{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:31:16Z","timestamp":1783125076785,"version":"3.54.6"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Severe anaemia is a common cause for hospitalization in children in sub-Saharan Africa. Malaria plays an important aetiological role, resulting in a substantial burden of paediatric transfusion in hospitals. A decline in malaria and paediatric admissions to the Kilifi District Hospital has been reported recently. This study aimed to investigate whether this trend affected clinical burden, clinical severity of anaemia and requirements for paediatric transfusion.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Eight-year retrospective review of paediatric admissions to Kilifi District Hospital, Kenya describing the frequency of moderate and severe anaemia, blood transfusion and case fatality over time. Definitions for severe anaemia were Hb &lt;8 g\/dl for newborns and &lt;5 g\/dl for other age groups and for moderate anaemia was Hb 8 to &lt;11 g\/dl for newborns and 5 to &lt;9.3 g\/dl for other age groups. Life threatening anaemia was defined as severe anaemia (Hb &lt;5 g\/dl) complicated by either deep breathing or prostration or profound anaemia (Hb &lt;4 g\/dl) alone.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of the 35,139 admissions 13,037 (37%) had moderate anaemia and 2,265 (6%) had severe anaemia; respiratory distress complicated 35% of cases with Hb &lt;5 g\/dl. Concurrent with the decline in malaria there was a marked decline in the prevalence of severe anaemia between 2002 (8%) and 2009 (&lt; 4%) (chi<jats:sup>2<\/jats:sup> for trend = 134, P &lt; 0.0001). The number and proportion of admissions transfused also declined significantly over this time (chi2 for trend = 152, P &lt; 0.0001). Of the 2,265 children with severe anaemia 191 (8%) died. Case fatality remained unchanged during this period (P &lt; 0.26) and was largely explained by the unchanged proportion with life-threatening anaemia, present in 58-65% of cases throughout the study period.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The impact of reduced malaria transmission on child morbidity has positive public benefits on the demand and use of blood for paediatric transfusion. Despite an overall reduction in paediatric transfusion requirement, case fatality of severe anaemia remained unchanged over this decade. Further research is required to improve outcome from severe anaemia, particularly in the high-risk group with life threatening features.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1475-2875-9-307","type":"journal-article","created":{"date-parts":[[2010,10,30]],"date-time":"2010-10-30T18:13:52Z","timestamp":1288462432000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Changing trends in blood transfusion in children and neonates admitted in Kilifi District Hospital, Kenya"],"prefix":"10.1186","volume":"9","author":[{"given":"Rosalon","family":"Pedro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Akech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Maitland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2010,10,30]]},"reference":[{"key":"1389_CR1","unstructured":"Hospital Care for Children: guidelines for the management of common illnesses with limited resources. 2005, Geneva, Switzerland: World Health Organization"},{"issue":"2S-2","key":"1389_CR2","doi-asserted-by":"crossref","first-page":"636S","DOI":"10.1093\/jn\/131.2.636S","volume":"131","author":"BJ Brabin","year":"2001","unstructured":"Brabin BJ, Premji Z, Verhoeff F: An analysis of anemia and child mortality. J Nutr. 2001, 131 (2S-2): 636S-645S. discussion 646S-648S","journal-title":"J Nutr"},{"issue":"12","key":"1389_CR3","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1097\/00002030-199712000-00013","volume":"11","author":"EM Lackritz","year":"1997","unstructured":"Lackritz EM, Hightower AW, Zucker JR, Ruebush TK, Onudi CO, Steketee RW, Were JB, Patrick E, Campbell CC: Longitudinal evaluation of severely anemic children in Kenya: the effect of transfusion on mortality and hematologic recovery. Aids. 1997, 11 (12): 1487-1494. 10.1097\/00002030-199712000-00013.","journal-title":"Aids"},{"key":"1389_CR4","unstructured":"Global database of blood safety. Summary report 1998-1999. 2000, Geneva: World Health Organization, Blood Transfusion Safety, Department of blood transfusion safety and clinical technology"},{"issue":"9","key":"1389_CR5","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1056\/NEJMoa072727","volume":"358","author":"JC Calis","year":"2008","unstructured":"Calis JC, Phiri KS, Faragher EB, Brabin BJ, Bates I, Cuevas LE, de Haan RJ, Phiri AI, Malange P, Khoka M: Severe anemia in Malawian children. The New England journal of medicine. 2008, 358 (9): 888-899. 10.1056\/NEJMoa072727.","journal-title":"The New England journal of medicine"},{"key":"1389_CR6","doi-asserted-by":"publisher","first-page":"c1350","DOI":"10.1136\/bmj.c1350","volume":"340","author":"B Nadjm","year":"2010","unstructured":"Nadjm B, Amos B, Mtove G, Ostermann J, Chonya S, Wangai H, Kimera J, Msuya W, Mtei F, Dekker D: WHO guidelines for antimicrobial treatment in children admitted to hospital in an area of intense Plasmodium falciparum transmission: prospective study. BMJ (Clinical research ed). 2010, 340: c1350-10.1136\/bmj.c1350.","journal-title":"BMJ (Clinical research ed)"},{"issue":"9730","key":"1389_CR7","doi-asserted-by":"publisher","first-page":"1969","DOI":"10.1016\/S0140-6736(10)60549-1","volume":"375","author":"RE Black","year":"2010","unstructured":"Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, Jha P, Campbell H, Walker CF, Cibulskis R: Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010, 375 (9730): 1969-1987. 10.1016\/S0140-6736(10)60549-1.","journal-title":"Lancet"},{"issue":"9305","key":"1389_CR8","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1016\/S0140-6736(02)07666-3","volume":"359","author":"M English","year":"2002","unstructured":"English M, Ahmed M, Ngando C, Berkley J, Ross A: Blood transfusion for severe anaemia in children in a Kenyan hospital. Lancet. 2002, 359 (9305): 494-495. 10.1016\/S0140-6736(02)07666-3.","journal-title":"Lancet"},{"issue":"8818","key":"1389_CR9","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/0140-6736(92)91719-O","volume":"340","author":"EM Lackritz","year":"1992","unstructured":"Lackritz EM, Campbell CC, Ruebush TK, Hightower AW, Wakube W, Steketee RW, Were JB: Effect of blood transfusion on survival among children in a Kenyan hospital. Lancet. 1992, 340 (8818): 524-528. 10.1016\/0140-6736(92)91719-O.","journal-title":"Lancet"},{"issue":"9","key":"1389_CR10","first-page":"1449","volume":"150","author":"WA Ghali","year":"1994","unstructured":"Ghali WA, Palepu A, Paterson WG: Evaluation of red blood cell transfusion practices with the use of preset criteria. Cmaj. 1994, 150 (9): 1449-1454.","journal-title":"Cmaj"},{"key":"1389_CR11","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1186\/1475-2875-7-256","volume":"7","author":"SO Akech","year":"2008","unstructured":"Akech SO, Hassall O, Pamba A, Idro R, Williams TN, Newton CR, Maitland K: Survival and haematological recovery of children with severe malaria transfused in accordance to WHO guidelines in Kilifi, Kenya. Malar J. 2008, 7: 256-10.1186\/1475-2875-7-256.","journal-title":"Malar J"},{"issue":"7","key":"1389_CR12","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1097\/00002030-199307000-00014","volume":"7","author":"EM Lackritz","year":"1993","unstructured":"Lackritz EM, Ruebush TK, Zucker JR, Adungosi JE, Were JB, Campbell CC: Blood transfusion practices and blood-banking services in a Kenyan hospital. Aids. 1993, 7 (7): 995-999. 10.1097\/00002030-199307000-00014.","journal-title":"Aids"},{"issue":"8","key":"1389_CR13","doi-asserted-by":"publisher","first-page":"e2903","DOI":"10.1371\/journal.pone.0002903","volume":"3","author":"KS Phiri","year":"2008","unstructured":"Phiri KS, Calis JC, Faragher B, Nkhoma E, Ng'oma K, Mangochi B, Molyneux ME, van Hensbroek MB: Long term outcome of severe anaemia in Malawian children. PloS one. 2008, 3 (8): e2903-10.1371\/journal.pone.0002903.","journal-title":"PloS one"},{"issue":"9649","key":"1389_CR14","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1016\/S0140-6736(08)61655-4","volume":"372","author":"WP O'Meara","year":"2008","unstructured":"O'Meara WP, Bejon P, Mwangi TW, Okiro EA, Peshu N, Snow RW, Newton CR, Marsh K: Effect of a fall in malaria transmission on morbidity and mortality in Kilifi, Kenya. Lancet. 2008, 372 (9649): 1555-1562. 10.1016\/S0140-6736(08)61655-4.","journal-title":"Lancet"},{"key":"1389_CR15","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1186\/1475-2875-7-162","volume":"7","author":"AA Gerritsen","year":"2008","unstructured":"Gerritsen AA, Kruger P, van der Loeff MF, Grobusch MP: Malaria incidence in Limpopo Province, South Africa, 1998-2007. Malaria journal. 2008, 7: 162-10.1186\/1475-2875-7-162.","journal-title":"Malaria journal"},{"issue":"8818","key":"1389_CR16","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/0140-6736(92)91719-O","volume":"340","author":"EM Lackritz","year":"1992","unstructured":"Lackritz EM, Campbell CC, Ruebush TK, Hightower AW, Wakube W, Steketee RW, Were JB: Effect of blood transfusion on survival among children in a Kenyan hospital. Lancet. 1992, 340 (8818): 524-528. 10.1016\/0140-6736(92)91719-O.","journal-title":"Lancet"},{"issue":"3","key":"1389_CR17","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1111\/j.1365-3148.2010.00989.x","volume":"20","author":"B Cheema","year":"2010","unstructured":"Cheema B, Molyneux EM, Emmanuel JC, M'Baya B, Esan M, Kamwendo H, Kalilani-Phiri L, Boele van Hensbroek M: Development and evaluation of a new paediatric blood transfusion protocol for Africa. Transfus Med. 2010, 20 (3): 140-151. 10.1111\/j.1365-3148.2010.00989.x.","journal-title":"Transfus Med"},{"issue":"4","key":"1389_CR18","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/S0272-2712(18)30245-2","volume":"16","author":"RH Walker","year":"1996","unstructured":"Walker RH: Mathematical calculations in transfusion medicine. Clin Lab Med. 1996, 16 (4): 895-906.","journal-title":"Clin Lab Med"},{"issue":"3","key":"1389_CR19","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1136\/adc.2007.135731","volume":"94","author":"SL Morley","year":"2009","unstructured":"Morley SL: Red blood cell transfusions in acute paediatrics. Archives of disease in childhood. 2009, 94 (3): 65-73. 10.1136\/adc.2007.135731.","journal-title":"Archives of disease in childhood"},{"issue":"6","key":"1389_CR20","first-page":"301","volume":"45","author":"J Vos","year":"1993","unstructured":"Vos J, Gumodoka B, Ng'weshemi JZ, Kigadye FC, Dolmans WM, Borgdorff MW: Are some blood transfusions avoidable? A hospital record analysis in Mwanza Region, Tanzania. Trop Geogr Med. 1993, 45 (6): 301-303.","journal-title":"Trop Geogr Med"},{"key":"1389_CR21","volume-title":"Cochrane database of systematic reviews (Online)","author":"M Meremikwu","year":"2000","unstructured":"Meremikwu M, Smith HJ: Blood transfusion for treating malarial anaemia. Cochrane database of systematic reviews (Online). 2000, CD001475-2"}],"updated-by":[{"DOI":"10.1186\/1475-2875-9-364","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2010,12,17]],"date-time":"2010-12-17T00:00:00Z","timestamp":1292544000000}}],"container-title":["Malaria Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1475-2875-9-307.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T05:55:53Z","timestamp":1630475753000},"score":1,"resource":{"primary":{"URL":"https:\/\/malariajournal.biomedcentral.com\/articles\/10.1186\/1475-2875-9-307"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,10,30]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2010,12]]}},"alternative-id":["1389"],"URL":"https:\/\/doi.org\/10.1186\/1475-2875-9-307","relation":{"erratum":[{"id-type":"doi","id":"10.1186\/1475-2875-9-364","asserted-by":"object"}]},"ISSN":["1475-2875"],"issn-type":[{"value":"1475-2875","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,10,30]]},"assertion":[{"value":"6 August 2010","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 October 2010","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 October 2010","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"307"}}