Abstract
Alloimmunisation is a notorious dilemma in blood transfusion intervention therapy, especially in low-resource countries, and studies have shown that individuals with sickle cell disease (SCD) are likely to be transfused once or more before attaining adulthood. Blood transfusion is a major therapeutic intervention in SCD. Sickle cell patients who receive repeated blood transfusions may develop alloantibodies, which may result in delayed transfusion reactions, difficulty in finding compatible blood, and sometimes death. In this chapter, we explored the prevalence of red blood cell alloantibodies in SCD patients in some low-income countries. We discussed some factors responsible for alloimmunisation as well as the risk factors and associated clinical manifestations. Studies have reported various prevalence figures for low-resource countries; this stems from a lack of antigen matching, different racial backgrounds, and inconsistent transfusion practices. Here, we looked at the diagnostic methods employed and how they mitigate the problem by adopting different approaches. We also delved into some management challenges while proposing strategies to strengthen transfusion safety, including extended phenotyping, improved blood services, and enhanced clinical monitoring. Addressing these gaps is essential to improving outcomes, better SCD management, and may contribute to reducing morbidity and mortality among SCD patients in resource-constrained settings.