The safety and efficacy of umbilical cord blood transfusion in severe malarialanaemia in children. (360G-Wellcome-073604_Z_03_B)

Severe anemia in young children is a major public health problem in the malaria-endemic regions of Africa. Emergency blood transfusion can be a life-saving procedure in the management of these children, the majority of which are aged less than 12 months. Despite World Health Organisation recommendations, most hospitals rely on relative donation of blood for transfusion and in many cases blood is not available when required. I have demonstrated in a feasibility study that umbilical cord blood, which is otherwise discarded, can be collected in sufficient volumes on an African labour ward to be of use in the treatment of severe anaemia associated with malaria. If cord blood can be safely collected and screened in this setting, it could have a major impact on the management of severe malarial anaemia in children but also benefit other patient groups requiring scarce blood. This strategic research project aims to address the practical issues that need to be resolved before routine cord blood collection and transfusion can be recommended for wider application. These are: To demonstrate the minimum contamination rates with which umbilical cord blood can be collected in the African setting. To establish a safe, pragmatic and ethical screening strategy for transfusion transmissible infections in cord blood. To demonstrate the safety and efficacy of cord blood transfusion in the treatment of severe malarial anaemia in children. I aim to carry out this study at KEMRI/Wellcome Trust Unit, Kilifi, Kenya where there is the necessary paediatric and laboratory support and follow up mechanisms in the community are well established.