Blood collections from organizations in north central Nigeria: a ten year review

Introduction: Voluntary blood donors in most developing sub Saharan countries are scarcely available with little or no safe donor retention strategies despite the rampant disease and man-made causes of anaemia frequently needing transfusion. The exploration of blood donor sourcing through effective collaboration with organised settings may create a break through.Aims: The study sought to determine the organisations and their contribution to blood collections at the blood service in North central Nigeria.Methods: The records of blood collections in organizations within the North Central Nigeria from 2007 to 2017 were studied. The records of the blood donation clinics and units of blood collected in the organizations were collated. Data was analysed using epi info 2010 version.Results: A total of 52,664 units were collected from volunteer donors at 756 blood donation clinics in three categories of organisations in North Central Nigeria from 2007 to 2017 with a ratio of 70 donations per clinic. 32,228 (61.20%) were from faith base organisations, 17,795 (33.79%) from educational institutions and 2,641 (5.01%) from work places. There were 478 (63.23%), 219 (28.97%) and 59 (7.80%) blood drive clinics with the mean donations rate of 67, 81 and 45 per clinics for the respective organisations.Conclusion: Organizations in North Central Nigeria have contributed to voluntary blood donation. Collaboration between organizations and the blood service could lead to the attainment of national blood security.Keywords: Organizations, North Central Nigeria, Blood, Collectio

The Biophysics and Flow Haemodynamics in Sickle Cell Patients: A Mathematical Model That Takes into Account Electochemical and Vascular Factors in the Genesis of Vaso-Occlusion

Sickle Cell Disease is inherited genetic disease. An autosomal recessive gene is responsible for the synthesis of Haemoglobin S. The disease manifests usually in Homozygous SS state. Synthesis of the Haemoglobin S is courtesy of beta globin gene mutation in chromosome number 11 within the nucleus of Erythroblast. Valine replaces Glutamic acid in position 6 of beta polypeptide chain of haemoglobin. But deoxygenation of Haemoglobin S results in polymerization of the Haemoglobin and the deformable discoid red cell changes to stiff sickle cell, and this is the hallmark of vaso-occlusion and crises. Intracellular concentration of both Magnesium ions and Potassium ions in red cells correlate positively with lower risk of sickling and crises in SCD according to studies. Introducing a hypothetical equation that determines Vaso-occlusion risk, shortened and christen VASOcclusity, a product of biochemical and biophysical considerations in SCD haemodynamics where the radius of the blood vessel and the Body Mass Index by extension are also considered strong factors and variables. Keywords:  Haemoglobin S, Polymerization, ions, Magnesium, Potassium, radius

Cultural practices and the use of icterogenic agents in glucose 6 phosphate dehydrogenase deficient neonates: Any effect?

Background: Cultural practices involving the use of certain agents known to cause haemolysis in Glucose-6-phosphate dehydrogenase (G6PD) deficient individuals are common during perinatal and neonatal periods. This study was targeted at identifying some of these agents and their role in the development of hyperbilirubinaemia in G6PD deficient neonates in our environment with a view at raising public awareness for an acceptable neonatal outcome.Materials and methods: One hundred and fifty neonates admitted into the Special Care Baby Units (SCBUs) of the Jos University Teaching Hospital, Bingham University Teaching Hospital, and the Plateau State Specialist Hospital with neonatal jaundice were enrolled for this study. Information on age, sex, history of drugs, chemicals and herbs used during or after pregnancy were obtained using a questionnaire. Five millilitres of the blood sample was collected into anticoagulated and plain sample bottles for Full Blood Count (FBC), Reticulocyte Count, Serum Bilirubin (SB) and G6PD assay.Results: Mean age at presentation was 3.28 ± 3.11 days. Mean haemoglobin concentration of the neonates was 15.90 ± 2.23 g/dL while mean reticulocyte count, total leukocyte and platelet count were 2.42 ± 0.71%, 7.10 ± 2.76 (x 109/L) and 228.45 ± 85.57 respectively. Sixty-one (40.7 %) of the studied neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb. Mean total serum bilirubin was 205.01 ± 96.57μmol/L. Icterogenic agent use was identified in 70 (46.7%) of the study subjects with naphthalene balls used in 19 (12.7%) study subjects.Conclusion: Icterogenic agents are being used for neonatal care in our environment despite the consequences of hyperbilirubinaemia in those with G6PD deficiency. Keywords: Glucose-6-phosphate dehydrogenase deficiency, Hyperbilirubinaemia, Icterogenic agents, Neonate

Determinants of severity of hyperbilirubinaemiaamong glucose-6- phosphate dehydrogenase deficient neonates in Jos north central Nigeria

Introduction: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited disorder capable of causing severe neonatal hyperbilirubinaemia, kernicterus and death. Identifying such neonates and other factors that could aggravate their clinical states have definite place in managing them for favourable outcomes.Materials and Methods: One hundred and fifty (150) icteric neonates admitted into the Special Care Baby Units of the Jos University Teaching Hospital, Plateau State Special Hospital and the Bingham University Teaching Hospital were recruited for this study. It was a cross sectional descriptive study conducted between March 2013 and February 2014. Parental consents were obtained and Clinical information was gathered using a questionnaire, weight were measured in grams while laboratory investigations that included FullBlood Count (FBC), Reticulocyte Count, Serum Bilirubin (SB) Assay and G6PD activity levels were carried out.Results: Mean age of the studied neonates at presentation was 3.28 ± 3.11 days while mean age of detection of jaundice was 2.86 ± 1.67. One hundred and five (70%) were delivered at full-term gestation (>37weeks) while 45 (30%) were delivered preterm (<37 weeks) with twenty-nine (19.3%) having history of jaundice in siblings. Fifty (35.7%) had birth weight of less than 2500g while the birth weight of 10 (6.7%) were unknown. Sixty-one of these neonates (40.7 %) were G6PD deficient with mean total serum bilirubin of 205.01 ±96.57µmol/L.Conclusion: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common enzyme disorder among neonates presenting with hyperbilirubinaemia which can be aggravated by other factors. Key words: Determinants, Hyperbilirubinaemia, Glucose-6-phosphate dehydrogenase deficiency, Neonate

The burden of Hepatitis B and C virus infections in patients with sickle cell anaemia in Jos – Nigeria

Background: Sickle cell anaemia (SCA) is an important public health problem in Nigeria associated with frequent blood transfusion. Patients with this disease are at increased risk of contracting hepatitis B and C virus through blood transfusions.Objective: The study aimed at determining the burden of hepatitis B and C virus infections in patients with sickle cell anaemia and the role of blood transfusion in these infections acquisition in Jos.Materials and methods: This was an observational cross-sectional study conducted on patients with SCA attending the Haematology Out-patient Clinic of Jos University Teaching Hospital,between November 2014 and August 2015.Consenting patients with SCA had their blood screened for anti- HBV and HCV antibodies using fourth generation Elisa techniques after completing a questionnaire.Results: One hundred and eleven patients with SCA participated. Antibodies to Hepatitis B virus (HBV) was detected in 21 (18.9%) while that to Hepatitis C virus (HCV) was found in 16 (14.7%). Seventy six (68.5%) of the participants had history of blood transfusion while 35 (31.5%) were never transfused. 22.4% and 15.8% of those transfused were positive for HBV and HCV antibodies respectively. There was no significant difference in the proportion of those positive for anti HBV or HCV with respect to their transfusion status (p=0.24 and 0.81 respectively).Conclusion: The proportion of our patients with SCA that were anti HBV and anti-HCV positive was high. Blood transfusion did not significantly influence their positive status. Strategies aimed at controlling these viral infections in these patients and the general population should be enforced after public awareness campaigns and advocacy are instituted.Keywords: Sickle Cell Anaemia, burden, Hepatitis B Virus, Hepatitis CVirus, infection, Blood Transfusio

Blood Donations in Correctional Centres in North Central Nigeria: The Implications on Recipients’ Safety

Introduction: Cardinal considerations for blood donor recruitment are the donor and recipient safety. High prevalence of transfusion transmissible infections has been documented among inmates in correctional homes, putting blood donation from this organisation at potential high risk of disease transmission.Aims and objectives: This study determined the characteristics of prison inmates’ blood donors and the prevalence of transfusion transmissible diseases.Methods: Records of inmate volunteer blood donors who donated to the blood service, from January 2018 to March 2019 were studied. Their biodata, responses to administered blood donation questionnaire and the outcome of Enzyme linked immune-sorbent assay screening tests for the human immunodeficiency, hepatitis B, hepatitis C viruses and syphilis of donated blood were reviewed.Results: 800 inmates were in the Jos, while 150 and 120 respectively were in the Pankshin and Shendam Correctional Homes. The inmate volunteer blood donors were 18 (2.8%) females and 625 (97.2%) males with the mean age of 32.5 years. Pre-donation minimum diastolic and systolic blood pressures of 50 and 90 mmHg respectively while the maximum diastolic and systolic blood pressures of 110 and 180 mmHg were recorded. The weight of the inmates who donated blood to the service ranged between 49 kg and 98 kg with a mean of 65.7 kg. The haemoglobin concentration of the donors, determined by HemoCue®Hb 301 System, ranged between 12.0 g/dL and 22.6 g/dL. Transfusion transmissible infections contaminated 105 (24.0%) units collected at the Jos Centre; 1.6%, 3.8%, 17.1% and 1.4%; HIV, HCV, HBV and syphilis respectively. The infectious agents were in the same order, positive in 3.5%, 5.3%, 23.0% and 0.9% of blood units collected from Pankshin, while units from the Shendam inmates were 1.1%, 7.6%, 16.3% and 1.1% reactive for the infectious agents.Conclusion: It is concluded from this study that, fixed blood donation clinic in correctional homes could provide opportunity for repeat blood collections from identified safe donors with overall blood transfusion infection safety advantage. French title: Dons de sang dans les centres correctionnels du centre -nord du Nigeria : les implications sur la sécurité des receveurs de sang Introduction : Les considérations primordiales pour le recrutement des donneurs de sang sont la sécurité du donneur et du receveur. Une prévalence élevée d'infections transmissibles par transfusion a été documentée parmi les détenus des maisons de correction, ce qui expose les dons de sang de cette organisation à un risque potentiel élevé de transmission de maladies.Buts et objectifs : Cette étude a déterminé les caractéristiques des donneurs de sang des détenus et la prévalence des maladies  transmissibles par transfusion.Méthodes : Les dossiers des détenus donneurs de sang volontaires qui ont fait un don au service du sang, de janvier 2018 à mars 2019 ont été étudiés. Leurs biodonnées, les réponses au questionnaire sur le don de sang administré et les résultats des tests de dépistage par  dosage immuno -sorbant lié aux enzymes pour l'immunodéficience humaine, l'hépatite B, les virus de l'hépatite C et la syphilis du sang donné ont été examinés.Résultats : 800 détenus se trouvaient dans le Centre de Jos tandis que 150 et 120 se trouvaient respectivement dans les maisons de correction de Pankshin et de Shendam. Les détenus donneurs de sang volontaires étaient 18 (2,8 %) femmes et 625 (97,2 %) hommes avec un âge moyen de 32.5 ans. Les pressions artérielles diastolique et systolique minimales avant le don étaient de 50 et 90mmHg  respectivement, tandis que les pressions artérielles diastolique et systolique maximales étaient de 110 et 180mmHg. Le poids des détenus  qui ont donné du sang au service variait entre 49Kg et 98Kg avec une moyenne de 65.7Kg. La concentration en hémoglobine des donneurs, déterminée par le système HemoCue®Hb 301, était comprise entre 12.0 g/dL et 22.6 g/dL. Les infections transmissibles transfusionnelles ont contaminé 105 (24.0%) unités collectées au Centre de Jos ; 1.6%, 3.8%, 17.1% et 1.4% pour le VIH, VHC, VHB et syphilis respectivement. Les agents infectieux étaient dans le même ordre, positifs dans 3,5%, 5,3%, 23,0% et 0,9% des unités de sang collectées à Pankshin, tandis que les unités des détenus de Shendam étaient 1.1%, 7.6%, 16.3% et 1,1% réactifs pour le agents infectieux.Conclusion : Il est conclu à partir de cette étude qu'une collecte de don de sang fixe dans les maisons de correction pourrait offrir la possibilité de prélèvements répétés de sang auprès de donneurs sûrs identifiés avec un avantage global en matière de sécurité des infections transfusionnelles

Coronavirus Pandemic: The Impact on the Zonal Blood Service of a Developing Country

Introduction: COVID-19 pandemic has affected all facets of life, sparing no country or continent. Its impacts on the health care system ofnations have been unprecedented, overwhelming in most developed and developing nations.Aims and objectives: This study sought to determine the impact of the COVID-19 pandemic on the zonal blood service in North-CentralNigeria.Methods: Registers of the donor clinic and laboratory departments of the North-Central zonal blood service in Jos were reviewed fromFebruary to April 2020, for the number of blood drives fixed and carried out, number of people sensitised, number of donors recruited,counselled, deferred, bled and failed bleed. The unit screened for Transfusion Transmissible Infections (TTIs), expired and units returned fromhospitals and hospitals that accessed blood were determined and compared with that of the same period in the preceding year. The trend of theTTIs screening outcome of blood units collected during COVID-19 outbreak was also evaluated.Results: COVID-19 pandemic had both negative and positive impacts on the blood service in North-Central Nigeria. There was reduction inblood drive fixtures, executions, number of donors counselled, donations, number of first time donors, units screened, hospitals served, and thenumber of safe units issued. However, repeat donations, failed bleed, crude transfusion transmissible infections rate, returned and expired unitsincreased. The trend of Transfusion Transmissible Infections (TTIs) outcome of units collected during COVID-19 pandemic improved towardssafety. Keywords: Impact, Coronavirus, Pandemic, Blood, Service, Transfusion French Title: Pandémie à coronavirus: l'impact sur le service de sang de zone d'un pays en développement Introduction: La pandémie de COVID-19 a touché toutes les facettes de la vie, n'épargnant aucun pays ni continent. Ses impacts sur le système de santé des pays ont été sans précédent, et accablants dans la plupart des pays développés ou en développement.Objectifs: Cette étude a cherché à déterminer l'impact de la pandémie à COVID-19 sur le service de sang de zone dans le Centre-nord du Nigéria. Méthodes: Les registres du département en charge de la gestin du donneur de sang et des services de laboratoire du service de sang de zone duCentre-nord de Jos ont été examinés de février à avril 2020, pour le nombre de collectes de sang effectuées, le nombre de personnes sensibilisées, le nombre de donneurs recrutés, conseillés, ajournés, prélevés. Les poches de sang testées pour le dépistage des infections transmissibles par la transfusion (ITT), périmées et les unités retournées des hôpitaux et des hôpitaux ayant eu accès au sang ont été déterminées et comparées à celle de la même période de l'année précédente. La tendance du résultat du dépistage des ITT des unités de sang prélevées pendant l'éclosion de COVID-19 a également été évaluée.Résultats: La pandémie de COVID-19 a eu des impacts négatifs et positifs sur les services de transfusion sanguine dans le centre-nord du Nigéria. Il y a eu une réduction des installations de collecte de sang, des exécutions, du nombre de donneurs conseillés, des dons, du nombre de premiers donneurs, des unités dépistées, des hôpitaux desservis et du nombre d'unités sûres délivrées. Cependant, les dons répétés, les échecs de  prélèvement, le taux brut d'infections transmissibles par transfusion, les unités retournées et expirées ont augmenté. La tendance des résultats des infections transmissibles par transfusion (ITT) des unités collectées pendant la pandémie de COVID-19 s'est améliorée vers la sécurité.Conclusion: la pandémie de COVID-19 a augmenté les activités de collecte de sang en salle dans le centre-nord du Nigéria, accompagnées d'une rétention accrue des donneurs et de la sécurité transfusionnelle. Mots clés: Impact, Coronavirus, Pandémie, Sang, Service, Transfusio