The effect of erythroferrone suppression by transfusion on the erythropoietin-erythroferrone-hepcidin axis in transfusion-dependent thalassaemia: A pre-post cohort study.

To track post-transfusion changes on the erythropoietin (EPO)-erythroferrone (ERFE)-hepcidin axis, we collected blood samples from 82 regularly transfused patients with ß-thalassaemia major (ß-TM) immediately before and 4-6 days after transfusion. The post-transfusion haemoglobin, hepcidin, and ferritin levels were increased, while the EPO, ERFE, and soluble transferrin receptor were suppressed. In addition, hepcidin change was inversely associated with erythropoietic change, which was confirmed by an increase in the hepcidin-to-ERFE ratio after transfusion. Age was the main predictor of serum ERFE, followed by EPO, transfusion frequencies, and ferritin. We found ERFE to be a highly sensitive indicator of erythroid activity in ß-TM and that the hepcidin-to-ERFE ratio after transfusion may be used as an appropriateness index of serum hepcidin regulation relative to the degree of erythropoiesis.

Cryptosporidiosis in Children in Duhok City / Kurdistan Region / Iraq.

This is the first study to detect cryptosporidiosis among children in Duhok city/Kurdistan region of Iraq. The study included 332 stool samples of children using Modified Ziehl Neelsen Method (MZNM) and 122 of these were randomly selected to detect Cryptosporidium by ELISA. By MZNM, the infection rate of Cryptosporidium oocysts was 66.95% in children; 44.68% in immunocompromised (ICD) and 22.27% in immunocompetent (ICT) group. Among ICT children, the infection rate was highest among less than one year of age (39.34%) in diarrheoic group, while in non-diarrheoic group, it was highest among 1-4 years age (28.57%). Among ICD children, the relations were non-significant among ages. Out of 122 stool samples of children, 26 (21.31%), and 30 (24.59%) were positive by MZNM and ELISA, respectively. In conclusion, ELISA was more sensitive and specific than MZNM which were 82.5% and 90.91% respectively. This study indicates that asymptomatic infection is common among different age groups of children.