Teddy C Adias

Distribution of antibodies to Salmonella in the sera of blood donors in the south-western region of Nigeria

BACKGROUND There are currently no reports of a multicentre assessment of the presence of antibodies to Salmonella in donated blood in Nigeria. MATERIALS AND METHODS Blood specimens from blood donors presenting at six selected public blood collection centres in the south-western region of Nigeria were analysed for the presence of Salmonella antibodies. RESULTS Out of the 200 specimen analysed, 106 (53%) were found to be Widal-positive with a minimum titre of 160. Among the positive cases, reactivity was most common to S. typhi (D) antigens (48.6%). The most frequently recorded titre of reactive specimens (i.e., the modal titre) was 160, with 71 donors (35.5%) of the total sample population from the different centres reacting at this level. Thirty-one donors had elevated titres of = 320 and nine donors had a titre of 640. The percentages of Widal-positive cases among donors with A positive and O positive blood groups were 58.7% and 64.2%, respectively; the percentage of Widal-positive cases was lowest among B positive blood donors (26.7%). The p-value for these differences (p<0.05) shows that blood group has a statistically significant impact on Widal reaction in donors. CONCLUSION.: This study confirms that salmonellosis is endemic in Nigeria and that many of our blood donors may be Salmonella carriers. This study also revealed a positive association between blood groups and typhoid fever.

Evaluation of coagulation parameters and liver enzymes among alcohol drinkers in Port Harcourt, Nigeria

Alcohol is a major contributor to the global burden of disease, disability, and death in high, middle, and low-income countries. Harmful use of alcohol is one of the main factors contributing to premature deaths and avoidable disease burden worldwide and has a major impact on public health. The aim of this present cross-sectional study was to investigate the effect of alcohol consumption on coagulation parameters and liver enzymes of subjects in Port Harcourt, Nigeria. Two hundred adults consisting of 120 alcohol dependent subjects and 80 age, gender-matched nondrinkers aged 25–65 years (mean age 45.25 ± 11.50 years) were enrolled in this study. Of the 120 chronic alcohol drinkers, 37 were dependent on local dry gin, while 83 were dependent on other alcoholic beverages. The mean values of the liver enzymes, aspartate aminotransferase and gamma glutamyl transferase, were significantly higher (P = 0.002 and P = 0.02 respectively) among the chronic alcohol consumers compared with their nondrinker counterparts. Although the value of alanine aminotransferase was higher in the chronic drinkers, it did not reveal any significant difference (P = 0.11). The coagulation parameters, prothrombin time and activated partial thromboplastin time were investigated among chronic drinkers and nondrinkers. The mean value of prothrombin time and activated partial thromboplastin time was significantly higher in the chronic alcohol drinkers compared to the nondrinkers (P = 0.04 and P = 0.02 respectively). We observed a positive and significant correlation between values of liver enzymes, serum gamma glutamyl transferase and aspartate aminotransferase, and values of prothrombin time among alcohol consumers (r = 0.72 and r = 0.68 respectively). The implementation of policies to target harm reduction strategies among alcoholics is urgently needed, alongside the building of a strong base of public awareness and community support required for the continuity and sustainability of alcohol policies. There is also the need for the Nigerian government to enforce tighter regulations and restrictions on the production and distribution of alcoholic beverages to reduce harmful use, and protect young people and other vulnerable groups.

Storage Related Haematological and Biochemical Changes of CPDA-1 Whole Blood in a Resource Limited Setting

Majority of the blood banks in Nigeria still practice whole blood banking. The changes associated with the storage of blood in our blood banks have not been reported. This study was aimed at bridging this gap. Blood (450 ml) was drawn from ten healthy volunteer donors into CPDA-1 anticoagulant and placed on the quarantine shelf of the blood bank refrigerator maintained at 2-8°C. Blood bags were screened for HCV, HBsAg, Syphilis and HIV 1&2 and were confirmed negative. Samples were collected at 1, 7, 14, 21 and 28 days and tested for hematological and biochemical using the PE-600 fully auto Haematology analyzer (China) for hematological parameters, Excite -40 ESR analyzer and Prestige 24i automated clinical analyzer for biochemical parameters. Comparison of day 1 versus day 7 revealed that the granulocytes were drastically reduced from 1.93 × 109 /L on day 1 to 0.33 × 109/L on day 7 (F=48.79, p=0.000, ESR values increased from 2.90 mm/hr on day 1 to 6.60 mm/hr on day 7 (F=7.45, p=0.013. For biochemical parameters, there was a significant decrease in Na value from 137.38 mEq/L on day 1 to 135 mEq/L on day 7 (F=43.66, p=0.000). Analysis of variance (ANOVA) showed that at the end of 28 days, there was significant changes in WBC, differential and absolute leucocytes, MPV, PDW, and ESR, albumin and potassium were significantly affected among the biochemical parameters. No significant changes were observed in Hb, PCV and other hematological parameters throughout the study. Rapid degeneration of leukocytes could lead to immunodulation related to blood transfusion. Whole blood should be leukodepleted before storage if it must be used beyond one week.

Frequencies of maternal red blood cell alloantibodies in Port Harcourt, Nigeria.

Background: Alloantibodies of clinical importance can cause transfusion reactions or hemolytic disease of the fetus and newborn (HDFN). The frequencies of these antibodies have not been reported in our locality. Aims: To determine the frequency of occurrence of alloantibodies among pregnant women in Port Harcourt, Nigeria. Settings and Design: This is a prospective study, which was carried out in the Braithwaite Memorial Specialist Hospital, Port Harcourt, Nigeria. Materials and Methods: Screening and identification of red blood cell alloantibodies was done on the sera of 500 pregnant women using the DiaMed, DiaCell, and DiaPanel reagents (Cressier, Switzerland). ABO and Rh blood groups were done using antisera bought from Biotec (Ipswich, UK). Results: Alloantibodies were identified in the serum of 17 of the 500 (3.4%) pregnant women. The specificity of the antibodies was as follows: anti-C 6 (1.2%), anti-E 3 (0.6%), anti-Jsb 3 (0.6%), and anti-K 5 (1.0%). No anti-D was identified despite 8.6% of the study population being Rhesus D (Rh D) negative. The distribution of the antibodies was found to be independent of the blood groups of the participants (χ2 = 4.050, P = 0.670). Blood group O constituted the highest percentage (48.0%). Conclusion: This study has identified the presence of non-Rh D antibodies to the proportion of 3.4%. Rh D antibody was absent in this population irrespective of the relatively high percentage of Rh D negative women. There is a need to determine the actual risk these antibodies may pose to the antenatal women and to include antibody screening and identification in routine antenatal care.

Haemoglobin electrophoretic pattern among resident in Sokoto, Nigeria

Abstract Background: Haemoglobinopathies are inherited disorders of haemoglobin synthesis that are responsible for significant morbidity and mortality all over the world. Communities in Africa constitute a major part of

Human Immunodeficiency Virus Testing Algorithm in Resource Limiting Settings

Testing and counseling for human immunodeficiency virus (HIV) is now recognized as a priority in national HIV programs because it is the gateway to HIV/AIDS prevention, care, treatment, and support interventions. In order to ensure access to HIV testing for large pop‐ ulations and to facilitate access to antiretroviral treatment in the context of the World Health Organization’s universal access strategy, radical scaling up of HIV testing and counseling services is being advocated globally.

Absolute lymphocyte count as a marker for CD4 lymphocyte count: criterion for initiating antiretroviral therapy in HIV-infected Nigerians

BACKGROUND Few laboratories in resource-constrained countries can afford to perform laboratory-monitoring tests required for the implementation of HIV therapy. In this case control study, we have investigated the relevance of absolute lymphocyte count as a surrogate marker for CD4 lymphocyte count as a criterion for initiating HAARTin HIV-infected Nigerians. METHODS A total of 100 consecutive recruited HIV-infected, previously antiretroviral naive persons and 30 HIV-negative individuals blood samples were run for absolute lymphocyte and CD4 lymphocyte counts and results were compared by a model of linear regression analysis. RESULTS An overall modest correlation was observed between absolute lymphocyte count and CD4 lymphocyte (r = 0.51) and at CD4 lymphocyte threshold relevant for clinical management of HIV-infected; <200, 200-350 and >350 cells/microL (r = 0.41, 0.30 and 0.21) respectively. Mean absolute lymphocyte count of 1.60 +/- 0.77 x 10(9)/L, 1.88 +/- 1.11 x 10(9)/L and 2.04 +/- 0.54 x 10(9)/L was equivalent respectively to CD4 of <200, 200-350 and >350 cells/microL. CONCLUSIONS This study indicates a modest correlation between absolute and CD4 lymphocyte counts of HIV-infected Nigerians and at CD4 lymphocyte count threshold significant for clinical management of HIV-infected. Absolute lymphocyte count can become a minimal inexpensive alternative to CD4 lymphocyte count in conjunction with WHO staging and clinical status of patient in determining the optimal time to initiate therapy particularly in resource limited settings where other expensive methods of CD4 enumeration are unavailable.

Uncommon Rh Phenotypes in a Cross Section of Nigerian Antenatal Women: Implications for Molecular Genotyping of Blood Groups

Background: This study aimed to determine the frequency of rare blood group antigens among pregnant women in Port Harcourt Metropolis. Methods: The frequencies of Rh antigens and phenotypes of the pregnant women in Port Harcourt Metropolis, Nigeria, were determined, using standard serologic techniques. Results: Of the 374 pregnant women studied, the frequencies of the Rh antigens within the population were D (89.0%), c (82.0%), e (54.0%), C (24.3%), E (20.1%). The frequencies of the Rh antithetical antigens were DD/Dd (91.2 %), Cc (19,5%), cc (84.5%), Ee (13.9%), ee (54.3%), CC (25.1%), EE (19.8%) and dd (10.4%). Seven (1.9%) were found to be Rhnull, sixteen(4.3%) were found to be D-- or exalted D. Phenotypes without RhD reactivity were –c- (2.9%), - Cc (0.3%), -C- (0.3%), -Ee (0.5%) and –E- (0.3%). The most frequently occurring Rh phenotype was Dccee with a frequency of (25.8%). RhD-ve was found to be significantly associated with HDN outcome ( 2=6.605 and P=0.01). Conclusion: We concluded that: 1) There is the presence of uncommon Rh phenotypes in our population. 2) Rhnull exists in this study population of which similar studies have not been reported in Nigeria. 3) There is need to conduct studies in other parts of Nigeria in order to compare the frequencies of these rare blood groups in Nigerian population. 4) Molecular studies to establish reasons for deletion and Rhnull phenotypes among Nigerian and Africans in general are hereby advocated.

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.