International Blood Research & Reviews

Background: Antiphospholipid antibodies (aPLs) are the serological markers used in the diagnosis of the antiphospholipid syndrome (APS). HIV infection has been associated with an elevated aPls level, but its link to the APS with clinical thrombosis is still been investigated. This study is designed to determine and correlate serum level of antiphospholipid antibodies with CD4 count and some haematological parameters of HIV seropositive subjects in comparison to those of healthy controls and also to compare these parameters between antiretroviral therapy (ART) naïve and treated patients.

Methodology: A cohort of 110 patients which consist of 90 HIV positive Patients (22 males and 68 females) and 20 HIV negative patients (10 males and 10 females) which serve as control attending Babcock University Teaching Hospital (BUTH) Ilishan-Remo, Ogun State, Nigeria were recruited for the cross-sectional study. HIV antibodies were detected using 3 rapid diagnostic kits (Determine, Unigold and Stat Pak). CD4+ cells were counted using Partec® Cyflow Counter (Germany). The Full Blood Count was analyzed using the Sysmex® Automated Haematology Analyzer (Kobe-Japan). Antiphospholipid antibodies (aPLs) were assayed using the Human Anti-Phospholipid Screen IgG/IgM ELISA kit (Alpha Diagnostic International, Texas, USA).                                       

Results: The present study showed that the mean serum antiphospholipid antibody level was significantly (P<0.001) higher in HIV positive Patients (11.83±7.36u/ml) compared to the control group (7.30±3.95u/ml). While on one hand, there was a strong positive correlation between serum aPLs level and PLT (r= 0.044), MCHC (r= 0.084) and LYM (r= 0.105) in HIV infection; on the other hand, there was a strong negative correlation with CD4 count (r= -0.094), PCV (r= -0.099), Hb (r= -0.072), RBC (r= -0.003), WBC (r= -0.063), MNO (r= -0.213), GRA (r= -0.003), MCV (r= -0.023) and MCH (r= -0.005). Also, there was no significant differences (P>0.05) between the aPLs level of HIV group on ART (11.44±7.74 u/ml) and those not on ART (12.00±7.24 u/ml). Some haematological parameters like PLT, PCV, Hb, RBC and red cell indices of the HIV group on ART did not differ significantly from those not on ART. However, the CD4 count (638.89±119.56 cell/μL), WBC (5.38±1.49X10³/μL), LYM (51.43±7.99%) and GRA (46.30±10.18%) of the HIV group on ART were significant higher than those not on ART (465.30±145.92 cell/μL, 4.55±1.57X10³/μL, 42.23±10.96% and 39.10±7.81%, respectively).                                                                                               

Conclusion: Significant elevated aPLs level is present in HIV infection; however, the information obtained is not sufficient to indicate the occurrence of anti-phospholipid syndrome in HIV infection. There was no strong relationship between aPLs level and indicators of immunohaematological abnormalities in HIV infection. This finding is plausible and would therefore require further investigation.

Aims: To observe any diversity of pattern in the anaemic parameters in the major ethnic groups of Pakistan.

Study Design: Observational, cross-sectional.

Place and Duration of Study: Department of Medicine, Creek general Hospital, Korangi, Karachi, Pakistan from October 2017 to March 2018.

Methodology: 1200 adults above 18 years were included. Pregnant females, age less than 18 years, any severe organ insufficiency, stroke, neurodegenerative disease, known blood dyscrasias or terminal illness at baseline evaluation were excluded. Their ethnic background was grouped into Urdu speaking, Punjabi, Balochi Sindhi, Pashtun, Bengali, and Gilgit according to their place of origin, mother tongue or parents’ place of origin. The complete blood picture was performed to identify anaemia, grade the severity, classify the red cell indices and exclude any blood dyscrasias in each of the ethnic group. 

Results: Out of 1200 adults, 626(52%) were anaemic. In decreasing order, the most anaemic were Bengalis (57.6%), Sindhis (55%), Urdu speaking (54%), Pashtuns (54%), Balochis (52%), Gilgits (49%) and Punjabis (45%). In males, Sindhis (60%), Pashtuns (57%), Bengalis (56%), and Urdu speaking (51%) were most anaemic. In females, Balochis (71%), Bengalis (64%), Urdu speaking (55%) were most anaemic. Anaemia was prevalent in the younger age group of the Urdu speaking, Pashtun and Sindhis community, while in the rest of the ethnic groups anaemia was most common in the middle age group. In males, anaemia was highest in the young age group of Urdu Speaking, Sindhis, and Pashtuns while in females in all the ethnic groups the middle age group was most anaemic and had least anaemia in elderly females except in Bengalis where the least was in young females. Mild anaemia was most common overall and in both genders. Regarding red cell indices, Punjabis and Bengalis were normocytic while in the rest the most were microcytic. In the males, Urdu speakers, Punjabis and Bengalis were significantly more normocytic anaemic, while Sindhis were more microcytic. In females, in all the ethnic groups’ microcytic anaemia was prevalent.  Anaemia was three times more in the Sindhi group of smokers compared to the Sindhi nonsmokers while in the rest of the ethnic groups there was no specific correlation.

Conclusion: This survey specifies that in Pakistan the key measures of health status are albeit dependent on the financial status, literacy rate, sanitation, access to primary care facilities, effective role of health providers but the genetic composition and cultural norms also play their part.

Aim: This study aimed to estimate the normal CD4 counts in healthy Bhutanese blood donors.

Study Design: A prospective descriptive study.

Place and Duration of Study: This study was carried out in the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu, between July 2015 to April 2016.

Methodology: We recruited healthy blood donors in the JDWNRH collecting demographic characters and blood samples from consenting donors. Blood samples were analyzed using the BD FACS count system.

Results: A total of 413 healthy blood donors, 288 (69.7%) males with a mean age of 27.3 years (18-62 years) were enrolled.  Ethnically, 351 (85.0%) were northern and 62 (15.0%) were southern Bhutanese. The mean CD4 count was 668.3 cells/µl (range 259 -1591 cells/µl) and the median was 663 cells/µl.  Females had significantly higher counts (p=0.004) and CD4 counts also significantly increased with increasing age but these differences were numerically small. Ethnicity did not produce significant differences in the CD4 count. In about 21% of the participants, counts were below the reference ranges and published data for Indians and Caucasians but comparable to other Asian, Middle East and African population. 

Conclusion: Upon validation with a larger study, a somewhat different CD4 cutoff may be required for the Bhutanese population. However, within the Bhutanese population, a single reference count may be advocated for adults disregarding the negligible numerical differences between age groups and gender.

Background: Glucose-6-phosphate dehydrogenase deficiency is one of the most common enzyme defects affecting all races and particularly in malaria-endemic areas. This study aimed at determining G6PD deficiency, bilirubin and oxidative stress biomarkers in G6PD deficient neonates among neonates in UDUTH, Sokoto.

Methods: Samples of cord blood were collected at delivery, in the Labour Room, from 300 neonates made up of 131 (43.7%) males and 169 (56.3%) females. Methaemoglobin reduction method was used for the screening of G6PD deficiency; total bilirubin level was estimated using bilirubinometer, total antioxidant capacity (TAC) was measured using TAC Assay Kit, and malondialdehyde (MDA) using thiobarbituric acid method. 

Results: Of the 300 neonates tested, a total of 90(30%) were G6PD-deficient while 210(70%) had normal G6PD status. Of the 90 G6PD-deficient neonates, 41(45.6%) were males and 49(54.4%) were females. The prevalence was 31.3% among male population and 29.0% among female population. The mean ± standard error of total bilirubin (mg/dL), TAC (uM CRE), and MDA (nmol/L) in G6PD-deficient and G6PD-normal neonates were 6.63 ± 0.12 and 6.11 ± 0.06, 364.34 + 18.76 and 390.99 + 24.18, 26.15 + 1.22 and 23.35 + 1.15 respectively. The total bilirubin was significantly higher (p<0.05) in G6PD-deficient neonate than in G6PD-normal neonates, both TAC and MDA values showed no significant difference between the G6PD deficient and G6PD normal neonates.

Conclusion: From this study, there is a high prevalence of G6PD deficiency among neonates in UDUTH, Sokoto. G6PD deficiency is a known cause of neonatal jaundice hence it is recommended G6PD screening be made routine for all neonates born in UDUTH, Sokoto.

Introduction: Administration of blood and blood products is very life-saving. However, the safety of blood transfusion in resource-limited nations is questionable unlike in many developed nations of the world. The risk of viral transmission has been significantly curtailed, but bacterial transmission and infection continue to be a significant challenge in transfusion medicine. Bacterial screening is not usually carried out on platelets and other components of blood in Nigeria except on rare occasions after transfusion reaction due to bacterial contamination is highly suspected.

Aims: To discuss the risk of bacterial contamination of blood components in a resource-limited setting like Nigeria and measures that can be instituted to reduce it.

Results: the sources and risks of bacterial blood contamination in Nigeria were reviewed and discussed as well as steps that can be taken to limit such.

Conclusion: Bacterial screening of blood and blood components prior to administration is rarely done in Nigeria and since the donor's arm is the primary potential source of contamination, efforts should be made to have a pool of altruistic non-remunerated blood donor to limit the risk.