Abstract
The ABO and Rhesus blood group systems are the most clinically relevant blood group systems from haemolytic disease of the foetus and newborn (HDFN) and haemolytic transfusion reaction (HTR) perspectives. Other clinically relevant blood group systems include the Kell, Duffy, Kidd and MNSs blood group systems. The clinical relevance of a blood group system depends on the ability of antibodies of the system to cause HDFN and HTR. This chapter discusses the distribution of ABO, Rhesus and other clinically relevant red cell antigens among Nigerians and implications for HDFN and HTR. There are several challenges associated with the management of Rhesus negative pregnancies, pregnancies associated with clinically significant alloantibodies, implementation of policy on routine antenatal anti-D prophylaxis (RAADP), management of Rhesus negative women that require termination of pregnancy (TOP), provision of antigen negative blood for certain patient groups and the management of pregnant and non-pregnant patients with clinically significant alloantibodies. This chapter highlights the need for Nigeria and other African countries to implement best practices to optimize the care offered to pregnant women as well as patients in whom red cell transfusion is indicated.
Highlights
1.1 History of NigeriaNigeria often referred to the giant of Africa is the largest Black nation in Africa
Management of Rhesus D negative pregnancies and pregnancies associated with clinically significant alloantibody is suboptimal
This failure in stewardship by the Nigerian government has a significant implication for Haemolytic Disease of the Foetus and Newborn and haemolytic transfusion reaction
Summary
Nigeria often referred to the giant of Africa is the largest Black nation in Africa It is a country located in West Africa bordered by Cameroon in the East, Benin Republic in the West, Niger Republic to the North and Chad Republic to the North East. The Nigerian health care system is continuously faced with a number of challenges; shortage of healthcare workers [2] predominantly due to significant emigration of skilled medical personnel to developed economies of the world (brain drain), suboptimal funding, decaying infrastructure, inter-professional conflict, perennial strike actions by healthcare professionals, lack of political will as well as bureaucratic bottlenecks in public health care delivery in Nigeria [3]. Nigeria is a party to the United Nation (UN) General Assembly adopted 2030 agenda for Sustainable Development and the UN High-Level Meeting (UN HLM) Universal Health Coverage (UHC) UHC2030. There is general expectation among Nigerians for the government to mix word with action by ensuring that all Nigerians in both rural and urban communities have access and can use the promotive, preventive, curative, rehabilitative and palliative health services they require, that is of sufficient quality and affordable [6]
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