The burden of the disease due to malaria is believed to share the same geographical distribution that correlates with G6PD deficiency and sickle cell haemoglobin (HbSS) due to protective advantage against malaria parasites. This study was aimed at studying the interactions between G6PD and haemoglobin variants in sub-clinical malaria infected pregnant women. Five millilitres (5ml) of venous blood was collected aseptically into 1% diamine tetraacetic acid bottle and carefully mixed for the analysis. G6PD activity was measured quantitatively with 3000 BSA spectrophotometer using the Randox G6PD kit. Malaria parasite density was determined microscopically using thick and thin Giemsa stained blood smears. Determination of haemoglobin variants was done using cellulose acetate membrane electrophoresis with Tris-EDTA-borate buffer (pH 8.9). All results were analysed using measure of significance taken as p values, that is (p>0.05) was regarded as insignificance while p<0.05 was regarded as significant. A total of eight hundred and twenty-eight (828) participated in the study. Of these, five hundred and seven 507 (61.2%) were infected with malaria parasite and three hundred and twenty-one (321) (38.8%) served as controls (uninfected subjects). HbAA genotype took dominance in malaria parasite infestation, 379 (74.8%), then HbAS 126 (24.9%) and HbSS 2 (0.4%). The mean age of the study participant was 29.5+5.31 years. Also, five hundred and seventeen 517 (62.4%) were G6PD deficient out of the eight hundred and twenty eight participants. The mean value of G6PD levels for HbSS was significantly elevated at 12.20+0.30u/gHb compared to HbAS, 6.28+0.16u/gHb and HbAA, 6.60+0.07u/gHb. It is therefore concluded that coinheritance of G6PD and HbS has no advantage over single inheritance of HbS variant.
Aim: The aim of the study was to assess the influence of gender on malaria parasite severity in children resident in Rivers State, Nigeria. Study Design: The study was cross-sectional observational study. Place and Duration of Study: University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, between the month of March and August 2020. Methodology: A total of 822 pediatrics (0-16 years), were randomly selected for this study after due parental consent. 5ml of venous blood was collected from each subject: 1ml was dispensed into paediatric EDTA (for haematologic and parasite density) and 4 ml into sodium citrate bottle for L-arginine assay by ELISA-method, while Full blood count was determined using haematological auto-analyser, Mindray BC-6800. Malaria density was determined by microscopic method using thick and thin Giemsa stained blood smears. Level of significance was set at P<0.05. Results: There was a significant decrease (p<.05) in the mean (41.04±3.80%) neutrophil count in female subject with complicated malaria compared with the control (42.81±0.98%) as against a significant decrease in mean (37.71±0.96%) neutrophil count of female subject with uncomplicated malaria. A significant decrease in neutrophil (28.05±3.37%) of male subjects with complicated malaria and uncomplicated malaria (36.10±0.79%) was seen when compared to control (44.32±0.88%). Again, a significant decrease (p<.05) in eosinophil count of female with complicated malaria (3.32±0.74%) was seen when compared with the control subject (3.81±0.19%) and no significant difference was seen in female subjects with uncomplicated malaria (3.62±0.19%) when compared with the control. A significant increase in eosinophil was seen in male subjects with complicated malaria (4.47±0.66%) and uncomplicated malaria (4.52±0.16%) when compared with the control (3.88±0.17%). There was observed a significant difference (p<.001) in the mean L-arginine values of female subjects with complicated (39.22±9.57pg/ml) and uncomplicated (65.13±2.41 pg/ml) malaria compared with the control (42.85±2.48 pg/ml). However, no significant difference was seen in male subjects with complicated (33.21±8.49) and uncomplicated (45.51±2.00 pg/ml) malaria when compared with control (47.97±2.21 pg/ml). Also, a significant difference (p<0.0019) was seen between the mean D2D values of female subjects with complicated (6436.64±568.94 pg/ml) and uncomplicated (2824.55±143.46 pg/ml) malaria among the study subjects as against the control (1866.39±147.35 pg/ml). Conclusion: In conclusion, this study showed a trend between gender and malaria type did not significantly change haematological parameters with the exception of the immune cells such as NEU, LYM, and EOS. However, a significant increase in L-arginine among female subjects was seen indicating a faster rate of malaria clearance.
Aim: The aim of this study was to assess some haemostatic parameters in sickle cell anaemia subjects in Rivers and Bayelsa States. Study Design: This study is a cross-sectional observational study. Place and Duration of Study: This study was carried out at the University of Port Harcourt Teaching Hospital, Rivers State, and the Federal Medical Centre, Yenagoa, Bayelsa State, between the months of February and August, 2020. Methodology: A total of four hundred and fifty (450) subjects with age range of 1-50 years were randomly selected. There were about 200 registered patients (adults and children alike) at the sickle cell clinics of the University of Port Harcourt Teaching Hospital, and the Federal Medical Centre, Yenagoa, with an average of 4 new patients per month. The sample size was obtained using a prevalence of sickle cell anaemia of 2% and the sample size was calculated using Cochran sample size formula. Five milliliters (5ml) of venous blood sample was withdrawn from the peripheral vein in the upper limb of subjects using a standard venipuncture technique. The sample was rocked gently to mix and kept at room temperature and the haemostatic parameters (vWF, FVIII, D-dimer, L-arginine, fibrinogen, ADAMTS13) were assayed quantitatively with Bioassay Technozym kit using Microplate Reader (Labtech microplate auto ELISA plate reader, an IS0 13485:2003 CE and WHO compliance Co., Ltd. Shanghai International Holding Corp. GmbH; Europe) calibrated to a wavelength of 450 nm with strict adherence to the manufacturer's instructions, while PT and APTT were analysed with Fortress reagent and Uniscope SM801A Laboratory using water bath.Data management and statistical analyses were conducted using Statistical Analyses System SAS 9.4 (SAS Institute, Cary, North Carolina, USA) and p values less than .05were considered statistically significant. Results: The results showed the mean comparison of haemostatic parameters in sickle cell anaemia and control subjects. The comparison of haemostatic parameters showed significant(p<.05) increasesand decreases inVaso-Occlusive Crisis (VOC) and steady state respectively compared with the control group. There was statistically significantreduction in the mean comparison of L-Arginine (p<.01) in VOC) condition than steady state in relation to the control group in our study population, while D-Dimer, ADAMTS13 were also significantly reduced statistically (p<.01) in VOC condition than steady state compared with the control group. However, the mean FVIII inhibitor, Fibrinogen, PT (INR) and APTT were significantly higher (p<.01) in VOC than steady state when compared to controls with normal haemoglobin (HbAA).Correlations of haemostaticparameters by sickle cell anaemia subjects’ condition showed more significant positive correlations in VOC than steady state. Conclusion: This study showed a heightened hypercoagulability in Sickle Cell Snaemia(SCA)subjects, and further pave way for better understanding particularly the diagnostic variables underlying SCA, specific to each subject condition (steady state and VOC). Subjects with SCA, particularly during VOC, undergo significant haemostatic alterations that increase their risk of developing coagulation activation-related complications. Thus, though selected markers of coagulation were significantly different between the subject conditions, they were often significantly higher in the SCA.
Aim: The aim of this study was to evaluate changes in some haematological parameters in sickle cell anaemia subjects in Rivers State. Study Design: This study is a cross-sectional observational study. Place and Duration of Study: University of Port Harcourt Teaching Hospital, Rivers State, and the Federal Medical Centre, Yenagoa, Bayelsa State, between the months of February and August, 2020. Methodology: A total of four hundred and fifty (450) subjects with age range of 1-50 years were randomly selected. There are about 200 registered patients (adults and children alike) at the sickle cell clinics of the University of Port Harcourt Teaching Hospital, and the Federal Medical Centre, Yenagoa, with an average of 4 new patients per month. The sample size was obtained using a prevalence of sickle cell anaemia of 2% and the sample size was calculated using Cochran sample size formula. Five milliliters (5ml) of venous blood sample was withdrawn from the peripheral vein in the upper limb of subjects using a standard venipuncture technique. The sample was rocked gently to mix and kept at room temperature and the haematological parameters were analyzed within 4 hours of samples collection. The haematological parameters: total white blood cell count (WBC), red blood cell count (RBC), Haemoglobin concentration (Hb), Haematocrit, mean cell volume (MCV), mean cell haemoglobin (MCH), mean cell haemoglobin concentration (MCHC), red cell distribution width (RDW-CV), Platelet count (PLT), MPV, Neutrophils, Lymphocyte, Monocyte, Eosinophils, and Basophils) were analyzed using Mindray BC-6800 auto Haematology analyzer system. Data management and statistical analyses were conducted using Statistical Analyses System SAS 9.4 (SAS Institute, Cary, North Carolina, USA) and p values less than .05 were considered statistically significant. Results: The results showed the mean comparison of haematological parameters in sickle cell anaemia and control subjects. The mean comparison of Haemoglobin F was significantly reduced statistically (p<.05) in vaso-occlusive crises (VOC) condition than steady state compared with the control group. There was increase trend of haematological parameters showing statistically significant difference across the subject conditions compared with the control. There were exceptions in few cases especially in lymphocytes which was not significant (p>.05) in the steady state and vaso-occlusive crisis compared with the control. Similarly, Neutrophils was not significant (p>.05) in the steady state and vaso-occlusive crisis compared with the control. Furthermore, Basophils was more significant (p<.05) in the steady state than in the vaso-occlusive crisis and control groups. Similarly, absolute eosinophil was less significant statistically (p<.05) in the steady state and vaso-occlusive crisis than in the control group. Conclusion: This study has shown that there are changes in haemtological parameters between SCA subjects and control subjects and the VOC and steady state sickle cell anaemia (SCA) subjects.
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