Background:Anaemia affects approximately 1.62 billion people globally corresponding to 24.8% of the world's population. Iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD) are the most common forms of anaemia. A hormone produced by the liver, hepcidin, is the primary regulator of iron homeostasis and its production increases in ACD and decreases in IDA. Usually, ACD and IDA coexist and sometimes look identical on peripheral blood smears. Aims and Objectives: The current study aims to evaluate the diagnostic value of hepcidin to predict ACD from IDA as well as the diagnostic value of hepcidin to predict ACD from a combination of IDA and ACD. Materials and Methods: Specimens presenting with haematological indices suggestive of IDA and/or ACD following World Health Organisation (WHO) standard case definitions were identified among samples coming to the Haematology laboratory for routine investigations. Serum hepcidin, serum ferritin, serum iron and total iron binding capacity (TIBC) were assessed. Demographic data was obtained from specimen requisition forms. Results: Of the 66 participants, 62.1% (n = 41) were females. IDA was more common among females (36.4%) than males (6.1%) while ACD was more common in males (19.7%) than females (12.1%). Iron Deficiency Anaemia participants had significantly lower hepcidin levels than ACD (p<0.001). There was a significant positive correlation between serum hepcidin and serum ferritin levels (p < 0.001). Conclusion: We found that IDA participants had significantly lower hepcidin levels than ACD and IDA/ACD combined. Therefore, serum hepcidin could be considered in diagnosing and distinguishing ACD from IDA or IDA/ACD as it also had high diagnostic sensitivity and specificity compared to other markers.
BackgroundHuman Parvovirus (B19V) is a small, single-stranded, non-enveloped DNA virus which is pathogenic to humans causing a wide array of clinical complications which include erythema infectiosum, aplastic crisis and hydrops foetalis. It is generally harmless in healthy individuals but may be life threatening in immunocompromised individuals such as patients with sickle cell disease, cancer, HIV and pregnant women. It has been shown to be transmissible by blood transfusion but donor screening for the virus is not yet mandatory in most sub-Saharan African countries including Zambia.Materials and methodsThis was a cross-sectional study undertaken at the Kitwe Central Hospital, blood bank and Tropical Diseases Research Centre at Ndola Central Hospital. A total of 192 blood samples were screened for Ig M antibodies against parvovirus B19 by ELISA.ObjectivesThe general objective of the study was to determine the seroprevalence of parvovirus B19 infections among healthy blood donors at the Kitwe Central Hospital blood bank. Specific Objectives were to detect parvovirus B19 Ig M antibodies in donor blood using serology and to analyse the age and sex distribution of parvovirus among blood donors.ResultsThe prevalence of parvovirus B19 Ig M in this study was 15.6%. The majority of the positive cases were in the age group 15–22 years (17.8%) but there was no statistical significance between occurrence of parvovirus and age ( p value=0.703). Prevalence in males was higher than in females that is 16.4% and 13.8%, respectively. The relationship between gender and parvovirus B19 occurrence was however not significant either (p value=0.516)ConclusionThis study showed a 15.6% prevalence rate of acute Parvovirus B19 infections in blood donors at the Kitwe Central Hospital, blood bank. Studies with larger sample sizes are needed to validate these results.
Background: Pancytopenia is a haematologic condition characterised by leukopenia, anaemia and thrombocytopenia. Pancytopenia is not a diagnosis and has to be qualified by determination of its cause. The aetiologies of pancytopenia are diverse, and study of bone marrow histomorphology via cytology and histology are key components that assist in the determination of the underlying cause. Pancytopenia is encountered regularly in medical practice in Zambia, however, no studies have been conducted on pancytopenia to date. This was a descriptive cross-sectional study done on adult pancytopenic patients admitted to the medical wards of the University Teaching Hospital (UTH) over an eight-month period. The aim of this study was to determine the histomorphology of the bone marrows of adult pancytopenic patients admitted to the UTH. Methods: A total of 45 bone marrow biopsies were collected over the study period. In all cases the indication was pancytopenia that had been confirmed by a full blood count done at the UTH and the biopsy site was either the anterior superior iliac spine or the posterior superior iliac spine. Demographic and clinical details were obtained using data collection sheets and from review of patient records. The collected data was analysed using the Statistical Package for the Social Sciences (SPSS) version 21. A Chi square test was used to measure association between categorical variables. A p value of < 0.05 at 95% confidence interval was considered statistically significant. Results: There were 32 females (71%) and 13 males (29%), and the age ranged from 15 to 72 years with an average age of 35 years. Forty percent (n=18) of t h e study participants had human immunodeficiency virus (HIV) and all of these all were on highly active antiretroviral therapy (HAART). There were 6 histologic patterns found the commonest being megaloblastosis seen in 38% of the patients, followed by malignancy and myelodysplasia both at 17.0%. Bone marrow aplasia accounted for 13.0%, non-megaloblastic erythroid hyperplasia accounted for nine percent and myelofibrosis for four percent. A chi square test was used to determine if there was association between each histomorphology and HIV status, the only significant result was obtained from the Chi test applied to HIV status and myelodysplasia which gave a p value of 0.026. The Chi square test involving the other histomorphologies all yielded a p value greater than 0.05. Conclusion: The bone marrow biopsies of the study population showed six histomorphologic pictures which in order of frequency were megaloblastosis, malignancy and myelodysplasia, bone marrow hypoplasia, non-megaloblastic erythroid hyperplasia and myelofibrosis. Association was found between HIV status and myelodysplasia via the Chi square test.
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