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Background:Immune thrombocytopenic purpura (ITP) is a rare bleeding disorder that may remit spontaneously. Life-threatening bleeding may require transfusion support, steroids, and other immunosuppressive therapy or splenectomy.Objective:To review the clinical presentation and laboratory features of ITP at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria.Subjects and Methods:A retrospective analytic study of case notes and bone marrow (BM) records of patients diagnosed with ITP at Haematology Department, ABUTH, Zaria, from January 1, 2004, to December 31, 2012.Results:There were nine cases (six females, three males), aged 6–20 (mean 11.11) years. The presentations were epistaxis 8 (88.9%), purpura 4 (44.4%), gum bleeding 4 (44.4%), menorrhagia 2 (22.2%), and intracranial hemorrhage (ICH) 1 (11.1%). Only 1 (11.1%) had clinical splenomegaly. Platelet count of <20 × 109/L was found in 4 (44.4%) while 6 (66.7%) had packed cell volume of <25%. All the nine cases had BM megakaryocytic hyperplasia. Six patients had blood transfusion support while 7 (77.8%) patients received oral prednisolone therapy with time to cessation of bleeding of 12–16 (mean of 8) weeks. One case had spontaneous remission while another had anti-D due to relapse after steroid therapy; this resulted in transient rise in platelet counts. None had other immunosuppressive therapy or splenectomy. Six (66.7%) cases were lost to follow-up after achieving remission and one died of ICH.Conclusion:ITP is not common in our center though its clinical presentations are varied. However, prednisolone and blood transfusion therapy are central to the management of these patients with favorable outcome.

Background Voluntary blood donation (VBD) is critical to adequate blood supply. Public health facilities in Nigeria rely mostly on replacement blood donation. Motivation for blood donation among hospital donors was assessed, and factors that influence VBD were determined in Kaduna, Nigeria.Methods This is a cross-sectional study on 361 blood donors in three selected hospitals. A structured questionnaire was used to collect information from respondents. Logistic regression was used to identify predictors of VBD at P < 0Á05. ResultsThe major motivator (86Á9%) for respondents was when relatives or friends required blood transfusion. About 86% (310) of the respondents had good attitude towards VBD. Having primary or no formal education [adjusted odds ratio {AOR} (95% CI): 0Á35(0Á12-0Á98)] and those who were not in marital relationships [AOR (95% CI)]: 0Á45 (0Á21, 0Á97) were less likely to have good attitude to VBD. Additional factors that hinder VBD were concerns that donated blood might be sold [AOR (95% CI)]: 0Á11 (0Á05, 0Á24) and poor phlebotomy technique by personnel [AOR (95% CI)]: 0Á10 (0Á03, 0Á41). However, repeat blood donors were more likely to have good attitude to VBD [AOR (95% CI)]: 4Á22 (1Á79, 9Á94). ConclusionThe main motivator for respondents is when a family member or a friend needs blood transfusion. Low educational attainment, not been in a marital relationship, concerns that donated blood might be sold and fear of phlebotomy technique were deterrents to VBD. Appropriate blood donor education and providing conducive setting with skilled personnel could convert eligible replacement donors to voluntary donors.

Introduction:Sub-Saharan Africa accounts for 25% of the estimated global 325 million people with chronic hepatitis B and C virus infections. Weak blood transfusion systems facilitate the spread of both hepatitis B and C virus infections. This is worsened by the absence of sustainable quality assurance programs and perennial shortage of sensitive screening kits. We aim to compare the validity of rapid diagnostic tests (RDTs) with the World Health Organization-recommended quality-assured enzyme-linked immunosorbent assay (ELISA) screening method for these viruses.Materials and Methods:We conducted a cross-sectional study on consecutive blood donor samples. Two hundred and sixty-four blood donor samples screened for hepatitis B and C viruses using RDTs were retested at a National blood transfusion service, Kaduna, Nigeria. Data were analyzed using OpenEpi version 3.01 to determine the sensitivity, specificity, and predictive values of RDTs versus ELISA.Results:The sensitivities of the RDTs at 95% confidence interval (CI) were low – 40% (19.8–64.3) and 50.0% (18.8–81.2) – for hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) antibody, respectively. The specificities and 95% CI were high – 99.9% (97.8–99.9) and 100.0% (98.5–100) for HBsAg and HCV antibody, respectively.Conclusion:Predonation RDTs screening of blood donor samples for hepatitis B virus and HCV in hospital donation units performed poorly compared to quality-assured ELISA screening in Kaduna. The risk of transmitting viral hepatitis through blood transfusion still exists. We recommend quality-assured ELISA screening of all donated units for HBsAg and HCV antibody to reduce the risk of these transfusion-transmitted infections.