Management of Anaemia: An Advocacy for the Integration of Bloodless Medicine and Surgery Program (BLMS) into the Health Care System of Sub-Saharan African Countries

Authors

  • Friday Wokoma Nephrology Unit, Department of Internal Medicine, University of Port Harcourt Teaching Hospital

DOI:

https://doi.org/10.60787/tnhj.v9i1%20-%204.20

Keywords:

Anaemia, Blood transfusion, Bloodless medicine &surgery, sub-Saharan Africa

Abstract

 

Background: The prevailing high sero- prevalence of the human immuno deficiency virus (HIV) and hepatitis B and C viral infections in the sub-Saharan African populations such as Nigeria, has further increased the risks associated with allogenic blood transfusion. It has also made the availability of free blood for transfusion to needy patients increasingly difficult in recent times in these populations. It has thus become imperative for clinicians to begin to adopt less blood dependent approaches in the care of anaemic patients. This review article introduces the subject of the principles and practice of bloodless medicine and surgery (BLMS) with a view to advocating its adoption and integration into the health care programs of sub-Saharan African countries such as Nigeria.

Methods: The literature base for this article was obtained through relevant manual and on-line search using Medline, goggle and other resources.

Results: Bloodless medicine and surgery (BLMS) program is currently being practiced in major hospitals in North America, Europe and other parts of the developed world. BLMS was primarily developed to cater for the needs of the Jehovah's witness(JW) religious group whose religion forbid the use of blood as a means of therapy. It is now of universal application. Virtually all medical and surgical procedures including organ transplants, open heart surgeries etc, are undertaken under the BLMS programs with outcomes as good as blood based therapies. BLMS has the potential of reducing the demand for allogenic blood transfusions, reduce morbidity and mortality associated with blood transfusions as well as reduce costs of prolonged hospitalization due to delayed surgical procedures on account of unavailability of blood.

Conclusions: The development and the integration of the BLMS program into the medical care services of resource poor, HIV/AIDS and hepatitis virus endemic sub-Saharan African countries will contribute significantly in reducing the demand for blood which is scarce, reduce the rate of irrational blood transfusions, reduce the transfusion acquired HIV/AIDS and viral hepatitis infections, as well as reduce the incidence of other transfusion related morbidities.

Downloads

Download data is not yet available.

Author Biography

Friday Wokoma, Nephrology Unit, Department of Internal Medicine, University of Port Harcourt Teaching Hospital

Senior Lecturer and Consultant Nephrologist

References

Robert M, deCastor MD. Bloodless surgery: Establishment of a program for the special medical needs of the Jehovah Witness society community- the Gynaecologic surgical experience at a community hospital. Amer J Obstr Gynaecol 1999; 180 (6): 1491-1498.

Vercillo AP, Susan V, Duprey JD. Jehovah's Witness and the transfusion of blood and blood products. N Y State J Med 1998;493-494.

Fleming AF. HIV and blood Transfusion in sub-Saharan Africa. Transfusion Science 1997;18:167-169.

Ejele OA, Nwauche CA, Erhabor O. Sero-prevalence ofHIV infection among blood donors in Port Harcourt, Nigeria. Niger J Med 2005; 14:287-289.

Hackensack University Medical Center. Administrative policy manual for the bloodless medicine and surgery programme. Policy number 1503, October 1997;1-19.

Royal College of Surgeons England. Code of practice for surgical management of Jehovah witness members. London :Royal college of Surgeons, England, 1966.

Lamptey P, Wigley M, Carr D, Collymore Y. Facing the HIV/AIDS pandemic. Population Bulletin 2002;57(3):3-37.

Joint United Nation program on HIV/AIDS(UNIAIDS). Report on global HIV/AIDS epidemic-July 2002.

Martins L, Smith STD. Ethical perspectives on Jehovah witness refusal of blood. Cleveland Clinic Journ Med 1997;64(9):475-481.

Dixon JL. Blood: whose choice and whose conscience? N Y State J Med 1988; 88(9):463-465.

Goldberg MA. Peri-operative epoeitin-alfa increases red blood cell mass and reduces exposure to transfusion: results of randomised clinical trials. Semin Haematol 1997; 37(3suppl.12):41-47.

Hutchinson AB, Fergusson D, Graham ID, Laupacis A, Herrin J, Hiller,CD. Utilization of technologies to reduce allogeneic blood transfusion in the United States. Transfus. Med 2001; 279-285.

Henry DA, O'Connell Dl. Effects of fibrinolytic inhibitors on mortality from upper gastrointestinal haemorrhage. BMJ 1989; 298:1142-1146.

.Semkiw LB, Schuman DJ, Goodman SB, Woolson ST. Post-operative blood salvage using cell-saver after total joint arthroplasty. J Bone Joint Surg Am 1989; 71:823-827.

Ward WF. The development of a hospital based bloodless surgery protocol. Erythropoeisis: new dimensions in the treatment of anaemia 1998; 8:102-111.

Trouwborst A, Hagenouw RR, Jeekel J. Ong GL. Hypervolaemic haemodilution in an anaemic Jehovah's Witness. Br. J Anaesth 1990; 64:646-648.

Stowell CP, Levin J, Spiess BD, Winslow RM. Progress in the development of RBC substitutes. Transfusion 2001;41:287-299.

Modig J. Regional anaesthesia and blood loss. Acta Anaesthesiol Scand 1988; 89(suppl 3):44-48.

Sollevi A. Hypotensive anaesthesia and blood loss. Acta Anaesthesiol Scand 1988; 89(suppl.32):39-43.

Family Health International (FHI) Laboratory testing in HIV. In: HIV/AIDS CARE AND TREATMENT: A clinical course for people caring for people living with HIV/AIDS.2003:51-58

Rosencrantz D, Shander A, Spence RK. Establishing a bloodless Medicine and Surgery Centre. Problems in General surgery2000; 17(1):71-76.

Downloads

Published

2015-11-29

How to Cite

Wokoma, F. (2015). Management of Anaemia: An Advocacy for the Integration of Bloodless Medicine and Surgery Program (BLMS) into the Health Care System of Sub-Saharan African Countries. The Nigerian Health Journal, 9(1 - 4), 1. https://doi.org/10.60787/tnhj.v9i1 - 4.20
Abtract Views | PDF Download | EPUB Download: 806 / 56

Similar Articles

<< < 6 7 8 9 10 11 12 13 14 15 > >> 

You may also start an advanced similarity search for this article.