A malaria control program’s effect on paediatric transfusion

BACKGROUND AND OBJECTIVES: Paediatric malaria is one of the leading causes for blood transfusion in sub-Saharan Africa. Malaria not only causes severe, sometimes life-threatening anaemia, but it leads to the exposure to a blood supply that may result in viral disease transmission. This study determined the frequency of paediatric malaria and transfusion for malaria before and after implementation of a Malaria Control Program in one of Ghana's districts. MATERIALS AND METHODS: Paediatric patients' malaria test results and blood transfusions were reviewed during two time periods: before Malaria Control Program implementation (2003) and after (2009). Results were analysed using descriptive and bivariate statistics. RESULTS: The number of paediatric malaria cases confirmed by laboratory testing declined by 40·7% after implementation of the program. The number of paediatric patients transfused decreased by 12·8% (P<0·005). Of those patients tested for malaria, the frequency of transfusion was lower in 2009 (11·3%) compared to 2003 (24·1%, P<0·005). Gender and age were not associated with altered rates of transfusion. Average haemoglobin was higher in 2009 (10·4±2·0 g/dl) compared to 2003 (8·7±2·1 g/dl, P<0·005). During both periods of study, malaria positive patients who were 0-5 years were more likely to be transfused (47·6% in 2003, 75% in 2009) compared to children 5-9 years (17·3% in 2003, 18·8% in 2009). CONCLUSION: The implementation of malaria control led to fewer paediatric patients with laboratory-confirmed malaria and fewer requiring blood transfusion. Such programs may reduce morbidity and mortality directly, while limiting exposure to blood transfusion.