Sensitivity and specificity of copper sulphate test in determining fitness of blood donors

Background: The accuracy of the copper sulphate method for the rapidscreening of prospective blood donors has been questioned because this rapid screening method may lead to false deferral of truly eligible prospective blood donors.Objective: This study was aimed at determining the sensitivity and specificity of copper sulphate specific gravity test for haemoglobin estimation as a determinant of fitness for blood donation at Lagos University Teaching Hospital, Lagos, Nigeria (LUTH).Methods: This study was a case control study carried out at LUTH between March and April, 2012. Subjects (n=263) recruited were classified into unfit donors/study group (n=153) and fit donors/control group (n=110). 5ml of venous blood withdrawn from each subject in EDTA bottle were used for full blood count analysis using the Haemoglobin auto-analyzer (Sysmex KX21, USA®) as a reference test for Haemoglobin determination.Results: The mean Haemoglobin, PCV and MCHC of the control group were significantly higher (P<0.05) than that of the study group. MCV and MCH were not significantly different (P>0.05). The sensitivity and specificity of the copper sulphate specific gravity method were found to be 40.52% and 86.4% respectively while the positive and negative predictive values were 80.5% and 50.1% respectively.Conclusion: The sensitivity, specificity, PPV and NPV of Copper sulphate test to determine fitness of donation were too low to recommend it. It is recommended that more sensitive methods such as automated haematology analyzer should be encouraged.Keywords: Copper Sulphate specific gravity method, Blood donors, Haemoglobi

Pattern of demographic risk factors in the seroprevalence of Anti-Toxopasma Gondii antibodies in HIV infected patients at the Lagos University Teaching Hospital

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Anxiety and depression in sickle cell anaemia: The impact of pain in a Nigerian population

There is a dearth of information on depression and anxiety among Nigerian SCA population. This study objective was to determine the prevalence of depression and anxiety as well as establish their relationships with pain among a Nigerian population with SCA. This was a cross-sectional study that included 226 SCA individuals. A well-structured socio and clinical demographic questionnaire, Wong-Baker FACES pain rating scale, and Hospital Anxiety and Depression Scale (HADS) were data collection instruments utilized. The data were subjected to frequency distribution, cross-tab and logistic regression analyses in SPSS® v20 IBM, USA. Overall, 226 individuals with SCA including 111 males (49.1%) and 115 females (50.9%) with mean age 28.9 ± 8.5 years (range 16-50 years) were recruited into this study. The prevalence of anxiety and depression symptoms among Nigerian SCA cohort is 49.5% and 30.5% respectively. Additionally, about 70% and 46.0% of SCA individuals with pain had abnormal anxiety and depression score. Statistically significant chi-square value for anxiety (χ2 = 58.573; Cramer's V = 0.509; P value = 0.000) and depression (χ2= 39.175; Cramer's V = 0.416; P value = 0.000) showed strong association with pain index. Logistic regression analysis revealed the odds of anxiety (OR = 3.430; 95% CI = 1.321-8.906; P value = 0.011) and depression (OR = 3.612; 95% CI = 1.251-10.427; P value = 0.018) event occurring with pain (relative to no pain). Finally, the prevalence of pain, anxiety and depression among Nigerian sickle cell anaemia cohort is high. Moreover, pain is a significant predictor of the risk of falling into anxiety and depression

Association of Q223R Leptin Receptor Gene Polymorphism with Obesity and Type 2 Diabetes Mellitus

The Leptin receptor gene mutation is thought to be associated with an impaired signaling capacity of the leptin receptors, making it a possible candidate gene in the aetiopathogenesis of obesity and diabetes mellitus (DM). However, available reports on the role of LEPR Q223R gene polymorphism in the development of obesity and DM still require further evaluation in African populations. This present study aims to determine the distribution and prevalence of the LEPR Q223R genotype and its allelic frequencies, and possible association with diabetes mellitus among populations in Lagos, South-West, Nigeria.Consenting adults with clinically established DM (n=120) were recruited for this study over a period of six (6) months from the diabetic clinic, and matched for age and sex with apparently healthy controls (n=120). Interviewer-administered questionnaires were used to obtain information on baseline characteristics, demographic data and relevant medical history.  Five milliliters of venous blood were collected for DNA extraction and subsequent PCR amplification and restriction enzyme digestion of amplicon using Msp1.Results show that the genotype frequencies for homozygous wild type (QQ) LEPR 223 SNP (20%); Heterozygous(QR) LEPR SNP (41.7%) and homozygous mutant (RR) recessive LEPR SNP (38.3%) in the study group, were similar to 13.3%; 60% and 26.7% for LEPR 223 QQ, QR and RR genotypes for control group respectively (χ2=4.080; p=0.133). The homozygous (QQ vs RR) and recessive (RR vs QR+QQ) study models showed no significant association with occurrence of DM in the study group (p>0.05). LEPR Q223R SNP was significantly associated with age of onset of DM (OR=2.111), complications of DM (OR=1.934), family history of DM (OR=2.127) and BMI (OR=2.028) among study group participants in a logistic regression model (p<0.05 respectively).We conclude that Leptin receptor gene polymorphism is significantly associated with risk of obesity, predisposition to diabetes mellitus related complications and early onset of DM among Nigerians.  Key words: Leptin receptor; gene polymorphism; Obesity; Diabetes Mellitu

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

The distribution of human leukocyte antigens genotypes among Nigerian sickle cell anaemia patients

Background: Human leukocyte antigens (HLA) are involved in the modulation of immune responses, thus specific haplotypes, alleles and residues at different loci have been linked with disease susceptibility. There is no substantial data regarding HLA allele's linkage to sickle cell anaemia (SCA) patients from Nigeria.Objective: This study was carried out to determine the HLA–A*, -B*, -C*, -DRB1* and -DQB1* allele frequency distribution among SCA patients of Nigerian origin.Methods: This was an observational descriptive study of 169 registered SCA patients of the Sickle Cell Foundation Nigeria who met the European Society for Blood and Marrow Transplantation (EBMT) criteria for haematopoietic bone marrow transplantation and they were counseled for HLA tissue typing along with their siblings to know if there were any potential match among them that could donate stem cell for HSCT. Ten milliliters of venous blood were collected in a sterile Na-EDTA anticoagulant tube from each consenting subject and samples were collected and sent in batches to Istituto Mediterraneo Di Ematologia (IME), Rome, Italy for HLA study. Genomic DNA was isolated from the lymphocytes through QIAGEN DNA mini-isolation kit.  HLA genotyping for HLA –A*, -B*, -C*, -DRB1* and -DQB1* loci typing was done using sequence specific oligonucleotide polymerase chain reaction.Results: Sixteen alleles were detected at HLA A* locus, 24 alleles at HLA B* locus, 12 alleles at HLA C* locus, 13 alleles at HLA DRB1* locus, and 5 alleles at HLA DQB1* locus. The allele frequencies of these most common alleles were ≥ 10-1. The less common alleles have allele frequencies (AF %) of ≥10-2.Conclusion: HLA (A*23, A*30 and A*02), (B*53 and B*15), (C*04 and C*07), (DRB1*15, DRB1*13, DRB1*11 and DRB1*03) and (DQB1*06, DQB1*05, DQB1*02 and DQB1*03) are the most frequent alleles among SCA patients in Nigeria.Keywords: Sickle cell anaemia, bone marrow transplantation, human leukocyte antigen, sequence specific oligonucleotide polymerase chain reaction, allel

Profile Of Haematological Emergencies In A Tertiary Hospital In Lagos, Nigeria: A 3 Year Retrospective Study

Background: Haematological emergencies are usually acute and life threatening conditions. Prompt and accurate diagnosis and institution of appropriate management is essential in order to reduce associated morbidities and/or mortalities. The knowledge of most emergencies is important and emergency physicians should be able to recognize and institute basic and potentially lifesavingtreatment. This study seeks to evaluate the pattern of haematological emergencies presenting at the Medical Emergency Department of the Lagos State University Teaching Hospital. Method: A retrospective study of medical records of the medical emergency department in LASUTH was assessed over a period of thirty six months between st st January 1 2015 and December 31 2017. Results: A total of 5498 patients' records were assessed. Non haematological diseases accounted for most of the emergencies (98.4%). 88 of 5498 (1.6%) were haematological emergencies out of which 66 (1.2%) were sickle cell anaemia patients in crisis. The commonest crisis seen was vasoocclusive crisis. Conclusion: Sickle cell anaemia crisis is the commonest haematological emergency seen at the Medical emergency department of LASUTH while the overwhelming majority of the cases seen were nonhaematological. Keywords: Haematological, non haematological, emergencies, sickle cell crisi

Haematological Parameters of Patients Attending the Geriatric Clinic of Lagos State University Teaching Hospital, Lagos, Nigeria

Normal aging process is related to a decline in the functional reserve of multiple organ systems which increases the probability of disease. Full blood count (or complete blood count) is one of the commonest laboratory investigations requested worldwide, and has numerous uses in the diagnosis and monitoring of different morbidities. Available literature suggest that an inverse relationship exists between most haematological parameters and age. It has been documented that aging leads to a decline in haemoglobin (Hb), packed cell volume (PCV), white blood cells (WBC) and platelet (PLT); and this suggest a reduction in bone marrow reserves. The aim of this study was to estimate the reference ranges for commonly used haematological parameters in patients attending the geriatric clinic in a Nigeria tertiary hospital. This was a descriptive cross-sectional study involving 100 geriatric patients with mean age of 71.3 + 74 years attending the Geriatric clinic of the Lagos State University Teaching Hospital. All participants' blood samples were collected and their full blood count was determined. The mean Hb concentration for the entire group was 11.43 ± 1.79g/dl with a mean of 11.84 ± 2.08 g/dl in males and 11.17 ± 1.54 g/dlin females. All these values were below the accepted reference ranges. However, the WBC and PLT counts were all within normal reference values. The mean Hb was higher in males than females and this difference was statistically significant (P= 0.01). In conclusion, evidence of lowered Hb level and normal WBC and PLT levels in the geriatrics population suggests aging may not affect all haematological indices production