{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:38:39Z","timestamp":1791999519270,"version":"4.4.0"},"reference-count":31,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2,8]]},"abstract":"<jats:p>Severe anemia is a leading indication for blood transfusion and a major cause of hospital admission and mortality in African children. Failure to initiate blood transfusion rapidly enough contributes to anemia deaths in sub-Saharan Africa. This article examines delays in accessing blood and outcomes in transfused children in Kenyan hospitals. Children admitted with nonsurgical conditions in 10 Kenyan county hospitals participating in the Clinical Information Network who had blood transfusion ordered from September 2013 to March 2016 were studied. The delay in blood transfusion was calculated from the date when blood transfusion was prescribed to date of actual transfusion. Five percent (2,875\/53,174) of admissions had blood transfusion ordered. Approximately half (45%, 1,295\/2,875) of children who had blood transfusion ordered at admission had a documented hemoglobin &lt; 5 g\/dl and 36% (2,232\/6,198) of all children admitted with a diagnosis of anemia were reported to have hemoglobin &lt; 5 g\/dL. Of all the ordered transfusions, 82% were administered and documented in clinical records, and three-quarters of these (75%, 1,760\/2,352) were given on the same day as ordered but these proportions varied from 71% to 100% across the 10 hospitals. Children who had a transfusion ordered but did not receive the prescribed transfusion had a mortality of 20%, compared with 12% among those transfused. Malaria-associated anemia remains the leading indication for blood transfusion in acute childhood illness admissions. Delays in transfusion are common and associated with poor outcomes. Variance in delay across hospitals may be a useful indicator of health system performance.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0735","type":"journal-article","created":{"date-parts":[[2016,12,6]],"date-time":"2016-12-06T02:50:28Z","timestamp":1480992628000},"page":"511-517","source":"Crossref","is-referenced-by-count":40,"title":["Blood Transfusion Delay and Outcome in County Hospitals in Kenya"],"prefix":"10.4269","volume":"96","author":[{"given":"Julius","family":"Thomas","sequence":"first","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Ayieko","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morris","family":"Ogero","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Gachau","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boniface","family":"Makone","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wycliffe","family":"Nyachiro","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Mbevi","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercy","family":"Chepkirui","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Malla","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."},{"name":"Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacquie","family":"Oliwa","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Irimu","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."},{"name":"Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"English","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya."},{"name":"Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"(Suppl)","key":"ref1","series-title":"Am J Trop Med Hyg","first-page":"23","article-title":"In-hospital morbidity and mortality due to severe malarial anemia in western Kenya","volume":"77","author":"Obonyo","year":"2007"},{"key":"ref2","series-title":"N Engl J Med","first-page":"888","article-title":"Severe anemia in Malawian children","volume":"358","author":"Calis","year":"2008"},{"key":"ref3","series-title":"AIDS","first-page":"1487","article-title":"Longitudinal evaluation of severely anemic children in Kenya: the effect of transfusion on mortality and hematologic recovery","volume":"11","author":"Lackritz","year":"1997"},{"key":"ref4","series-title":"Malar J","first-page":"307","article-title":"Changing trends in blood transfusion in children and neonates admitted in Kilifi District Hospital, 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