Abstract:To assess the prevalence and risk factors of anaemia in pregnancy and recommend a cut-off value for antenatal women in developing countries, a cross sectional study was carried in the University of Port Harcourt Teaching Hospital, Port Harcourt, a 523 bed tertiary health care institution in Nigeria. 1371 apparently healthy asymptomatic pregnant women visiting the antenatal clinic for the first time were enrolled for the study. Another 60 age-matched non-pregnant apparently healthy women served as controls. Haemoglobin concentration, malaria, human immunodeficiency virus (HIV)S, haemoglobin electrophoretic pattern and C-reactive protein as marker of infection were investigated using standard haematological and serological procedures. Anaemia in pregnancy (Hb <11.0g/dl) and (Hb<10.0g/dl) were found to be 23.2% and 6.7% respectively. The aetiology of anaemia was found to be multifactorial; 40.2% had anaemia of infection, 20.3% had Plasmodium falciparum alone, 8.5% had HIV alone, 2.5% had HIV and malaria parasite co-infection; 8.9% undetermined infections and 0.6% had sickle cell anaemia. There is moderate prevalence of anaemia in pregnancy in this part of the world. Since the mean Hb value of the pregnant women in this study was 11.62±1.21g/dl and the pregnant women with Hb values around 10g/dl are apparently healthy, a cut-off value of 10.0g/dl may be considered ideal for defining anaemia in pregnancy in developing countries.
Asymptomatic malaria infection is a common feature of malaria endemic regions in the tropics. In this prospective cross sectional survey, involving 240 children aged 1 to 8 years (Boys = 117, Girls = 123; Ratio 1:1.05), the median platelet count was 115 x 10(9)/L (IQR 97.5-190). Thirty-three out of 240 (13.75%) of the children had thrombocytopenia (platelet count < 100 x 10(9)/L). Malaria parasite was found to exert significant reduction in platelet count. This reduction was more pronounced in children under 5 years and also at higher parasite counts. An inverse relationship was established between parasite density and platelet count (y = -0.017x + 96.2, r = -0.2). Thrombocytopenia is not only a feature of acute malaria infection but also that of asymptomatic malaria infection in the tropics and might be a useful indicator of malaria in children.
Parasite density estimation using the assumed count of 8.0 x 10(9)/L might result in over-estimation of the parasite burden. The WBCs of individual patients should always be estimated when parasite density is required.
Anti-HCV pre-transfusion testing among blood donors has not been introduced as a mandatory test in Rivers State, hence the risk of transfusion-transmitted HCV cannot be fully ascertained. One thousand (1000) apparently healthy blood donors were screened using a rapid second - generation test, the HEP C SPOT HCV assay. An overall prevalence of 2.9% was observed in this study. The highest prevalence (8.1%) was found among adults aged between 26 and 33 years and commercial donors.
Laboratory screening for the diagnosis of hepatitis B virus (HBV) infection in blood donors currently consists of testing for hepatitis B surface (HBsAg) antigen alone. The prevalence of isolated anti-HBc-IgM is not yet known in the semi arid region of Nigeria. The major objective of this study was to determine the sero-prevalence of antibody to hepatitis B core antigen (anti-HBc-IgM) and other infectious agent markers; HBsAg, HCV, HIV and Syphilis among blood donors in the North Eastern region of Nigeria. In a cross sectional study from October 2010 to January 2011, 266 blood donors were tested for the infectious disease markers using standard ELISA procedures as contained in the manufacturer's standard operating procedures. The prevalence of various infectious markers obtained were as follows: HBsAg (8.6%); anti-HCV (1.5%); HIV (2.6%) and anti-HBc-IgM(18.4%). There was a zero percent prevalence of Syphilis in this donor population. The proportion of isolated anti- HBc-IgM antibody obtained was 18.1%. Performance indices for HBsAg were as follows: Sensitivity (10.2%), specificity (91.7%), positive predictive value (PPV) (21.7%), Negative predictive value (81.9%), and efficiency (76.7%). The prevalence of anti-HBc- IgM antibody was higher among first time blood donors (21.4%), and in some ethnic groups. There is a high prevalence of isolated anti-HBc-IgM antibody among blood donors in Maiduguri. The sensitivity of HBsAg was found to be very low and as such many recent HBV infections may be missed during pre-transfusion screening. The use of anti-HBc-IgM screening as a mandatory pre-transfusion screening test is hereby advocated.
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