Open Access Review Article

Hospital-based Clinical Transfusion Process Audit and Quality Improvement in Africa: A Critical Review

Joseph Aondowase Orkuma, Michael Tyodoo Maanongun

International Blood Research & Reviews, Page 1-16
DOI: 10.9734/IBRR/2017/32666

Background: Clinical transfusion process (CTP) in Africa is an age long practice yearning for scientifically sound, evidence-based findings to address existent challenges of quality.

Objective: To review relevant aspects of hospital-based transfusion practices in Africa wherein practices were assessed against standards (audit) and its impacts weighted on quality improvement. We also sought to identify challenges to auditing and proffered strategies for practice improvement where necessary.

Methodology: A systemic review of literature searched on MEDLINE, Google, other internet sources using related search words as well as hand searches of review articles and files.

Results: Audit reports on hospital-based transfusion process in Africa are generally few when compared to the multiple steps and procedures involved, wide geographical spread and heterogeneity of the continent. Prevailing practice challenges includes unstructured transfusion services with paucity of voluntary non-remunerated blood donors, absence of many guidelines, low funding and commitment for effective oversights and paucity of trained audit personnel.

Conclusion: Quality in hospital-based CTP in Africa can continuously improve if all stakeholders evaluate their performances against acceptable standards and provide evidence-based facts that can be deployed in correcting inadequacies existing therein and in advancing transfusion therapy as obtainable in other climes. A functional and well supported structured transfusion service in all African nations that will nurture more transfusion-based researches for guideline development is advocated. Also, increased funding, legislation and general oversights by central governments as well as synergetic continental, regional and group cooperation by hospitals in proximate locations will offer opportunities for manpower development, knowledge transfer and effective inventory management desirable for promoting hospital-based CTP audit practices in Africa.  

Open Access Original Research Article

Assessment of Some Key Haematological Parameters on Cytomegalovirus Antibody Positive Pregnant Women in Makurdi Nigeria

Onoja A. Michael, Onoja A. Theresa, Alao O. Olusayo, S. I. Nwadioha

International Blood Research & Reviews, Page 1-8
DOI: 10.9734/IBRR/2017/34415

Background: There is high prevalence of Cytomegalovirus (CMV) in pregnancy worldwide, primary infection in particular has been associated with significant haematological changes and childhood neurodevelopmental disabilities. There is however, paucity of information on the effect of CMV seropositivity in pregnancy on the haematological parameters of pregnant women from our centre.

Aim: This study was therefore designed to determine the effects of CMV sero-positivity among pregnant women, in Makurdi Nigeria, on some key haematological parameters.

Methods: A cross sectional study of 211 pregnant women aged 15-50 years attending antenatal clinic at The Benue State University Teaching Hospital & Federal Medical Centre, Makurdi, Nigeria, from November 2016 to April 2017 was conducted. They were screened & grouped based on their CMV status into three groups: The overall CMV status (irrespective of antibody type), CMV IgG status and CMV IgM status. Their Mean White Blood Count (WBC), Platelet Count, Absolute Neutrophil Count (ANC), Absolute Lymphocyte Count (ALC) and Haemoglobin (Hb) levels were estimated & compared. Data obtained were coded, entered and analysed with SPSS version 20. Simple proportion was used to determine CMV positivity. The independent sample t-test and Pearson's chi-square were used for comparison of quantitative variables and chi-square test for qualitative variables. Relationships were determined, and a P< .05 was considered significant.

Results: The younger pregnant women age 21-30 years constituted 75.4%, and represented the highest respondents. In those who were CMV IgG positive, WBC, platelets, ALC & haemoglobin all appeared lower & ANC appeared higher. In the CMV IgM positive, Haemoglobin & platelets appeared lower, while WBC, ANC & ALC all appeared higher. Overall, in those positive for CMV (irrespective of antibody type), WBC, platelet and haemoglobin appeared lower and ANC & ALC appearing higher. In all, these differences were not statistically significant, with P> .05

Conclusion: Cytomegalovirus seropositivity was found not to have any statistically significant effect on the haematological parameters of the pregnant women. We recommend further research in this area, education, and follow up on women with primary infection.


Open Access Original Research Article

Sero-prevalence of Anti- HCV among Yemenis Blood Donors Attending National Blood Transfusion and Research Centre in Sana'a: Yemen

Tawfique K. A. Al-Zubiery, Talal Alharazi, Hafez Alsumairy, Amar Abdullah Jabir, Manal Jamil Muckbil, Majdi Abdullhabeeb Saleh, Eqtesad Abdu Ali Al-Shibani

International Blood Research & Reviews, Page 1-6
DOI: 10.9734/IBRR/2017/34731

Aim: To determine the current sero-prevalence of HCV among blood donors in Sana'a city: Yemen.

Study Design: A descriptive cross sectional study.

Place and Duration of Study: This study was conducted on 3606 blood donors at the National Blood Transfusion and Research Centre in Sana'a, Yemen, during the period from October 2016 to January 2017.

Methodology: A descriptive cross-sectional study was conducted to estimate the prevalence of anti-HCV antibody using enzyme immunoassay (EIA) technique at the National Blood Transfusion and Research Centre in Sana'a Yemen during the period from October 2016 to January 2017.

Results: A total of 3606 blood donors were enrolled in this study, 1.6% of them were anti-HCV positive. Distributed as the following, 1.1%, 2.8%, 2.2%, 2.9%, 3.4%, 2.4% and 1.7% of anti-HCV antibody was among blood donors resident the capital city of Sana'a, Sana'a rural area, Taiz, Ibb, Dahmar, Amran and Almahwet governorate respectively. The prevalence rate of HCV was higher among Handicraft (1.8%). High HCV seropositivity were detected among the age group 36-45, the difference was found statistically insignificance.

Conclusion: Low percentage of HCV sero-prevalence was detected among our blood donors. Specific strategies for the screening of blood donors should be followed in the blood bank centers in Yemen.


Open Access Original Research Article

A Preliminary Study of the Effect of Alchornea laxiflora on Haematological Parameters and Organ Weight in Albino Rats

S. O. Bada, A. M. Oyetayo, K. M. Adaramola-Ajibola, E. O. Giwa

International Blood Research & Reviews, Page 1-6
DOI: 10.9734/IBRR/2017/35722

Aim: The aim of this study is to investigate the effects of ethanol extract of Alchornea laxiflora on internal organs as well as haematological indices of rats.

Methodology: The plant materials were air dried and grinded mechanically followed by solvent (ethanol) percolation for 72 hrs. The resultant crude extracts were kept in sterile airtight bottles and stored in the refrigerator until use. Twenty albino rats were placed in four groups of five (5) rats each, group I, II and III were given 100, 200 and 300 mg/Kg body weight of the extract respectively while group IV received only water for a period of 21 days. Haematological indices such as White blood cells (WBCs), Red blood cells (RBCs), packed cell volume (PCV), Neutrophil, Lymphocytes, Monocytes, platelets, Haemoglobin (Hb) were assayed while the internal organs including heart, lungs, liver and kidneys were weighed in triplicates after blood collection.

Results: The plant extract showed a significant (p<0.05) increase on the levels of red blood cells (RBC), white blood cells (WBC), packed cell volume (PCV), platelet and haemoglobin concentration (Hb) at all the concentration used in the assay. The increase was observed along the concentration gradient. Moreover, the plant extract had a significant (p<0.05) reduction on neutrophyll level while a significant (p<0.05) increase was observed for monocytes and lymphocytes at concentration at 300 mg/kg body weight concentration. Also, there was no significant (p<0.05) difference in the weight of kidney of the control and experiment groups whereas there were increase in the weight of heart and lungs of group treated with 200 and 300 mk/kg body weight albeit, there was a significant (p<0.05) reduction in the weight of liver in all the treated groups.

Conclusion: From the foregoing, A. laxiflora extract appears to possess haematopoietic activity albeit with possible adverse effect on some major internal organs of rats at high doses therefore caution should be applied in its use in the management anaemic conditions in traditional medicine system as blood tonic.


Open Access Case Report

Pseudo-Pelger-Huët Anomaly in Megaloblastic Anemia

Ajay Kumar Khandal

International Blood Research & Reviews, Page 1-5
DOI: 10.9734/IBRR/2017/34868

The Pelger-Huët anomaly (PHA) is a morphologic abnormality of segmentation involving the neutrophils predominantly; however, all leucocytes may be variably affected; it is an autosomal dominant condition. It has a global prevalence; with certain Indian populations having a reported prevalence as high as 1 in 300. PHA should be considered when clinical labs suggest a profound left shift in the setting of normal leucocyte count. Clinically, PHA needs differentiation from the pseudo-Pelger-Huët anomaly (PPHA), which though morphologically similar is associated with multiple disease states such as; myelodysplasia, myeloproliferative disorders, leukemias, or drugs. PPHA with megaloblastic anemia is rarely seen. Reported herein, is a case of megaloblastic anemia with PPHA.