The cost-effectiveness of predonation screening for transfusion transmissible infections using rapid test kits in a hospital-based blood transfusion centre.

OBJECTIVE: Blood transfusion practice emphasises safety, efficacy and appropriate use. These require cost-effective programme management. This study focused on the cost of screening for transfusion transmissible infections (TTI). METHODS: This was a 1 year (2016) analysis of screening in a hospital-based transfusion centre. The cost of screening all blood donors by ELISA was compared to the cost of serial screening starting from rapid kit, taking into account, the estimated cost of blood bags prevented from discard after ELISA screening (attributable cost). The cost of voluntary donor drive plus cost of ELISA screening was compared with the present cost of screening. RESULTS: A total of 5591 donors were screened for HIV, hepatitis B and C using the rapid kit, 291 donors were deferred (5.2%). A total of 5300 units were further screened by ELISA. A total of 435 blood units (8.2%) were discarded due to TTI positivity. TTI positivity rate was 12.98%. Only 2.36% were voluntary donors and among these 9.1% were TTI positive. The attributable cost of serial screening was 55,653.5 USD while that of screening by ELISA only was 55,910 USD. The attributable cost of rapid screening for only hepatitis B and then ELISA was 53,313.9 USD taking into consideration that 187 blood units would be prevented from undue discard. CONCLUSIONS: This analysis demonstrated that with proper donor selection, rapid screening for hepatitis B virus only before ELISA screening is more cost-effective. This will also reduce the waiting time for donors and counselling if HIV positive.

Red cell membrane protein abnormalities as defined by sds-page among patients with anemia in a West African region hospital practice.

BACKGROUND: Erythrocytes require an ability to deform and withstand shear stress while negotiating microcirculation. These properties are largely due to their excess surface area per volume and the characteristics of the membrane's protein. Deficiencies of these proteins are associated with chronic hemolysis. METHODS: This was a cross-sectional study aimed at determining the prevalence of red cell membrane protein abnormalities as determined by sodium dodecyl sulphate polyacrilamide gel electrophoresis (SDS-PAGE) among patients with anemia attending the outpatient clinics of the hospital. RESULTS: A total of 823 participants were recruited into the study with a mean age of 34±14 years. There were 410 (49.8%) participants with hematocrit ≥ 36% and 413 with hematocrit ≤ 35.9% of which 192 participants (23.3%) had abnormal red cell indices. Following SDS-PAGE, 21 (10.9%) of the 192 participants had deficient PAGE tracing. Abnormal spectrin band was observed in 17 (81%) of the 21 participants. The hematocrit was significantly lower while the reticulocyte count and red cell distribution width were higher in participants with red cell membrane abnormalities. CONCLUSION: One in ten patients with mild anemia and abnormal red cell indices in clinical practice may be having hereditary red cell membrane protein defect. Presence of raised reticulocyte count, family history of mild anemia, increased red cell distribution width and red cell morphology may be used to screen for membrane deficiency.

An Assessment of Knowledge, Awareness, and Attitude of Undergraduates toward Sickle Cell Disease in Lagos, Nigeria.

BACKGROUND: Sickle cell anaemia is an autosomal recessive disorder which occurs as a result of the substitution of glutamic acid with valine at the 6th position of the haemoglobin beta chain, resulting in the synthesis of abnormal haemoglobin and the consequent production of the characteristic sickled red blood cells. Sickle cell anaemia is the homozygous form where two HbS genes are inherited, whilst in Sickle cell disease, the HbS is inherited along with another abnormal haemoglobin eg HbE, HbC, etc. AIMS AND OBJECTIVES: This study was aimed at assessing the awareness and knowledge of sickle cell disease among students in a tertiary institution, as well as their attitude to the disease. MATERIALS AND METHODS: This was a cross-sectional quantitative interviewer administered questionnaire study, involving 200 undergraduates of the Lagos State University Ojo Campus, Lagos. Information collected include socio-demographic information, as well as questions to assess the awareness, knowledge and attitude to Sickle Cell Disease. Data obtained were analyzed using SPSS version 16.0. RESULTS: The total knowledge score was 20 and depending on the total score of the respondents, knowledge levels were grouped as poor (0-6), fair (6-13) and good (14-20). Of the 200 respondents, 37.5% had good knowledge of SCD, despite high level of awareness (92.5%). The knowledge level of the respondents based on the score revealed a mean score 12.05 + 3.14 indicating fair general knowledge of the respondents. 67.5% of respondents were aware of their haemoglobin phenotypes. More than half (59%) of the respondents knew someone living with sickle cell disease and 154 (77%) agreed that haemoglobin phenotype would play a significant role in their choice of a life partnzer. CONCLUSION: The awareness of SCD among the students is high but this awareness did not translate to good overall knowledge about the disease. This underscores the importance of increased public health education on SCD, in order to increase the knowledge about SCD.

Mycosis fungoides: case report and literature review.

Mycosis fungoides (MF), also known as Alibert-Bazin syndrome or granuloma fungoides, is the most common form of cutaneous T-cell lymphoma. Cutaneous lymphomas are an uncommon, heterogeneous group of non-Hodgkin lymphomas (NHLs) of T- and B-cell origin where the skin is the primary organ of involvement. This is a case of a 60-year-old Nigerian woman, who was diagnosed and managed as a case of chronic dermatitis but further investigations confirmed a diagnosis of MF; she was thereafter managed with topical glucocorticoids/chemotherapy and improved on these treatments. We make a plea for better awareness of the disease among physicians and pathologists in Africa.