Based on the study entitled "Transfusion Services in Tropical Africa: Challenges and Prospects from the Nigerian Perspective'' (2022), conducted by Sagir Gumel Ahmed. A preliminary study in Nigeria revealed that the incidence of clotting in blood bags in northwest Nigeria was quite high at about 3%. What are the root-cause of this high prevalence rate of clotted blood bags in a developing country, particularly Nigeria?
Source: Ahmed, S. G. (2022). Transfusion services in tropical Africa: Challenges and prospects from the Nigerian perspective. Niger J Haematol, 3, 1-17.
In a tropical low-resource country such as Nigeria, blood clot incidence rate are expected to be high due to systematic inadequacies such as low level of quality control, poor hemovigilance during manual collection, a lack of automated blood collection monitors, and a lack of automation during blood collection. According to Ahmed, there are also four potential trigger mechanisms for coagulation activation and clot formation in blood bags during blood collection.
- First, significant damage in the vascular endothelial with exposure to sub-endothelial microfibrils and collagen due to an untidy and unduly traumatic venipuncture might trigger contact activation of platelets and FXII, as well as tissue factor-mediated activation of FVI.
- Second, a poor vein selection that may lead to slow blood flow upon venipuncture within the anticoagulant-free plastic tubing can also lead to contact activation of blood coagulation
- Third, clot formation due to over-filling or under-mixing of blood within the bag
- Fourth, contamination of bacteria due to inadequate cleansing can trigger coagulation and eventually cause clot formation in blood bags
Reference:
Ahmed, S. G. (2022). Transfusion services in tropical Africa: Challenges and prospects from the Nigerian perspective. Niger J Haematol, 3, 1-17.