Sero-Prevalence of Rubella IgG/IgM and Cytomegalovirus IgM among Blood Donors in Lagos State, South-Western Nigeria

Blood transfusion is usually a lifesaving and therapeutic intervention.However, many preventable errors (especially transfusion transmissible infections) may make this a harmful procedure. Most of these transfusion transmissible infections are caused by viruses. In this study, sero-prevalence of two viruses (rubella and cytomegalovirus) that are usually overlooked in transfusion medicine were determined in Lagos state, Nigeria. This is a cross sectional study which took place at Lagos University Teaching Hospital (LUTH). Consented and eligible blood donors at LUTH were purportedly selected daily until 181 donors were recruited. A structured questionnaire was used as data collection tool. Samples were analyzed in batches using ELISA method. Out of 181 blood donors that participated, male blood donors constituted 87.8% (159) while the females were only 22 (12.2%). The sero-prevalence of Rubella IgG was 87.8% while that of Rubella IgM was 0.0% and anti-CMV IgM was 11.0%. There was a significant association between gender and rubella infection (p=0.03).  Routine pre-donation screening for anti-rubella and anti-CMV antibodies might not be cost effective as few donors were sero-negative to these viruses. Key words: Rubella, CMV, IgM, IgG, Sero-prevalence, blood donor

Seroprevalence of Hepatitis E virus and the rate of co-infection with other viruses in blood donors in Oyo State, Nigeria: A pilot study

Hepatitis E Virus (HEV) infection is a major public health challenge in developing countries where it has caused large waterborne epidemics. However, the risk of transfusion transmitted HEV through contaminated blood and blood products remains unknown.This cross-sectional study aimed at determining the seroprevalence of HEV among 186 blood donors who visited the University College Hospital blood bank, Ibadan in Nigeria, between January and June, 2018. Five ml of venous blood was drawn from each subject into plain sample bottles. The sera were analyzed for HEV, HCV, HBsAg, HIV and VDRL via ELISA techniques. Our findings showed HEV (4.3%) to be the most prevalent transfusion-transmissible infections (TTIs), followed by HIV (3.2%), HBV (3.2%), HCV (2.7%) and syphilis (1.1%). Prevalence rate of HEV/HIV co-infection recorded was 0.54%, HBsAg/HCV co-infection was 0.58% while HBsAg/HIV co-infection was 1.08 %. Also, statistical relationship was observed between HEV and increasing age (P = 0.038). Among the seropositive donors 62.5% reported to have donated blood in the past. In conclusion, the study showed a high seroprevalence rate of HEV among the donors; higher than the other routinely screened viral markers. Blood donors above age 30, which is the age bracket of most donors, have a higher probability of being seropositive. Thus posing significant health risks to blood transfusion recipients. Hence, it is recommended that HEV be routinely screened for along with other viral TTIs

A Preliminary Report on the Pattern of Plasma Homocysteine- Protein Ratio among Pregnant Women in Lagos, Nigeria

In plasma, homocysteine (Hcy) is majorly bound to protein, and have been significantly associated with adverse obstetric outcomes such as placental abruption or placental infarction, unexplained recurrent fetal loss, and pre-eclampsia among others; including the possibility of predicting women at risk of these conditions.Estimated Hcy levels have been observed to vary significantly with age, sex, lifestyles, hereditary factors, and ethnicity among several other confounding factors. However, the evaluation of homocysteine-protein ratio (Hcy/Pro) may provide a more reliable biomarker by adjusting for variations in serum proteins. The aim of the study was to determine the pattern of Hcy/Pro among pregnant Nigerian females and evaluate possible associations with some haematological variables (Haemoglobin-Hb; Mean cell volume-MCV; Mean cell haemoglobin concentration-MCHC; White blood cell count-WBC and Platelet count-PLT).This study was an observational, hospital based, Cross-Sectional study comprising 130 pregnant women (cases) and 130 non-pregnant women (controls). The participants were recruited from the Lagos University Teaching Hospital (LUTH).Structured questionnaires were applied to obtain demographic, medical, socio-economic, and nutritional histories. Plasma Hcy was evaluated using Enzyme linked Immunosorbent Assay (ELISA), and Plasma protein was evaluated using a fully automated Beckman Synchron LX20 by Beckman Coulter, Inc., 250 S. Kraemer Blvd. Brea, CA 92821, USA. Statistical analyzes were performed using SPSS version 23. Reference range for Hcy/Pro for non-pregnant females was estimated to be 0.050 – 0.098µmol/g. Homocysteine-protein ratio was observed to decline progressively throughout pregnancy (F=36.565; p=0.0001). The mean Hcy/Pro of control group participants (0.074 ± 0.012 µmol/g) was significantly higher than the 0.057 ± 0.019 µmol/g reported for the study group (p=0.001). Homocysteine-protein ratio correlated negatively with gestational age (GA) of study group participants (r= - 0.364; p=0.003).The Hcy/Pro showed a progressive decline throughout pregnancy, compared to total plasma Hcy pattern, and may be a truer reflection of plasma homocysteine pattern in pregnancy. Keywords: Homocysteine-protein ratio, homocysteine, pregnancy, protein

Genotypic and Phenotypic Markers of Pre-Eclampsia: A Folate Based Algorithm in Pregnancy

Pre-eclampsia among pregnant women in Nigeria accounts for a high proportion of maternal and perinatal morbidity and mortality that has been reported. This study aimed to determine the pattern, sensitivity, and specificity of some genetic polymorphisms, epigenetic modification and phenotypic characteristics of some key enzymes in the folate cycle, in the pathogenesis and as potential markers of Pre-Eclampsia (PE) among pregnant women. Demographic and clinical histories were obtained from a group of 200 pregnant females clinically diagnosed with PE (Study Group) and 200 pregnant, normotensive females (Control Group) through questionnaires and hospital records. The biochemical parameters measured in the study were: red cell folate, plasma homocysteine (Hcy), plasma protein, methylene tetrahydrofolate reductase enzyme level (MTHFR) and malondialdehyde (MDA). The MTHFR C677T and MTR A2756G SNPs were amplified using PCR, and digested with Hinf I and Hae III restriction enzymes respectively. Methylation status of the MTHFR gene was assessed using the methylation specific PCR method. Homocysteine/MTHFR (Hcy/MTHFR) ratio at 81% sensitivity and homocysteine/protein ratio (Hcy/pro) at 77% sensitivity were better indicators of PE than Hcy (63% sensitivity) at a false positive rate of 10%. However, a combined nine parameter biomarker comprising of BMI, Hcy, MTHFR enzyme, MDA, Hcy/pro, Hcy/MTHFR, CpG island methylation status, MTHFR677 SNPs, and MTHFR/MTR Haplotypes, presented the highest sensitivity (83%) at 90% specificity for identifying PE at a cut-off value of 11 point (of 25). Folate metabolic derivatives, folate cycle gene polymorphisms and epigenetic modifications are significant factors in the pathogenesis of PE and may play significant role in the early identification of PE among pregnant women