The True Status of Family Replacement Blood Donors in a Tertiary Hospital Blood Service in Central Nigeria

Background: To make up for the low blood collection from voluntary non-remunerated blood donors (VNRBD), by the blood services in Nigeria, patients’ families are often requested to provide substitute blood donors for their family members’ usage. However, many so-called family replacement donors (FRDs) are thought not to be true relatives.Objective: The objective of this study was to establish the true family status of donors presenting as FRDs in a tertiary hospital blood service in central Nigeria.Methods: Consecutive blood donors were studied with a structured questionnaire immediately after blood donation. The questionnaire contained six pretested, variably discriminatory and revealing questions. Donors’ responses to questions about the recipients were verified by cross-checking with hospital records, and also by interviewing recipients. Personal telephone contacts given by the donors were verified by calls to the phone numbers. Donors’ responses were scored, and donors scoring below a cut-off point were classified as false relatives.Results: Seven hundred and sixty consecutive blood donors were recruited for the study. Sixty-seven (8.8%), 673 (88.8%), and 20 (2.6%) of them claimed to be VNRBD, FRD, and paid blood donors (PBDs) respectively. Of the 673 presumed FRDs, 323 (48%) scored below the cut-off mark of 5 points. Hence, 48% of the presumed FRDs were regarded as false family donors.Conclusion: Significant proportions (48%) of presumed FRDs were found likely to be false family donors. Unquestioning acceptance of such donors may compromise blood safety.Key Words: VNRBD, FRD, PBD, Blood safety, false family donor French Title: Le Véritable Statut des Donneurs de Sang Familiaux ou de Remplacement dans un Service de Sang d'un Hôpital Tertiaire au Nigeria CentralContexte: Pour compenser la faible collecte de sang des donneurs de sang volontaires non rémunérés (DVNR) par les services de transfusion sanguine au Nigeria, les familles des patients sont souvent invitées à fournir des donneurs de sang de substitution. Cependant, de nombreux soi-disant donneurs familiaux de remplacement (DFR) ne sont pas considérés comme de vrais parents.Objectif: L’objectif de cette étude était d’établir le véritable statut familial des donneurs se présentant sous la forme de DFR dans un service de transfusion dans un hôpital tertiaire du centre du Nigéria.Méthodes: Les donneurs de sang consécutifs ont été étudiés avecun questionnaire structuré immédiatement après le don de sang. Lequestionnaire comportait six questions prétestées, discriminatoireset révélatrices. Les réponses aux questions des donneurs concernantles bénéficiaires ont été vérifiées par recoupement avec lesdossiers de l’hôpital, ainsi que par des entretiens avec les bénéficiaires.Les contacts téléphoniques personnels donnés par les donneursont été vérifiés par des appels téléphoniques. Les réponses des donneurs ont été notées, et les donneurs dont le score était inférieur à un seuil ont été classés dans la catégorie de faux parents.Résultats: Sept cent soixante donneurs de sang consécutifs ont étérecrutés pour l'étude. Soixante-sept (8,8%), 673 (88,8%) et 20 (2,6%) d'entre eux se sont déclarés comme étant des DVNR, DFR et des donneurs rémunérés (DR), respectivement. Sur les 673 DFR présumés, 323 (48%) ont obtenu un score inférieur à la barre des 5 points. Ainsi, 48% des DFR présumées étaient considérées comme de faux donneurs de la famille.Conclusion: Des proportions significatives (48%) de DFR présumésétaient susceptibles d'être de faux donneurs de la famille. L'acceptationinconditionnelle de tels donneurs peut compromettre la sécurité du sang

Clinico-Pathologic Features and Outcome of Chronic Lymphocytic Leukemia In Ilorin, North Central Nigeria.

A retrospective analysis of all patients that were diagnosed and managed for Chronic lymphocytic Leukemia (CLL) in the Department of Haematology of University of Ilorin Teaching Hospital, Ilorin between 1st January 2005 and 31st December 2018 was carried out with the aim of characterizing the clinical, haematological and prognostic features as well as outcome in the patients. A total of 39 patients were reviewed consisting 25 (64.1%) males and 14 (35.9%) females giving a M:F ratio of 1.6:1. The median age of patients at diagnosis was 65.5 years and the highest prevalence was found in the 60 – 69 years age group. The commonest symptoms at presentation were night sweats (59.0%), Body weakness (51.3%), fever (41.0%), and weight loss (41.0%) while the commonest signs included lymphadenopathy in all patients (100%), splenomegaly (87.2%), pallor (53.9%) and hepatomegaly (46.2%). The mean values of haematological parameters were: Packed cell volume (28.6%), Haemoglobin concentration (9.4g/dL), Total white blood cell count (87.6 x 109/L), Absolute lymphocyte count (55.8 x 109/L) and platelet count (134.8 x 109/L). The majority of the patients (94.9%) were diagnosed with advanced disease (Rai stage III and IV) while only 2(5.1%) had Rai stage II and none in Rai stage 0 – I. Chlorambucil-based regimen was used in 71.8% of patients, and only 2 patients had Rituximab as part of their treatment regimen. The clinical presentation, haematological features and disease outcome observed in our study was similar to what had been reported in Nigeria and other parts of the world. Keywords: Clinical, Haematological, Features, Chronic lymphocytic leukemia, Ilori

Distribution of the Most Prevalent Spa Types among Clinical Isolates of Methicillin-Resistant and -Susceptible Staphylococcus aureus around the World: A Review

Background: Staphylococcus aureus, a leading cause of community-acquired and nosocomial infections, remains a major health problem worldwide. Molecular typing methods, such as spa typing, are vital for the control and, when typing can be made more timely, prevention of S. aureus spread around healthcare settings. The current study aims to review the literature to report the most common clinical spa types around the world, which is important for epidemiological surveys and nosocomial infection control policies. Methods: A search via PubMed, Google Scholar, Web of Science, Embase, the Cochrane library, and Scopus was conducted for original articles reporting the most prevalent spa types among S. aureus isolates. The search terms were "Staphylococcus aureus, spa typing." Results: The most prevalent spa types were t032, t008 and t002 in Europe; t037 and t002 in Asia; t008, t002, and t242 in America; t037, t084, and t064 in Africa; and t020 in Australia. In Europe, all the isolates related to spa type t032 were MRSA. In addition, spa type t037 in Africa and t037and t437 in Australia also consisted exclusively of MRSA isolates. Given the fact that more than 95 of the papers we studied originated in the past decade there was no option to study the dynamics of regional clone emergence. Conclusion: This review documents the presence of the most prevalent spa types in countries, continents and worldwide and shows big local differences in clonal distribution