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Sawadogo S, Nebie K, Kima D, Ouedraogo SKA, Nagnon PA, Koulidiati J, Traore C, Sawadogo S, Kafando E, Deneys V. Feasibility and performance of in-house red blood cell reagents to detect unexpected antibodies in immunized patients in Burkina Faso. Immunohematology 2023; 39:172-180. [PMID: 38179780 DOI: 10.2478/immunohematology-2023-025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
In sub-Saharan Africa, antibody detection tests remain inaccessible because of the high cost and limited shelf life of red blood cell (RBC) reagents. This study aimed at investigating the feasibility and performance of locally prepared RBC reagents for antibody detection in Burkina Faso. We conducted an experimental study comparing commercial RBC panels and a local panel prepared from phenotyped blood donors in Ouagadougou, Burkina Faso. Antibody detection testing was performed by the indirect antiglobulin test using a gel card filtration column in a low-ionic-strength solution. Judgment criteria were the concordance rate and the kappa agreement coefficient of results generated by the two panels. A total of 302 blood donors were phenotyped for the major antigens of the RH, KEL, MNS, FY, JK, LE, and P1PK blood group systems. From this pool of donors, we designed an RBC detection panel that was used to screen for unexpected antibodies in 1096 plasma samples from 832 patients with a history of transfusion and 264 recently delivered or pregnant women with no history of blood transfusion. A positive antibody detection test was observed in 8.1 percent of the samples using the local panel versus 6.4 percent with the commercial panels. A total of 23 samples were negative with the commercial panels and positive with the local panel, while the findings were reversed for four samples. The concordance rate was 97.5 percent, and the kappa agreement coefficient was 0.815. Our results suggest that the development of local RBC panels can be an alternative to commercial panels in countries with limited resources. It could also be a cost-effective intervention, mainly for children under 5 years of age, women of childbearing age, and pregnant women, all of whom are most at risk for malaria and sickle cell disease complications. Blood services could develop and implement appropriate strategies to make phenotyped donor pools available for the design of suitable RBC panels.
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Affiliation(s)
- S Sawadogo
- biomedical and pharmaceutical sciences Lecturer/Medical Biologist, Laboratory of Hematology, University Joseph KI-ZERBO, 01 BP 7021 Ouagadougou 01, Ouagadougou, Burkina Faso
| | - K Nebie
- Lecturer/Medical Biologist, Laboratory of Hematology, University Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - D Kima
- immunology and biochemistry, Laboratory of Hematology, University Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - S K A Ouedraogo
- Laboratory of Hematology, University Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - P A Nagnon
- Laboratory of Hematology, University Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - J Koulidiati
- Lecturer/Hematologist, Department of Medicine, University Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - C Traore
- Lecturer/Hematologist, Department of Medicine, University Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - S Sawadogo
- Senior Lecturer/Biological Hematologist, Department of Biological Laboratories, University Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - E Kafando
- biomedical and pharmaceutical sciences, Professor/Medical Biologist, Laboratory of Hematology, University Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - V Deneys
- biomedical and pharmaceutical sciences, Professor/Medical Biologist, Catholic University of Louvain, Brussels, Belgium
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Sawadogo S, Nébié K, Traoré C, Bonzi YJ, Boro M, Yonli D, Yaméogo J, Ouédraogo P, Coulibaly C, Zala J, Deneys V, Kafando E. Prevalence and specificity of red blood cell antibodies in patients transfused in tertiary hospitals in Burkina Faso. Transfus Med 2023. [PMID: 36946030 DOI: 10.1111/tme.12970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 02/03/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Sub-Saharan African countries face the challenge of immunological transfusion safety that puts many patients at risk of post-transfusion hemolytic reactions. This is because pre-transfusion testing for irregular/unexpected antibodies that helps to prevent these risks are neither universally available nor accessible. The aim of our study was to determine the prevalence of red blood cell alloantibodies and their specificity in patients transfused in Burkina Faso. MATERIALS AND METHODS This was a cross-sectional study including patients who had received at least one blood transfusion. Indirect antiglobulin testing using LISS-enhanced medium gel column agglutination technique was used for antibodies screening and identification. Enzymatic technique with papain-treated red cell reagent was performed in attempt to solve some difficulties if necessary as well as auto-control test and RH-KEL phenotyping when possible to help antibodies identification. RESULTS A total of 832 patients were included, 51.6% of whom were female, and the median (IQR) age was 34 (20-49) years. Of these, 43.7% had chronic kidney disease and 20.4% were sickle cell patients. The median (IQR) number of immunisation episodes (blood transfusion and pregnancies) was 3 (2-6) with the median (IQR) number of blood units received per patient of 2 (1-5). The proportion of patients with RBCs antibodies was 6.4% (53/832), with mainly anti-Rh antibodies. A combination of 2 antibodies was found in 7 patients and a combination of 3 antibodies in one patient. Antibodies of unknown specificity (AUS) were encountered in 29%. Independent factors associated with antibody positivity were age (OR = 1.02; p = 0.026), sickle cell disease (OR = 3.23; p = 0.017) and receiving more than 10 blood units (OR = 7.33; p = 0.01). CONCLUSION In this study, the proportion of patients with RBC antibodies was quite similar to that observed in Sub-Saharan African countries. However, the availability and accessibility of pre-transfusion compatibility tests as well as the quality of methods used should be improved to ensure the safety of blood transfusions.
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Affiliation(s)
- Salam Sawadogo
- Haematology Laboratory, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
- Institute of Health and Society, Catholic University of Louvain, Brussels, Belgium
- National Blood Transfusion Center, Ouagadougou, Burkina Faso
| | - Koumpingnin Nébié
- Haematology Laboratory, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
- National Blood Transfusion Center, Ouagadougou, Burkina Faso
| | - Catherine Traoré
- Hematology Department, Teaching Hospital Sanou Sourô, Bobo-Dioulasso, Burkina Faso
| | - Yérémadé Juste Bonzi
- Nephrology and hemodialysis department, Teaching Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso
| | - Mariam Boro
- National Blood Transfusion Center, Ouagadougou, Burkina Faso
| | - Dieudonné Yonli
- National Blood Transfusion Center, Ouagadougou, Burkina Faso
| | - Joseph Yaméogo
- Haematology Laboratory, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Paul Ouédraogo
- Sickle Cell Disease Unit, Saint Camille Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Catherine Coulibaly
- Sickle Cell Disease Unit, Saint Camille Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Jedida Zala
- Sickle Cell Disease Unit, Saint Camille Hospital of Ouagadougou, Ouagadougou, Burkina Faso
| | - Véronique Deneys
- Institute of Health and Society, Catholic University of Louvain, Brussels, Belgium
| | - Eléonore Kafando
- Haematology Laboratory, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
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