The microbiologic safety of umbilical cord blood transfusion for children with severe anemia in Mombasa, Kenya.

Hassall, Oliver, Thitiri, Johnstone, Fegan, Greg, Pole, Lewa, Mwarumba, Salim, Denje, Douglas, Wambua, Kongo, Lowe, Brett, Parry, Christopher M, Mandaliya, Kishor, Maitland, Kathryn and Bates, Imelda ORCID: https://orcid.org/0000-0002-0862-8199 (2012) 'The microbiologic safety of umbilical cord blood transfusion for children with severe anemia in Mombasa, Kenya.'. Transfusion, Vol 52, Issue 7, pp. 1542-51.

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Abstract

BACKGROUND
Severe anemia requiring blood transfusion is common in hospitalized young children in sub-Saharan Africa but blood is often in short supply. Umbilical cord blood may be a useful source of blood if microbiologic safety concerns can be addressed.
STUDY DESIGN AND METHODS
Cord blood, donated on the labor ward at the provincial hospital in Mombasa, was cultured soon after collection (screening culture) and after a period of storage (poststorage culture). Conventional blood transfused to children at the hospital was cultured only at the time of issue (poststorage culture). Maternal sera (cord blood) and conventional blood donations were also screened for transfusion-transmitted infection.
RESULTS
At poststorage culture, the overall contamination rate of cord blood was one-third that of conventional blood (13/449 vs. 38/434; odds ratio [OR], 0.31; 95% confidence interval [CI], 0.15-0.61) and for bacteria of high pathogenic potential it was half that of conventional blood (4/449 vs. 7/434; OR, 0.55; 95% CI, 0.12-2.18). Screening cultures were positive in 50% (2/4) of cord blood packs where an organism of high pathogenic potential was isolated at poststorage culture. Cord blood donors had a lower seroreactivity than conventional donors for human immunodeficiency virus (OR, 0.63; 95% CI, 0.29-1.18), hepatitis B virus (OR, 0.32; 95% CI, 0.16-0.59), and hepatitis C virus (OR, 0.20; 95% CI, 0.24-0.76). For syphilis, initial seroreactivity in cord blood donors was 3.8% compared to 1.8% in conventional blood donors (OR, 2.10; 95% CI, 1.15-3.60) but was 0.5% after retesting.
CONCLUSION
With respect to bacterial contamination and seroreactivity for transfusion-transmitted infection, the safety of cord blood in Mombasa compares favorably with conventional blood. Clinical trials of cord blood transfusion are justified.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WB Practice of Medicine > Therapeutics > WB 356 Blood transfusion WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WC Communicable Diseases > Tropical and Parasitic Diseases > WC 770 Therapy WS Pediatrics > Diseases of Children and Adolescents > By System > WS 300 Hemic and lymphatic system WS Pediatrics > By Age Groups > WS 430 Infancy WS Pediatrics > By Age Groups > WS 440 Preschool child
Faculty: Department:	Groups (2002 - 2012) > International Health Group
Digital Object Identifer (DOI):	https://doi.org/10.1111/j.1537-2995.2011.03487.x
Depositing User:	Rachel Dominguez
Date Deposited:	08 Apr 2013 10:26
Last Modified:	22 Oct 2019 08:22
URI:	https://archive.lstmed.ac.uk/id/eprint/3346

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