International Blood Research & Reviews

Background: Hypertension is the more frequent cardiovascular risk factor among diabetic patients and it amplifies the risk of other cardiovascular diseases.

Aims: This survey aimed to determine factors incriminated in the outcome of the hypertension among diabetic patients attending the diabetics follow up center of Matanda hospital.

Methodology: We carried out a descriptive cross-sectional survey during 3 months, from October to December 2015 at the diabetics follow up center of Matanda hospital.

Results: The global frequency of the hypertension among diabetic patients followed at Matanda hospital was 63.1% i.e.101 patients out of 160 diabetic patients. 63.9% of the diabetic women presented HTA. 81.3% of diabetic patients aged of more than 60 years present the HTA. 65.5% of diabetic patients with HTA have a normal BMI (18.5-24.9Kg/m²). The HTA was diagnosed in 30% of patients after diabetes. 17.5% of the patients had a HTA of grade 1, 12.5% for HTA of grade 2, 6.2% for HTA of grade 3 and 20.6% for the isolated systolic HTA. 52% of patients with HTA are taking cardioaspirin in prevention of cardiovascular complications of diabetes and 65.2% of them respect the diabetic diet. The regular physical activity is done in 42.1% by patients with HTA.

Conclusion: Hypertension is an important problem in the diabetic population. Thus, care and prevention would be of paramount importance.

Aim: The objective of this study is to assess the haematological profile of our patients with chronic kidney disease.

Study Design: This was a cross-sectional case-control study.

Place and Duration of Study: University of Port Harcourt Teaching Hospital, Rivers State Nigeria 2015.

Methodology: A total of 186 subjects with chronic kidney disease (CKD) were enrolled at the University of Port Harcourt Teaching Hospital (UPTH); among these, 124 subjects had received more than one unit of blood within one month or more than ten units of blood within three months. The remaining 62 CKD subjects (control population) have never been transfused. Complete blood count, serum creatinine and urea levels were determined for all participants. Estimated GFR (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease (MDRD) formula.

Results: The red cell count, haemoglobin, haematocrit and red cell indices were decreased in all the study participants with chronic kidney disease. The mean haemoglobin, haematocrit and red cell count were found to be significantly lower in the multiply transfused patients compared to the non-transfused patients. Serum creatinine showed negative correlation with red cell count, haemoglobin and haematocrit in the study population.

Conclusion: The study shows that anaemia was present in all subjects, and was inversely proportional to the severity of chronic kidney disease in this setting.

Background: High dose chemotherapy with autologous stem cell transplantation (ASCT) is the standard of care and commonly used procedure for patients with relapsed non Hodgkin lymphomas (NHL). There is no clear evidence of superior conditioning regimen and studies that comparing different high dose regimens regarding the efficacy and toxicity profiles were little.

Objectives: To compare efficacy and toxicity profiles of BU/CY and CMV conditioning regimens in patients with relapsed NHL scheduled for ASCT.

Patients and Methods: Between June 2013 and January 2017, a total of 50 patients were enrolled in the study, 25 patients received CMV and 25 patients received BU/CY followed by ASCT in Bone Marrow Transplantation Center, Nasser Institute and El Sheikh zayed Hospitals, Egypt.

Results: The median time for both neutrophil and platelet engraftment showed no significant difference between the two groups (p= .4) and (p=.3) respectively. Transplant related mortality (TRM) was less in CMV arm, but p value didn't reach the statistical difference (p= .1). The 3- year DFS and OS were slightly higher in CMV arm. However, they didn't show any significant statistical difference 72.8% and 66.5%, (p =.81) and (p= .07). The toxicities, Grade III / IV mucositis, nausea/vomiting and diarrhea occurred slightly higher in BU/CY than in the CMV (16%, 24%, 8% vs. 12%, 16%, 4% respectively).Pulmonary toxicity was higher in BU/CY (3 patients (12%) in BU/CY arm and 1 patient (4%) in CMV arm). However, the toxicities didn't reach the statistical difference.

Conclusion: We found that both BU/CY and CMV regimens are not significantly different in terms of efficacy and toxicity. Although, the small number of patients that were enrolled in our study, we recommend further trial with larger number of patients to confirm the results.

Aims: To profile CD4 count, TNFα levels and cytopenia in HIV seropositive patients on ART and also evaluate the prevalence of hematological cytopenia.

Study Design: The present study is a cross sectional study and was carried out in the department of immunology, hematology and blood transfusion, department of pharmacology university of Port Harcourt and university of port-Harcourt teaching hospital, between May 2016 and July 2016.

One hundred patients (45 males and 55 females) were recruited for this study, patients included in this study were HIV positive and on anti-retroviral treatment for at least three months, they were not on any mind altering medications and were mentally sound and above 18 years 4 patients dropped out of the study.

The Results: Hematological examination, CD4 count and serum TNF α levels were done. The prevalence of anemia was high (43.7%), neutropenia and leucopenia showed prevalence of 26.00% and 21.9% respectively. Prevalence of lymphopenia was 2.1%, whereas thrombocytopenia was 11.5%. A profile of immunological markers showed that mean CD4 was 395.81±273.046, high serum TNF α 65.33.20±58.52 pg/ml was observed. WBC, lymphocyte and neutrophil were 4.82±1.38, 45.09±10.17 and 42.83±11.05 respectively, serum TNF α was increased while relative lymphocyte and neutrophil counts were decreased in patients with CD4 less than 200. Platelet count of participants in this study was 243.62±66.13 while RBC, PCV and hemoglobin was 3.82±0.75, 36.39± 4.10 and 12.00±1.806g/l respectively. 

Conclusion: Patients with CD4 less than 200 showed increased TNF-α, reduced CD4, total lymphocyte and neutrophil counts. Finding from this study has led to the recommendation that these parameters be used as biomarkers in monitoring patients and disease control in Nigeria.

Background: Increased morbidity and mortality rates have been reported among patients co-infected with Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV).

Aims: To determine the prevalence of HBV infection among HIV-infected anti-retroviral therapy (ART) naïve patients attending two Public Health Facilities in Osun State, Nigeria; as well as to determine the effect of HIV/HBV co-infections on CD4 count and some haematological parameters.

Study Design: This is a prospective, analytical and Institutional based study.

Place and Duration of Study: HIV Out-Patients Clinic, State Specialist Hospital Osogbo and State Hospital Iwo, Osun State, Nigeria, between February and August, 2015.

Methodology: A total of 321 blood samples were collected from 121 HIV HAART Naïve patients and 200 HIV negative patients, aged between 4 and 52 years. HIV antibodies were detected using 3 rapid diagnostic kits (Determine, Unigold and Stat Pak). Hepatitis B surface antigen (HbsAg) was detected using Clinotech Diagnostic test strips. CD4+ cells were counted using Partec® Cyflow Counter (Germany); while Platelet Count and Haemoglobin concentration were determined using Sysmex auto-analyzer (Japan).

Results: The prevalence of HBV infection was found to be significantly higher (P<0.05) among HIV positive patients (16.5%) than in HIV negative patients (3.5%). HIV status was identified as a risk factor for acquiring HBV infection. There were no significant differences between the CD4 Count, Platelet Count and Haemoglobin Concentration of HIV/HBV co-infected and mono-infected group on the basis of age, except for gender. The mean CD4 Count of HIV/HBV co-infected males (327±200.64 Cells/µL) was found to be significantly higher (P<0.05) than their mono-infected counterparts (274.5±81.33 Cells/µL), whereas, their Platelet Count and haemoglobin concentration did not differ significantly (P>0.05). Also, the mean CD4 cell count of co-infected females (408.4±331.28 Cell/µL) was significantly (P<0.05) higher than that of their male counterparts (327.6±81.33 Cell/µL). However, there were no significant differences in their mean platelet count and haemoglobin concentration.

Conclusion: HBV exist among HIV positive patients living in Osun State, Nigeria, with a prevalence rate of 16.5%. Although, no significant difference was observed in the Platelet count and Haemoglobin concentration of HIV/HBV co-infected when compared to those of HIV mono-infected patients, regular monitoring of their CD4 Count, Platelet Count and Haemoglobin Concentration is encouraged to prevent associated sequalea.

Aims: This study investigated the prevalence, and associated factors of hepatitis B virus (HBV) infection among pregnant women attending antenatal clinic at Mulago National Referral Hospital, in Uganda.

Study Design: This was a cross- sectional study.

Place and Duration of Study: This was conducted at Mulago National Referral Hospital, located in Kampala, Uganda. The study was carried out during the months of January to June, 2016.

Methodology: We collected about 4militres of blood samples from 323 assented/ consented female participants. These were analyzed for hepatitis B surface antigen using one step immunochromatographic test. A structured questionnaire was used to explore predisposing factors to HBV. Associated factors of HBV infection were determined using logistic regression analysis.

Results: The survey covered 323 pregnant women. Majority (N=141, 43.7%) were in the age category of 25 to 29 years (range 14–43 years). Their mean parity was 2.2; 106 (32.8%) were nullpara and 179 (55.4%) were in their first trimester. Three participants (0.9%; 95% Confidence Interval: 0.45-1.22) tested positive for hepatitis B surface antigen. The HBV infection was recorded most among the polygamous (100%), as well as multipara (66.7%). There was a statistical association between HBV infection with pregnant women who were in a polygamous relationship (AOR: 5.8; 95%: CI 2.1-10.4), scarification (AOR: 4.2; 95% CI: 3.2-17.9) and shared sharps (AOR: 8.6; 95% CI: 3.7-17.1).

Conclusion: We report a high prevalence of HBV infection, and the pattern tends towards increased perinatal HBV transmission. We identified a knowledge gap pertaining transmission, causation and prevention of HBV infection.

Background: Transmission of HBV infection has been documented from hepatitis B surface antigen negative blood donors.

Objective: To determine the prevalence of serological markers of hepatitis B virus infectivity among hepatitis B surface antigen negative blood donors at the University College Hospital Ibadan.

Materials and Methods: A cross-sectional study was carried out among 490 blood donors who were negative for HBsAg. Anti-HBc and other viral markers such as anti-HBs, HBeAg and anti-HBe were tested using ELISA kits by DIAPRO Diagnostic Bioprobes Milano, Italy.

Results: The mean age of participants was 32.5 years (±9.5), majority were males, 462 (94.3%). Eighty-three (16.9%) were positive for anti-HBc, out of which 35 (7.1%) had anti-HBc alone, 30 (6.1%) had both anti-HBc and anti-HBs while 18 (3.7%) were positive for anti-HBc, anti-HBs and anti-HBe. Antibody to HBsAg (anti-HBs) was detected in 54 (11%) donor samples, of which 6(1.2%) were positive for anti-HBs alone. The number of donors positive for anti-HBeAg was 18 (3.7%). However, no subject was positive for HBeAg.

Conclusion: This study has showed that some blood units containing other markers of HBV are being transfused to recipients even after screening for HBsAg is negative. These blood units are potentially infectious and can cause post-transfusion hepatitis in the recipients. There is need to consider introduction of testing for other markers of HBV infection in our blood banks.

Aim: To measure serum myoglobin concentration in stable patients with chronic kidney disease (CKD) who had not commenced hemodialysis and determine its relationship with cardiovascular risk factors.

Study Design: Cross-sectional study.

Place and Duration of Study: Renal Unit, Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria from January 2014 to December 2015.

Methodology: Blood pressure, serum myoglobin, HDL-cholesterol, total cholesterol, triglyceride, fasting plasma glucose, urine and serum albumin, urine and serum creatinine concentrations were measured in 83 diagnosed chronic kidney disease patients attending the renal clinic and 83 age- and sex-matched healthy control subjects. Body mass index (BMI), estimated glomerular filtration rate (eGFR), urinary albumin-creatinine ratio (UACR) and LDL-cholesterol were calculated. 

Results: CKD patients had higher myoglobin, higher blood pressure, higher serum creatinine, higher triglyceride, higher UACR, lower serum albumin, lower HDL and lower eGFR compared to controls. Nineteen (22.9%) patients versus zero (0%) controls had elevated myoglobin. Among patients, myoglobin was associated positively with serum creatinine and UACR but inversely with eGFR. Apart from obesity, high myoglobin levels were not significantly associated with cardiovascular risk factors.

Conclusion: Serum myoglobin elevation in CKD patients was associated with high UACR and low eGFR, which are indicative of progressive decline of renal function. Myoglobin levels are influenced by impaired renal status and not primarily related to cardiovascular risk factors in stable patients with CKD. Thus, it may not be useful as a biomarker of myocardial injury in CKD patients.

Aims: To determine the prevalence of Hepatitis B Virus among Ambulance Drivers and Mortuary workers in Plateau State with possible associated risk factors for the infection.

Study Design: A cross section, descriptive study.

Place and Duration of Study: Various hospitals in plateau state(Jos University Teaching Hospital (JUTH) in Jos, Plateau State Hospital in Jos, Air-Force base Hospital in Jos, Our Lady of Angels Hospital in Jos, MRS Hospital in Bassa Local government and Pankshin General Hospital in Pankshin Local Government in Plateau State) between December 2015 and February 2016.

Methodology: Eighty (80) blood samples were collected from Ambulance Drivers and Mortuary workers from various hospital for the determination of Hepatitis B surface Antigen and Hepatitis B core Immunoglobulin-M Antibody. Rapid Immunochromatographic Assay (Strip test) and Indirect Enzyme Linked Immunosorbent Assay (ELISA) were used in the analyses of the samples.

Results: Out of 80 samples screened, 6 (7.5%) were positive for Hepatitis B surface Antigen and 7(8.8%) were positive for the Hepatitis B core Immunoglobulin-M antibody. Of the 80 samples analyzed, 56 were males of which 2 (3.6%) were positive for Hepatitis B surface antigen and 3(5.4%) were positive for Hepatitis B core Immunoglobulin-M Antibody respectively. In Females, 4 (16.7%) were positive for Hepatitis B surface antigen and 4 (16.7%) tested positive for Hepatitis B surface antigen. The presence of anti-Hepatitis B core Antibody (HBcAb) indicates previous or ongoing infection with Hepatitis B Virus. The 7 positive samples for Hepatitis B Immunoglobulin-M Antibody in this study indicate recent or acute infection with Hepatitis B Virus.

Conclusion: The use of Personal Protective Equipment (PPE), well screened blood, vaccination and having one sexual partner needs to be advocated through public enlightment campaigns or education for proper prevention of Hepatitis B Virus infection among Health care workers.

Aim: No data are available regarding the frequencies of clinically significant alloantibodies among patients requiring transfusion in Sokoto North western Nigeria. We intend to provide information on the prevalence of clinically significant alloantibodies and their specificity among patients that required blood transfusion in this region.

Study Design: In this present cross sectional descriptive study, 229 patients consented to the study, with median ages of 26.5 years, 24.0% were males while 174 (76.0%) were females. There were 11 patients who had sickle cell disease (SCD), 10 patients had cancers (Ovarian 4, Bladder 3 and Cervical 3), while other were admitted for various diseases but pregnancy complications predominates. The study was carried out between the months of September and October 2015.

Materials and Methods: Three millilitres of whole blood was collected from each subject into an EDTA anticoagulated tubes. The plasma was collected screened for the presence of clinically significant alloantibodies by Ortho Biovue system cassettes (AHG/Coombs) technique using the Lorne Laboratories of UK antibody screen cells and panel cells.

Results: The result indicated that 14.85% of the patients had clinically significant alloantibodies in their plasma of which 64.71% were female and 35.29% were male. 100% of anti-D and anti-c and 50% of anti-E were identified in female. Anti-f, anti-Jka, anti-Leb, anti-Fyb, anti-Pi and anti-Kpa each 0.44% were identified in female plasma, anti-C^w was found in 0.44% in male while about 9.17% of the alloantibodies could not be identified. We observed that 6 out of 23 patients with chronic diseases developed alloantibodies.

Conclusion: We concluded that the prevalence of alloantibodies among the studied population was high. However, 9.17% of the formed clinically significant alloantibodies in these patients cannot be identified by the known panels of cells made from the Caucasians population. It could be that unknown antigens exist in this part of the world.

Background: The aim of this study was to determine the prevalence of the deficiency of Glucose-6-phosphate 10 dehydrogenase (G6PD) activity among students of Sultan Abdurrahaman School of Health Technology Gwadabawa, Sokoto State.

Methodology: A total of 164 subjects comprised of 82 (50%) males and 82 (50%) females were recruited for this study. Randox G6PD qualitative in vitro test screening was used for the diagnosis of G6PD deficiency.

Results: Of the 164 subjects tested, 144 (87.8%) were normal while 20(12.2%) were G6PD-deficient.Out of the 82 male subjects studied, 64 (78%) were normal while 18 (22%) were G6PD deficient compared to 80 (97.6%) and 2 (2.4%) females subjects who were normal and deficient for G6PD respectively. There was a significant difference between gender (p<0.01) using chi-square.

Conclusions: The Prevalence of G6PD deficiency was concentrated predominantly among male subjects (22%). There is a need for the routine screening of subjects on a much wider scale for G6PD deficiency in our environment, especially in malaria endemic areas, where quinine and its derivatives be used. This would allow for evidence-based management of subjects with G6PD deficiency and also educate them so as to avoid food, drugs, and other agents that can potentially predispose them to hemolytic crisis or oxidative stress.

Aims: To assess the overall performance of the transfusion-transmissible infection testing laboratory through the evaluation of the results obtained from the participation in a blood proficiency testing study (B-PTS).

Study Design: The B-PTS study was designed, organized and conducted by European directorate for the quality of medicines (EDQM). We were requested to test the B-PTS samples and to report the results on the online result data sheet.

Place and Duration of Study: The 3 blood testing laboratories of the Institute of transfusion medicine in Macedonia; July 2017.

Methodology: Each set of B-PTS-samples contained 4 panels: Anti-HCV (032), anti-HIV/p24 (033), anti-Treponema (034) and HBsAg panel (035). The samples were subjected to serological testing with two assays: Enzyme immunoassay with Enzygnost system, Siemens using BEP2000 and chemiluminescent microparticle immunoassay with Architect system, Abbott using Architect i2000.

Results: The laboratories were classified as “satisfactory” for B-PTS032 and B-PTS034. For B-PTS033 the classification was “non evaluable” because the results were not properly submitted. The B-PTS035 results were classified as “unsatisfactory” because two laboratories reported the reactive sample number 3 as “Not Reactive” with the Enzygnost assay and one laboratory reported it as “Not Reactive” with the Architect assay. The single observed non-conformity was that the S/Co (1.22) of the positive control for the Architect HBsAg assay was out of rang (1.65-4.96) for the corresponding reagent lot.

Conclusion: The participation in a B-PTS study provides an objective and independent evaluation of the overall performance of the laboratory. The management of the non-satisfactory PTS results should be documented and performed in a controlled manner. Appropriate corrective and preventive measures should be taken in order non-conformities not to repeat.