Prevalence of significant bacteriuria among symptomatic and asymptomatic homozygous sickle cell disease patients in a tertiary hospital in Lagos, Nigeria

Background: Patients with sickle cell disease have an amplified vulnerability to urinary tract infection, because of abnormally dilute and alkaline urine, which favors bacterial proliferation. This is due to altered blood flow in the renal vasculature, which causes papillary necrosis and loss of urinary concentrating and acidifying ability of the nephrons. Asymptomatic bacteriuria is common, but the prevalence in populations varies widely with age, gender, sexual activity and the presence of genitourinary abnormalities. The aim of this study was to determine the prevalence of significant bacteriuria in symptomatic and asymptomatic sickle cell patients in Lagos.Materials and Methods: This was a cross‑sectional study of patients attending the sickle cell clinics of Lagos State University Teaching Hospital, Ikeja. Single voided aseptically collected mid‑stream urine was obtained from each patient and all samples processed immediately, were sent for urinalysis and culture. Isolates were considered significant if there were ≥105 colony forming units per milliliter (CFU/ml) with two or less isolates, doubtful significance if ≤105 CFU/ml. Significant isolates were selected for identification. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 16.0 (SPSS, Inc., Chicago, Ill).Results: A total of 100 consenting participants were recruited into the study. The mean age was: 23.42 ± 8.31 years and a range of 14‑50 years. Only 9% (9/100) had significant bacteriuria while 44.4% (4/9) participants who had significant bacteriuria were asymptomatic. Escherichia coli was isolated in 66.6% (6/9) participants who had significant bacteriuria while Klebsiella oxytoca, Klebsiella pneumonia and Staphylococcus aureus (11.11%) was isolated in each of the remaining three participants.Conclusions: Significant bacteriuria is found in only one‑tenth of sickle cell patients, nearly half of the participants who had significant growth had asymptomatic bacteriuria.Key words: Asymptomatic bacteriuria, prevalence, screening, sickle cell disease patients, significant bacteriuri

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.

Funder: laura and john arnold foundationBACKGROUND: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care

Seroprevalence of Human Cytomegalovirus (HCMV) infection in patients with haematological malignancies in Lagos, Nigeria

With improvement in the management of cancer patients, viral infections have become important complications affecting morbidity and mortality. This study aimed to determine the prevalence of Human Cytomegalovirus (HCMV) infection in patients with haematological malignancies, with or without past history of blood transfusion in Lagos State University Teaching Hospital, Ikeja (LASUTH). A cross-sectional, case control study was carried out among healthy blood donors attending the blood donor clinic and patients with confirmed haematological malignancies. A total of 5 ml blood sample was collected from each consenting participant and the serum was assayed for CMV IgG and CMV IgM using an enzyme-linked immunosorbent assay (ELISA)-based kit. A total of 148 participants were recruited into the study consisting of 72 patients with haematologic malignancy and 76 healthy blood donors. The seroprevalence of anti-CMV IgG was similar in both groups (98.6% and 94.7% respectively) while there was a higher anti-CMV IgM seropositivity in patients with haematologic malignancies ( 26.4%) than in healthy blood donors (9.2%).A history of blood transfusion was not significantly related to CMV seropositivity (p= 0.791). Anti-CMV IgM seropositivity was higher in patients with haematologic malignancies than in healthy controls, while seroprevalence of anti-CMV IgG was similar in both groups. Previous history of blood transfusion was not related to CMV seropositivity.Keywords: CMV antibodies, haematological malignancy, blood donor

Human parvovirus B19 infection in patients with sickle cell anemia in Lagos State University Teaching Hospital (LASUTH), Lagos, South West, Nigeria

No AbstractKeywords: Parvovirus B19 IgG, Parvovirus B19 IgM, Elisa, sickle cell anaemia, seroprevalenc

Gestational thrombocytopaenia among pregnant women in Lagos, Nigeria

Background: Thrombocytopaenia is a common haematologic abnormality during pregnancy. Pregnant women with thrombocytopenia have a higher risk of bleeding excessively during or after childbirth, particularly if they need to have a caesarean section or other surgical intervention during pregnancy, labour or in the puperium. The aim of this study was to determine the prevalence of gestational thrombocytopaenia among pregnant women reporting for antenatal care at tertiary health care centres in Lagos. Materials and Methods: Platelet count was analyzed in 274 consecutive pregnant women who gave informed consent and 70 non-pregnant female staff of the hospitals. Platelet count was performed on each sample using the Sysmex KN-21N automated haematology analyzer. The study design was cross-sectional, proportions were analyzed for statistical significance with the chi-square, and Odds ratio was also calculated. Thrombocytopaenia is classically defined as a platelet count of less than 150 × 109/L.3,4 Counts from 100 to 150 × 109/L are considered mildly depressed, 50 to 100 × 109/L are moderately depressed and less than 50 × 109/L are severely depressed. Results: Thirty-four (13.5%) pregnant women were thrombocytopaenic compared with three (4.3%) non-pregnant women. This was statistically significant; P = 0.03; Odds ratio: 3.5 (95% CI 1.03-11.82). Out of the 37 pregnant women who were thrombocytopaenic, most of them (78%) had mild thrombocytopenia, only 6% had severe thrombocytopaenia. Conclusion: The prevalence of gestational thrombocytopaenia in this study was 13.5%. Although majority of the pregnant women had mild thrombocytopaenia, healthcare providers should screen all pregnant women routinely for thrombocytopaenia to avoid excessive bleeding during or after childbirth.Keywords: Gestational thrombocytopaenia, platelet count, haemorrhag

Prevalence of significant bacteriuria among symptomatic and asymptomatic homozygous sickle cell disease patients in a tertiary hospital in Lagos, Nigeria

Background: Patients with sickle cell disease have an amplified vulnerability to urinary tract infection, because of abnormally dilute and alkaline urine, which favors bacterial proliferation. This is due to altered blood flow in the renal vasculature, which causes papillary necrosis and loss of urinary concentrating and acidifying ability of the nephrons. Asymptomatic bacteriuria is common, but the prevalence in populations varies widely with age, gender, sexual activity and the presence of genitourinary abnormalities. The aim of this study was to determine the prevalence of significant bacteriuria in symptomatic and asymptomatic sickle cell patients in Lagos. Materials and Methods: This was a cross-sectional study of patients attending the sickle cell clinics of Lagos State University Teaching Hospital, Ikeja. Single voided aseptically collected mid-stream urine was obtained from each patient and all samples processed immediately, were sent for urinalysis and culture. Isolates were considered significant if there were ≥105 colony forming units per milliliter (CFU/ml) with two or less isolates, doubtful significance if ≤105 CFU/ml. Significant isolates were selected for identification. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 16.0 (SPSS, Inc., Chicago, Ill). Results: A total of 100 consenting participants were recruited into the study. The mean age was: 23.42 ± 8.31 years and a range of 14-50 years. Only 9% (9/100) had significant bacteriuria while 44.4% (4/9) participants who had significant bacteriuria were asymptomatic. Escherichia coli was isolated in 66.6% (6/9) participants who had significant bacteriuria while Klebsiellaoxytoca,Klebsiellapneumonia and Staphylococcus aureus (11.11%) was isolated in each of the remaining three participants. Conclusions: Significant bacteriuria is found in only one-tenth of sickle cell patients, nearly half of the participants who had significant growth had asymptomatic bacteriuria

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials

Background: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX). Methods: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung–Knapp–Sidik–Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. Conclusions: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care

Additional file 1 of Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials

Additional file 1. Search strategy

Additional file 2 of Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials

Additional file 2. Email invitation

Additional file 5 of Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials

Additional file 5. Risk of bias