Samuel Kipkemoi Kipchumba, MBChB, MMED
Nominated From: University of Michigan
Research Site: Moi University
Research Area: Cancer
Primary Mentor: Nate Nessle
Research Project
Barriers to The Access of Blood and Blood Products for Children Cancer Treatment at the Moi Teaching and Referral Hospital, Kenya
Barriers to The Access of Blood and Blood Products for Children Cancer Treatment at the Moi Teaching and Referral Hospital, Kenya. Children with cancer require frequent transfusion of blood and blood products throughout the course of their treatment. Studies looking at the utilization of blood and blood products all point towards cancer as the top indicator and consumer of these products. However, the demand for these blood and blood products is often unequal to the supply. While poor survival is multifactorial, treatment-related complications such as opportunistic infections, low immune system, bleeding and toxicities due to the treatment regimen significantly contribute. Therefore, ensuring constant access to all blood products -red blood cells, platelets, plasma- is necessary for the safe, timely delivery of treatment for children with cancer and is vital to the management and improved survival of these patients. In LMICs, challenges such as low donation rates, a high rate of Transfusion Transmitted Infections (TTIs) leading to discards, lack of qualified medical laboratory personnel, underfunding of regional blood centres and low capacity to process blood into different components contribute to poor availability of blood products. This will be an observational prospective mixed methods study that will be carried out at the Moi Teaching and Referral Hospital (MTRH) and the Eldoret Regional Blood Transfusion Centre (ERBTC). It will describe the clinical characteristics of children with malignancies, their transfusion indications, blood product availability and process for the transfusion. Qualitative interviews will be carried out using questionnaires that will be administered to medical staff and patient caregivers in an exploratory manner to explore the barriers to and enablers of effective blood product transfusion practice and access to blood and blood products. Results from this study will highlight the situation of the demand versus supply of blood and blood products for children on cancer treatment at MTRH. The qualitative aspect will give insight into the challenges and associated barriers to the access of these products thus providing an avenue for the implementation of recommendations and lead to overall improvement of patient care.
Research Significance
This mixed methods study will identify the gaps linked to challenges in accessing blood and blood products. Through the clinical description of the quantitative data, this study will be able to quantify supply, demand, and the indication for transfusion of blood and blood products. The outcomes will provide evidence-based clinical recommendations for transfusions in children with cancer and help improve existing guidelines and adherence to protocols for transfusion in this population. The qualitative assessment of the medical staff and caregivers will provide impactful knowledge and understanding of the factors contributing to the challenges and barriers to accessing blood and blood products. We will use these study results to identify impactful strategies, such as guideline development, to support improved transfusion practices, product allocation, and improve donation practices.
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