Author:
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Blood Transfusions for Chronic Malaria Anemia in Prisoners of War on the Thai–Burma Railway 1943–1945
Madeleine Payne
Madeleine Payne
London School of Hygiene and Tropical Medicine, London, United Kingdom;
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Martin Gorsky
Martin Gorsky
London School of Hygiene and Tropical Medicine, London, United Kingdom;
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Colin J. Sutherland
Colin J. Sutherland
London School of Hygiene and Tropical Medicine, London, United Kingdom;
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G. Dennis Shanks
dennis.shanks@defence.gov.au
G. Dennis Shanks
Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia;
School of Public Health, University of Queensland, Brisbane, Australia
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School of Public Health, University of Queensland, Brisbane, Australia
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ABSTRACT.
Allied prisoners of war (POWs) working on the Imperial Japanese Army’s railroad from Thailand to Burma during 1943–1945 devised a blood transfusion service to rescue severely ill fellow prisoners who were otherwise unlikely to survive the war. Extant transfusion records (1,251 recipients, 1,189 donors) in ledger books held by the United Kingdom National Archives at Kew were accessed and analyzed. Survival to the end of the war in 1945 was determined from Commonwealth War Graves Commission records. The records examined indicate that freshly donated whole blood was manually defibrinated and transfused after crossmatches based on POW medic sera. Overall survival to the end of the war was 74% in recipients and 88% in donors. Postwar survival rates were significantly higher for transfusion recipients with malaria (89.3%) than for other diagnoses: 52.6% for malnutrition, 59.3% for dysentery, 67.2% for skin ulcers, and 75.4% for other causes (odds ratio: 3.97; 95% CI: 2.79–5.28; P <0.0001). By 1945, the vast majority of blood transfusions were given for severe anemia caused by chronic relapsing vivax malaria. Although the POW situation was admittedly extreme, our data provide evidence that blood transfusions to treat severe anemia were associated with higher survival among patients with Plasmodium vivax infection than among those with other morbidities.
Author Notes
Financial support: No specific funding was given for this work.
Disclosures: M. Payne used some of the materials as part of an MSc degree program in tropical medicine and international health at the London School of Hygiene and Tropical Medicine. G. D. Shanks is an employee of the Australian Defence Force and a retired U.S. Army officer. No authors claim any conflicts of interest. The opinions expressed are those of the authors and do not necessarily reflect those of the Australian Defence Force or the U.S. Department of Defense.
Current contact information: Madeleine Payne, East Kent Hospitals University, NHS Foundation Trust, London, United Kingdom, E-mail: madeleine.payne@nhs.net. Martin Gorsky and Colin J. Sutherland, London School of Hygiene and Tropical Medicine, London, United Kingdom, E-mails: martin.gorsky@lshtm.ac.uk and colin.sutherland@lshtm.ac.uk. G. Dennis Shanks, Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia, E-mail: dennis.shanks@defence.gov.au.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Marsden A, 1946. Observations by a pathologist during three and a half years as a prisoner of war in Malaya and Thailand. Med J Australia 1: 766–769.
-
2.
Gill G, Parkes M, 2017. Burma Railway Medicine: Disease, Death and Survival on the Thai–Burma Railway, 1942–1945. Lancaster, United Kingdom: Palatine Books.
-
3.
Farrell B, 2015. The Defence and Fall of Singapore. Singapore: Monsoon Books.
-
4.
Brune P, 2014. Descent into Hell: The Fall of Singapore, Pudu and Changi, the Thai Burma Railway. Sydney, Australia: Allen & Unwin.
-
5.
Mills K, Horne M, 2018. Jungle camp science: Do-it-yourself medicines in two POW hospital camps on the Japanese Burma–Thailand railway, 1942–45. Health History 20: 30–53.
-
6.
McCormack G, Nelson H, 1993. The Burma–Thailand Railway: Memory and History. Chiang Mai, Thailand: Silkworm Books.
-
7.
Kratoska PH, 2018. The Japanese Occupation of Malaya and Singapore, 1941–45: A Social and Economic History. Singapore: NUS Press, 188–189.
-
8.
Hearder R, 2004. More complex than a stereotype: Australian POW doctors and the Japanese in captivity, 1942–45. Health History 6: 75–91.
-
9.
Dunlop EE, 1946. Medical experiences in Japanese captivity. BMJ 2: 481–486.
-
10.
Walker A, 1963. The Burma–Thailand Railway. Middle East and Far East. Canberra, Australia: Australian War Memorial.
-
11.
MacArthur P. Capt. P. MacArthur Diary. London, United Kingdom: Imperial War Museum. Available at: https://www.iwm.org.uk/collections/item/object/1030021102. Accessed January 2, 2025.
-
12.
Walker A, 1962. Blood Transfusion. Clinical Problems of War. Canberra, Australia: Australian War Memorial.
-
13.
Markowitz J, 1946. Transfusion of defibrinated blood in P.O.W. camps at Chungkai and Nakom Paton, Thailand.J R Army Med Corps 86: 189–197.
-
14.
Anonymous, 1945. Recipients and Donors for Blood for Transfusions. Chungkai, Thailand: United Kingdom National Archives.
-
15.
Payne M, 2022. A Comparative Survival Analysis of Blood Donors and Recipients in a Prisoner of War Camp in Thailand Between August 1943 and September 1945. London, United Kingdom: London School of Hygiene and Tropical Medicine.
-
16.
Kratoska PH, 2006. Japanese Government report on employment of war prisoners in Siam–Burma railway construction. Kratoska PH. The Thailand–Burma Railway 1942–1946 Documents and Selected Writings. London, United Kingdom: Taylor and Francis, 8342–366.
-
17.
Shanks GD, 2019. Malaria-associated mortality in Australian and British prisoners of war on the Thai–Burma Railway 1943–1944. Am J Trop Med Hyg 100: 846–850.
-
18.
Shanks GD, 2017. Malaria-associated mortality in the Australian Defence Force during the twentieth century. Am J Trop Med Hyg 97: 544–547.
-
19.
Hardie R, 1983. The Burma–Siam Railway: The Secret Diary of Dr. Robert Hardie 1942–45. London, United Kingdom: Imperial War Museum.
-
20.
Sutherland JM, 1942–1945. Jungle Journal. Canberra, Australia: Australian War Memorial. Available at: https://awm.gov.au/collection/C2476726. Accessed January 2, 2025.
-
21.
Wilson T, Reid J, 1949. Malaria among prisoners of war in Siam (“F” Force).Trans R Soc Trop Med Hyg 43: 257–272.
-
22.
Douglas NM et al., 2014. Mortality attributable to Plasmodium vivax malaria: A clinical audit from Papua, Indonesia. BMC Med 12: 217.
-
23.
Maitland K et al.; TRACT Group, 2019. Transfusion volume for children with severe anemia in Africa.N Engl J Med 381: 420–431.
-
24.
Shanks GD, 2023. Pernicious Plasmodium vivax as a historical cause of malarial cachexia? Am J Trop Med Hyg 108: 1093–1095.
-
25.
MacArthur B, 2005. Surviving the Sword: Prisoners of the Japanese in the Far East, 1942–1945. New York, NY: Random House.
-
26.
Feachem RGA et al., 2019. Malaria eradication within a generation: Ambitious, achievable, and necessary. Lancet 394: 1056–1112.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 31791 | 31791 | 30891 |
| Full Text Views | 103 | 103 | 40 |
| PDF Downloads | 74 | 74 | 21 |