Evaluation of the QBC Star centrifugal three-part differential haematology system.

The QBC Star haematology system includes the QBC Star centrifugal analytical analyser and the QBC Star tube system. Together, they are capable of producing a haematology profile on venous or capillary whole blood. The aim of this study is to compare full blood count (FBC) including differential white cell count performance between the QBC Star analyser and a gold standard Sysmex XE-2100 haematology analyser. The FBC performance was evaluated according to the National Committee for Clinical Laboratory Standards (NCCLS) document H20-A. Imprecision, correlation and linearity studies all showed excellent results. Overall, the haemoglobin, haematocrit, white cell count (WCC) and platelet count parameters showed excellent correlation. Mean corpuscular haemoglobin concentration (MCHC) results showed poor comparability. The white cell differential parameters showed good correlation within certain clinically significant limits. Imprecision for haemoglobin, haematocrit, WCC, MCHC and platelet count was considered acceptable. The re-read function was found to be stable over the five-hour testing period under the authors' laboratory environmental conditions. The subjective assessment by biomedical scientist staff demonstrated that the system was user friendly, required little maintenance, and no user calibration was required. Staff considered the user manual to be excellent. Overall, the QBC Star appears to be an excellent point-of-care (POC) dry haematology analyser that delivers clinically significant nine-parameter complete blood count and will make a good POC analyser for use in field hospitals, research, screening programmes, GP surgeries as well as in emergency and intensive care units. It is a health and safety-friendly analyser considering the fact that it uses dry haematology reagents instead of the bulky wet reagents that are often associated with liquid biohazard waste.

HIV among military personnel in the Niger Delta of Nigeria.

The military community is considered a high-risk environment for HIV transmission. In this study, a total of One hundred and fifty military personnel aged between 20 and 55 years attending the Nigerian army Hospital, Air Force Clinic and Police Clinic in the Niger Delta of Nigeria were randomly recruited for the study. Samples were tested for HIV using an immunochromatographic assay. The CD4 cell count was estimated using the Partec Cyflow Counter (Partec, Germany). Results of the study showed an overall HIV prevalence rate of 14.67%. The prevalence of HIV was significantly higher among subjects in the ≥40 years age group (P = 0.03). The HIV prevalence was higher among female subjects compared to male military personnel (P = 0.05). Also, there was a significant negative correlation between the CD4 count and HIV positivity (r = -0.443, P<0.01). Out of the 22 subjects positive for HIV, 9.1% were severely immune compromised with CD4 count below<200 cells/µL while 72.7 and 18.2% had CD4 count of 200-350 and 350-500 cells/µL respectively. There is need for the development of a strategic plan that integrates HIV/AIDS and other STIs programs into existing systems and structures to foster behavior change through information dissemination. Policies should be instituted to make condoms regularly available and freely distributed, with the goal of achieving a 100%-condom-use rate. There is the need for an effective voluntary counseling and testing (VCT) and sentinel surveillance survey in the Nigerian military. Also critical is the establishment of a fully integrated and comprehensive care and support system including universal access of antiretroviral treatment for infected people.

Alloantibodies to glycoprotein La/LLa (anti-HPA-5a and -5b) and IIb/IIIa (anti-HPA1a, -3a and -4a) in Nigerian parous women.

Human platelet antibodies are often implicated in conditions such as neonatal alloimmune thrombocytopenia (NAIT), idiopathic thrombocytopenic purpura (ITP) and platelet refractoriness; however, the frequency of such alloantibodies has not been reported in Nigeria and West Africa. A cross section of apparently healthy adult female staff at a tertiary health facility in the Niger Delta, Nigeria, was screened for alloantibodies to human platelet antigens (HPA) using the GTI PakPlus qualitative solid-phase enzyme-linked immunosorbent assay (ELISA) method. Among the 100 women screened, no anti-glycoprotein IIb/IIIa (anti-HPA-Ia,-3a and -4a) antibodies were detected; however, prevalence of anti-glycoprotein Ia/IIa (anti-HPA-5b) was 30% and pf anti-glycoprotein Ia/IIa (anti-HPA-5a) was 18%. Parity had a significant influence on the development to HPA antibodies (Fisher's Exact test: 11.683, P < 0.05; 13.577, P < 0.01). Platelet count did not have an influence on the development of antibodies (P > 0.05). Clearly, there is need to initiate platelet serology in this setting and also a need to educate women about the risk associated with frequent pregnancies. Furthermore, caution should be exercised when recruiting parous women as blood donors

Cryptosporidiosis among HIV-infected persons in the Niger Delta of Nigeria.

BACKGROUND: Since the discovery of acquired immunodeficiency syndrome (AIDS), many studies demonstrated that intestinal parasites were frequently associated with pictures of severe diarrhoea in patients with HIV. OBJECTIVES: To determine the prevalence of Cryptosporidiosis among HIV-infected persons in the Niger Delta of Nigeria. METHOD: Faecal samples from One hundred and five HIV/AIDS infected subjects made up of 48 males and 57 females aged 18-54 years, mean age and CD4 count of 36.14 +/- 8.46 years and 320 +/- 140 cells/microl respectively were evaluated for Cryptosporidiosis using the Modified Ziehl-Neelsen staining method. RESULTS: Of the one hundred and five faecal samples examined, 3 (2.9%) were positive for cryptosporidium oocyst. Prevalence was significantly higher among females 2/57 (3.5%) compared to males 1/48 (2.1%), among subjects with diarrhoea 3(11.5%) and among subjects with CD4 lymphocyte count < 200 cells/microl (p < 0.01). CD4 count of subjects positive for cryptosporidium oocyst was significantly lower (150 +/- 50 cells/microl). The mean CD4 count of subjects with diarrhoea was significantly lower (mean 180 cells/microl) compared to those without diarrhoea (360 cells/microl). CONCLUSION: Our study indicates that the prevalence of intestinal colonization due to Cryptosporidium is significantly higher among HIV-infected persons presenting with diarrhoea and low CD4 lymphocyte count of < 200cells/microl and re-emphasizes the need to incorporate routine faecal parasitological examination (FPE) in the follow up management of patients with HIV/AIDS. This is likely to optimise treatments in these patients by eradicating opportunistic pathogens and improve the quality of life of these patients.

Zero tolerance for complacency by government of West African countries in the face of COVID-19.

A novel Coronavirus (SARS-CoV-2) causing a cluster of respiratory infections (Coronavirus Disease 2019, COVID-19) first discovered in Wuhan, China, is responsible for a new illness that has been found to affect the lungs and airways of patients with associated symptoms of fever, cough and shortness of breath. In the light of few cases recorded so far in West Africa there is tendency for complacency. The region needs to make strategic plans based on available evidence to enable them effectively deal with this rapidly evolving pandemic. At this very moment countries like China, Italy, France, Spain, Iran, UK and many others are witnessing sustained and intensive community transmission of this virus and increasing numbers of severe disease and death particularly among elderly patients with other comorbidities. The reality of the seriousness of this pandemic is alarming. Government of member states of ECOWAS need to prepare themselves by building capacity as well as implement evidenced-based steps to mitigate this rapidly evolving pandemic by testing persons presenting with symptoms (fever, cough and shortness of breath), isolating and treating those found positive, tracing and quarantining contacts, implementing social distancing as well as optimizing human and material endowment to allow healthcare workers offer safe quality clinical care for affected patients to prevent secondary infection among healthcare workers.

Anaemia and thrombocytopenia among pregnant women attending Aminu Kano Teaching Hospital, Kano State, North Western Nigeria.

BACKGROUND: Pregnancy induces a number of physiologic changes either directly or indirectly that affect the haematologic parameters. The most frequent haematologic complication associated with pregnancy is anaemia and thrombocytopenia. OBJECTIVES: The aim of this case-control study was to investigate the prevalence of anaemia and thrombocytopenia among one hundred and twenty consecutively-recruited pregnant subjects and sixty age-matched non-pregnant controls. METHOD: Socio-demographic and clinical data were obtained using a questionnaire. Three milliliters of blood were obtained from both the pregnant subjects and non-pregnant controls and distributed into EDTA and used for full blood count was determined using the fully automated Mythic 18 3-part differential haematology analyzer. RESULT: The socio-demographic distribution among the subjects showed that the age group 25-29 years had the higher number of participants 41 (34.2%) followed by 30-34 years 39 (32.5%). Distribution based on socio-demography indicated that majority of the subjects were of Hausa ethnic group 47 (78.3), had no formal or Islamic education 53 (44.2%) and predominantly housewives 74 (61.7%). Distribution based on obstetric variables indicated that majority of the subjects were multiparous 86 (71.7%), had no problem in their previous pregnancies 99 (82.5%) and are not having problem in this current pregnancy 109 (90.8%). The HBG and HCT were significantly lower among the pregnant subjects compared to controls (p= 0.05 and 0.0308) respectively. The prevalence of anaemia and thrombocytopenia among the pregnant subjects was 75% and 6.7% respectively. The prevalence of anaemia (80%) and thrombocytopenia (8.0%) was higher among pregnant women in the second trimester compared to those in the first and third trimesters. CONCLUSION: The values obtained from this research showed an increase in prevalence of anaemia and thrombocytopenia among pregnant women compared to the non-pregnant controls. It is vital to routinely monitor the indices of anaemia and thrombocytopenia among pregnant women to reduce the incidence of these diseases and of their complications.

Prevalence of some hepatitis B virus markers among pregnant women attending antenatal clinic in Specialist Hospital Sokoto Nigeria.

BACKGROUND: Hepatitis B virus infection is a global public health problem. The virus has infected more than one-third of the global population. It has been estimated that 360 million chronic carriers are living around the world with a high risk for developing cirrhosis, hepatic carcinoma and hepatic failure. OBJECTIVE: The aim of this study was to determine the prevalence of some hepatitis B markers among pregnant women attending antenatal clinic in Sokoto Specialist Hospital, Nigeria. METHODS: The hepatitis testing was carried out using the Skytec-Rapid Diagnostic HBV-5 rapid kit (Skytec-Rapid Diagnostic, USA). The kit is based on lateral flow chromatographic immunoassay for the qualitative detection of HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb in human serum or plasma. Panel format can conveniently test for five targets at once and utilizes all markers to help distinguish between acute and chronic infections. RESULTS: Out of 117 pregnant women tested, 15 were positive for HBsAg (12.8%), 6 positive for HBsAb (5.1%), 1 for HBeAg (0.9%), 14 tested positive for HBeAb (12.0%), and 14 tested for HBcAb (12.0%). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on ethnicity. HBsAb was significantly higher among the Hausa ethnic group (p= 0.001). The prevalence of HBsAb, HBeAg, HBcAb and HBcAb was not affected by ethnicity (p> 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on age. Infection by the hepatitis B virus markers was higher among young adult and middle age groups. The difference was however not statistically significant (p> 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on the educational status, previous history of blood transfusion, jaundice, employment status and previous history of still births among the pregnant subjects. There were no statistically significant differences in the prevalence of Hepatitis B virus markers (p> 0.05). CONCLUSION: The study observed a high prevalence of various hepatitis B viral markers among pregnant women attending antenatal care in Specialist Hospital Sokoto. There is need for routine screening of all pregnant women and infants born to hepatitis B positive mothers. Government and non-governmental organizations should intensify efforts to enlighten the general population on the public health importance of the disease and the importance of hepatitis screening. There is also need for the development of a treatment protocol for the management of pregnant women positive for hepatitis B to prevent mother to child transmission. There is an urgent need for the implementation of evidenced-based best practice of providing universal vaccination against hepatitis B for all hepatitis B negative women of child bearing age in particular and all Nigerians in general.

Some haematological parameters, manganese and zinc levels among diabetic patients of African descent attending Specialist Hospital Sokoto, Nigeria.

BACKGROUND: World Health Organization statistics identifies that there are about 150 million people with diabetes mellitus worldwide and suggest that this figure may double by 2025. OBJECTIVE: This research was conducted to determine the status of full blood count, zinc and manganese levels among Diabetic patients attending Specialist Hospital, Sokoto. METHODS: The participants were divided into two groups; 58 diabetic subjects and 29 non-diabetic controls. Five milliliters of blood were collected into EDTA and plain containers for full blood count, serum zinc and manganese analysis. The FBC investigation was carried out using automated Mythic Haematology analyzer (Orphee, Switzerland) while Zn and Mn investigations were carried out using Atomic Absorption Spectrometry (AAS). The FBC, Zn and Mn status of both control and subjects were compared statistically. RESULTS: The results obtained in this study showed a significant increase in RBC, PCV, Hb, Basophils, Eosinophil, Lymphocyte count and Manganese levels of diabetic subjects (p⩽ 0.05) when compared with controls. There was no statistically significant difference in the other FBC parameters and Zinc levels between diabetic subjects and non-diabetic controls (p> 0.05). There was a statistically significant difference in the Hb, PCV and lymphocyte of diabetic patients based on gender (p< 0.05). FBC, Manganese and Zinc have no effect based on age group, while other socio-demographic factors also have no effect on the FBC, Manganese and Zinc parameters of diabetic patients. The study also showed no statistical difference in the FBC, Manganese and Zinc of smokers and non-smokers (p> 0.05, respectively). In conclusion, this research shows that some haematological parameters (RBC count, Basophils, Eosinophil, Lymphocyte, Hb and Manganese) of the diabetic patients are significantly higher compared to non-diabetic controls. Marital status had a significant effect on the Hb, PCV and Lymphocyte of the diabetic patients (p< 0.05). The age group had no significant effect on the Hb, PCV and Lymphocyte of diabetic subjects (p> 0.05).CONCLUSIONS There is need to routinely monitor the full blood count, zinc and manganese levels among diabetic subjects in the area to optimize the care offered to these patients.

Seroprevalence of hepatitis B surface antigenaemia in children in a tertiary health institution in the Niger Delta of Nigeria.

BACKGROUND: There is paucity of data on the seroprevalence of HBV infection in children living in urban areas of the Niger Delta of Nigeria. The aim of this study is to determine the seroprevalence of hepatitis B surface antigenaemia among children presenting to the University of Port Harcourt Teaching Hospital (UPTH), to determine the trend in the seroprevalence of HBsAg over a five-year period and to correlate serological findings to clinical features. METHODS: Serum samples from 251 consecutively recruited children in UPTH aged =16 years were tested for Hepatitis B surface antigen using Clinotech HBsAg kits and confirmed using the Trinity Biotec enzyme linked immunosorbent assay based HBsAg kits. Medical records of the children were also obtained. RESULTS: The overall prevalence of HBsAg among children tested was 12.4%. HBsAg prevalence was highest in the 11-15 years age group (24.5%) and the lowest in the 6-10 years age group (11.0%). There was a statistically significant difference in the prevalence of HB V positivity based on age groups (?2, = 8.47, p = 0.014). Prevalence rate was relatively higher among males (13.7%) compared to females (10.7%). There is a statistically significant trend in the decline of HBsAg prevalence 1999 to 2004 (?2, for trend = 11.38, p = 0.001). The predominant symptoms among children positive for HBsAg were hepatosplenomegaly (75%) and jaundice (64.5%). CONCLUSION: This study indicates a high prevalence of HBsAg among children presenting to a tertiary health facility in Port Harcourt.

Epidemiology and management of occupational exposure to blood borne viral infections in a resource poor setting: the case for availability of post exposure prophylaxis.

OBJECTIVES: The aim of this study was to demonstrate the epidemiology and risk of occupational exposure to HIV, HBV and HCV among health care workers (HCWs) and highlight areas where greater training is required. METHODS: The study population included 13 health care workers; 5 males (38.5%) and 8 females (61.5%), mean age 34.15 +/- 6.8 years including 3 doctors (23.1%), 2 laboratory scientist (15.4%), 1 laboratory technician (7.7%), 6 medical students (46.2%) and 1 trainee laboratory assistant (7.7%). The care and follow-up provided to the health care workers in the 500 -bed tertiary health hospital that had percutaneous exposure to patient's blood between June 2002 and June 2005 were analyzed. All exposed health care workers were evaluated and offered follow up counseling. Five milliliters of blood from each of the HCWs and the source patients were screened by immmuno-enzymatic testing for HIV, HBV, and HCV. RESULTS: Exposures were concentrated in few areas of the hospital; pediatrics (46.2%); surgery (15.4%); obstetrics and gynecology (7.7%) and laboratory unit (30.8%) (divided by 2 = 7.72, p = 0.05). Risk of exposure was significantly higher among females (61.5%) compared to males (38.5%) (divided by 2 = 29.96, p = 0.001). All exposed HCWs were seen and offered post exposure prophylaxis within 24 hours of exposure. All the exposed health care workers were sero-negative to HIV, HBsAg and anti-HCV at exposure. The source patients were known in all cases. Evidence of HIV was present in 5 (38.5%); 1 (7.7%) had HBV while none had HCV infection. Of all the HCWs who completed the follow-up, only 1(7.7%) confirmed case of HBV seroconversion occurred in a HCW who was not previously vaccinated against HBV but who received post exposure HBV vaccination. Exposure rate was significantly higher among house officers 7 (53.9%) followed by registrars 3 (23.1%) and laboratory scientist 3 (23.1) (divided by 2 = 74.79, p = 0.0001). CONCLUSIONS: There is need to address the issue of occupational exposure in Africa by providing training on universal precaution, phlebotomy, modifying procedures that have high risk, developing institutional policy for handling of sharps and post-exposure management of health care workers, provision of protective HBV vaccine for all HCWs coupled with the provision of post exposure prophylaxis for exposed HCWs.

Rate, pattern and barriers of HIV serostatus disclosure in a resource-limited setting in the Niger delta of Nigeria.

The disclosure of HIV serostatus is a difficult emotional task creating opportunity for both support and rejection. In this study, we evaluated the rate, patterns and barriers to HIV serostatus disclosure. A pre-tested interviewer-administered questionnaire from 187 HIV infected people residing in a resource-limited setting in the Niger Delta of Nigeria was analysed. Of the 187 HIV seropositive patients studied, 144 (77.0%) had disclosed their HIV-serostatus while 43 (23.0%) had not. Results showed that the patients had disclosed their HIV-serostatus to: parents (22.3%), siblings (9.7%), pastors (27.8%), friends (6.3%), family members (10.4%) and sexual partners (23.6%) (P = 0.004). Females were more likely (59.7%) to disclose their HIV serostatus compared with males (40.3%) (P = 0.003). Mothers were twice as likely (65.6%) to be confided in compared with fathers. Barriers to HIV serostatus disclosure included fear of stigmatization, victimization, fear of confidants spreading the news of their serostatus and fear of accusation of infidelity and abandonment (P = 0.002). Married respondents were more likely to disclose their status. Better-educated respondents with tertiary education were more likely to disclose their HIV-serostatus. Expectation of economic, spiritual, emotional and social support was the major reason for disclosure. The ratio of disclosure to non-disclosure among patients with non-formal education was (2.6:1.0), primary education (2.3:1.0), secondary education (3.3:1.0) and tertiary education (10.0:1.0). Disclosure of HIV serostatus can foster economic social and economic support. There is need for the re-intensification of interventional measure that combines provider, patients and community education particularly in the aspect of anti-stigma campaign, partner notification and skill building to facilitate appropriate HIV serostatus disclosure.

Anaemia in human immunodeficiency virus infection: a review.

BACKGROUND: Human immunodeficiency virus infection is associated with myriads of haematological abnormalities and complications, including anaemia. This review aims at presenting the epidemiologic evidence of HIV associated anaemia, and also examine its effects on patients' survival and the need for specific diagnosis and treatment. METHODS: A review of relevant literature on the subject was sourced manually and by PUBMED internet search. The following keywords were used for internet search: anaemia, chronic disease, highly active antiretroviral therapy human immunodeficiency virus, haematological abnormalities, and AIDS. RESULTS: Human immunodeficiency virus (HIV) is associated with numerous abnormalities of red blood cells production and lifespan. One of these consequences is anaemia. The prevalence of these estimates varies widely from one population to another; however, anaemia was consistently shown to be a predictor for increased disease progression and decreased survival of patient infected by HIV. CONCLUSION: Regular evaluation of patients infected by HIV is necessary, to determine the specific causes of anaemia in order to ensure the institution of appropriate intervention.

Some haematological parameters in plasmodial parasitized HIV-infected Nigerians.

BACKGROUND: Nigeria is highly burdened by malaria and HIV-infection, yet researchers know little about the impact of this co-infection on the haematological profile of HIV-infected adult Nigerians. This case control study is an attempt to investigate the effect that HIV/malaria co-infection has on some haematological parameters of HIV-infected Nigerians. METHODS: Complete blood count (CBC) of 30 plasmodium parasitized HIV-infected subjects and 70 non-parasitized controls were studied. RESULTS: Of the 30 parasitized subjects, 28 (93.3%) were positive for falciparum malaria and 2 (6.7%) for vivax malaria. The incidence of anaemia, thrombocytopenia, neutropenia and leucopenia were significantly higher in parasitized subjects compared to non-parasitized controls 66.7%, 60%, 36.7% and 63.3% versus 32.9%, 42.9%, 24.3% and 24.3% respectively. A statistically significant difference was observed between the haemoglobin, platelet count and the erythrocyte sedimentation rate (ESR) of parasitized and non- parasitized individuals (p < 0.05) respectively. A significant positive correlation was observed between the level of parasitaemia and anaemia (r = 0.37, p < 0.04) in parasitized subjects. The incidence of anaemia was two times higher in parasitized subjects compared to non-parasitized controls (66.7% versus 32.9%). Red cell morphology showed a normocytic and normochromic picture in 40% and 67.1% of parasitized and non- parasitized individuals respectively. Microcytic, hypochromic picture was observed in 60% and 23% respectively in parasitized and non- parasitized individuals. Striking eosinophilia was seen in 5 (16.7%) of parasitized and 3 (4.3%) of non-parasitized individuals. CONCLUSION: Incidence of cytopenia appear significantly higher in parasitized subjects compared to non-parasitized control and bring to bare the need for regular anti-malaria prophylaxis for HIV-infected patients particularly in Nigeria.

Absolute lymphocyte count as a marker for CD4 T-lymphocyte count: criterion for initiating antiretroviral therapy in HIV infected Nigerians.

BACKGROUND: Few laboratories in resource-constrained countries can afford to perform laboratory-monitoring tests required for the implementation of HIV therapy. In this case control study, we have investigated the relevance of absolute lymphocyte count as a surrogate marker for CD4 lymphocyte count as a criterion for initiating HAARTin HIV-infected Nigerians. METHODS: A total of 100 consecutive recruited HIV-infected, previously antiretroviral naive persons and 30 HIV-negative individuals blood samples were run for absolute lymphocyte and CD4 lymphocyte counts and results were compared by a model of linear regression analysis. RESULTS: An overall modest correlation was observed between absolute lymphocyte count and CD4 lymphocyte (r = 0.51) and at CD4 lymphocyte threshold relevant for clinical management of HIV-infected; <200, 200-350 and >350 cells/microL (r = 0.41, 0.30 and 0.21) respectively. Mean absolute lymphocyte count of 1.60 +/- 0.77 x 10(9)/L, 1.88 +/- 1.11 x 10(9)/L and 2.04 +/- 0.54 x 10(9)/L was equivalent respectively to CD4 of <200, 200-350 and >350 cells/microL. CONCLUSIONS: This study indicates a modest correlation between absolute and CD4 lymphocyte counts of HIV-infected Nigerians and at CD4 lymphocyte count threshold significant for clinical management of HIV-infected. Absolute lymphocyte count can become a minimal inexpensive alternative to CD4 lymphocyte count in conjunction with WHO staging and clinical status of patient in determining the optimal time to initiate therapy particularly in resource limited settings where other expensive methods of CD4 enumeration are unavailable.

Seroprevalence of hepatitis C virus in the Niger Delta of Nigeria.

The objective of this cross-sectional survey was to determine the prevalence of anti bodies to hepatitis C virus in 366 consecutively recruited individuals comprising 209 males and 157 females. Anti-HCV was detected in 11 (3.0% ) of the subjects tested. The highest prevalence was found in the 30-39 year age group (3.8% ) while the lowest prevalence occurred in the 40-49 year group (2.2% ). Anti-HCV infection prevalence was higher in less educated subjects (4.6% ) compared to highly educated (1.4% ), in females (3.8% ) compared to males (2.4% ) and was found to be almost two times higher among unmarried (4.1% ) compared to married subjects (2.2% ). This study confirms a high prevalence of anti-HCV and calls for urgent health education and awareness in the Niger Delta area of Nigeria to check further spread of the virus.

The effects of highly active antiretroviral therapy (HAART) of stavudine, lamivudine and nevirapine on the CD4 lymphocyte count of HIV-infected Africans: the Nigerian experience.

OBJECTIVES: The objective of this study was to investigate the short-term effect of highly active antiretroviral therapy on the CD4 lymphocyte count of HIV-infected Nigerians. DESIGN: A case control study of 70 HIV-infected subjects placed on highly active antiretroviral therapy. Thirty HIV-infected yet to start therapy due to unaffordability were observed as controls. SETTING: This study was carried out at the Hematology Department of the University of Port Harcourt Teaching Hospital a 500 bed tertiary hospital and one of the designated antiretroviral therapy pilot centers. METHODS: CD4 lymphocyte count was determined at baseline for subjects and controls. Subjects were placed on HAART for 12 weeks while controls that were yet to start therapy were monitored as controls. CD4 lymphocyte count was repeated after 12 weeks and the differences compared statistically. RESULTS: We observed that subjects and control patients did not differ significantly in their CD4 lymphocyte count at baseline (p>0.05), but after 12 weeks HAART in subjects and untreated control there was a mean increase in CD4 count of (39 cells/microL) in subjects, while untreated controls showed a mean decline of (12 cells/microL) p< 0.05. There was a statistically significant variation in the therapy dependent increases in CD4 count of HAART treated subjects based on pre-therapeutic baseline CD4 count (divide2 = 180.39, p<0.05). The HAART dependent increase in CD4 counts was higher in younger subjects 19-28 years (31 cells/microL) compared to older subjects 49-58 years (21 cells/microL) (p = 0.01). Similarly CD4 response was found higher in females compared to males (p = 0.01). CONCLUSION: This study indicates the importance of accessing the CD4 lymphocyte count of HIV infected patients before the initiation of HAART, its use as a prognostic maker in predicting the initial response to HAART and in determining the optimal time to initiate therapy.

The risk of transfusion-acquired hepatitis-C virus infection among blood donors in Port Harcourt: the question of blood safety in Nigeria.

OBJECTIVE: This study was undertaken to establish the sero-epidemology of Hepatitis C Virus (HCV) antibodies among blood donors in Port Harcourt, Nigeria. METHODS: One Thousand Five Hundred consecutive blood donors presenting to the blood transfusion unit of the University of Port Harcourt Teaching Hospital between January and April, 2003 comprising of 1481 males and 19 females were screened for hepatitis C antibodies using the commercially available Clinotech anti-HCV test strips. All initially positive samples were subsequently tested using a second-generation Trinity Biotec enzyme linked immunosorbent assay. RESULTS: HCV antibodies were detected in 7 (0.5%) of donors. Although statistically not significant, the overall sero prevalence of HCV antibodies was higher in males 7 (0.5%) compared to zero prevalence among females. (chi-squared = 1.94, p = 1.000). Commercial remunerated donors had a higher prevalence of anti-HCV anti-bodies 5 (0.8%) compared to family replacement donors (0.2%) (chi-squared = 1.25, p = 0.26). The highest infection rate occurred in the 18 - 27 years age group 7 (0.7%). CONCLUSION: This study shows a 0.5% prevalence of HCV antibodies among blood donors and describes their demographic characteristics. This calls for urgent implementation of a universal donor screening for HCV antibodies and setting up of a national blood transfusion service run on the basis of voluntary, non-remunerated low risk donors.

Seroprevalence of HIV infection among blood donors in Port Harcourt, Nigeria.

BACKGROUND: This study was undertaken to determine the seroprevalence of human immunodeficiency virus infection among blood donors living in the Niger Delta area of Nigeria. METHODS: A total of 1500 consecutive donors comprising 1481 males and 19 females were screened for HIV-I and HIV-II antibodies using the World Health Organization (WHO) approved Immunocomb HIV I and II test kit. All initially reactive samples were confirmed using the Genscreen HIV I and II test kit. RESULTS: The overall prevalence of HIV was 1.0%. The highest prevalence occurred in the 20 - 29 years age group (60%), followed by 30 - 39 years age group (21.5%). Commercial remunerated donors had the highest infection burden (1.4%) followed by the family replacement donors (0.7%) (p < 0.05). HIV-I accounted for the more predominant strain (0.8%). CONCLUSION: This study has shown an overall prevalence of 1% among blood donors in the Niger Delta area of Nigeria with the highest prevalence amongst donors in the 20 to 29 years age group. We advocate for the mandatory screening of donor units intended for transfusion and the immediate take off of the national blood transfusion service. Furthermore, there is an urgent need for the health education of the people of the Niger Delta area on preventive measures aimed at arresting the spread of HIV.

Seroprevalence of HIV among unemployed individuals undergoing pre-employment medical examination in Port Harcourt, Nigeria.

BACKGROUND: Human immunodeficiency virus (HIV) infection is highly endemic in Nigeria, particularly with the prevalence in 2001 at 5.8%. This study was undertaken to determine the prevalence of HIV among unemployed individuals undergoing pre-employment medical examination in Port Harcourt. METHOD: HIV screening was performed on 868 individuals comprising 373 males and 495 females presenting to the University of Port Harcourt for the purpose of pre-employment medical examination using a double ELISA confirmatory test of Immunocomb and Genscreen HIV 1 & 2 kits. RESULTS: The sero-prevalence rate was 27/868 (3.19%) among the total population. HIV seroprevalence was relatively higher among females 18/495 (3.6%) compared to males 9/373 (2.4%). The highest prevalence was found in the <19 years age group 7/135 (5.1%) and lowest in the 40-49 years age group 3/130 (2.3%), although the difference was not statistically significant (chi2 = 4.86, p = 0. 09). The highest prevalence occurred among separated subjects 2/26 (7.7%) compared to singles 18/460 (3.9%) and married subjects 7/382 (1.8%). CONCLUSIONS: This study indicates a 3.1% prevalence of HIV infection among unemployed individuals studied and calls for urgent and concerted efforts aimed at promoting behavioural, cultural and social changes that will reverse the current trend in the prevalence of HIV among Nigerians.

Pre-marital HIV testing in couples from faith-based organisations: experience in Port Harcourt, Nigeria.

BACKGROUND: This descriptive cross-sectional study was conducted among prospective couples referred from Faith-Based Organisations in Port Harcourt, Nigeria for pre-marital HIV screening. The study sought to establish the sero-prevalence of human immunodeficiency virus (HIV) in this peculiar study group. METHODS: A total of 84 healthy heterosexual couples who required pre-marital HIV screening were tested between January 2000 and December 2003 using a Double ELISA confirmatory test of Immunocomb and Genscreen HIV I&II Kits. RESULTS: Amongst the 168 individuals tested, 35 (20.8%) were found positive. Seroprevalence was significantly higher among females 23 (27.4%) compared to males 12 (14.3%). Infection rate was highest in the 25-29 years group (29.7%, n=22) and lowest in those of 35-39 years (6.1 %, n=2), though this difference was not statistically significant (p-value=0.058). Infection rate was significantly higher among females (p-value=0.036); among prospective couples from Orthodox churches (p-value=0.021); couples with prolonged courtship (>6 months) (p-value=0.0001); couples with history of premarital sex (p-value=0.0001); and couples with history of cohabitation (p-value=0.0001). CONCLUSION: Our findings prompt a wake-up call for faith-based organizations (FBOs) to urgently initiate or be more receptive of measures that emphasize behavioural and social changes amongst members. Government and non-governmental organizations should organise capacity building training for religious based organizations to enable them cope with the challenges of HIV/AIDS. The outcomes of this study further underscores the value of voluntary counselling and confidential HIV testing and especially pre- and post-test counselling as the basis of pre-marital HIV testing.