Know better, do better: A study of blood transfusion adverse events reporting in Rivers State, Nigeria

Abstract

Background: Blood transfusion is a critical life-saving intervention, particularly in resource-limited settings. However, it is not risk-free. Inadequate haemovigilance systems and inconsistent reporting practices obscure the true burden of transfusion-related adverse events. This study aimed to assess the incidence, types and characteristics of adverse transfusion reactions in healthcare facilities across Rivers State, Nigeria.

Materials and Methods: A prospective observational study was conducted across 30 healthcare facilities from September 2024 to January 2025. Data collection utilised a standardised reporting tool adapted from international haemovigilance guidelines. A total of 359 transfusion recipients were monitored for adverse events, and descriptive statistics were applied to analyse incidence patterns by demographic, clinical and facility characteristics.

Results: Twenty-four adverse transfusion events were reported out of 397 blood units transfused, yielding a 6.0% incidence rate. The majority were reported in tertiary urban facilities, with packed cells and whole blood emerging as the most frequently implicated components. Cough (2.2%), headaches (1.4%) and dyspnoea (0.8%) were the most reported symptoms. However, likely due to limitations in recognition and documentation, 95.8% of reactions were labelled ‘unclassified (UNC)’.

Conclusion: This study highlights significant gaps in transfusion safety monitoring and reporting in Rivers State. The high rate of ‘UNC’ events reflects deficiencies in training, diagnostic capacity and report standardisation. Strengthening haemovigilance infrastructure, promoting staff education and establishing hospital transfusion committees are urgent steps needed to enhance transfusion safety and reduce adverse outcomes in this setting.