Background:Sonographic evaluation of abdominal organs is an important work up in managing sickle cell disease (SCD) patients. This study aimed at evaluating abdominal organs by sonography among SCD patients.Methodology:A cross-sectional study was carried out in Maiduguri, Nigeria from April 2014 to July 2015. Two hundred and fifty-two patients participated in the study, with 126 controls and 126 SCD patients. There were 131 (52%) males, and 121 (48%) females, with age range 3–38 years. Measurements were done using ultrasound machine with probe frequencies ranging from 1–4MHz and 4–9MHz in supine, right and left oblique positions for optimum visualization of the abdominal organs.Results:Participants within the age range of 10–15 years had the highest frequency with 88 (34.9%), followed by those within the age group of 17–23 years with 86 (34.1%), and the least were those within the age group of 30 years and above with 8 (3.2%). Hepatomegaly was found in 53 (75.7%), and increased echogenicity of the liver was found in 50 (94.3%) of the SCD patients, P = 0.000. Gallstones were found in 45 (17.9%), gallbladder sludge was found in 51 (21.4%) and thickened gallbladder wall was found in 84 (33.3%) of the SCD patients, P = 0.000. Autosplenectomy was found in 45 (17.9%), splenomegaly in 63 (24.9%), and calcified spleen in 18 (8.7%) of the SCD patients, P = 0.000. Enlarged kidneys in SCD patients were found in 61 (98.4%) and 63 (98.4%) on the right and left kidneys, respectively. Shrunken kidneys were found in 5 (2.0%) and 4 (1.6%) of the SCD patients on the right and left kidneys, respectively, P = 0.000.Conclusion:Abdominal sonography in SCD patients revealed varied remarkable changes in the size, echotexture, intraluminal deposits and wall thickness in the liver, gallbladder, kidneys, and spleen.

Nigeria has the fourth highest prevalence of TB and the highest prevalence of Sickle cell anaemia (SCA) in the world. SCA patients have impaired immunity and are vulnerable to TB. Hence, we studied the haematological indices of SCA patients with TB in Nigeria. A total of 23 SCA patients with TB were studied in parallel with equal number of age and sex matched SCA patients without TB. SCA patients with TB had significantly lower haematocrit, higher level of circulating sickle cells (CSCs) and similar level of reticulocyte count in comparison to patients without TB. SCA patients with TB had significantly higher mean WBC count associated with higher frequency of neutrophilia in comparison to those without TB. Monocytosis and eosinopenia were exclusively found in SCA patients with TB at frequencies of 52% and 65% respectively. Lymphocyte and basophil counts were normal in all patients with and without TB. Mean platelet counts were high in both patient groups but the frequency of thrombocytosis was significantly higher in patients with TB. SCA patients with TB had significantly higher mean ESR than their counterparts without the infection. The findings of this study revealed that TB in SCA patients was associated with rising level of CSCs, falling level of haematocrit, sub-optimal reticulocytosis, neutrophilia, monocytosis, thrombocytosis, eosinopenia and rising level of ESR. Hence, SCA patients presenting with these haematological indices should be investigated for TB.

BackgroundInvolvement of the kidneys in patients with sickle cell anaemia is a well recognised chronic complication. This study seeks to determine the prevalence of chronic kidney disease in patients with homozygous sickle cell disease (HbSS) and to identify risk factors associated with its development.MethodologyThe subjects consisted of adolescents and adults with HbSS recruited sequentially from the adult haematology outpatient clinic and Daycare ward of the unit. Clinical variables including age at diagnosis of SCA, the frequency of vaso-occlusive crisis and transfusion therapy, as well as laboratory data including haematological profile and renal function tests were obtained. The glomerular filtration rate was estimated (eGFR) using the ‘modification of diet in renal disease’ (MDRD) formula.ResultsTwo hundred and eighty-four HbSS patients were recruited. The prevalence of CKD amongst them was 38.9%. Further stratification of the patients based on eGFR showed that sixty-nine (26.8%) had hyperfiltration; 35 (13.6%) stage 1 CKD; 53 (20.6%) stage 2 CKD; 33 (12.8%) stage 3a CKD; 28 (10.9%) stage 3b CKD; 30 (11.7%) stage 4 CKD and 9 (3.5%) had end stage renal disease. There was significant association between eGFR and clinical parameters such as age (r −0.353, p=0.000), SBP (r −0.148, p= 0.021), DBP (r −0.213, p=0.001) and total number of blood received (r −0.276, p=0.000); and laboratory parameters such as PCV (r 0.371, p=0.000); urea ( r 0.527, p=000); creatinine (r 0.625, p=0.000) and uric acid ( r −0.419, p=0.000).ConclusionsThe present study has revealed a high prevalence of CKD amongst patients with SCA in our region. Clinical and laboratory predictors of CKD using eGFR were identified to include age, SBP, number of units of blood transfusion, PCV, urea, creatinine and uric acid levels.

Background: Nigeria is the most populous black nation with the heaviest burden of Sickle Cell Anaemia divided into a cold and dusty harmattan season and a hot non-harmattan dry season. We studied the impact of seasonal variations of climatic factors on the frequencies of acute vaso-occlusive morbidities, including Vaso-Occlusive Crisis (VOC), Acute Chest Syndrome (ACS), priapism and stroke among patients with SCA in northern Nigeria.Methods: This is a six-year prospective study conducted from 2005 to 2010 in university teaching hospitals of Maiduguri and Kano cities of northern Nigeria. Consecutive patients with SCA who presented with VOC, ACS, priapism and stroke were diagnosed, recruited and enumerated. The monthly and seasonal frequencies of each morbidity (VOC, ACS, priapism or stroke) during the period of study were calculated and graphically evaluated. Results:The frequencies of VOC showed 3 peaks: during the harmattan dry season in January, during the non-harmattan dry season in April and during the rainy season in August. The frequencies of ACS showed a peak during the harmattan dry season in December. The frequencies of priapism showed a peak during the nonharmattan dry season in April. The frequencies of stroke showed a peak during the rainy season in July/August. Conclusion:The frequencies of acute vaso-occlusive morbidities in SCA patients could be adversely affected by seasonal variations in climatic factors. There is need for patients and care givers to be adequately educated on how to mitigate the adverse effects of weather on SCA. Moreover, governmental and non-governmental organizations should take seasonal variations of climatic factors into consideration when drafting health care plan for patients with SCA.(SCA). The climate in the north is characterized by a short rainy season and a long dry season that can be sub- Journal of Blood Disorders & TransfusionJ ou rnal of B lo o d Dis orde rs & Tr ans fusi on

Sickle cell anaemia (SCA) is a globally widespread genetic disorder affecting 5% of the world's over 6 billion people. Parvovirus infection and the resulting aplastic crisis is a recognised complication in individuals with SCA. Aplastic crisis increases the need for blood transfusion and its attendant risk of Transfusion Transmissible Infection (TTI). Hence there is a vicious cycle in which Parvovirus B19 causes aplastic crisis which in turn causes increased transfusion need; and transfusion increases risk of transfusion transmissible infection in which parvovirus B19 is included in certain parts of the world. Sickle cell anaemia is associated with foetal death and infection with parvovirus B19 increases the risk to early mortality. The objective of this study was to determine the seroprevalence of parvovirus B19 among SCA and compare with that of controls in the study area. Furthermore clinical and laboratory profile of subjects were analysed to identify possible correlation with parvovirus B19 seropositivity and explore the possibility of involvement of white cell and platelets. A total of 90 subjects comprising 45 consecutive SCA case subjects and 45 age-and sex-matched non SCA controls were studied in a cross sectional comparative study. Ten millilitres of blood was drawn from the antecubital fossa of each subject after obtaining informed consent. The 10mls of blood was divided into two aliquots, 4.5 mls was added into EDTA anticoagulated bottle and was used for basic complete blood count (CBC), while the remaining 5mls was added into a plain specimen container allowed to clot and serum obtained to test for anti-parvovirus B19 IgG and IgM using an immunochromatography based technique specifically BIOCARD TM Parvo B19 diagnostic test kit. There was male preponderance in the study. The SCA subjects comprised 26 males and 19 females (male to female ratio = 1.4:1), while the non-SCA controls comprised 25 males and 20 females (male to female ratio 1.3:1).. The analysis of anti-parvovirus B19 IgG antibody revealed a prevalence of 23.3% among SCA cases with 18.9% among controls. The haematological profile is not affected by IgG seropositivity. However pregnancy outcome revealed that the total number of stillbirths is 12 among IgG seropositive SCA cases which is higher than the 6 encountered in IgG seronegative SCA subjects; the difference is statistically significant (p=0.04).