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Review
. 2024 Sep;24(3):417-429.
doi: 10.4314/ahs.v24i3.46.

Frequency of red blood cell allo-immunization in transfused patients with sickle cell disease in Africa: a systematic review with meta-analysis

Theresa Ukamaka Nwagha  1   2 , Angela Ogechukwu Ugwu  1   2 , Martins Nweke  3   4
Affiliations
Review

Frequency of red blood cell allo-immunization in transfused patients with sickle cell disease in Africa: a systematic review with meta-analysis

Theresa Ukamaka Nwagha et al. Afr Health Sci. 2024 Sep.

Abstract

Background and objectives: Blood transfusion is an effective and proven treatment for some severe complications of sickle cell disease. Recurrent transfusions have put patients with sickle cell disease at risk of developing antibodies against the various antigens they were exposed to. This study aims to investigate the frequency of red blood cell alloimmunization in patients with sickle disease in Africa.

Materials and methods: This is a systematic review of peer-reviewed and published literature. The review was conducted consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.Data sources for the review include MEDLINE, PubMed, AJOL, CINAHL, Psych-Info and Academic Search Complete. Included in this review are articles that reported the frequency/prevalence of red blood cell alloimmunization in sickle cell disease patients in Africa. Eligible studies were subjected to independent full-text screening and data extraction. Risk of bias assessment was conducted with the aid of the mixed method appraisal tool. We employed a random-effects model of meta-analysis to estimate the pooled prevalence. We computed Cochrane's Q statistics and I2 and prediction interval to quantify heterogeneity in effect size.

Results: The prevalence estimates range from 2.6% to 29%. Pooled prevalence was estimated to be 12.1% (95% CI 8.1 to 17.7), with significant heterogeneity (I2= 91.83; PI = 2 to 54%).

Conclusion: The frequency of red cell alloantibody varies considerably in Africa.

Keywords: Africa; Systematic review; alloimmunization; red blood cell; sickle cell disease.

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Figures

Figure 1
Figure 1
PRISMA Flow Diagram of the systematic review “Frequency of red cell alloimmunization and antibody specificities among patients with sickle cell disease in Africa (1994-2022)
Figure 2
Figure 2
Forest Plot displaying the frequency of red cell alloimmunnizationhe amongst patients with Sickle cell disease
Figure 3
Figure 3
Funnel plot depicting publication bias
See this image and copyright information in PMC

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