‘Lack of voluntary blood donors, funds make automatic blood transfusion difficult for sickle cell patients’ 

'Lack of voluntary blood donors, funds make automatic blood transfusion difficult for sickle cell patients' 

Amarachi Okeh <

A public health expert, Dr. Adiat Adeniyi, has bemoaned the lack of voluntary blood donors and access to grants, noting that they are some of the major challenges people living with sickle cell face while trying to access automatic exchange blood transfusion services in Nigeria.

The physician disclosed that the manual blood transfusion in adults is gradually being overtaken by the automatic exchange transfusion which is easier and better.

He, however, noted that accessing this easier option is not always easy for those who need it.

Speaking in an interview with PUNCH HealthWise, Adeniyi, who works with the Sickle Cell Foundation, described the manual Exchange Blood Transfusion as ‘very very tedious,’ noting that it takes longer time, prone to infections and contamination.

He, nevertheless, said that despite the risks associated with it, it is the only other option that most patients living with sickle cell can afford.

Adeniyi said, “The manual once seems to be a popular reason being socio-economic factors because of the expenses of the automated.”

He, however, noted that the automated EBT is gradually being accepted more by adults with sickle cell because of the availability of the machine, but noted that the main hurdle to its use is the lack of funds by patients.

“How many patients can afford almost 300k for a session and it is even subsidised in our centre here. Imagine how much it would cost outside.”

“But the procedure is necessary for people who need it, he clarified.

He stated that undergoing EBT is necessary because “you want to avoid complications like stroke, cerebral vascular accidents in a sickle cell patient because their blood tends to form clots and become solid that is why it is needed.”

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While the exchange blood transfusion does not remove the sickled blood cells, it reduces the chances of the person developing complications. In some cases, a patient may need to undergo the procedure monthly.

According to The University of Illinois Hospital and Clinics, exchange transfusion is performed to remove the abnormal sickle red blood cells and replace them with normal red blood cells, to help reduce complications, including acute chest syndrome, stroke, and multi-organ failure.

Speaking with our correspondent, Amaka Chukwulete, a sickle cell patient said choosing the automatic exchange blood transfusion was a no-brainer option.

she disclosed that she told her haematologist that she needed an exchange blood transfusion on her first time undergoing an EBT.

Chukwulete had never needed an exchange blood transfusion nor had she suffered a chronic recurring crisis until last year.

“Last year I was falling sick so often. At one point I stayed a month at a stretch in the hospital. Then in October, I was in and out of the hospital.

“Every week I was in the hospital. I would be out the next two days I would be back in the hospital,” she told PUNCH HealthWise.

Due to the recurring crises, the Anambra-based lady had to cut her visit to Enugu short and head home to meet her haematologist in Anambra to know why she was having such recurring crises.

“My haematologist ran a test, they found out that my blood was sickling faster and the sickling ratio was high so she advised that I do an exchange blood transfusion,” she said.

But on making inquiries, Chiamaka learned that the manual exchange blood transfusion was pretty painful and took several days while the automated was painless and only takes a few hours.

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Though she did not have the funds for the cost of the automated version, Chiamaka knew that she couldn’t endure any other additional pain.

Thus the major challenge she faced was financing the procedure. Her family, she said, was unprepared for this emergency.

She disclosed that she had to reach out to her friends for help while looking for funds for this single procedure that would cost almost half a million naira.

Through the benevolence of her friends and the kind-heartedness of some Twitter followers, she raised N200,000 and crowdfunded almost N1,000,000 respectively within a short period.

She disclosed that she had the lifesaving procedure in Lagos last December and was able to return to Anambra the next day.

“Since the EBT I haven’t had any serious crises. I get pains but when I go to the hospital they treat me easily with analgesics and then I come back home. I have not slept in the hospital this year,” she said.

According to her, she was recently reminded that she needs to undergo the procedure again. She disclosed that she is considering it, but “I don’t know how I’m going to get the money,” she explained.

Chiamaka is one of the few persons living with sickle cell in Nigeria in need of financial support to undergo the automated EBT procedure.

According to a study published on thelancet.com, “Nigeria has the highest birth prevalence of sickle cell disease in the world, with an estimated 150,000 annual births of babies with sickle cell anemia, the most common form of sickle cell disease.” 

Also, according to a study led by Ogbonna Nwabuko titled, ‘An overview of sickle cell disease from the socio-demographic triangle – a Nigerian single-institution retrospective study’ it is estimated that four to six million people live with the disease in Nigeria thus making the country an epicentre zone for the condition.

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Adeniyi also stated that if people are more willing to donate blood it would greatly impact the cost of the automated procedure. He estimated that an average of 10 persons visit the facility per month for this essential service as of last year. He noted that some of the patients travel from the ends of the country as the equipment is not available in their states of residence.

“One of the challenges we face is the availability of blood. We don’t have blood at the centre. People don’t usually donate blood voluntarily.

“Most of the people that you see outside, maybe because of the poverty of mind, they don’t fully understand why blood donation is good.

“Another challenge is the cost of the procedure itself. People are ready to come for it but they are dissuaded by the cost. The reason people are coming for the one here is that it is subsidised,” he said.

Adeniyi pleaded with Nigerians to be willing to freely donate blood. He also urged Nigerians to support the Foundation with funds, noting that getting financial support from more people would help reduce the cost of the procedure for persons living with sickle cell.



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