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RÉSUMÉ
Introduction. L'anémie sévère constitue un défi thérapeutique majeur en pédiatrie en Afrique subsaharienne, représentant la première indication transfusionnelle. À Douala, Cameroun, les données sur les pratiques transfusionnelles et le pronostic des enfants anémiques transfusés en milieu urgentiste restent limitées. Cette étude visait à décrire les caractéristiques épidémiologiques, les indications transfusionnelles et le devenir des enfants présentant une anémie et recevant une transfusion sanguine aux urgences pédiatriques de l'Hôpital Laquintinie de Douala. Méthodologie. Une étude transversale rétrospective a été menée du 1er septembre 2023 au 31 mars 2024. Tous les enfants âgés de 1 mois à 15 ans ayant bénéficié d'une transfusion sanguine aux urgences pour anémie documentée par un hémogramme ont été inclus. Les données démographiques, les paramètres de l'anémie, les indications, le délai et le type de transfusion, ainsi que l'évolution ont été analysés. Résultats. Sur 861 admissions, 145 enfants (16,9%) ont été transfusés. Parmi eux, 84 dossiers complets ont été analysés. L'âge médian était de 1,6 an avec une prédominance masculine (56%). Le taux médian d'hémoglobine pré-transfusionnel était de 6,5 g/dL, et l'anémie était sévère dans 58,3% des cas. L'indication principale était l'anémie décompensée (92,7%). Le concentré de globules rouges était utilisé dans 52,4% des cas. Le délai médian de transfusion était court (3,2 heures). Aucun effet indésirable transfusionnel immédiat n'a été rapporté. La durée médiane d'hospitalisation était de 4 jours. La mortalité globale était élevée, atteignant 35,7%. Conclusion. Cette étude souligne la fréquence des transfusions pour anémie décompensée en urgence pédiatrique à Douala. Bien que le délai transfusionnel soit court, la mortalité reste très élevée, suggérant que la sévérité de l'état sous-jacent est le principal déterminant du pronostic. Ces résultats appellent à une optimisation de la prise en charge globale pré- et post-transfusionnelle de ces enfants.
ABSTRACT
Introduction. Severe anemia is a major therapeutic challenge in pediatrics in sub-Saharan Africa, representing the primary indication for transfusion. In Douala, Cameroon, data on transfusion practices and the prognosis of anemic children transfused in emergency settings remain limited. This study aimed to describe the epidemiological characteristics, transfusion indications, and outcomes of children presenting with anemia who received a blood transfusion in the pediatric emergency department of Laquintinie Hospital in Douala. Methodology. A retrospective cross-sectional study was conducted from September 1, 2023, to March 31, 2024. All children aged 1 month to 15 years who received a blood transfusion in the emergency department for anemia documented by a blood count were included. Demographic data, anemia parameters, indications, delay and type of transfusion, as well as outcomes were analyzed. Results. Out of 861 admissions, 145 children (16.9%) were transfused. Among them, 84 complete records were analyzed. The median age was 1.6 years with a male predominance (56%). The median pre-transfusion hemoglobin level was 6.5 g/dL, and anemia was severe in 58.3% of cases. The main indication was decompensated anemia (92.7%). Packed red blood cells were used in 52.4% of cases. The median transfusion delay was short (3.2 hours). No immediate transfusion adverse effects were reported. The median hospital stay was 4 days. Overall mortality was high, reaching 35.7%. Conclusion. This study highlights the frequency of transfusions for decompensated anemia in pediatric emergency care in Douala. Although the transfusion delay is short, mortality remains very high, suggesting that the severity of the underlying condition is the main determinant of prognosis. These results call for an optimization of the overall pre- and post-transfusion management of these critically ill children.

Keywords

Children anemia transfusion practices indications enfants anémie pratiques transfusionnelles indications

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Mbono Betoko Ritha, Mbessa Djama Josefa, Eposse Charlotte, Bianca Ekame Bulu, Epée Eboumbou Patricia, Kedy Koum Danielle, & Calixte Ida Penda. (2025). Transfusion Practices for Severe Anemia in Pediatrics in Douala: A Cross-Sectional Study on Indications and Clinical Outcomes: Pratiques Transfusionnelles pour Anémie Sévère en Pédiatrie à Douala : Une Étude Transversale sur les Indications et les Issues Cliniques. HEALTH SCIENCES AND DISEASE, 26(10). https://doi.org/10.5281/hsd.v26i10.7068
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