International Blood Research & Reviews

Aims: To determine the effect of intestinal parasites on the haemoglobin concentration and eosinophil levels among the patients treated at the University of Calabar Teaching Hospital (UCTH), Nigeria.

Study Design: This was cross sectional study. Ethical approval and patients’ informed consent were sought and obtained before collection and processing of samples.

Place and Duration of Study: Outpatient clinic, UCTH, Calabar between July, 2013 and May, 2014.

Methodology: We included 300 patients (114 males, 186 females). Intestinal parasites were detected by direct stool microscopy and formol ether concentration technique. Haemoglobin (Hb) concentration was determined by Cyanmethaemoglobin method while eosinophil levels were determined by differential eosinophil count.

Results: Overall, 30% of the studied subjects were positive for intestinal parasites, 23% had low Hb concentration (below 110.0 g/L) while 27% had high eosinophil count (≥ 7%). Parasite positive subjects had lower Hb concentration and higher eosinophil levels compared to their parasite negative counterpart (56.7% versus 8.6%) and (70% versus 8.6%), respectively (P< 0.001). Multiple infections was more related to Hb reduction and high eosinophil levels than single infections (80% versus 45%) and (90% versus 60%), respectively (P< 0.001). Hook worm showed the highest occurrence (26.7%) followed by Ascaris lumbricoides 23.3%, Trichuris trichiura 10%, and Entamoeba histolytica 6.7%. In single infections, Hook worm infected subjects recorded more reduction in Hb and increased eosinophil count (99.0 g/L and 15%, respectively) while in multiple infections, hookworm/Entamoeba histolytica co-infected subjects took the lead (70.0 g/L and 19%, respectively). There was no association between intestinal parasites prevalence by gender of subjects (P = 0.2128).

Conclusions: Intestinal parasitosis may result in anaemia and eosinophilia and the decrease in haemoglobin concentration and increase in eosinophil count is directly related to the degree of parasitosis. It is recommended that stool microscopy, haemoglobin estimation and eosinophil counts be routinely performed for all patients visiting the hospital.

Background and Aims: To know blood group antigen frequencies in a population has various benefits as the assessing risk of alloimmunization, the providing antigen-negative compatible blood to patients with multiples antibodies and the development of a donor data bank for the preparation of indigenous cell panels. The aims of this study is to determine the frequencies of the ABO, Rh and Kell antigens in the blood donors in Kisangani, in the northeast region of Democratic Republic of Congo. 

Materials and Methods: Blood samples from 252 volunteer blood donors coming to the Blood Transfusion Provincial Center at Kisangani in 2015 were typed by serologic test for ABO, Rh (D, C, E, c, e) and K antigens.

Results: For the 252 blood donors, the most frequent phenotype in the ABO blood group, was O (47.6%) followed by A (30.6%), B (17.1%) and AB (4.1%). If combined ABO and Rh blood groups, O positive was most frequent, followed by A positive, B positive, AB positive, O negative and A negative respectively. In the Rh system, the c antigen was the most frequent (98.8%), followed by e antigen (97.6%), D antigens (96.42%), C antigen (15.9%) and E antigen (13.9%). Among ten phenotypes identified in the Rh system, the phenotype R₀r was the most frequently encountered (71.03%). In the Kell system, 100% of donors were K-k+.

Conclusion: Although the Africa specificities for the most immunogenic antigens and the context of limited resources, it is important for better care of patients to improve tests as phenotyping red cells.

Background: Anaemia is common in critically ill trauma patients admitted into the Intensive Care Unit. The aetiology of the anaemia in trauma patients is often multi-factorial, usually resulting from the trauma event, from subsequent interventions and from complications that may arise such as severe sepsis and multiple organ failure. Treatment of anaemia in severely injured patients admitted into the Intensive Care Unit often necessitates blood transfusion. Presently, there is a dearth of quality studies on blood transfusion and outcome among trauma patients especially in Nigeria. This article is aimed at evaluating the association between red blood cell transfusion and severity of injury in adult patients admitted to a trauma ICU.

Methods: Prospective observational study without intervention on transfusion pattern in adult patients admitted to the trauma ICU of a dedicated trauma Hospital in Nigeria between the periods October 1, 2010 and September 30, 2011.

Results: One hundred and fifty eight (158) patients (30.4%) out of the 664 patients admitted into the trauma ICU during the period of observation received a total of 447 units of blood. The mean age of patients that were transfused was 34.7 ±11.2 years, a mean injury severity score (ISS) of 24.1 ± 9.9, and an average frequency of transfusions of 3.5 ± 2.0 units. The mean pre-transfusion [Hb] for all patients was 66.5 g/L ± 10 g/L. The need to receive blood transfusion was significantly correlated to the Injury Severity Score (rho = 0.29, p < 0.001) but not with Simplified Acute Physiology II Score (p >0.05). Blood transfusion was significantly associated with longer stay in the ICU (4.5 ± 4.0) days versus (3.5 ±2.8) days, P < 0.0001) and longer hospital stay (21.9 ± 17.5) days versus (8.6 ±7.2 days) for transfused and non-transfused patients respectively. This relationship increases with the number of blood transfused (p< 0 0.0001). Also the risk of developing some complications in patients with severe injury admitted into the ICU increases with transfusion, OR (CI) of having a complication between the patients that received transfusion and those that were not transfused was 20.808 (12.6951 -  34.1062), {(z stat.) = 12.040, p <0.0001} Whereas there was association between blood transfusion and higher mortality (4 versus 2) respectively, this association was not statistically significant (p> 0.05) for the patients that received blood transfusion and those that did not.

Conclusions: Anaemia often requiring RBC transfusion is common in patients admitted to the trauma ICU, and the anaemia increases progressively during the course of ICU admission. Older patients and patients with higher severity of injury have higher tendency to receive blood transfusion in the trauma ICU. Despite that blood transfusion can be life-saving; it is associated with identifiable adverse consequences which is dose dependent.

Background: Fetal hemoglobin (HbF) can inhibit the deoxygenation induced polymerization of sickle hemoglobin (HbS) that drives the Pathophysiology of sickle cell disease. The aim of this study was to determine fetal Hb level in Sudanese sickle cell disease patients as well as to find out the effect of fetal hemoglobin level on different severity groups.

Materials and Methods: This was descriptive cross sectional study included 100 Patients with sickle cell disease diagnosed by Positive sickling test and Hemoglobin electrophoresis. The Patients were attended Sudan sickle cell anemia center (SSCAC), Elobied-Sudan during September 2015 – July 2016. Clinical history was obtained to perform the severity of the disease according to Hedo et al. scoring. Fetal hemoglobin was estimated by Betke's method. Data were analyzed using SPSS software computer program version 21.

Results: The mean of HbF level among the studied population was 7.6%. The descriptive analysis showed that, the mean level of HbF in 38 (38%) patients with mild disease was 7.7%, while in 54 (54%) patients with moderate disease the mean level of HbF was 7.6% and the last 8(8%) patients with severe disease showed HbF level 7%. There was no statistical significant differences observed when HbF level was less than 10% (P value = 0.146), while the statistical significant differences was observed among patients with HbF level more than10% (P value = 0.03).

Conclusion: The study concluded that Hb F level has no effect in severity of the disease among studied sickle cell patients, unless HbF level more than 10%.

Aims: HCV causes both acute and chronic infections and can be easily transmitted through contaminated blood or other body fluids. The present study deals with the molecular detection of HCV with help of one-step RT-PCR assay followed by nested PCR and agarose gel electrophoresis. 

Study Design: RNA extracted from the confirmed positive samples of HCV was utilized for the standardization of the one-step RT-PCR assay and nested PCR assay for diagnosis of HCV.

Place and Duration of Study: Centre for Biotechnology, Maharshi Dayanand University, Rohtak Haryana, India, during period of one year (January-December 2015).

Methodology: HCV positive samples were obtained from Department of Medicine, Maulana Azad Medical College (MAMC), New Delhi, India. Published primers from most conserved regions of HCV were taken and these primers were able to amplify all the strains of HCV. One-step RT-PCR kits, primers, extracted RNA from these positive samples were used for standardization of molecular diagnostic assays. The results were checked by 2% agarose gel electrophoresis.

Results: Positive samples of HCV were detected by nested PCR. Positive samples showed sharp band of 405bp while there was no amplification in the negative control.

Conclusion: Rapid tests have low sensitivity and specificity while molecular assays are rapid, sensitive and specific. Conventional one-step RT-PCR assay followed by nested PCR is rapid, specific, sensitive and it is also less costly than real-time RT-PCR. Cost of an assay is an important factor in controlling a disease in resource limited settings of developing countries.