Imperial College London
Alternate

ProfessorKathMaitland

Faculty of Medicine, Department of Surgery & Cancer

Professor of Tropical Paediatric Infectious Disease
 
 
 
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Contact

 

k.maitland CV

 
 
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Location

 

Based full-time at KEMRI/Wellcome Programme, KenyaQueen Elizabeth and Queen Mary HospitalSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Maitland:2019:10.1056/nejmoa1900105,
author = {Maitland, K and Kiguli, S and Olupot-Olupot, P and Engoru, C and Mallewa, M and Saramago, Goncalves P and Opoka, RO and Mpoya, A and Alaroker, F and Nteziyaremye, J and Chagaluka, G and Kennedy, N and Nabawanuka, E and Nakuya, M and Namayanja, C and Uyoga, S and Kyeyune, Byabazaire D and M'baya, B and Wabwire, B and Frost, G and Bates, I and Evans, JA and Williams, TN and George, EC and Gibb, DM and Walker, AS and TRACT, Group},
doi = {10.1056/nejmoa1900105},
journal = {The New England journal of medicine},
pages = {407--419},
title = {Immediate Transfusion in African Children with Uncomplicated Severe Anemia.},
url = {http://dx.doi.org/10.1056/nejmoa1900105},
volume = {381},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - <h4>Background</h4>The World Health Organization recommends not performing transfusions in African children hospitalized for uncomplicated severe anemia (hemoglobin level of 4 to 6 g per deciliter and no signs of clinical severity). However, high mortality and readmission rates suggest that less restrictive transfusion strategies might improve outcomes.<h4>Methods</h4>In this factorial, open-label, randomized, controlled trial, we assigned Ugandan and Malawian children 2 months to 12 years of age with uncomplicated severe anemia to immediate transfusion with 20 ml or 30 ml of whole-blood equivalent per kilogram of body weight, as determined in a second simultaneous randomization, or no immediate transfusion (control group), in which transfusion with 20 ml of whole-blood equivalent per kilogram was triggered by new signs of clinical severity or a drop in hemoglobin to below 4 g per deciliter. The primary outcome was 28-day mortality. Three other randomizations investigated transfusion volume, postdischarge supplementation with micronutrients, and postdischarge prophylaxis with trimethoprim-sulfamethoxazole.<h4>Results</h4>A total of 1565 children (median age, 26 months) underwent randomization, with 778 assigned to the immediate-transfusion group and 787 to the control group; 984 children (62.9%) had malaria. The children were followed for 180 days, and 71 (4.5%) were lost to follow-up. During the primary hospitalization, transfusion was performed in all the children in the immediate-transfusion group and in 386 (49.0%) in the control group (median time to transfusion, 1.3 hours vs. 24.9 hours after randomization). The mean (±SD) total blood volume transfused per child was 314±228 ml in the immediate-transfusion group and 142±224 ml in the control group. Death had occurred by 28 days in 7 children (0.9%) in the immediate-transfusion group and in 13 (1.7%) in the control group (hazard ratio, 0.54; 95% confidence
AU  - Maitland,K
AU  - Kiguli,S
AU  - Olupot-Olupot,P
AU  - Engoru,C
AU  - Mallewa,M
AU  - Saramago,Goncalves P
AU  - Opoka,RO
AU  - Mpoya,A
AU  - Alaroker,F
AU  - Nteziyaremye,J
AU  - Chagaluka,G
AU  - Kennedy,N
AU  - Nabawanuka,E
AU  - Nakuya,M
AU  - Namayanja,C
AU  - Uyoga,S
AU  - Kyeyune,Byabazaire D
AU  - M'baya,B
AU  - Wabwire,B
AU  - Frost,G
AU  - Bates,I
AU  - Evans,JA
AU  - Williams,TN
AU  - George,EC
AU  - Gibb,DM
AU  - Walker,AS
AU  - TRACT,Group
DO  - 10.1056/nejmoa1900105
EP  - 419
PY  - 2019///
SN  - 0028-4793
SP  - 407
TI  - Immediate Transfusion in African Children with Uncomplicated Severe Anemia.
T2  - The New England journal of medicine
UR  - http://dx.doi.org/10.1056/nejmoa1900105
UR  - http://hdl.handle.net/10044/1/72706
VL  - 381
ER  -
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