604 pc) and the Intensive Care Unit (15.7 pc). Medicine issued only 3.8 pc of the orders. Children under five years old were the target of most (43.3 pc) orders; among them 71.1 pc were under three years old. The volumes ordered most often were 500 ml (25 pc) and 1,000 ml (18.3 pc). Fifty seven pc of orders were for packed blood cells, followed by whole blood (34.7 pc). Orders for fresh frozen plasma accounted for only 6.9 pc. Anaemia was the diagnosis mentioned most often (59.3 pc). In 27.1 pc of orders for anaemia, malaria was the specific cause. Haemoglobin values of transfusions' recipients ranged between 1 and 14.7 g/dL. Most (72.9 pc) were below 6 g/dL. Orders for use during the perioperative period accounted for 22.8 pc. On the basis of our results, we suggest that the Surgery and Gynaecology-Obstetrics Departments should review their policies on haemotherapy, particularly for the peri-operative method. We also suggest creation of a transfusion advisory committee, to establish guidelines and implementation mechanisms for the rational use of blood. Combined with continuous education of blood therapy prescribers, this may lead to a reduction of unnecessary transfusions and to the subsequent reduction of blood-borne disease transmission in Maputo.