Inherited blood disorders, known as haemoglobinopathies and blood clotting disorders like fetal and neonatal alloimmune thrombocytopenia (FNAIT), are the most common reason children and newborns in India receive blood transfusions. This finding comes from the first large-scale study of its kind in the country, recently published in the medical journal Vox Sanguinis.
India has one of the highest rates of inherited blood conditions in the world. About 8% of the population carries the trait for beta-thalassaemia, with that number rising to 9% in states like Maharashtra and Gujarat. This results in an estimated 32,400 babies born with the disease every year. Until now, there was no national data tracking why children needed blood, making it difficult for hospitals to plan their blood supplies effectively.
To solve this, researchers formed the ITBP-In study group. They collected data from 23 medical centers across India over six months in 2022. The centers recorded the age, sex, diagnosis, and transfusion history for every request involving a child or newborn. Each request for blood was tracked as an individual event to get a clear picture of the demand.
Out of nearly 400,000 total blood requests at these centers, about 13% (over 52,000) were for patients under age 18. Most of these patients were boys, with the largest group aged 5 to 12. Nearly half of the children needed more than one transfusion. Red blood cells were the most requested component (68%), followed by platelets (used for clotting) and plasma.
Medical conditions caused over two-thirds of the transfusion requests. Within that group, blood diseases were the biggest factor, far outweighing cancer or infections. Specifically, thalassaemia and sickle cell disease were the top reasons for transfusions across the entire group of children. For those over age five, these inherited disorders were the primary reason they needed red blood cells. When surgery was the reason for a transfusion, heart and stomach surgeries were the most common.
Newborns (babies under one month old) made up about 12.5% of the childhood requests. Their needs were different from older children; while they still needed red blood cells, they required more plasma and platelets. This is because newborns often face issues like severe infections (sepsis), bleeding disorders or heart surgery. For these patients, the main medical reasons for blood were anemia (low red blood cell count) and problems with blood clotting.
The researchers pointed out that India’s blood needs are very different from those in wealthy nations, where cancer and heart surgery are the main reasons children need blood. They called for India to create its own specific transfusion guidelines and better prevention programs for thalassaemia. While the study is a major step forward, the authors noted that it mostly focused on large academic hospitals and tracked “requests” for blood rather than “confirmed” transfusions.
The researchers concluded that this data provides a vital “benchmark” for India. By understanding exactly why children need blood, the country can better plan its national blood supply, improve how it manages thalassaemia, and create safer systems for monitoring how children react to transfusions.
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