Demand for blood and blood components has risen sharply at blood banks across Dhaka amid the dengue outbreak, with some institutions reporting a three- to fourfold increase over normal levels in recent months.
However, blood collection is coming under pressure as many regular donors are temporarily unable to donate after contracting dengue, influenza and other fevers.
There is no shortage of blood bags or other supplies needed for transfusions this year, according to relevant institutions.
When the platelet count of 12-year-old Sayan, who was infected with dengue, fell to 18,000, his relatives appealed for O-positive blood on Facebook. They later collected blood from two donors for him. Sayan, who is receiving treatment at Uttara Adhunik Hospital in Dhaka, is now recovering.
Similar appeals for blood and platelets are being posted on social media daily as demand rises at hospitals and blood banks.
According to the Quantum Voluntary Blood Donation Program, 3,201 bags of blood and blood components were supplied to dengue patients from August to 20 October.
The number rose from 741 in August to 1,442 in September, while another 1,018 bags were supplied in the first 20 days of October.
The organisation currently receives daily requests for around 20 to 25 bags of blood and blood components for dengue patients.
Data from the Police Hospital Blood Bank also show rising demand for platelets. It supplied 161 bags in August, 246 in September and 174 in the first 20 days of October.
Quantum Voluntary Blood Donation Program organiser Shamima Nasrin Munni told The Business Standard that demand for blood and its components had increased alongside the rise in dengue cases in August, September and October.
Depending on their condition, patients may need whole blood, platelets, or other components.
Many regular voluntary donors are themselves suffering from dengue, influenza and other fevers, making them temporarily ineligible to donate, she said. As a result, rising demand is coinciding with a decline in blood collection.
Blood bank officials said patients do not always need to seek blood from separate blood banks as many hospitals have their own facilities and arrangements for apheresis platelet collection.
The Red Crescent Blood Bank supplies a significant portion of hospitals' blood requirements.
An official of the institution, speaking on condition of anonymity, said demand had increased two to three times compared with normal levels, particularly for single-donor platelets. Donors sometimes have to be arranged from outside Dhaka to meet the demand.
As donors cannot give blood again for a specified period after donating, regular donors alone cannot always meet the rising need, the official said.
This year's dengue season also appears to be lasting longer, with demand for blood remaining unusually high at this time of year.
A unit of platelet concentrate collected from random donors requires four donors, which can be difficult for patients to arrange.
Apheresis platelets, by contrast, are collected from a single donor but are more expensive and can also be difficult to obtain.
At the Red Crescent Blood Bank, one unit of platelets from random donors costs Tk4,500, while single-donor platelets cost Tk25,400.
Sudden rise in demand, fewer eligible donors
Dr Ashraful Hoque, assistant professor and head of the Department of Transfusion Medicine at Cumilla Medical College Hospital, said the sudden surge in dengue cases had sharply increased demand for blood and its components, leaving little time to coordinate additional donors.
He clarified that the problem was not a shortage of collection equipment or management.
Rather, the usual balance between donors who respond to requests and those who donate voluntarily had become difficult to maintain amid the sudden rise in demand.
Another challenge was that regular donors were contracting dengue, influenza and other fevers, temporarily reducing the number of healthy people eligible to donate, he said.
"Searching for blood donors only during emergency needs will not do. The continuity of voluntary blood donation must be maintained in a planned manner throughout the year," Dr Ashraful said.
He also stressed that dengue patients should not receive blood or platelet transfusions without medical necessity, so that limited supplies remain available for those who genuinely need them.
Doctors advise against unnecessary platelet transfusions
Although dengue can cause platelet counts to fall, a low count does not automatically mean a transfusion is necessary.
Doctors consider the patient's overall condition, signs of bleeding and other clinical factors before deciding.
Professor Dr Dilip Kumar Dhar of the Department of Internal Medicine at MH Samorita Hospital and Medical College said platelet transfusions could often be avoided with proper awareness among doctors and patients.
"Normally, we become alert when a dengue patient's platelets drop below 20,000. However, the matter varies from patient to patient. Even if someone's platelets drop to 15,000, if there is no bleeding, withholding platelets poses no problem," he said.
Meanwhile, seven more people died of dengue, taking this year's death toll to 364, while 1,373 new patients were admitted to hospitals nationwide in the 24 hours until 8am on 21 October.
The cumulative number of dengue cases reported across the country has reached 116,990.