Newborns might help malaria kidsBlood 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 | | |
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 | | |
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. | 
