Assessment of Zinc Level and its Relationship with Some Hematological Parameters among Patients with Sickle Cell Anemia in Abakaliki, Nigeria

Background: Sickle cell anemia (SCA) is an inherited hemoglobin (Hb) disorder with susceptibility for oxidative damage due to chronic redox imbalance in red blood cells (RBCs) which often results in hemolysis, endothelial injury, recurrent vaso-occlusive episodes, and derangement in hematological parameters. Zinc is an antioxidant which helps to reduce oxidative damage. This study aimed to assess the serum level of zinc and its relationship with some hematological parameters in patients with SCA (HbSS). Materials and Methods: This was a cross-sectional comparative study which involved HbSS patients in steady state with sex‐ and age‐matched HbAA control. Assay of Hb phenotype, serum zinc level, and some haematological parameters were done. Ethical approval was gotten from the institutional review board, and each participant gave informed written consent before recruitment into the study. Analysis of all data obtained was done using SPSS software, version 20. Results: Thirty adult patients with SCA and thirty sex- and age-matched controls with a mean age of 26.7 ± 7.6 years and 27.7± 5.3, respectively, were studied. There was a significant decrease in serum zinc level among patients with HbSS compared to those with HbAA (P = 0.038). Similarly, patients with HbSS had significantly lower Hb level, packed cell volume, and RBC count compared to HbAA control (P < 0.05). On the contrary, patients with HbSS had significantly higher white cell count and platelet count compared to HbAA individuals (P < 0.05). Correlation between serum zinc level and blood counts showed weak positive relationship between zinc level and Hb level (r = 0.04, P = 0.8) and weak negative relationship between serum zinc level and platelet count (r = −0.3, P = 0.1), as well as zinc and white blood cell (WBC) count (r = −0.2, P = 0.4). Conclusion: There was a significantly low level of zinc among patients with HbSS compared with HbAA controls. Patients with HbSS had zinc levels that weakly correlated with Hb level positively but weakly negatively correlated with platelet and WBC counts. Further studies are required on a wider scale to assess whether zinc supplementation may improve blood counts in patients with SCA

Awareness, knowledge, risk perception and uptake of maternal vaccination in rural communities of Ebonyi State, Nigeria

Introduction: Knowledge and uptake of maternal vaccination has been reported to be low in low- and middle-income countries. Objectives: To determine the knowledge, uptake and determinants of uptake of maternal vaccination among women of childbearing age. Methods: A cross sectional study was done among 607 women of childbearing age selected from rural communities in Ebonyi State using multi-staged sampling technique. A pretested, interviewer administered questionnaire was used. The proportion of maternal vaccination uptake and predictors of uptake was determined at 5% level of significant using multiple logistic regression model. Results: Most of the respondents (39.9%) were in the 15-24 years age group. Only 1.3% and 41.5% were knowledgeable and had received any form of maternal vaccines respectively. The main reasons adduced for non-receipt of the vaccine was lack of information (65.8%) and not being pregnant (23.5%). Pregnancy was the predictor for uptake of maternal vaccine among the study population. Conclusions: There was low level of knowledge and uptake of maternal vaccine among rural women and a myth that the vaccine is only given when pregnant. This calls for increase targeted enlightenment of rural women on maternal vaccine in order to improve uptake. Keywords: Maternal vaccination; rural communities; Nigeria

Knowledge and adherence to isoniazid preventive therapy among people living with HIV in multilevel health facilities in South-East, Nigeria: baseline findings from a quasi-experimental study

Introduction: isoniazid preventive therapy is a crucial component of TB/HIV collaborative program and patient good knowledge and adherence to this preventive treatment are essential in improving implementation. The aim of this study was to determine the knowledge and adherence to isoniazid preventive therapy among patients receiving HIV care. Methods: this is a baseline result of a quasi-experimental study which was carried out among 200 patients receiving HIV care in six high patient load health facilities providing comprehensive HIV care in Ebonyi State. This included a tertiary health facility and five secondary level health facilities. We used structured interviewer-administered questionnaire to collect information from the participants. Adherence was assessed by self-reports. Descriptive, bivariate and multivariate logistic regression analyses were conducted using SPSS version 20 at 5% level of significance. Results: majority (65%) of the respondents were between 30 and 49 years and most (73.5%) were females. Majority (85%) had been on antiretroviral therapy (ART) for more than one year. More than half of the respondents had ever received and had been counselled on IPT (55%, 62% respectively) while only 17.5% were on IPT during the study. More than half (60.5%) of the respondents had low level of knowledge. Marital status was the only predictor of knowledge. Unmarried respondents were 2 times more likely to have knowledge of IPT compared with the married (AOR = 2.11, CI = 1.10-4.06). Among the 35 patients who were on IPT, 32 (91%) reported good adherence in the 30 days preceding the survey. Conclusion: there was poor knowledge of IPT among the respondents however self-reported adherence was high. We recommend intensification of general and personalized education of PLHIV on IPT by health workers

Preventive Measures of Vaso‑Occlusive Crisis Among Sickle Cell Disease Patients in South‑Eastern Nigeria: How Much Do Our Patients Know?

Background: Vaso‑occlusive crisis (VOC) is a feature of sickle cell disease (SCD), an inherited medical condition which is more common in Sub‑Saharan Africa especially Nigeria and is saddled with multi-systemic complications. Knowledge and practice of preventive measures of VOC by patients may reduce the risk of morbidity and mortality. Aim: The purpose of this manuscript is to determine the knowledge, attitude, and practice of the various preventive measures of VOC by patients and their relationship with their frequency of painful crisis. Materials and Methods: A cross-sectional descriptive survey was used. This study was conducted between August, 2018, and February, 2019. Participants were selected consecutively as they came for clinic consultations. Demographic characteristics and the knowledge, attitude, and practice of various preventive measures of VOC were obtained using a structured interviewer‑administered questionnaire. The analysis was performed using Statistical Package for the Social Sciences software version 23.0. Descriptive and inferential statistics were used with P < 0.05 which was considered statistically significant. Ethical clearance and informed consent were obtained before the commencement of the study. Results: A total of 154 SCD patients participated in the study and were made up of 73 (47.4%) males and 81 (52.6%) females, with a male‑to‑female ratio of 1: 1.1. Majority of the respondents (76.6%) had good knowledge of preventive measures toward VOC in SCD. This study also found that 59 (38.3%) participants had good practice of preventive measures toward VOC while 95 (61.7%) had fair practice. Majority (68% [40/59]) of those who had good practice of preventive measures were less likely to have more than three crises in a year compared to those who do not practice good preventive measures, though not statistically significant (OR = 2.489, P = 0558) (confidence interval = 0.480 – 0.637). Conclusion: Majority of the patients have good knowledge and practice of preventive measures of VOC and this appears to have reduced the frequency of their crisis in a year. Health education for sickle cell patients is an important tool that may reduce morbidity and mortality by reducing the frequency of crisis

Vaccine safety: Assessing the prevalence and severity of adverse events following COVID-19 vaccination amongst healthcare workers in tertiary health facilities in Nigeria

Background: Vaccines, including COVID-19 vaccines, are known to be cost-effective interventions for disease prevention and control. However, adverse events following immunisation (AEFI) may challenge the acceptance of these vaccines. This study assessed the prevalence and severity of COVID-19-related AEFI amongst healthcare workers at tertiary health facilities in Nigeria. Materials and Methods: This descriptive, cross-sectional study was conducted among healthcare workers who had received the COVID-19 vaccine. A multi-stage sampling technique was used to select participants from six Tertiary Health Facilities in Nigeria. Ethical approval (NHREC/01/01/2007-19/07/2021) was obtained from NHREC. Data were analysed using IBM® SPSS version 25 and categorical variables were presented in tables/charts using frequencies and proportions. Results: A total of 2130 respondents participated in the study, with a mean age of 37.4 ± 9.1 years. Most of the respondents, 1674 (78.6%), had two doses of the vaccine, and the overall prevalence of AEFI was 813 (38.2%). Common among the AEFI reported following the administration of the first dose of the vaccine were fever 649 (30.5%) and pain at the injection site 644 (30.2%), while it was pain at the injection site 216 (10.1%) and fever 173 (8.1%) for second dose. The higher proportions of AEFI were mostly mild to moderate. Conclusion: The study observed a relatively low prevalence of AEFI, with the commonly reported ones being fever and injection site pain. It is crucial that countries continuously collect the data on AEFI and establish causality as a way to improve quality and guarantee vaccine safety