Rational use of blood components in children with dengue by using WHO and NVBDC guidelines
DOI:
https://doi.org/10.18203/2349-3291.ijcp20190730Keywords:
Blood component, Dengue fever, NVBDCP, Plasma, Platelets, Transfusion, WHOAbstract
Background: Dengue fever has become a major public health concern. The disease is now endemic in more than 100 countries with very high case fatality rate and children are the most affected age group worldwide. During explosive outbreaks, there is sudden surge in demands of blood components. Hence the aim of present research was to study the rational use of blood components in children with dengue by using WHO 2012 and NVBDCP 2015 (GOI) guidelines.
Methods: Total 219 children of age ˂12 years, who has been diagnosed to have dengue and received blood component therapy during 12 months of study period, were included in the study. The transfusions of blood components [packed red cells (PRC), platelets and fresh frozen plasma (FFP)] were being given to the cases accordance to the WHO and NVBDCP guidelines. The patients’ demographic data, diagnosis, details of blood component therapy used the reason for transfusion was recorded.
Results: Out of 219 children, 12(5.4%) children received platelet transfusion, 4(1.8%) children received PRC transfusion and 5(2.2%) children received FFP transfusion. One transfusion (4.7%) out of 12 platelet transfusion was inappropriate and all PRC and FFP transfusions were appropriate according to WHO and National Vector Born Disease Control Programme (GOI) guidelines.
Conclusions: The need for platelet transfusion is often overemphasized and the fact is that the platelet count alone is not a predictor of bleeding. Unnecessary and empirical use of platelets should be completely avoided.
References
Makroo RN, Raina V, Kumar P, Kanth RK. Role of platelet transfusion in the management of dengue patients in a tertiary care Hospital. Asian J Trans Sci. 2007;1(1):4-7.
Dengue/DHF situation in India: National Vector Borne Disease Control Programme (NVBDCP). Available at: http://nvbdcp.gov.in/index4.php?lang=1&level=0&linkid=431&lid=3715.
World Health Organization, Regional Office for South-East Asia. Comprehensive Guidelines forPrevention and Control of Dengue and Dengue Hemorrhagic Fever, Revised and Expanded Edition. WHO-SEARO 2011. (SEARO Technical Publication Series No. 60) 2011.
Shivbalan S, Anandnathan K, Balasubramanian S, Datta M, Amalraj E. Predictors of spontaneous bleeding in dengue. Indian J Pediatr. 2004;71(1):33-6.
Pothapregada S, Kamalakannan B, Thulasingham M, Sampath S. Clinically profiling pediatric patients with dengue. J Global Infect Dis. 2016;8(3):115-20.
Kaur P, Kaur G. Transfusion support in patients with dengue fever. International J Appl Basic Med Res. 2014;4(Suppl 1):S8.
Verma A, Agarwal P. Platelet utilization in the developing world: Strategies to optimize platelet transfusion practices. Transfus Apher Sci. 2009;41(2):145-9.
Aggarwal A, Chandra J, Aneja S, Patwari AK, Dutta AK. An epidemic of dengue hemorrhagic fever and dengue shock syndrome in children in Delhi. Indian Pediatr. 1998;35(8):727-32.
Mittal H, Faridi MMA, Arora SK, Patil R. Clinicohematological profile and platelet trends in children with dengue during 2010 epidemic in North India. Indian J Pediatr. 2012;79(4):467-71.
Ahmed S, Arif F, Yahya Y, Rehman A, Abbas K, Ashraf S, et al. Dengue fever outbreak in Karachi 2006-a study of profile and outcome of children under 15 years of age. J Pak Med Assoc. 2008;58(1):4-8.
Shah I, Deshpande GC, Tardeja PN. Outbreak of dengue in Mumbai and predictive markers for dengue shock syndrome. J Trop Pediatr. 2004;50(5):301-5.
Zaki SA, Shanbag P. Clinical manifestations of dengue and leptospirosis in children in Mumbai: an observational study. Infect. 2010;38(4):285-91.
Prathyusha CV, Srinivasa Rao M, Sudarsini P, Uma Maheswara Rao K. Clinico-haematological profile and outcome of dengue fever in children. Int J Curr Microbiol App Sci. 2013;2(10):338-46.
Yudhishdran J, Navinan R, Ratnatilaka A, Jeyalakshmy S. Dengue haemorrhagic fever presenting with cholestatic hepatitis: two case reports and a review of literature. BMC Res Notes. 2014;7(1):568.
Chairulfatah A, Setiabudi D, Agoes R, Colebunders R. Thrombocytopenia and platelet transfusions in dengue haemorrhagic fever and dengue shock syndrome. Dengue Bull. 2003;27(27).
Narvaez F, Gutierrez G, Pérez MA, Elizondo D, Nuñez A, Balmaseda A, et al. Evaluation of the Traditional and Revised WHO Classifications of Dengue Disease Severity. PLoS Negl Trop Dis. 2011;5(11):e1397.
Ratageri VH, Shepur TA, Wari PK, Chavan SC, Mujahid IB, Yergolkar PN. Clinical profile and outcome of dengue fever cases. Indian J Pediatr. 2005;72(8):705-6.
Kulkarni N. Study on the effectiveness of transfusion program in dengue patients receiving platelet transfusion. IJBTI-Int J Blood Transfus Immunohematol. 2012;22:11-1.
Mahapatra S, Sahu A, Sahoo D, Patjoshi S, Parida P. Platelet transfusion in a dengue epidemic as per recent WHO classification. Int J Clin Trials. 2014;1(1):27-30.
