Analysis of Transfusion Support in Dengue Epidemic in Military Setting of Sri Lanka

Abstract

Background: Severe dengue affects most Asian and Latin American countries and becomes a leading cause of hospitalization and death among children and adults in these regions. During the year 2017, a total of 186,101 suspected dengue cases were reported, and as of May 24, 2018, a total of 19,459 suspected dengue cases were reported to the Ministry of Health of Sri Lanka with over 320 deaths in 2017 and 202 deaths in 2018. The aim of the study was to evaluate whether the blood and component transfusion for the dengue patients and the routine inventory management at our blood bank were affected by the nonfollowed transfusion guidelines in dengue management of Sri Lanka. Methods: This retrospective descriptive study analyzed the distribution of relative frequencies of variables in the requests received and tangible transfusions done from January 1, 2017, to December 31, 2017. Results: A total of 717 transfusion requests received from the confirmed dengue patients in 2017. In this cohort, 73 requests were for dengue fever, 494 requests for dengue hemorrhagic fever (DHF), 97 requests for DHF leaking phase, 46 requests for DHF critical phase, and 7 requests for dengue shock syndrome. Conclusions: Even though 60% of the actual transfusion requests followed the guidelines of the dengue management, 40% (13 requests) violated the guidelines in the actual transfusions. However, compared to the 717, total requests for transfusions this number is very minimal (0.97%). Of 3601 inventories managed at blood bank during 2017, additional dengue-related 717 requests, less than 1% violated the guidelines of transfusion requests according to the current guidelines of dengue management. No extra burden was created to inventory management due to nonfollowed guidelines. An unusual preponderance of transfusion requirements of AB patients was highlighted. Comparing the published data, dengue management at our hospital is exemplary.