A review of the impact of cost and quality of HIV kits on HIV testing in a Nigerian Teaching Hospital

Background: When HIV antibodies testing was introduced in Aminu Kano Teaching Hospital, Kano a couple of years ago, Double ELISA was used to test blood samples before a particular specimen was diagnosed as reactive or non-reactive. A time came when immunoconfirmatory test was introduced into HIV antibodies testing for confirmations of the presence of HIV. Objectives: This present retospective study is to review the impact of cost and quality of HIV reagent kits in the two periods A and B on the patients and confidence on the health care provider. Methods: We collated and compared laboratory records for both periods of HIV antibodies testing at Aminu Kano Teaching Hospital Kano consisting of period A from November 1997 to May 1998 (7 months) and period B from November 1998 to May 1999 (7months). In period A, double ELISA was used (Genie II and Immunocomb Bispot) while in period B, Immunocomb Bispot and Immunoconfirm II were used Results: The results show that the cost per test increased from two hundred and fifty Naira($2) to five hundred Naira($4). There was a reduction on the number of patients from 289 to 258 within the two periods. But the prevalence of reactive HIV antibodies decreased from 43.6% to 36.8%. Conclusion: The period when Immunoconfirmatory technique was introduced brought assurance, reliability and confidence to HIV diagnosis test in the centre

Cervical screening with Luviva machine for early detection of cervical dysplasia: experience from Ekiti state, Nigeria

Background: Cervical cancer is a preventable and potentially curable cancer when detected early, yet it continues to be among the leading causes of cancer death in developing countries. Screening for cervical dysplasia is critical for early detection in order to reverse this trend. Several traditional screening methods such as pap smear test, HPV-DNA screening test, visual inspection with acetic acid or lugol iodine are in vogue with different specificity and sensitivity. LuViva advanced cervical scan is a new automated screening tool that has great promise for the detection of the disease in itsearliest form both in developing and developed countries.Objective: This study was designed to describe our experience with the use of LuViva advanced cervical scan as a primary screening tool for cervical dysplasia.Method: This is a descriptive cross-sectional study, whose data was obtained from the free health screening for civil servants in Ekiti State conducted between 11th and 21st February, 2014. Screening for Cervical dysplasia was conducted using the LuViva advanced cervical scan for women 40 years old and above. The result was automatically recorded and transferred to an Excel sheet for analysis.Result: A total sum of 254 patients was screened during the study period. Only one patient had a prior pap smear done. The automated self-reporting LuViva scan presented the result of the benign changes on the cervix as low risk in 143 patients (56.3%), moderate risk in 52 patients  15%) and high risk in 59 patients (11.5%). The machine further classified the dysplastic changes of the low, moderate and high risk categories as Atypical glandular cell (AGC), Atypical glandular cell favouring neoplasia (AGC-FN), Atypical g l a n d u l a r c e l l o f u n d e t e r m i n e d significance(AG-US), Atypical squamous cell of undetermined significance (ASC-US), Atypical squamous cell where high grade cannot be excluded (ASC-H) and Low grade squamous Intraepithelial lesion (LSIL). The proportion of moderate and high risk AGC (31.2%) was just slightly lower than the moderate and high risk of ASC-US (35.2%) while a higher percentage of43.9% in low grade squamous intraepithelial lesion was recorded among the patients.Conclusion: Our experience suggests that there is a place for the use of luViva scan in the primary screening for cervical dysplasia and there is a correlation between LuViva scan high risk result and histological diagnosis of cervical dysplasia.Keywords: Cervical screening, cervical dysplasia, civil servants, LuViva Scan, Ekiti State Nigeri

Maternal understanding of fetal movement in third trimester: A means for fetal monitoring and reducing stillbirth

Background: Fetal movement, a sign of life, is widely considered as an indicator of fetal health status. Therefore, perceived alteration in regular fetal movement after the age of viability may signify impending adverse perinatal outcome.Aims: This study aimed to determine maternal knowledge, behavior, and concerns about abnormal fetal movement in the third trimester of pregnancy.Materials and Methods: A total of 225 women were surveyed using a self.administered questionnaire at the out-patient prenatal clinics of two tertiary health facilities in Nigeria between December 1, 2012 through January 31, 2013. Questions addressed knowledge, perception behavior, and concerns about experience of abnormal fetal movement.Results: Correct Knowledge of excessive and decreased fetal movement was found in 47% and 31.1% of respondents, respectively. Majority of women (87.6%) either had no knowledge of normal parameters of fetal activity or did not recall being told that movement frequency and strength should increase in the third trimester. The proportion of women who expressed concern over excessive and decreased fetal movement was 31.1% and 21.8%, respectively. Maternal education was significantly associated with correct knowledge of decreased fetal movement (P = 0.026). Almost 36% of respondents had knowledge of at least one potential consequence of abnormal fetal movement.Conclusion: Maternal educational level is an important factor in the early identification of abnormality of fetal movement. The unsatisfactory  knowledge and poor perception behavior among respondents reflect the need for a guideline, particularly during antenatal care, on information and management of abnormal fetal movement in our setting to preventavoidable stillbirth. Key words: Antenatal care, concerns, fetal movement, knowledge,  maternal knowledge, pregnancy, surveillance, stillbirt

Diabetes Mellitus Is Associated with Shortened Activated Partial Thromboplastin Time and Increased Fibrinogen Values

OBJECTIVE: This study was designed to examine the relationship between shortened activated partial thromboplastin time (APTT) and increased fibrinogen values with diabetes mellitus. METHODS: APTT, prothrombin time (PT), fibrinogen, fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c) levels were measured in 1,300 patients. Patients were divided into three groups according to their HbA1c and FPG levels. RESULTS: When participants were grouped according to their HbA1c levels, we found significantly shorter APTT values (26.9±5.6 s) and increased fibrinogen levels (3.1, 1.9-6.3 g/L) in the diabetes group when compared with the other two groups. When participants were grouped according to their FPG levels, we found significantly shorter APTT values (26.9±6.2 s) and increased fibrinogen levels (3.1, 1.8-6.2 g/L) in the diabetes group when compared with the euglycemic group. CONCLUSIONS: Shorter APTT and increased fibrinogen levels might be useful hemostatic markers in patients with diabetes and in patients at high risk for diabetes

Knowledge of sickle cell disease and haemoglobin electrophoresis: A survey of students of a tertiary institution

No Abstract

Priapism in sickle cell anaemia patients; a review of aetiopathogenenis and current management approach

No Abstract

The Seroprevalence of Cytomegalovirus Antibodies among Prospective Blood Donors in Jos

Background: Human cytomegalovirus, otherwise called human herpes virus type 5, is a significant cause of morbidity and mortality in pregnancy, and among immunocompromised patients like recipients of organ transplants. Cytomegalovirus is transmissible via blood transfusion, among other parenteral routes. This study therefore aims at establishing the seroprevalence of CMV antibodies among prospective blood donors in Jos. This is with a view to making recommendations on donor screening and transfusion protocols among susceptible patients. Methods: A total of 200 prospective blood donors were recruited into the study. Screening for CMV antibodies was done using ELISA kit, manufactured by “DIALAB”, Austria (www.dialb.at) Results: Of the 200 prospective blood donors analysed, 184 donors were found to be positive for cytomegalovirus antibodies, representing a prevalence rate of 92%.The peak age prevalence was in the 25-29 years age range, representing 30.4%.Cytomegalovirus prevalence was lowest in the 15-19 years age range and above 50 years(1.6% each). Conclusion: A cytomegalovirus antibody prevalence rate of 92% indicates that screening for CMV should be included in screening algorithm for potentially susceptible recipients of blood and its products. Non infected susceptible persons should be transfused CMV negative or leucocyte depleted blood and blood products. Keywords: Prevalence, Cytomegalovirus, Prospective Blood Donors, Jos Nigerian Journal of Medicine Vol. 17 (2) 2008: pp. 200-20

Haematology Request Forms at a New Tertiary Health Institution in North central, Nigeria: Evaluation of Level of Compliance with Entries and the Impact on Results

Meticulous completion of the haematology request forms is an essential component of pre-analytical protocol. This process that contributes to the quality of laboratory results is critical for patient management. We set out to determine the level and adequacy of information provided when haematological investigations are requested and its impact on patient management.Requests forms submitted for haematological examinations were checked for completeness. The number of times items on the forms that were properly filled and omitted were recorded. The rate of compliance with filling in each item was determined. Comparisons were made between physicians and surgeons and among departments. Descriptive analysis of the data generated was carried out. Four thousand request forms were analyzed for completeness. 26.5 % (1060) were completely filled while 73.5% (2940) had one or more omissions. Client's name was filled in 100% of the forms while the item with the lowest level of compliance (56.3%) was the time of specimen collection. On the average, the rate of completeness of the forms was 86.6%. Physicians significantly completed the request forms more than the surgeons (32.8% vs 19.2%, p=0.0001). Department of Medicine had the highest completion rate of 43.7%, followed by Paediatrics 20.6%, Obstetrics and Gynaecology was 19.5% and the least was Surgery 18.8%. Incomplete information on the request forms lead to non-interpretation of 21.5% of the laboratory requests by the laboratory physicians. This study revealed low compliance with the supply of information required in the request form at the Benue State University Teaching Hospital, Makurdi. This negatively impacted on the interpretation of the laboratory results. Modification of medical curriculum, education of clinicians, introduction of electronic requesting and rejection of request forms lacking critical items are being recommended.Keywords: Haematology request form, Evaluation, Nigeria, and Tertiary Hospita

Knowledge and Awareness of Personal Sickle Cell Genotype Among Parents of Children with Sickle Cell Disease in Southeast Nigeria

Sickle cell trait (SCT; HbAS), the heterozygous state for the sickle cell allele of the beta globin gene, is carried by as many as 100 million individuals worldwide. Nigeria has the highest prevalence of SCT, impacting an estimated 25 % of adult population. This study was designed to assess timing of awareness, knowledge of SCT status and preferred method of education among parents of children with sickle cell disease (SCD). We conducted a cross-sectional survey of parents of children with SCD from June 2013–March 2014. Participants completed a 20-item questionnaire to assess (1) awareness of personal sickle cell genotype, (2) timing of awareness of personal sickle cell genotype, and (3) knowledge of SCT. One hundred and fifty-five participants completed the survey. Seventy-eight percent were females, and 87 % (135/155) were aware of their own sickle cell genotype. Timing of awareness varied as follows: following birth of a child with sickle cell disease (45 %); during marriage (21.5 %); school admission (9.6 %); during pregnancy (9.6 %); and other times (14 %). Approximately 35.5 % of participants thought that sickle cell trait was a mild form of sickle cell disease. Radio (43.9 %), informational community meetings (27.7 %), and television (21.9 %) were identified by participants as the most effective method of increasing sickle cell trait awareness. Innovative approaches are needed to increase the proportion of individuals who are aware of their own sickle cell genotype prior to having a child with sickle cell anemia in line with the Healthy People 2020 objective