Blood Transfusion Service Challenges and Patterns at Kampala International University Teaching Hospital, Ishaka-Bushenyi, Western Uganda: Insights from a Comprehensive Prospective Study

Abstract

Uganda, a developing East African nation with nearly 20% of its populace living below the poverty line, faces significant constraints in its national blood transfusion service. Despite serving over 3 million individuals in Regional Referral Hospitals, a chronic scarcity of blood persists, impacting critical healthcare provisions, notably at Mulago, Uganda’s National Referral Hospital. This study conducted a meticulous assessment of the indications and influential factors shaping blood transfusion services at Kampala International University Teaching Hospital, Ishaka-Bushenyi, adopting a prospective descriptive cross-sectional design encompassing a 100% review of the target patient population receiving blood transfusions. Employing a pretested questionnaire as the data collection instrument, the gathered information underwent meticulous coding, sorting, entry, and analysis utilizing statistical software. Results were systematically presented through tables and charts. The findings revealed that a considerable proportion (42.3%) of transfused individuals fell within the age range of 20-39 years, with infants and young children (<5 years) comprising 22.4% of the recipients. Males accounted for 58.7% of the transfused population. Predominant indications for blood transfusions included anemia (30.4%), obstetric and gynecological conditions (23.4%), surgical operations (19.0%), infections (14.2%), and incidents involving road traffic accidents or assault (13.0%). The study identified the availability of a blood storage facility as a significant factor motivating the utilization of blood transfusion services, with an 87.4% availability rate reported. Notably, the demand for transfusions was notably high among females (56.1%) compared to males (43.9%), with anemia (53.3%) and blood group O (48.6%) constituting the majority of cases. Blood group distributions varied across different indications, with group O being predominant in most categories. Additionally, the Rh factor played a role, with Rh+ constituting 90.5% of cases and Rh- comprising 9.5%. Blood Group O had the highest occurrence of Rh+, while Blood Group A had the highest occurrence of Rh-. In summary, the study outlined several prominent factors influencing blood transfusion indications at KIUTH, notably anemia, obstetric and gynecological conditions such as postpartum hemorrhage and cesarean sections, surgical procedures (e.g., abdominal obstructions), infections (e.g., malaria), and incidents involving road traffic accidents or assault. These indicators are influenced by factors such as blood availability, age, gender, medical conditions, and blood type, with Blood Group O Rh+ being the most prevalent. Keywords: Blood transfusion, Gynaecology, Anaemia, Blood Group O.