Newborns might help malaria kids
Blood from umbilical cords could
treat anaemia caused by tropical disease.
15 November 2002
TOM CLARKE
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| Transfusions can save the
lives of children with malaria. |
| © A.Crump/TDR |
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Transfusions of blood from newborns' umbilical cords could
save children who are acutely ill with malaria in parts of the
world that lack a routine supply of donated blood.
Untreated, malaria destroys the red blood cells that shunt
oxygen around the body. The best treatment for the resulting
severe anaemia - a particular problem in children - is a blood
transfusion. This replaces haemoglobin, the molecule that
harvests oxygen.
"If you don't get their haemoglobin levels up within 24 hours
they're dead," Janet Hemingway, director of the Liverpool School
of Tropical Medicine told a meeting of tropical disease experts
at the European Molecular Biology Laboratory in Heidelberg,
Germany, last week. Malaria kills more than one million people a
year, most of them children.
But in many poor countries, especially in sub-Saharan Africa
where malaria is rife, spare blood is in short supply. Although
some children recover after treatment with antimalarial drugs,
as many as 25% with severe anaemia die because they do not
receive a transfusion, or get one too late1.
A solution could lie in the maternity ward down the corridor,
Hemingway's colleagues Imelda Bates and Oliver Hassall found
during a study at the Komfo Anokye Teaching Hospital in Kumasi,
Ghana.
Along with their Ghanaian colleagues, the researchers
collected precious blood by simply hanging the umbilical cord
and placenta of newly delivered babies upside-down in a rack.
Less than half a cupful dripped through a needle into specially
designed collection bags.
But even this tiny volume of umbilical-cord blood is enough
to save a child of the same blood group. There are sufficient
deliveries at Komfo Anokye to transfuse 60% of anaemic children
awaiting blood in the same hospital, and boost their haemoglobin
to safer levels.
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| An umbilical cord provides
about half a cup of blood. |
| © A.Crump/TDR |
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The team did not actually transfuse blood into children. "We
first need to do a clinical trial to assess the benefits versus
disadvantages," she says. The researchers also intend to modify
their collection technique to reduce contamination.
The drip method leads to higher levels of bacteria than in
donated blood. "This problem has to be overcome before this can
be suggested seriously as a useful approach," says Brian
Greenwood, director of malaria research at the London School of
Hygiene and Tropical Medicine.
It's unconventional, but there's nothing wrong with using
cord blood in principle, says Lorna Williamson, a transfusion
scientist with Britain's National Blood Service. "This is not
something we'd do here," she says, "but if there's no other
blood supply it seems absolutely fine."
Even if proved safe and reliable, the technique might not
work in small hospitals, warns Mike English, a paediatrician at
Kilifi District Hospital in Kenya. With 30 deliveries a day,
Bates' hospital has a steady supply of cord blood. "We have
around five," he says, making it much harder to meet the demand
for blood. |
