RISK FACTORS AND SERO-PREVALENCE OF HEPATITIS B SURFACE ANTIGEN AMONG BLOOD DONORS IN UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN, NIGERIA.

BACKGROUND: Availability of safe blood and blood products for transfusion is increasingly difficult globally, especially in developing countries because of high prevalence of Transfusion Transmissible Infections. OBJECTIVES: To determine the prevalence of HBsAg among blood donors and to evaluate the socio-economic, demographic and medical factors associated with its infection. DESIGN: A prospective study. SUBJECTS: Three hundred and fifty consecutive blood donors were recruited. 2 ml of venous blood was collected aseptically from the ante-cubital vein and subjected to serological test for HBsAg. RESULTS: High prevalence rate 10.9% was recorded. All the donors reactive to HBsAg were males (38,100%) with a mean age of 30.7 ± 8.02 years, while 55.3%, 44.7%, 5.3%, 42%, 47.4%, 5.3% of them were single, married, primary school graduate, secondary school graduate, tertiary school graduate and illiterate respectively with 36.8%, 23.7%, 39.5% and 0% been unemployed, civil servants/professionals, skilled artisans and business/petty traders. The most common risk factor was multiple sexual partners 55.3%, followed by extra marital affairs 13.2%, tattooing 10.5%, previous blood transfusion 5.2%, previous surgery 2.6% and sex trading 2.6%. CONCLUSION: Active public enlightenment programmes and strict blood donation selection criteria need to be put in place in order to provide safe blood and blood products for transfusion.

Screening programme for retinopathy of prematurity in Ilorin, Nigeria: a pilot study.

BACKGROUND: The Neonatal Intensive Care Unit (NICU) of our hospital has a 30% survival rate among babies born premature weighing <1,000g. This hospital serves about 10 million people; there was no retinopathy of prematurity (ROP) screening program in place in Nigeria. MATERIALS AND METHODS: Babies born premature were recruited based on preset criteria: ≤ 35 weeks Gestation Age and birth weight ≤ 1.9 kg. The first retina examination was done at 3-4 weeks post-delivery and were documented on a proforma and analyzed with SPSS 15 Statistical Package. RESULTS: 58 eyes of 29 babies were examined. The birth weight range was 950-1900g, 17(58.6%) babies were ≤ 1500g, and 12 (41.4%) 1500-1900g. The Gestation age range was 27-35 weeks with a mean of 30. Avascularity in retina zones 2&3 was found in 52(89.6%) eyes mostly among babies <32 weeks gestation age and <1500g. Risk factors associated with retinal avascularity are highlighted. The challenges were with co-ordination of follow-up visits and accessibility to treatment such as laser and newer treatment methods. CONCLUSION: A cost effect screening criteria for ROP in Nigeria is suggested to include birth weight ≤ 1500g and gestational age ≤ 32 weeks. Dedicated staff & resources for treatment and imaging are needed for a successful program. An opportunity exists to study the effect of genetics on the development and severity of ROP among native African babies.

Sero-prevalence of syphilis among patients with mental illness: comparison with blood donors.

BACKGROUND: Mentally ill individuals (MII) are at risk of acquiring syphilis and other sexually transmitted infections. This study aimed at determining sero-prevalence of syphilis among MII and compare them with voluntary blood donors (VBD) at University of Ilorin Teaching Hospital (UITH), Nigeria. METHODS: A cross-sectional study done between June, 2010 and June 2011, and involving 350 each of VBDs and MII in and out-patients of UITH. Serological test was done using venereal disease research laboratory (VDRL) and the Treponema Pallidum Haemagglutination (TPHA) kit. RESULTS: Of the 700 subjects, 324 (92.6%) MII, and 349 (99.7%) VBDs were <55 years; 71 (21.4%) MII were Civil Servants compared with 96 (27.4%) VBDs. Significantly more VBDs had higher education than MII (185 or 52.9%, and 140 or 40% respectively). Christians constituted the majority (176 or 50.3%) among MII, and Muslims (210 or 60%) among VBDs. Significantly more married VBDs (204/206 or 99.0%) live with spouses; more VBDs consumed alcohol (37 or 10.6%), smoked (19 or 5.4%), and engaged in extramarital sex (105 or 30.0%). Significantly more MII had blood transfusion (40 or 11.4); engaged in sex trade (12 or 3.4%); and more syphilis prevalence (5.4%). In addition, more syphilitic MII smoked (18 or 94.7%); and all syphilitic MII had psychotic disorders. CONCLUSION: The prevalence of syphilis in MII is significantly higher than among VBDs. Routine screening of MII is advocated to stem this problem.

Normal CD4 Count Range among Healthy Nigerian Population in Ilorin.

BACKGROUND: For the establishment and monitoring of the immune status, CD4 count is critical. OBJECTIVES: To determine the CD4 count range of apparently healthy Nigerians resident in Ilorin and compare with the national value. METHODS: An automated blood analyzer was used to determine the full blood count and CD4 count. The percentage of CD4 count was derived by using other variables. RESULTS: Of the 1205 participants, the reference CD4 count (percentage of CD4) range for adult was 400 to 1288 cells/mm3 (19%-48%) and for children was 582 to 3652 cells/mm3 (17%-50%). CD4 count and percentage of CD4 were significantly ( P = .001) higher in females than in males, and the CD4 count declined significantly with increasing age ( r = -.174, P ≤ .0001). The percentage of CD4 count shows less variation with age ( r = -.051, P = .076). Adult residents of Ilorin had significantly lower absolute mean CD4 count (808 ± 260) than that of the national reference values of 847.0 ± 307.0 cells/mm3 ( P = .001). CONCLUSION: We therefore advocate the use of CD4 count range derived in this study is lower than that of the national reference values.

Effect of Hepatitis B Virus Co-Infection on CD4 Cell Count and Liver Function of HIV Infected Patients.

BACKGROUND: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) share similar routes of transmission, making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naïve patients and investigate the effect of co-infection on CD4 count and liver function. STUDY DESIGN: This was a hospital based descriptive cross sectional study of one hundred consecutive therapy-naive HIV-infected individuals. The CD4 count, Hepatitis B surface antigen, Serum albumin, total Protein, and liver enzymes were determined using standard techniques. RESULTS: The prevalence of HIV and HBV co-infection was 37%. The mean serum ALT and ALP were significantly higher in the co- infected patients (P-values <0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT, AST and ALP of mono and co-infected patients with CD4 count<200/µl were significantly higher than those with count ≥ 200 cells/µl. (p-value of <0.01). The mean ALT and AST of the co-infected patients and all patients with CD4 count <200 cells/µl were higher than the normal reference range. CONCLUSION: Approximately one third of HIV positive patients had hepatitis B virus co-infection. Co-infection and CD4 count <200 cells/µl are likely to result in abnormal ALT and AST. We recommend that co-infected patients and those with CD4 count <200 cells/µl should be given non-hepatotoxic antiretroviral drug.

Effect of hepatitis-B virus co-infection on CD4 cell count and liver function of HIV infected patients.

BACKGROUND: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) share similar routes of transmission making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naïve patients and investigate the effect of co-infection on CD4 count and liver function. STUDY DESIGN: This was a hospital based descriptive cross sectional study of one hundred consecutive therapy-naive HIV-infected individuals. The CD4 count, Hepatitis B surface antigen. Serum albumin, total Protein, and liver enzymes were determined using standard techniques. RESULTS: The prevalence of HIV and HBV co-infection was 37%. The mean serum ALT and ALP were significantly higher in the co-infected patients (P-values <0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT, AST and ALP of mono and coinfected patients with CD4 count<200/µl were significantly higher than those with count ≥ 200 cells/µl. (p-value of <0.01). The mean ALT and AST of the co infected patients and all patients with CD4 count <200 cells/µl were higher than the normal reference range. CONCLUSION: Approximately one third of HIV positive patients had hepatitis B virus co-infection. Co-infection and CD4 count <200 cells/µl are likely to result in abnormal ALT and AST. We recommend those co-infected patients and those with CD4 count <200 cells/µl should be given non-hepatotoxic antiretroviral drug.