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Aim: This study was designed to determine the prevalence of HBV, HCV and HIV infections among individuals with Sickle Cell Disease (SCD) in Ibadan, southwestern Nigeria. Methodology: In this case-control study, 1017 patients with SCD and 1017 age and gender matched controls were enrolled from 6 health facilities and some communities in Ibadan, southwestern Nigeria. Blood samples were tested for the presence of HIV, HBV and HCV infections. Structured questionnaire was used to capture participants’ information and data analyzed using descriptive statistics, McNemar Chi-square/Fishers exact test. Results: Blood transfusion was significantly more common among SCD cases [566 (55.7%)] than controls [54 (5.3%)], while history of vaccination was higher in the control group (p = 0.001). The overall prevalence of HIV [2 (0.2%) vs 11 (1.1%)], HBV [58 (5.7) vs 66 (6.5%)] and HCV [10 (1.0) vs 22 (2.2%)] was lower among SCD cases than controls, respectively, although significantly different only in HCV infection (p = 0.048). All three infections were significantly higher in adults than in children. Co-infection was found only in four of the participants, all of whom were SCD patients. Conclusion: The prevalence of HIV, HBV and HCV infection among SCD patients indicates an improvement in the transfusion safety measures in the region. The prevalence of HBV and HCV found in this study is still relatively high when compared with reports from some other regions. There is a need for continued surveillance and subsidized cost of drugs for treatment of these infections, especially for SCD patients who already have a compromised immunity.

Introduction: Homocysteine is produced from the conversion of methionine to cysteine. Conditions resulting in hyper homocysteinemia leads to an increased risk of both arterial and venous thromboembolisms by about 2 fold. 20% of HIV infected patients with objective evidence of venous thromboembolism are found to be thrombophilic with higher homocysteine levels. We enquired into homocysteine levels prior to the development of a clinical evidence of a venous thrombus in both HAART naïve and those on HAART of HIV /AIDS population. We evaluated the association between homocysteine, CD4 lymphocyte count and ART use in order to identify possible risk factors for hyper homocysteinemia in HIV population. Method: Employing a cross sectional design; we compared mean plasma levels of homocysteine, full blood count parameters and CD4+ lymphocytes counts in HIV positive patients and HIV negative controls. One hundred and twenty patients with HIV infection attending the APIN clinic at the University College Hospital Ibadan and St Mary’s Catholic Hospital Eleta Ibadan and one hundred and twenty-six HIV negative healthy controls were compared in the study. Results: Fifty-nine point one percent of the HIV positive patient had hyperhomocysteinemia i.e. homocysteine levels of >18µmol/l. The mean plasma homocysteine levels were significantly higher at 24.4µmol/l (SD=13.8) (CI -2 to -8; p=0.002) in the HIV positive group compared with 19.5µmol/L (SD=10.6) in the control group. The use of Anti-retroviral drugs was not associated with higher homocysteine level in the seropositive group and neither were factors like age, gender or the use of combined oral contraceptive pills. There was no correlation between CD4 cell count and homocysteine levels (r= -0.01; p=0.9). Conclusion: Homocysteine levels are elevated in HIV positive patients and hyperhomocysteinemia was found in a significant number of HIV positive patients. None of the patients investigated had features of thromboembolism or outright deep venous thrombosis. Neither CD4 cell counts nor traditional risk factors were associated with the higher homocysteine levels.

Background and objectives: Sickle cell disease(SCD) is a disorder of red cells resulting from the co-inheritance of hae- moglobin S (HbS) with another abnormal haemoglobin. The diagnosis of acute leukaemia is uncommon in our patients with sickle cell disease more so the patients have high morbidity and mortality due to the sickling process.Acute leukemia is a malignant clonal disorder of haemopoietic precursor cells resulting in accumulation of immature blood cells in the bone marrow and blood.The objective of the case series was to highlight the challenges of diagnosis and management of SCD patients with acute leukaemia, the importance of peripheral blood film review and propound a possible risk factor. Methods: Records of 58 patients diagnosed and managed for acute leukaemia over a 7 year period at the University College Hospital, Ibadan were reviewed. The diagnosis of acute leukaemia was based on clinical features in addition to peripheral and bone marrow smears findings. Microsoft excel version 2013 was used for statistical analysis. Results: Five (8.6%) of the patients with acute leukaemia also had sickle cell disease: 3 males and 2 females were described. Recurrent fever and anaemia were the most consistent presenting features in the patients. All the patients were not on any routine medications meant for SCD patients and had poor history of clinic attendance prior to the diagnosis of acute leu- kaemia. The diagnosis of acute leukaemia was not made until the patients were seen by a haematologist. The principal tool of diagnosis in all the patients was peripheral blood film review. Two patients were discharged against medical advice.The treatment period ranged between one month and one year in the remaining three patients. Conclusion: SCD patients are not exempted from developing acute leukaemias and the diagnoses of the two conditions overwhelms the social and economic support of patients and care givers.The study also underscores the relevance of high level of suspicion and prompt review of peripheral blood film of SCD patients particularly when patients present with un- remitting symptoms associated with anaemia and fever. Keywords: Acute leukaemia; sickle cell disease; anaemia.

Background: Hepatitis B virus infection is one of the greatest threats to blood safety all over the world. The laboratory algorithm based on only the detection of hepatitis B surface antigen (HBsAg) leaves a gap for infected HBsAg negative donors to donate blood during the “window period” (WP) and late stages of infection. Objective: To estimate the frequency of the presence of HBV deoxyribonucleic acid (DNA) in HBsAg negative blood units screened using two different assays for HBsAg in a high endemic region. Methods: Frozen serum aliquot of 100 replacement blood donors who donated blood units that were HBsAg negative were retrieved and tested for HBV DNA. Sample positive for HBV DNA was sequenced by Sanger’s method, genotyped and the viral load was determined. Results: One sample (1%) was positive for HBV DNA. The HBV viral load of the sample was 768,000 IU/ml. The partial S-gene of the Hepatitis B virus isolated was genotype E using the NCBI viral genotyping tool. Conclusions: There is still a risk of HBV infected blood unit escaping detection when donor testing is limited to HBsAg screening. The use of NAT which can substantially reduce HBV infected blood donors from the donor pool should be considered. Keywords: Hepatitis B surface Antigen; Hepatitis B Virus; DNA; blood donors; blood safety.

Ethnopharmacological relevance Evaluation of plants such as Combretum racemosum with claimed traditional use in the management of sickle cell anaemia in Nigeria and other parts of West Africa could serve as a useful research strategy in the search for potential anti-sickling drugs and templates. Aim of the study: This study aimed at evaluating the antisickling potential of C. racemosum by activity-guided purification and isolation of its active constituents. Materials and methods Crude methanol extract of the root of C. racemosum and the fractions obtained by partitioning with chloroform, ethyl acetate, and aqueous were investigated for anti-sickling activity against sodium metabisulphite induced sickling of sickle cell haemoglobin (HbSS). Repeated chromatographic separations were conducted on the most active chloroform fraction to purify and isolate bioactive compounds for further tests for anti-sickling activity. The characterization of the isolated compounds was done by mass spectrometry (FD+MS) and nuclear magnetic resonance (1HNMR) spectroscopy. Results The chloroform fraction (FA) (% sickled erythrocyte ranged from 3.0 to 34.1) exhibited better anti-sickling activity than aqueous (% sickled erythrocyte ranged from 38.9 to 51.5) as well as the crude methanol (% sickled erythrocyte ranged from 19.1 to 30.4). Hence, the phytochemical investigation was focused on the chloroform fraction, which led to the identification of two ellagic acid derivatives (3,3′,4′-tri-O-methyl ellagic acid (A) and 3,3′-di-O- methyl ellagic acid (B). The two isolated compounds possessed good, comparable anti-sickling activities with compound A exhibiting a slightly better in vitro activity. Conclusion This paper reports for the first time anti-sickling principles from C. racemosum and therefore, provided some justification for the ethnomedicinal use of the plant in the management of sickle cell disease.

Background: Recurrent chronic leg ulcers and its are morbidities associated with sickle cell anaemia (SCA). Compression therapy increases the rate of healing of these ulcers and also decreases the rate of recurrence. Objective: This study evaluated the haematological parameters of patients with SCA and chronic leg ulcers placed on high compression bandaging to provide data for improved ulcer management and prevention. Methods: Eighteen patients with SCA and chronic leg ulcers were recruited for treatment by compression therapy in Ibadan, Nigeria, from March to June 2015. Eighteen SCA patients with no history of chronic leg ulcers were age and sex matched and recruited as controls. Blood samples, wound biopsies and swabs were collected at different time points for full blood count, microbiology, culture and antimicrobial susceptibility tests. Haemoglobin variants were quantified by high performance liquid chromatography. Fasting blood sugar was tested for leg ulcer patients to determine diabetic status. Results: Ulcers ranged from 0.5 cm2 to 416 cm2 (median: 38.4 cm2). Post-intervention ulcer size ranged from 0.0 cm2 to 272 cm2 (median: 18.6 cm2, p 0.001); four ulcers completely healed. Compared to the control group, haematological indices at commencement of treatment were more severe in leg ulcer patients (p = 0.02). No patients with chronic leg ulcer was diabetic. Microorganisms isolated from the leg ulcers include Pseudomonas aeruginosa, Staphylococcus aureus, Proteus sp., Escherichia coli and Klebsiella oxytoca. Conclusion: Measures to improve haematological parameters during leg ulcer treatment in SCA patients should be taken to aid wound healing.

Background: The homozygous sickle cell anemia (SCA) has an unstable hemoglobin (HbS). The heme group dissociates easily from globin chain and the iron is released and free within the red cell. In addition, the sickle red cells release cell-free hemoglobin after undergoing intravascular hemolysis. These contribute to increased reactive oxygen species and oxidative stress ensues. Oxidative stress contributes to complications such as acute chest syndrome and pulmonary hypertension both of which are severe manifestations of SCA. Objectives: In this study, we set out to correlate inflammatory markers of disease severity with oxidative stress. Materials and Methods: We compared the total antioxidant status of 61 steady-state SCA patients with 60 HbAA controls. We then investigated associations between the total antioxidant levels and hematological and clinical indices of the patients in order to establish a relationship between markers of oxidative stress and markers of sickle cell severity. Results: We found that that total antioxidants were significantly lower in SCA compared with control levels (50% lower). The total antioxidants levels were inversely proportional to leukocyte and especially neutrophil cell counts which are pro-inflammatory markers. Conclusion: Oxidative stress which leads to secondary complications correlates with pro-inflammatory markers of clinical severity in SCA.

Background: At the University College Hospital (UCH), Ibadan, there is a policy of compulsory blood donation by relatives of pregnant women registered for care. This study assesses the perception of these women about blood donation and transfusion and compliance with the policy. Materials and Methods: This cross‑sectional study was among women registered for antenatal care at UCH. By nonprobability purposive sampling, 300 pregnant women >18 years were recruited from July 1, 2017, to September 30, 2017. Women presenting for emergency care and Jehovah’s Witnesses were excluded from the study. Information was obtained using pretested questionnaires. Data are presented as means (standard deviation), simple frequency, and percentages. Results: Among the 300 participants, the mean age was 31.0 (±3.7) years, 194 (64.6%) were multiparous, 94.4% had postsecondary education, and 263 (87.7%) were Yoruba by ethnicity. Concerning perception about blood donation, 221 (73.7%) agreed that blood can be donated and stored for the future use, 279 (93.0%) thought that blood donation is good, 214 (71.3%) agreed that voluntary blood donation is best, and both men and women could donate (269, 89.7%). Concerning the effect of blood donation, 229 (74.6%) agreed/strongly agreed that donation could cause weakness. However, 195 (65.0%) and 194 (64.0%) disagreed/strongly disagreed with donation causing loss of sexual drive or death. Concerning transfusion, 273 (90.7%) and 253 (84.3%), respectively, agreed that women may need blood during pregnancy/delivery, and hemorrhage during labor/delivery may lead to death. Finally, 266 (88.7%) were aware of the hospital policy although only 133 (44.3%) had complied. Conclusion: The positive perception was unmatched with compliance suggesting unidentified factors for further research. Keywords: Blood donation; blood transfusion; perception; pregnancy

BACKGROUND: Change in immunoglobulin (Ig) subclass levels, a manifestation of altered immune status, is thought to contribute to pathogenesis of non-Hodgkin's lymphoma (NHL). Furthermore, pretreatment Ig level in NHL patients scheduled to receive immunotherapy has prognostic significance. AIMS AND OBJECTIVES: This study was carried out to provide information on the levels of Ig subclass in patients with NHL in our center. METHODS: A descriptive cross-sectional study of patients diagnosed with NHL over an 8-month period was conducted. Controls were apparently healthy voluntary blood donors. Clinical information and results of hematology and clinical biochemistry investigations were retrieved from patients' case notes. The working formulation classification was used to subtype the NHL. Serum IgG, IgA, IgM, and IgE concentrations were assayed for for the levels in patients and controls. RESULTS: A total of 68 participants (cases n = 35, controls – 33) were included in this study. The mean age of the patients was 48.67 ± 17.3 years (range: 18–85). The hematological and clinical biochemistry results were within reference values for the population except hematocrit (Hct) which was low (28% ± 7%) and high erythrocyte sedimentation rate of 72 mm/h (interquartile range [IQR] – 52.0–100.0). IgD levels were significantly lower in the cases than the controls (P = 0.029) with a Cohen's medium effect size. There was a significant drop in IgE from Stage I to III of the disease (χ2(3) = 7.93, P = 0.047). Furthermore, there were significant positive correlations between IgD, IgA, IgM, and Hct and platelets. CONCLUSION: Immune paresis is associated with progressive disease or late clinical presentation, and this should be taken into consideration when managing these patients.

Recurrent bone pain or vaso-occlusive crisis (VOC) constitutes a major presentation in patients with sickle cell anaemia. This is partly attributable to vasospasm, oxidative stress and inflammation. Xanthine oxidase is released during VOC and it had been implicated in the pathogenesis of bone pain crisis in patients with sickle cell anaemia. This study was aimed at comparing the plasma levels of xanthine oxidase activity in adult patients with Sickle cell anaemia (SCA), during bone pain crisis (BPC) and steady state and correlating it with the severity of bone pain crisis. Thirty adult sickle cell anemia patients with BPC and 30 in steady state attending Haematology clinic at the University College Hospital, Ibadan, Nigeria and 30 normal haemoglobin A, age- and sex-matched controls were enrolled for this study. Severity of BPC was assessed with total summary pain score. Haematological parameters were determined by a 5-part autoanalyzer. Plasma xanthine oxidase activity was determined using enzyme linked immunosorbent assay (ELISA). Data obtained were analyzed using the Statistical Package for the Social Science (SPSS) version 20. Results were considered statistically significant if p

Background Hyperhomocysteinemia is a modifiable risk factor associated with deep venous thrombosis (DVT). Low serum concentrations of vitamin B12 and folate are modifiable causes of hyperhomocysteinemia. This study was carried out to determine the prevalence of hyperhomocysteinemia in Nigerian patients with DVT and also to assess the association of homocysteine with vitamin B12 and folate. Patients and methods A case–control study was carried out in which serum homocysteine, vitamin B12, and folate levels were measured in 45 Doppler ultrasound confirmed cases of DVT and 43 controls. Hyperhomocysteinemia was defined by serum levels more than 15.0 μmol/l, low serum folate less than 3 μg/l, and low serum vitamin B12 less than 160 ng/l. Results The prevalence of hyperhomocysteinemia in DVT patients was 20 (44.4%) compared with four (9.35%) in the control (P Conclusion Hyperhomocysteinemia may be a risk factor for DVT in the Nigerian population but may not be responsible for thrombosis in all cases. There was however no significant correlation between serum level of homocysteine and serum levels of vitamin B12 and folate in DVT patients. Therefore, larger sized sample studies should be carried out to investigate the relationship between hyperhomocysteinemia and related vitamins as well as genetic causes of hyperhomocysteinemia in DVT patients in our environment.

The existence and sustenance of the blood bank depends on blood donors. It is imperative that the donation experience is satisfactory for the donors. Therefore this study was carried out to determine the frequency of undesirable events experienced by the blood donor as part of donor haemovigilance. This was a retrospective descriptive study of the events that occurred amongst the blood donors of the blood bank of a tertiary institution. The blood donor incident book was reviewed for the period of six months. Negative undesirable events occurred in 2% of the donor populations, of which 45.8% could not complete the blood donation process while only 16.7% completed the blood donation process. Mild vasovagal attack occurred in 0.2% of the donor population. Undisclosed deferrable risk factors/ behaviours were identified by the phlebotomist in the bleeding room which made donors unfit for donation even though they had passed the donor screening criteria. This accounted for 20.8% of those with negative experience. Guidelines are required to identify donors that are not likely to complete donation to avoid wastage of time, blood, resources and reduce undesirable experiences.

Women of child-bearing age (especially pregnant and lactating women) are in the most nutritionally-vulnerable stages of the life cycle. The aim of this study was to assess the knowledge, attitude and practice of good nutrition among women of childbearing age in Somolu Local Government (LG), Lagos state. This study was a crosssectional descriptive survey of 244 women of childbearing age (15-49 years). Excellent knowledge and good attitude towards good nutrition was observed among 61.89% and 86.89% respectively. During pregnancy, greater than 80% took folic acid, iron supplements and increased daily consumption of fruits and vegetables while 43.59% avoided eggs, fish, meat and chocolate beverage because of taboos. Seven days prior to interview, over 90% had consumed fast foods, 56.15% and 50.01% of the respondents ate fruits and vegetables every day to ≥4 times in a day respectively. A majority of the respondents knew and had a good attitude towards good nutrition supporting studies from Kenya and Northern Nigeria. This, however, did not translate to good practice for about half of the respondents.

Aim : To determine indices of insulin sensitivity and oral disposition index (DIo) derived from 30 min of glucose challenge in adults with sickle cell anaemia; a group in whom there is chronic inflammation. Study Design : Case-controlled study.

Background: Sickle cell disease (SCD) and glucose-6-phosphate dehydrogenase (G6PD) deficiency are inherited disorders associated with chronic haemolysis. Therefore, coinheritance of both disorders could worsen haemolysis in the former and compound a haemolytic crisis. This study compared clinical and laboratory features of deficient and non-deficient SCD patients and the G6PD activities of SCD patients and apparently healthy controls. Materials and Methods: This is a case–control study of 175 SCD patients and 166 non-SCD controls. G6PD assay was carried out on haemolysate from washed red cells. The G6PD activity was measured by spectrophotometry. Results: The mean age of patients and controls was 27.3 ± 9.4 and 35.9 ± 9.7 years, respectively, with 75 (46.2%) and 87 (52.4%) being males, respectively. G6PD activity was similar in cases and controls (6.7 ± 3.3 vs. 6.9 ± 3.0 IU/gHb), respectively (P = 0.6). The prevalence of G6PD deficiency was higher in patients than controls (28.6% vs. 22.3%, P = 0.18), and SCD patients were twice more likely to have enzyme activities below 3.0 IU/gHb. No significant difference was observed in the clinical parameters between deficient and non-deficient patients. Deficient patients were more likely to have lower haematocrit (22.8 ± 3.9% vs. 24.5 ± 5%, P = 0.04) and non-significantly higher bilirubin and reticulocyte counts. Furthermore, in patients, severe deficiency resulted in higher bilirubin than in those with mild deficiency (60.5 vs. 21.7 IU/L, P < 0.001). G6PD activity correlated positively with haematocrit (r = 0.91, P = 0.01) and mean corpuscular haemoglobin concentration (r = 0.17, P = 0.02). Conclusions: Coinheritance of both disorders could worsen haemolysis in SCD patients, and care should, therefore, be taken in the choice of drugs in deficient SCD patients.

All diseases result from our genes and from the environment. This is conventional teaching for first year medical students: and if the medical school is in Africa it is hard to find a better example than blood diseases, given that in Africa, on one hand, haemoglobinopathies affect millions of people (WHO Working Group, 1982), while on the other hand, malaria, hookworm and nutritional deficiency (folate, or iron or both) are the main causes of anaemia (Boele van Hensbroek et al, 2010). In medical school we must also deal with the role of Darwinian selection in evolution. This is a central thread throughout biology, and almost everyone agrees it applies extensively also to the human species: yet, when it comes to giving an example, whether the class is held in Africa or elsewhere, the teacher will fall back on how the haemoglobin S gene has been selected in tropical areas through the relative resistance it confers to heterozygotes against Plasmodium falciparum (see Fig 1 and Luzzatto, 1979).

Iron (Fe) remains a commonly prescribed supplement in pregnancy. Its possible pathologic potential is either uncommonly considered or ignored. We determined the antioxidant status in pregnant women with and without Fe supplements. Fifty-eight apparently healthy pregnant women on Fe supplements were selected for the study from the antenatal clinic of the University College Hospital, Ibadan, Nigeria. Fifty-five aged matched pregnant women who were not on Fe from various parishes of the Christ Apostolic Church, Ibadan (non-drug using Christian sect) were randomly selected as controls. Both groups were classified according to the trimesters of pregnancy. The gestational age in both pregnant women on Fe supplements and non-supplement pregnant women was similar. Fruit and vegetables consumption was higher in the supplement than in the non-supplement group (57.2% vs. 37.3%). Anthropometric indices, weight, height, and BMI, were also similar. But while the weight of the Fe supplement group decreased by nearly 3% in the third trimester, it increased by over 10% (p0.00) in the non-supplement group in the same period. Serum Fe level was significantly higher in the supplement than the non-supplement group (p0.001). In contrast, the levels of the antioxidants, ascorbic acid, copper (Cu), zinc (Zn), and bilirubin were all significantly decreased (p0.05, p0.001, p0.05, and p0.05, respectively). Uric acid level though also lower in the supplement group did not reach statistical significance (p0.05), while vitamin E was similar in both groups. There was relative stability of all antioxidants except uric acid, which declined from the first to the last trimester in the non-supplement group. The significantly higher Fe level in the second trimester was sustained in the third trimester though to a lesser degree (p0.05) and associated with significant decreases in the following antioxidant levels in the supplement group, ascorbic acid, bilirubin, Cu, and Zn (p0.02, p0.02, p0.02, and p0.001, respectively). Uric acid and vitamin E though lower in the supplement group were not significantly different. Remarkably, percentage changes between the first and third trimesters revealed that serum Fe increased by over 116% in the Fe supplement group, while it only increased by over 50% in the non-supplement group. This was associated with 23.50% decrease in ascorbate level (p0.003) in the supplement group, while it decreased by only 3.70% in the non-supplement group (p0.05). Again vitamin E decreased by 17.22% in the supplement group, while it decreased by only 7.30% in the non-supplement group during the period. Uric acid and bilirubin levels decreased by similar proportions during the period, while Zn decreased by 18.55% in the supplement group and by 14.86% in the non-supplement group. In contrast Cu increased by 7.20% in the supplement group, while it increased by only 2.96 in the non-supplement group. Additionally, all the antioxidants in the supplement group except vitamin E, viz, ascorbic acid, bilirubin, Cu, uric acid, and Zn, were significantly inversely correlated with serum Fe level (r - 0.299, p0.05, r - 0.278, p0.05, r - 0.383, p0.05, and r - 0.0369, p0.05). These data imply markedly depressed antioxidant status in the Fe supplement pregnant group with attendant oxidative stress (most probably pro-oxidant Fe-induced). This is associated with molecular and cellular damage as well as a number of pathologic and clinical correlates that underlie the exacerbation of morbidity and mortality in maternal and child populations, particularly in the developing countries. This appears to call for serious caution and prior evaluation of antioxidant and Fe status and during the use of Fe supplements in pregnancy for monitoring and prognostic purposes and to avert or ameliorate oxidative stress-induced pathologies in maternal and fetal systems.

Objective: Screening of blood before transfusion is an effective strategy to reduce transfusion-transmitted viruses. However, reports on viral marker trends among the donor population are scarce. This study looked at trends in the seroprevalence of hepatitis B (HBV) and C (HCV) and human immunodeficiency virus (HIV). Method: This is a retrospective study among blood donors at a tertiary hospital in Nigeria. We used the blood bank records to calculate yearly seroprevalence rates for HBV, HCV and HIV per 100 donations from 2001 to 2006. Results: A total of 33,682 prospective donors were screened, of which 13.2% were positive for HBsAg. The overall seroprevalence rates for HIV and HCV were 7.66% and 3.69%, respectively. HIV seroprevalence rose from 4.25% in 2001 to peak at 12.64% in 2003, before a steep drop to 6.35% in 2004 and a gradual decline to 5.70% in 2006 (p < 0.05). Conclusion: The seroprevalence rates for HIV and HBsAg fluctuated greatly during the study period while the seroprevalence of HCV was consistent. The screening kits used may be partly responsible for these fluctuations. Innovative programs for donor education, with the use of a formal questionnaire in donor selection, are recommended to ensure a safe donor population.

Departments of Haematology, College of Medicine, University of Ibadan, Nigeria. 2 Departments of Chemical Pathology, College of Medicine, University of Ibadan, Nigeria. Departments of Obstetrics and Gynaecology, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria. 4 Department of Community Health, Federal Medical Centre, Owo, Ondo State, Nigeria. Department of Cancer Studies and Molecular Medicine, Oxidative Stress Group, University of Leicester, United Kingdom. Departments of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Nigeria.

Objective : The red cell membrane of sickle cell anaemia is vulnerable to attack from the alternative complement pathway. The activation of the alternative complement pathway is initiated by externalization of phosphatidylserine on red cell membrane. Serum and cell bound regulators normally prevent amplification of the cascade. However, red blood cells in sickle cell anaemia appear to be exposed and the cell lysing membrane attack complex is ubiquitous on irreversible sickle red blood cells. It is possible that there are deficiencies (either functional or quantitative) of complement regulators. In this study the quantitative defects of the most abundant serum phase regulator, complement factor H in sickle cell anaemia was investigated. Methods : We compared the plasma levels of complement factor H (a serum phase regulator of the alternative pathway) in 61 steady state Hb SS with 60 healthy Hb AA using an enzyme linked immunosorbent assay to analyze complement factor H level in the plasma. The full blood count parameters were estimated using flow cytometry. Results : There was no significant difference in the serum complement factor H levels between the steady state Hb SS and healthy Hb AA. Significant inverse relationships existed between complement factor H, total white cell count, granulocyte cell count and platelet count as well as significant direct relationships between complement factor H, haematocrit, and the haemoglobin concentration. Conclusion : Complement factor H in patients with sickle cell anaemia who are in steady state is not significantly lower than in controls. Keywords : Complement factor H, sickle cell anaemia, alternative pathway

Africa has the highest prevalence of transfusion transmitted infections. The World Health Organization recommends universal and quality-controlled screening of blood donations for the major transfusion-transmissible infections (TTIs): human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis. Therefore a retrospective study was conducted to assess the effect of strategies in our blood bank to improve blood safety on the seroprevalence of HIV, HCV, HBV and syphilis infections among the donors over a seven year period. Existing data in the blood bank was used to determine number of the blood donors who were infected with HIV, HCV, HBV and syphilis. The test methods used to screen the donors were identified. The trend of prevalence of the transfusion transmitted infections among the blood donors from 2009 to 2015 was also determine. A total of 41,445 blood donors were screened. Voluntary blood donors constituted 11.1% of the donor population. The overall seroprevalence rate for the TTI was 12.3%. The prevalence was highest for HBV (8.5%) followed by HIV (1.8%), HCV (1.4%) and least for syphilis (0.5%) respectively. The infections showed significant inter-year variation (p

Click on the link to view the abstract.The Tropical Journal of Health Sciences Vol 20 No 2 (July 2013)

Background: Alteration in hematological profile is a common finding in systemic and infectious diseases. The knowledge of the frequency of the haematological abnormalities in patients with acute viral hepatitis will support the need for this indispensable tool in the investigation of infectious diseases. The objective of this study is to describe the haematological profile of patients with acute viral hepatitis.Methods: Packed cell volume (PCV), white blood cell count (WBC), platelet count, prothrombin Time (PT) and partial thromboplastin time in kaolin (PTTK) were reviewed in 50 patients with acute viral hepatitis at the Gastroenterology and Haematology clinics of the University College Hospital Ibadan compared with controls. The patients were not followed up for outcome of disease.Result: Among the patients, anaemia was detected in 12(24%) with mean WBC count of 8.1 ± 11.4 x 109/mm3. The WBC count was abnormal in 8(16%) of the patients; 2(4%) of the patients were leucopenic. Neutrophilic and lymphocytic leucocytosis were observed in 6(12%) patients. Thrombocytopenia was not observed in any of the patients. One third of the patients had abnormal coagulation profile.Conclusion: Haematological abnormalities in patients with acute viral hepatitis are non-specific. However, abnormal haematological profile found in one quarter of the patients underscores the need for routine blood count in acute viral hepatitis. Follow up of patients with leucopenia or bicytopenia even after recovery from acute viral hepatitis should constitute an essential part of these patients’ management.

Background: Abnormal lipid homeostasis has been reported in sickle cell anaemia (SCA) as well as in other haematological disorders. However, there is little information on the lipid profile of SCA subjects in vaso-occlusive crisis (VOC). This study determined the lipid profile of adult SCA subjects in VOC and in steady state (SSCA). Materials and Methods: Fifty-eight (58) adults with HbSS (30 in steady state and 28 in vaso-occlusive crisis) and 24 age-matched healthy individuals with HbAA genotype were recruited into this study. Standard methods were used for the determination of blood pressure (BP), packed cell volume (PCV), total white blood cell count (WBC) and haemoglobin phenotype. After an overnight fast, 5 ml of venous blood was obtained from each SSCA and the controls while samples were collected upon admission in the VOC group. Plasma lipid profile was determined using enzymatic method. Differences between two groups were determined using independent Student's t-test or Man-Whitney U as appropriate. P-values less than 0.05 were considered significant. Results: Plasma total cholesterol (TC) and high density lipoprotein (HDL) were significantly lower while the ratio of triglyceride (TG) to HDL (TG/HDL) was significantly higher in SSCA compared with the controls. Low density lipoprotein (LDL) and TC were significantly lower in SCA subjects in VOC compared with controls. However, TC, TG, LDL and TG/HDL were significantly lower while HDL was significantly higher in VOC compared with SSCA. Conclusion: Sickle cell anaemia subjects have defective fasting lipid metabolism which becomes pronounced with VOC.