Fiekumo Igbida Buseri

Sero-epidemiology of transfusion-transmissible infectious diseases among blood donors in Osogbo, south-west Nigeria

BACKGROUND Transfusion-transmissible infectious agents such as hepatitis B virus (HBV), human immunodeficiency virus (HIV), hepatitis C virus (HCV) and syphilis are among the greatest threats to blood safety for transfusion recipients and pose a serious public health problem. This cross-sectional study was undertaken with the aim of determining the seroprevalence of HIV, HCV, hepatitis B surface antigen (HBsAg) and syphilis and correlates the findings with sex and age to ascertain the associations, if any, in the occurrence of the pathogens. MATERIALS AND METHODS HBsAg, antibodies to Treponema pallidum and HCV were determined using Clinotech test strips. Antibodies to HIV types 1 and 2 were screened with Determine and Immunocomb. All the reactive samples were confirmed using enzyme-linked immunosorbent assays. Antibodies to Treponema pallidum were confirmed with a Treponema pallidum haemagglutination test. RESULTS A total of 1,410 apparently healthy prospective blood donors aged between 18 and 64 years (mean+/-SD, 32.58 +/- 10.24 years) who presented for blood donation at the Ladoke Akintola University of Technology Teaching Hospital Blood Bank, Osogbo were studied. The male:female ratio was 6:1. Of the prospective blood donors, 406 (28.8%) had serological evidence of infection with at least one infectious marker and 36 (2.6%) had dual infections. The overall seroprevalence of HBsAg, HIV, HCV and syphilis was found to be 18.6%, 3.1%, 6.0% and 1.1%, respectively. The highest prevalences of HBsAg, HIV, HCV and syphilis infections occurred among commercial blood donors and those aged 18 to 47 years old, the most sexually active age group. There were no significant associations between pathogens except for syphilis and HIV (p > 0.001). CONCLUSION The high seroprevalence of blood-borne pathogens among prospective blood donors in Osogbo, Nigeria calls for mandatory routine screening of blood donors for HBV, HIV, HCV and syphilis.

Prevalence of antibodies to hepatitis C virus in apparently healthy Port Harcourt blood donors and association with blood groups and other risk indicators

BACKGROUND Testing for hepatitis C virus (HCV) is not yet mandatory in blood transfusion laboratories in Port Harcourt, Nigeria, so the current prevalence rate of this infection in our locality is unknown. The aim of this study was to determine the prevalence of HCV among apparently healthy blood donors in our area and also to assess some of the risk factors associated with the infection. MATERIALS AND METHODS The presence of anti-HCV antibodies was determined in the serum of 300 blood donors in Port Harcourt, Nigeria. A second-generation rapid screening test, the HEP C SPOT HCV assay was used. Initial reactive results were confirmed by repeat testing with UBI HCV EIA 4.0 enzyme immunoassay. The ABO and Rh blood groups of donors were also determined using standard serological procedures. RESULTS The majority of our blood donor population was constituted of males (88%) and commercial donors (63%). The blood group distribution of the donors was as follows: O RhD-positive (73%), AB RhD-positive. (4.0%), A RhD-positive (10.0%), B RhD-positive (3.0%), O RhD-negative (4.0%), A RhD-negative (3.0%), AB RhD-negative (1.0%) and B RhD-negative (2.0%). Fifteen of the 300 donors were positive for HCV, giving a prevalence rate of 5.0% in this study population. The age group 21-30 years was identified as the highest risk group with 60% of the subjects with HCV infection being in this group, compared to 20% each in the age groups 31-40 years and 41-50 years old. Twelve of the 15 (80%) HCV-positive subjects were commercial donors. The prevalence of HCV was statistically significantly higher among female donors than among male donors (chi2 = 81.000, p < 0.01). With regards to the distribution of HCV-positivity according to blood group, 4.1% of the O RhD-positive subjects, 10% of the A RhD-positive subjects and 25% of the AB RhD-positive were HCV-positive. No cases of HCV-positivity were found among the donors with other blood groups. No statistically significant relationship was found to exist between blood groups and HCV prevalence (p > 0.05). CONCLUSION There was a moderate prevalence of HCV infection (5%) in apparently healthy blood donors in Port Hartcourt, Nigeria. The prevalence was higher among commercial donors and in donors in the age bracket of 21-30 years of age.

Iron deficiency anaemia and evaluation of the utility of iron deficiency indicators among healthy Nigerian children

Abstract The hemoglobin (Hb), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TS) and serum ferritin (SF) values of 240 apparently healthy children were determined in a prospective cross-sectional study conducted in Port Harcourt, Nigeria. Standard colorimetric and enzyme immunoassay procedures were used for the estimation all variables. The mean values of all parameters in this study population were; Hb (11.2 ± 1.83 gldl), TIBC (361.4 ± 245.7 ugldl, logc SI (1.807 ± 0.45), logc SF (1.51 = 0.47) and TS (29.3 ± 18.5%). There was an age-dependent statistical significant difference in the Hb, TIBC and TS values (P < 0.01). Sex was not found to exert any significant influence on the parameters except TIBC. TS had the highest sensitivity and efficiency values of 48 and 95%, respectively. Positive predictive value (PPV), likelihood ratio (LR+) and post-test probability values were highest with SF (58%, 3.3 and 62.2%, respectively) as a diagnostic indicator. Hb values correlated positively and significantly with TS (P < 0.01), logc SI and logc SF concentrations (P < 0.05). Logc SF also correlated positively and significantly with Hb and TIBC (P < 0.05). The overall prevalence of iron deficiency anaemia among these children was 33.75%. We conclude that there is a high prevalence of iron deficiency anaemia among apparently healthy children under the age of five years in this part of the world and these results may justify the need for the introduction of a broad intervention programme for this highly vulnerable group. This study is also in support of the hypothesis that SF is the best test for diagnosing or excluding iron deficiency anaemia. The combination of SF, Hb and TS determinations may prove more useful in a resource-limited moderate setting.

Plasma Fibrinogen Levels in Nigerian Homozygous (Hb SS) Sickle Cell Patients

The plasma fibrinogen levels in 50 Nigerian sickle cell disease (Hb SS) patients in steady state and 50 healthy age and sex-matched (Hb AA) control subjects were determined for the purpose of assessing their baseline values. The fibrinogen levels were assessed using two methods, the clot weight and Clauss, on all the samples for the purpose of comparison. It was observed in this study that the Hb SS patients had significantly higher fibrinogen levels than the healthy Hb AA control subjects, both by the clot weight method (p < 0.001) and the Clauss (p < 0.005). The mean fibrinogen levels (4.1 ± 2.1 g/L) of the Hb SS patients as determined by the clot weight method, were significantly higher than the values (2.2 ± 0.3 g/L) obtained by the Clauss method. The mean values for the two methods were 2.8 ± 0.9 and 2.0 ± 0.08 g/L, respectively, among the control individuals with a statistically significant difference (p < 0.005). Estimation of the plasma fibrinogen levels in sickle cell disease patients might be a useful indicator of hyper coagulability, while early diagnosis may help to prevent vaso-occlusive crises in these patients.

Malarial iron-deficiency anaemia among asymptomatic Nigerian children

Purpose. There is widespread subclinical (asymptomatic) malaria in our locality. The effects exerted by malaria on the body iron status remain incompletely understood. The aim of this study was to investigate the prevalence of malarial iron‐deficiency anaemia and the effect of asymptomatic malaria on iron status indicators.Design. A cross‐sectional prospective study.Methods. Seven parameters, haemoglobin concentration, white blood cell (WBC) count, malaria parasite, serum iron, total iron binding capacity (TIBC), serum ferritin, and percentage transferrin saturation, were evaluated among 240 children of both genders, aged 1–8 years. Estimation of the variables was carried out using standard haematological, colorimetric and enzyme‐linked immunosorbent assay procedures.Results. Of the 240 children surveyed, 66 (27.5%) were parasitized with Plasmodium falciparum. The overall prevalence of iron‐deficiency anaemia (defined as haemoglobin <11 g dl−1, serum ferritin <12 ng ml−1 and transferrin saturation <16%) i...

Plasma levels of some blood coagulation parameters in Nigerian homozygous sickle cell patients (HbSS) in steady state

Abstract The plasma levels of some blood coagulation parameters; prothrombin time, (PT), partial thromboplastin time with kaolin (PTTK), thrombin clotting time, (TCT), fibrinogen and factor X assay were determined in 50 Nigerian homozygous (HbSS) patients and 50 HbAA healthy individuals for the purpose of assessing their baseline values and susceptibility of patients with sickle cell disease (SCD) to hyper coagulability. Standard procedures were used for all variables. The mean age of the study participants was 21.7 ± 5.0 years. The mean PT of 13.7 ± 1.4s in HbSS patients was found to be significantly longer than the mean PT value of 12.9 ± 1.0 in HbAA control subjects (p < 0.001). The mean PTTK values of 46.0 ± 9.6s in HbSS patients was also found to be significantly higher than the 41.0 ± 3.7s recorded among the control subjects (p < 0.001). The mean TCT of 6.4 ± 0.8s in HbSS patients was however found to be significantly lower than the mean value of 10.6 ± 0.8s obtained in the control group. Fibrinogen level (4.1 ± 2.1 g/l) in HbSS patients and 2.8 ± 0.9 g/l in HbAA controls was also found to be significantly different (p < 0.001). Factor X level in the sickle cell patients, (64.6 ± 14.9%) was equally found to be significantly lower than that of the apparently healthy HbAA control individuals (95.2 ± 7.2%) (p < 0.001).

Frequency of anti-glycoprotein Ia/IIa (anti-HPA-5b,-5a) and anti-glycoprotein IIb/IIIa (anti-HPA-1a,-3a,-4a) alloantibodies in multiparous women of African descent

®qualitative solid phase ELISA reagent. Platelet count was done using the ICSH approved procedure using 1% ammonium oxalate reagent. Study design: A cross-section of apparently healthy adult Nigerian multiparous non-pregnant women, who were staff of a tertiary health facility in the Niger Delta, Nigeria, were screened for alloantibodies to human platelet antigens. Results: Of the one hundred (100) women screened, the prevalence of anti-glycoprotein IIb/ IIIa (anti-HPA-Ia,-3a,-4a) was zero percent (0%), anti-glycoprotein Ia/IIa (anti-HPA-5b) accounted for 30% of results, while anti-glycoprotein Ia/IIa (anti-HPA-5a) was 18%. Parity was found to exert significant influence on the development to HPA antibodies (Fisher’s Exact Test = 11.683, P , 0.05; 13.577, P , 0.01). The platelet count of the women did not appear to exert any influence on the development of the antibodies (P . 0.05). Conclusion: This study has observed a high prevalence of anti-HPA-5b in our sample population. The prevalence of alloantibodies to HPA antigens was found to associate strongly with parity. These results indicate that there is a need to initiate platelet serology in our tertiary health institutions, as well as educate our women on the risk associated with frequent pregnancies, and ensure that adequate caution is taken when recruiting multiparous women

Baseline Iron Status of Apparently Healthy Children in Port Hacourt, Nigeria

Aim: Iron deficiency is one of the micronutrient disorder affecting mostly children in the developing countries. There is paucity of information on this subject in our locality. Aim: This study was aimed at assessing the baseline iron status of apparently healthy children aged 1-8 years in Port Harcourt, Rivers state, Nigeria. Methods: Four biochemical iron indicators; serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TS) and serum ferritin(SF), were used for the assessment. Standard colorimetric and Enzyme linked immunosorbent assay (ELISA) procedures were followed for the estimation of all variables. Results: The mean values of the parameters estimated were serum iron, 19.8 + 21.8 umol/l; TIBC, 62.9 + 46.0 umol/l, transferrin saturation, 29.2 + 18.5 %, serum ferritin, 50.6 + 62.3 nglml The mean values of all the parameters estimated in the under fives were found to be significantly lower than the values obtained in the five to 8 years group (P < 0.01). Similarly a sex related difference in the mean values was obtained in all variables except transferrin saturation. The prevalence of iron deficiency among the participants by single ferritin (<15 nglml) model was 13.75%. Combination of serum ferritin (< 15 nglml) and transferrin saturation (< 16%) gave a prevalence of 7.5%. Conclusion: We concluded that iron deficiency is more pronounced among children under five years of age and this finding in consistent with what obtains in the literature worldwide.