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Oxford University Global Surgery Group's (OUGSG) work on the pertinent subject of paediatric anaemia in the context of surgery in low- and middle-income countries was recently presented at the 69th British Association of Paediatric Surgery (BAPS) Congress in Bruges, Belgium on 23 June 2023.

International forum speakers and participants at the 69th British Association of Paediatric Surgery Congress in Brugge, Belgium on 23rd June 2023
International forum speakers and participants at the 69th British Association of Paediatric Surgery Congress in Brugge

This work encompasses three phases beginning with a literature review on the subject which gained international recognition through a publication in the Lancet Child and Adolescent Health in 2019. This review highlighted the issue of paediatric anaemia in developing nations and the challenges it posed in the context of surgery where currently there is a lack of global consensus on its management.

OUGSG project lead Professor Kokila Lakhoo, OUGSG researcher and surgical trainee Somy Charuvila, and CRICS lead Professor Tahmina Banu.Phase 2 was a retrospective study in Bangladesh which laid out in detail the challenges of preoperative anaemia testing in children at a tertiary hospital where lack of timely and affordable testing posed a significant challenge. 

In response to this, Phase 3 was conducted in the form of a large prospective study involving 1033 children in Bangladesh where bedside point-of-care haemoglobinometers were introduced to tackle the challenges in anaemia testing and management. This intervention led to a significant increase in the detection of anaemia. In addition to this, a local patient blood management education strategy led to a restrictive transfusion approach which was associated with a reduced length of hospital stay and post-operative intensive care requirements. 

The three phases were conducted as a result of a successful collaboration between OUGSG and the Chittagong Research Institute for Children's Surgery (CRICS) in Bangladesh. Under the leadership of Professor Kokila Lakhoo (OUGSG) and Professor Tahmina Banu (CRICS), a diverse group of multidisciplinary clinicians from surgery, anaesthesia and haematology backgrounds worked closely towards this cause.

Pictured above: Professor Kokila Lakhoo (left), OUGSG researcher and surgical trainee Somy Charuvila (centre) and Professor Tahmina Banu (right). 

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