In sickle cell anaemia (SCA), continuous activation of the vascular endothelium by inflammatory cytokines leads to increased elaboration and secretion of von Willebrand Factor (vWF), a potent mediator of adhesive interactions involving the endothelium and circulating blood cells. Non-O blood groups are associated with the elevation of vWF concentration. Thus, SCA and non – O blood groups are determinants of increased levels of vWF, which plays a pivotal role in the pathophysiology of vaso-occlusive crisis (VOC). To determine the influence of plasma vWF:Ag levels, ABO and Rh (D) blood groups on the risk of occurrence of sickle cell vaso-occlusive crisis. We conducted a prospective study of frequencies of VOC with respect to plasma vWF:Ag levels, ABO and Rh (D) blood groups of 50 SCA patients. In comparison with blood group O, patients with non – O blood groups had significantly higher mean vWF concentration (4.17+3.16 IU/l vs 3.46+3.69 IU/l, p< 0.001), with a significantly higher mean number of VOC episodes per patient (3.2 vs 1.3, p<0.001). The relative risk of VOC for patients with non- O blood groups was 1.87 (95% confidence interval 1.5 - 2.2, p<0.001). However, the association of Rh (D) blood group of the patients and their plasma vWF:Ag levels on the risk of occurrence and frequency of VOC was not statistically significant (P = 0.155). SCA patients with non – O blood groups had more episodes and higher risk of VOC that were likely due to the effect of higher plasma vWF concentration. These results indicate that the non- O blood group is a risk factor for frequent VOC and an unfavourable prognostic marker in SCA. We hereby recommend that a large multicentre prospective study be carried out to definitely determine the impact of ABO, Rh and other blood groups on the overall clinical course of SCA.

Background: Blood transfusion is a veritable intervention in many clinical situations. However, the provision of safe, readily available, affordable and adequate supply of blood and blood products is still a major public health challenge in developing countries like ours. Healthcare support staff are expected to be conversant with donor blood procurement processes and the challenges of blood supply, therefore should take the lead in forestalling the occurrence of blood supply deficits. Aims: To assess the knowledge, attitude and practice of voluntary blood donation among non-physician healthcare workers. Methods: This was a cross-sectional study carried out at the University of Uyo Teaching Hospital, Uyo as part of the 2021 World Blood Donor Day Programme. A total of 120 Staff were recruited. Pre-tested questionnaire were used to assess their knowledge, attitude and practice of voluntary blood donation. Results: The mean age of the respondents was 36.9+9.8 years, range 18-58 years with females accounting for 51.7%. Sixty percent were married, 86.7% attained tertiary level of education and majority of the respondents (20.8%) were nurses. Most of the study participants had good knowledge and positive disposition towards blood donation. However, only 25.8% had donated blood in the past with 38.7% being voluntary. Male staff were more likely to donate (P = 0.001). There were no statistically significant associations between blood donation practice and marital status, level of education and professional status of the respondents (P values – 0.083, 0.557 and 0.05 respectively) Conclusion: There is need for active education program to encourage the healthcare workers and the general populace to participate in voluntary blood donation.

Background: There has been an increase in the prevalence of Lymphomas in our environment lately. Thorough literature search reveals a limited number of reports on the prevalence of Lymphoma and no information on the clinicopathologic pattern and outcome of treatment of this disease in our centre. Data on the burden of Lymphoma across different regions are important, as there may be variation in incidence in different locations even within the same country. This will keep healthcare providers informed about the current trend of Lymphomas in the region and facilitate prompt and appropriate diagnosis and treatment as well as assist Government agencies in better healthcare planning. Aim: To determine the burden, clinicopathologic characteristics and treatment outcome of Lymphoma among a cohort of adult patients accessing care in a Referral Hospital in Southern Nigeria Methods: This was a longitudinal prospective study of all lymphoma cases managed in the Department of Haematology, University of Uyo Teaching Hospital, Uyo, between January 1, 2014 and December 31, 2018 Results: There were 59 cases. Forty 40 (67.8%) were males and 19(32.2%)were females giving a male to female ratio of 4.4:1. Hodgkin Lymphoma(HL) accounted for 11(18.6%) of the cases while Non-Hodgkin Lymphoma(NHL) accounted for 48( 81.4%)of the cases , with the mean ages for HL and NHL patients being 32.09 +9.22 years and 40.88 + 12.21 years, respectively. The distribution of the different histologic subtypes of the malignancy were as follows: HL; Nodular Lymphocyte Predominant(7cases;63.6%), Nodular Sclerosis(2 cases;18.2%) and Lymphocyte Depleted(2 cases;18.2%). NHL; Small Lymphocytic Lymphoma(23cases;47.9%),Diffuse Large Cell Lymphoma(15 cases;31.3%),unspecified (4 cases;8.3%), Follicular Lymphoma(2 cases;4.2%),Lymphoblastic Lymphoma(2 cases;4.2%), Mantle Cell Lymphoma(1 case;2.1%) and Adult T-Cell Lymphoma(1 case;2.1%). Fourteen 14 (29.2%) out of all the NHL patients had immunohistochemistry and only nine 9 of them were CD20 positive. Relapse rate among the cohort was 11.9% (7/59), while 15.3% (9/59) were still in remission. The cure rate was 5.1%, loss to follow up was 22.0% and 37.3% of patients died in the course of therapy either from advanced disease, non -compliance to treatment or late presentation. All the HL patients received ABVD (Adriamycin, Bleomycin, Vinblastine and Dacarbazine) regimen alone. Majority of the NHL patients (91.7%, 44/48) received CHOP (Cyclophosphamide, Doxorubicin, Oncovin and Prednisolone) regimen alone, while 8.3% (4/48) received Rituximab with CHOP (R-CHOP). Conclusion: The clinicopathological profile, age and sex distribution of lymphoma in our study were comparable to those reported by other authors with nodular lymphocyte predominant being the most common HL histologic subtype and small lymphocytic lymphoma the predominant NHL histologic subtype in our environment. The general outcome was very poor with a high default rate and unsettling mortality figures.

Background: Blood transfusion is an invaluable therapeutic intervention in sickle cell anemia (SCA) patients’ care. Sickle cell anemia patients usually require frequent blood transfusion and are at increased risk of contracting human immunodeficiency virus (HIV), hepatitis B and C virus infections through these transfusions. Aims: To determine the seroprevalence of HIV, hepatitis B and C virus infections in patients’ with sickle cell anemia and the role of blood transfusion in the transmission of the infections. Methods: This was a prospective, observational cross-sectional study conducted on adult patients with SCA attending the Haematology Outpatient Clinic of University of Uyo Teaching Hospital, Uyo, from January 1, 2019 through December 31, 2019. Relevant clinical history was obtained from consenting subjects. Blood samples were collected for hemoglobin electrophoresis and viral antigen/antibody screening using ELISA kits. Data were analyzed using Statistical Package for Social Sciences (SPSS) windows version 23.0. Results: Eight-six patients with SCA participated in the study. Forty (46.5%) of the subjects were male and 63 (73.3%) of the participants were within the age range of 20–29 years. Seventy-five (87.2%) of the subjects had blood transfusion while 11 (12.8%) never received blood transfusion in their entire life. Seroprevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among the transfused SCA patients in this study was 9.3%, 24.0%, and 18.7% respectively while those not transfused had seroprevalence of 9.1% for HIV and 0% for both HBV and HCV. One (1.2%) of the transfused subjects tested positive for HIV and HCV. There was no statistically significant difference in the seroprevalence of HIV, HBV, and HCV infections in relation to the transfusion status of the subjects (p=0.98, 0.07, and 0.12, respectively). Conclusion: The proportion of our SCA patients who were HIV, HBV, and HCV positive was considerable. Blood transfusion did not significantly influence the seroprevalence rates of these viral infections. Measures aimed at controlling the infections in the patients and the general population should be scaled up.

Background: Sickle cell anaemia (SCA) is a major public health issue in Sub-Saharan Africa, including Nigeria. Transfusion of red blood cells is an essential therapeutic modality in SCA. Repeated RBC transfusions can cause alloimmunization resulting in haemolytic transfusion reactions, transfusion refractoriness among other complications. Aims and Objectives: The study aimed to determine the prevalence and specificities of immune erythrocyte alloantibodies among adult patients with SCA compared with healthy HbAA blood donors in Uyo, South-South Nigeria. Materials and Methods: All participants were interviewed using a structured questionnaire to obtain information on bio- data, blood transfusion history and other relevant SCA history. Antibody screening and identification were carried out using tube agglutination method with commercially made panel of cells. Results: A total of 160 subjects were studied. They were made up of 80 SCA patients and 80 healthy HbAA blood donors. Prevalence of red cell alloimmunization among multi-transfused patients with SCA was observed to be 11.3%. Alloantibodies identified were mainly against Rh antigens contributing 66.7% (anti-E 22.2%, anti-C 22.2%, anti-D 11.1% and anti-e 11.1%). Antibodies directed against Kell and Lutheran blood group antigens together constituted 33.3%. No antibody was detected in the controls. Advancing age (30 years and above) and ABO blood group were statistically associated with alloimmunization (P values of 0.043 and 0.013, respectively). Conclusion: Repeated blood transfusion is associated with the development of alloantibodies. Immunohaematologic tests in transfusion care of SCA patients should be improved to include extended red cell phenotyping and routine alloantibody screening and identification.