Household living conditions and food insecurity in Nigeria: a longitudinal study during COVID-19 pandemic.

OBJECTIVE: This study set out to investigate the risk of household food insecurity in Nigeria during the novel COVID-19 pandemic using a harmonised dataset of Nigeria's prepandemic face-to-face survey and two waves of the COVID-19 National Longitudinal Phone Survey (NLPS). SETTING: Nigeria. PARTICIPANTS: A representative sample of 1674 households is used in the analysis. DESIGN: A longitudinal study. RESULTS: Our longitudinal study reveals a significant increase in the prevalence of food insecurity in Nigeria during the COVID-19 crisis. For a sample of 1674 households used in the analysis, nearly 32% were moderately food insecure in the baseline survey (ie, the prepandemic period), compared with 74% and 72% that faced the same degree of food insecurity in the two waves of the COVID-19 phone survey. In like manner, not up to 4% of the households faced severe food insecurity in the prepandemic period, compared with 43% and 22% that experienced the same level of food insecurity during the period of the pandemic. Based on the available information in the dataset, we construct a composite non-monetary measure (or index) of household well-being and employ the binary logistic model to investigate the objects under study. The empirical results show that the well-being index has a strong negative association with household food insecurity. Further investigation reveals that the risk of being food insecure increases for households in relatively poor living conditions compared with those in the middle category and conversely declines for households in much better living conditions. CONCLUSION: This study informs an understanding of the prevalence and risk of household food insecurity in Nigeria during the novel COVID-19 pandemic and provides insights that can guide policy actions in responding to the current wave of food crises in Nigeria.

Socio-economic determinants of prenatal anaemia in rural communities of South-West Nigeria: a preliminary report.

BACKGROUND: Anaemia is common worldwide and pregnant women are one of the most vulnerable group. Although, anaemia in the general population including pregnant women is multi-factorial in aetiology, the most frequent cause in pregnancy worldwide is iron deficiency. In Nigeria, an estimated prevalence of anaemia among pregnant women ranges from 35-75%. Anaemia in pregnancy (AIP) is associated with significant perinatal and maternal morbidity and mortality including premature birth and low birth weight. AIM: The aim of this study was to determine the prevalence, demographic and socio-economic determinants of anaemia in pregnancy in a rural community of South-West Nigeria. MATERIALS AND METHODS: One-hundred and fifty consenting pregnant women aged 18-42 years in the three trimesters were recruited from four primary health centres of Ikene Local Government of Ogun State of Nigeria after ethical approval was obtained from the Ethics Unit of the Medical officer of Health of the Local Government. Pre-tested interviewer-administered questionnaire was used to collect data on socio-demographic information and 24-hour dietary recall. Using a finger prick, the haemoglobin concentration of each respondent was determined with a haemoglobinometer (DG-300HB manufactured by DouBle, China). Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 20. RESULTS: All the respondents belonged to low socio-economic class. The mean haemoglobin (Hb) concentration obtained in this study was 10.22±1.60 g/dL with a range of 6-14.8 g/dL. Using WHO cut-off Hb concentration of 11 g/dL, the prevalence of anaemia in this study was 67.3%. The frequency of anaemia increased with increase in age group. P=0.010. About 21.4% of those with adequate dietary iron intake were anaemic when compared with 72.1% (98 of 136) of those with inadequate dietary iron intake who were anaemic. AOR-0.090; 95% CI- 0.018-0.457; P=0.004. CONCLUSION: Increasing age, low socio-economic status, poor health education and low dietary iron intake were the predominant socio-economic determinants of prenatal anaemia in the population studied. Efforts must be intensified to alleviate poverty in rural areas and give health education on iron-rich foods to girls and women of children-bearing age in the rural communities.

Absence of human leukocyte antigen-B*57:01 amongst patients on antiretroviral therapy in Nigeria: Implications for use of abacavir.

Background: The presence of human leukocyte antigen (HLA) B*57:01 allele predicts hypersensitivity reaction (HSR) to abacavir (ABC), a nucleoside reverse-transcriptase inhibitor used for human immunodeficiency virus (HIV) treatment. However, the prevalence of this allele amongst Nigerians with HIV is yet to be established. We aimed to determine the prevalence of HLA-B*57:01 allele amongst Nigerians with HIV infection. Methods: We conducted a multicentre cross-sectional epidemiologic survey. Between April 2016 and April 2017, patients were enrolled across five HIV treatment facilities in Nigeria. Participants' demographic information and their history of ABC exposure were obtained, and venous blood was obtained for HLA typing. Results: One thousand five hundred and four (1504) adults were enrolled, with a mean age of 44.6 ± 10.7 years, 1078 (71.7%) were female. 1463 (97.3%) were on antiretroviral therapy. ABC use was reported by 12 (0.8%) participants and none reported HSR. Of 1500 blood samples that were processed, 1458 (97.2%) were successfully typed. Of these, 132 (9.1%) were HLA-B*57 positive using non-specific low-resolution HLA-B*5701 primer mix. On further analysis, none of the 132 samples (0%) had the HLA-B*5701 allele. Conclusion: HLA-B*5701allele is rare amongst Nigerians.

Awareness, Knowledge, and Acceptance of Haematopoietic Stem Cell Transplantation for Sickle Cell Anaemia in Nigeria.

Background. Sickle cell anaemia (SCA) is an inherited condition whose clinical manifestations arise from the tendency of haemoglobin to polymerize and deform red blood cells into characteristic sickle shape. Allogeneic bone marrow transplantation offers a cure. The aim of this study was to determine the level of awareness, knowledge, and acceptance of this beneficial procedure in Nigeria. Materials and Methods. This multicentre cross-sectional study was conducted in 7 tertiary hospitals in Nigeria in 2015. Approval was obtained from each institution's research and ethics committee. A pretested structured questionnaire was administered to respondents aged 18 years and above and to the parents or guardians of those below 18 years of age. Results. There were 265 respondents comprising 120 males and 145 females. One hundred and seventy-one (64.5%) respondents were aware of BMT for the treatment of SCA. About 67.8% (116 of 171) of those who were aware believed SCA can be cured with BMT (p = 0.001) and 49.7% (85 of 171) of the respondents accepted BMT (p = 0.001). Conclusion. Awareness of BMT in Nigeria is low when compared with reports from developed countries. The knowledge is poor and acceptance is low. With adequate information, improved education, and psychological support, more Nigerians will embrace BMT.

Electrocardiographic Study in Adult Homozygous Sickle Cell Disease Patients in Lagos, Nigeria.

Background. This study sought to identify the pattern of electrocardiographic changes in steady state adult sickle cell anaemia. Methods. A case-control, cross-sectional study was conducted amongst sickle cell patients attending the sickle cell clinic of Lagos State University Teaching Hospital, Ikeja, and HbAA controls. All consenting participants had haemoglobin electrophoresis done and were subjected to electrocardiography (ECG). The descriptive data were given as means ± standard deviation (SD). The differences were considered to be statistically significant when the p value obtained was <0.05. Results. A total of ninety-three sickle cell anaemia (SCA) patients and ninety haemoglobin AA (controls) were enrolled. There was no significant difference in the age of the participants with SCA and that of the controls but the body mass index was significantly higher in controls (p = 0.0001). Overall, 73.1% (68 of 93) had abnormal ECG while only 2 of 90 (2.2%) of controls had abnormal ECG. The common abnormalities observed were left ventricular hypertrophy, biventricular hypertrophy, and right ventricular hypertrophy. Conclusion. Patients with SCA in steady state tend to have normal heart rate but about 50% of them would have had ECG changes before the age of 20 years. ECG being a noninvasive test may be used to identify patients at risk for early intervention.

Impact of HIV Infection and Zidovudine Therapy on RBC Parameters and Urine Methylmalonic Acid Levels.

Background. Anaemia is a common complication of human immunodeficiency virus (HIV) infection. The aim of this study was to investigate the impact of HIV infection and zidovudine on red blood cells (RBC) parameters and urine methylmalonic acid (UMMA) levels in patients with HIV infection. Material and Methods. A cross-sectional study involving 114 subjects, 94 of which are HIV-infected nonanaemic and 20 HIV negative subjects (Cg) as control. Full blood count parameters and urine methylmalonic acid (UMMA) level of each subject were determined. Associations were determined by Chi-square test and logistic regression statistics where appropriate. Results. Subjects on zidovudine-based ART had mean MCV (93 fL) higher than that of control group (82.9 fL) and ART-naïve (85.9 fL) subjects and the highest mean RDW. Mean UMMA level, which reflects vitamin B12 level status, was high in all HIV-infected groups but was significantly higher in ART-naïve subjects than in ART-experienced subjects. Conclusion. Although non-zidovudine therapy may be associated with macrocytosis (MCV > 95 fL), zidovudine therapy and ART naivety may not. Suboptimal level of vitamin B12 as measured by high UMMA though highest in ART-naïve subjects was common in all HIV-infected subjects.

Haematopoietic stem cell transplantation in Nigerian sickle cell anaemia children patients.

BACKGROUND: Sickle cell anaemia (SCA) remains associated with high risks of morbidity and early death. Children with SCA are at high risk for ischaemic stroke and transient ischaemic attacks, secondary to intracranial arteriopathy involving carotid and cerebral arteries. Allogeneic haematopoietic stem cell transplantation (HSCT) is the only curative treatment for SCA. We report our experience with transplantation in a group of patients with the Black African variant of SCA. PATIENTS AND METHODS: This study included 31 consecutive SCA patients who underwent bone marrow transplantation from human leukocyte antigen (HLA)-identical sibling donors between 2010 and 2014 following a myeloablative-conditioning regimen. RESULTS: The median patient age was 10 years (range 2-17 years). Before transplantation, 14 patients had recurrent, painful, vaso-occlusive crisis; ten patients had recurrent painful crisis in association with acute chest syndrome; three patients experienced ischaemic stroke and recurrent vaso-occlusive crisis; two patients experienced ischaemic stroke; one patient exhibited leukocytosis; and one patient exhibited priapism. Of the 31 patients, 28 survived without sickle cell disease, with Lansky/Karnofsky scores of 100. All surviving patients remained free of any SCA-related events after transplantation. CONCLUSION: The protocols used for the preparation to the transplant in thalassaemia are very effective also in the other severe haemoglobinopathy as in the sickle cell anaemia with 90% disease free survival. Today, if a SCA patient has a HLA identical family member, the cellular gene therapy through the transplantation of the allogeneic haemopoietic cell should be performed. Tomorrow, hopefully, the autologous genetically corrected stem cell will break down the wall of the immunological incompatibility.

Hemoglobin and Ferritin Concentrations in Subjects with Metabolic Syndrome.

BACKGROUND: Metabolic syndrome (MetS), a clinical condition characterized by insulin resistance, glucose intolerance, dyslipidemia, hypertension, and obesity, has been linked with raised levels of serum ferritin (Sfr) concentrations. OBJECTIVES: This study was carried out to compare hemoglobin (Hb) and Sfr concentrations in patients with MetS, regular donors and first-time donors. MATERIALS AND METHODS: A total of 102 subjects who were between 18 and 60 years were enrolled for the study. They were divided into three groups. The first group (n = 20) was made up of 5 males and 15 females, all who met the criteria that define MetS. The second group (n = 52; M = 34, F = 18) were regular donors, while the last group (n = 30; M = 16, F = 14) were first-time donors or those who had not donated before. Following an overnight fast, 20 mL of venous blood was drawn from each subject. About 5 mL of this was put into sodium ethylenediaminetetraacetate (EDTA) specimen bottles for the full blood count parameters with Sysmex KX-21N hematology analyzer (made in Japan). The remaining 15 mL had serum separated for Sfr assay using enzyme-linked immunosorbent assay (ELISA) with a commercial assay kit manufactured by Teco Diagnostics. RESULTS: Significant difference was found in the mean Sfr concentration of subjects with MetS (163 ± 136.92 ng/mL) and regular donors (41.46 ± 40.33 ng/mL), P = 0.001. The mean Sfr concentrations of subjects with MetS (163 ± 136.92 ng/mL) were also higher than that of first-time donors (102.46 ± 80.26 ng/mL), but it was not statistically significant, P = 0.053. The Hb concentrations of the three groups were not significantly different. CONCLUSION: Sfr concentrations of regular donors were lower than that of subjects with MetS and first-time donors. The difference between regular donors and subjects with MetS was statistically significant. However, there is no significant difference in the Hb concentrations in the three groups. MetS is not associated with anemia or hyperferritinemia.

Factors influencing CD4 cell count in HIV-positive pregnant women in a secondary health center in Lagos, Nigeria.

BACKGROUND: Immunity in pregnancy is physiologically compromised, and this may affect CD4 count levels. It is well-established that several factors affect CD4 count level in pregnancy. This study aimed to determine the mean and reference range of CD4 count in human immunodeficiency virus (HIV)-positive pregnant women in Lagos, Nigeria. METHODS: A retrospective study was carried out at antenatal clinics of the Maternal and Child Center of a secondary health center in Lagos State, Nigeria. Records of HIV-positive pregnant women at various gestational ages, including CD4+ cell count at booking, packed cell volume (PCV) at booking and labor, gestational age at delivery, and infant weight and sex were retrieved. The descriptive data was given as mean ± standard deviation (SD). Pearson's chi-squared test and correlation were used for analytical assessment. RESULTS: Data were retrieved for a total of 143 patients. The mean age was 31.15±3.78 years. The mean PCV was 31.01%±3.79% at booking and 30.49%±4.80% during labor. The mean CD4 count was 413.87±212.09 cells/µL, with a range of 40 to 1,252 cells/µL. The mean infant weight was 3.05±0.45 kg, with a range of 2 to 5 kg. Age of the mother, gestational age, and PCV at booking were not statistically significantly associated with CD4 count. CONCLUSION: Maternal age, gestational age, and PCV at booking had no significant effects on CD4+ cell count levels in pregnancy. The mean CD4+ cell count of HIV-positive pregnant women in Lagos is 413.87±212.09 cells/µL.

Seroprevalence of human T lymphotropic virus antibodies among healthy blood donors at a tertiary centre in Lagos, Nigeria.

INTRODUCTION: Transmission of human T-lymphotropic viruses (HTLV) occurs from mother to child, by sexual contact and blood transfusion. Presently, in most centres in Nigeria, there is no routine pre-transfusion screening for HTLV. The study aims to determine the prevalence of HTLV-1 and HTLV-2 among healthy blood donors at a tertiary centre in Lagos. METHODS: A cross-sectional study was carried out at the blood donor clinic of the Lagos State University Teaching Hospital (LASUTH), Ikeja. About 5 mls of venous blood was collected from each subject into a sterile plain bottle after obtaining subject's consent. The serum separated and stored at -200C. Sera were assayed for HTLV by an enzyme-linked immunoassay (ELISA) for the determination of antibodies to HTLV 1 and HTLV -2. Western blot confirmatory testing was done on reactive samples. All donors were also screened for HIV, HBsAg and HCV by rapid kits. RESULTS: The seroprevalence of HTLV -1 by ELISA was 1.0% and 0.5% by Western Blot among blood donors. A total of 210 healthy blood donors were enrolled. Only 2 (1.0%) blood donors were repeatedly reactive with ELISA test. On confirmatory testing with Western Blot, 1 (0.5%) blood donor was positive for HTLV. All the healthy blood donors were negative for HIV, HbsAg and HCV. None of the 210 blood donors had been previously transfused; as such no association could be established between transfusion history and HTLV positivity among the blood donors. CONCLUSION: The seroprevalence of HTLV in this environment is low among healthy blood donors.

The relationship between red blood cell distribution width and blood pressure in patients with type 2 diabetes mellitus in Lagos, Nigeria.

BACKGROUND: High red blood cell distribution width (RDW) is related to impairment of erythropoiesis, reflecting chronic inflammation and increased levels of oxidative stress, both of which are telltale signs of type 2 diabetics. The aim of this study was to evaluate the relationship between the RDW and fasting blood sugar/blood pressure, and compare the results from diabetics with nondiabetic controls. METHODS: This was an unmatched case-control study involving 200 participants consisting of 100 diabetics and 100 nondiabetic controls. Blood (4.5 mL) was collected from all of the diabetics and nondiabetic controls, and placed into EDTA anticoagulant tubes. A full blood count was performed using the Sysmex KX-21N, a three-part auto analyzer able to run 19 parameters per sample, including RDW. Blood pressure was measured during sample collection and in a sitting position. RESULTS: The mean fasting blood sugar level was 95.20±30.10 mg/dL in the controls, and 147.85±72.54 mg/dL in the diabetics. The mean blood pressures for diabetics was 138/90 mmHg and for non-diabetics 120/80 mmHg. The mean RDW-SD (RDW standard deviation) was 46.44±4.64 fl in the controls, and 46.84±3.18 in the diabetics. The mean RDW-CV (RDW coefficient of variation) was 14.74%±1.94% in controls, and 14.80±0.71 for diabetics. No statistically significant correlation was found between the RDW-SD and fasting blood sugar/blood pressure in the diabetics. A statistically significant positive correlation was found between the RDW-CV and blood pressure in the diabetics. CONCLUSION: A positive correlation between the RDW-CV and blood pressure was established in the diabetics in this study.

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.

Seroprevalence of human T-lymphotropic virus antibodies among patients with lymphoid malignancies at a tertiary center in Lagos, Nigeria.

BACKGROUND: There is a significant association of human T-lymphotropic viruses (HTLV) with lymphoid malignancies. HTLV causes a lymphoproliferative malignancy of CD4-activated cells called adult T-cell leukemia/lymphoma (ATL) and a chronic myelopathy called tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). This study aims to determine the prevalence of HTLV among patients with lymphoid malignancies at a tertiary center in Lagos. METHODS: A cross-sectional study was carried out at the hematology clinic of the Lagos State University Teaching Hospital. After obtaining consent, approximately 5 mL of venous blood was collected from each subject. The serum was separated and stored at -20°C. Sera were assayed for HTLV by an enzyme-linked immunoassay (ELISA) for the determination of antibodies to HTLV-1 and -2. Western blot confirmatory testing was done on reactive samples. All patients were also screened for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) by rapid kits. RESULTS: A total of 39 patients with lymphoid malignancies were enrolled, consisting of 24 (61.5%) with solid malignancies, while 15 (38.5%) had leukemia. Only two patients (5.1%) with lymphoid malignancies were reactive on the ELISA test. On confirmatory testing with Western blot, two patients (5.1%) with lymphoid malignancies were also positive for HTLV. All patients were HIV negative, but four were positive to HBsAg and HCV. There was no association between history of previous blood transfusion and positivity to HTLV (P=0.544). CONCLUSION: A prevalence of 5.1% of HTLV among patients with lymphoid malignancies was found in this study, and previous history of blood transfusion was not found to be a significant cause of HTLV infection.

The kikuchi-fujimoto disease in Nigeria: a case report and literature review.

The Kikuchi-Fujimoto is a rare, self-limiting disease, which is characterized by regional lymphadenopathy. It occurs worldwide with a higher prevalence among Asians and women below the age of forty years. We present 41-year-old Nigerian woman who was investigated extensively for unilateral left cervical lymphadenopathy. She was eventually diagnosed as having the Kikuchi-Fujimoto disease and was managed conservatively thereafter. We describe a case report and review of literature for better awareness of the disease amongst medical practitioners and pathologists in Africa.

Full blood count pattern of pre-chemotherapy breast cancer patients in Lagos, Nigeria.

UNLABELLED: Background : Full blood count has been shown to predict disease severity and mortality risk in cancer patients. This study aimed to highlight the degree of derangements of full blood count parameters and provide mean values in pre-chemotherapy breast cancer patients compared with apparently normal control subjects. METHODS: This was an unmatched case-control study among breast cancer patients attending Oncology clinic of Lagos State University Teaching Hospital, Ikeja and the nurses of the institution as control. A total of 4.5 mls of blood was collected from each participant into EDTA bottle for full blood count analysis, done on the same day of collection. RESULTS: A total of 100 histologically diagnosed, consenting, pre-chemotherapy patients of the clinic (cases) and 50 nurses of the institution as controls were studied. Anemia was found in 58%, 43% and 20% of cases compared with 38%, 36% and 2% of controls using PCV< 36%, 30-36% and 30%, respectively. The mean MCV, MCH, MCHC (82.62±7.48 fl, 26.01±2.78 pg, 30.73±4.06 g/l respectively) of cases were lower than the controls (85.36±5.74 fl, 27.24±1.90 pg, 31.81±0.8 g/l, respectively and RDW of cases (15.61±3.53) was higher than the control (14.24±0.75). The mean WBC counts, neutrophil and lymphocyte percentages of cases (6.96±7.22, 54.75±13.1% and 38.19±12.70%, respectively) were higher than the controls (5.47±1.57, 44.39±8.78% and 8.82±15.97%, respectively). The mean platelet count of cases 291.51±103.38 was also higher than the controls (222.82±57.62). CONCLUSION: Breast cancer patients presented with deranged full blood count pattern, consequent to the disease compared with the controls.

Prevalence of Priapism and Its Awareness amongst Male Homozygous Sickle Cell Patients in Lagos, Nigeria.

Background. Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation. Impotence and infertility are major problems in male sickle cell disease patients, and priapism has been implicated as a cause of impotence and infertility. The aim of this study is to determine priapism prevalence and assess the knowledge of male homozygous male patients about it in Lagos, Nigeria. Methods. A cross-sectional study was conducted amongst male homozygous sickle cell disease patients of Lagos State University Teaching Hospital. Pretested questionnaires were distributed to determine the prevalence and assess their knowledge on priapism. Data were analyzed using SPSS version 16.0. Results. A total of 114 consenting subjects filled the questionnaires, 85 of 114 (74.6%) had not heard about priapism before this study. A total of 77 of 114 (67.5%) did not know that they are at risk of priapism. Whilst 84 of 114 (73.7%) were not aware that priapism is a complication of SCD. The majority, 94 of 114 (82.5%), were not aware that priapism could cause impotence. Conclusion. There is a need to create more awareness about this complication amongst sickle cell disease patients in order to stem the incidence of impotence and infertility amongst them.

Serum ferritin levels in adults with sickle cell disease in Lagos, Nigeria.

BACKGROUND: Serum ferritin is considered to be one of the most important tools in the measurement of iron balance in steady-state sickle cell disease. Increased gastrointestinal absorption of iron has been reported in sickle cell disease because of the associated chronic hemolysis, and it is also thought that repeated red cell transfusion consequent to chronic hemolysis and anemia causes excessive iron levels. The aim of this study was to determine overall and gender-specific mean ferritin levels in patients with steady-state sickle cell disease in order to establish the prevalence of iron deficiency and overload. METHODS: This was a cross-sectional study in homozygous patients with sickle cell disease attending the sickle cell clinic at Lagos State University Teaching Hospital, Ikeja. A 5 mL blood sample was collected in plain bottles from consenting participants during steady-state periods. The serum was separated and analyzed for ferritin by enzyme-linked immunosorbent assay. Another 5 mL sample was collected for a full blood count, done on the same day of collection, to determine red blood cell indices, ie, mean cell volume, mean cell hemoglobin concentration, and mean corpuscular hemoglobin concentration. The Pearson Chi-square test was used for statistical analysis. The differences were considered to be statistically significant when P was <0.05. RESULTS: In total, 103 patients were recruited for this study and comprised 58 women (56.40%) and 45 men (43.70%). The overall mean ferritin concentration was 93.72 ± 92.24 ng/mL. The mean ferritin concentration in the women was 92.00 ± 88.07 ng/mL and in men was 96.41 ± 99.80 ng/mL. Only eight (7.76%) of the 103 patients had a serum ferritin level < 15 ng/mL, while two subjects (1.94%) had a serum a ferritin level > 300 ng/mL. Ninety-three subjects (90.29%) had serum ferritin within the normal reference range of 15-300 ng/mL. CONCLUSION: In this study, 90% of subjects with sickle cell disease had normal iron stores; serum ferritin was higher in men than in women, and iron deficiency was more common than overload in the disease.

Iron stores in regular blood donors in Lagos, Nigeria.

BACKGROUND: Apart from challenging the bone marrow to increase its red cell production, thereby producing more blood for the donor, regular blood donation has been shown to have several benefits, one of which is preventing accumulation of body iron which can cause free radical formation in the body. This study was carried out to assess body iron stores in regular blood donors. METHODS: A total of 52 regular (study) and 30 first-time (control) volunteer blood donors were studied prospectively. Twenty milliliters of venous blood was drawn from each subject, 5 mL of which was put into sodium ethylenediamine tetra-acetic acid specimen bottles for a full blood count, including red blood cell indices. The remaining sample was allowed to clot in a plain container, and the serum was then retrieved for serum ferritin, serum iron, and serum transferrin receptor measurement by enzyme-linked immunosorbent assay. RESULTS: Mean hemoglobin and packed cell volume in the study group (13.47 ± 2.36 g/dL and 42.00 ± 7.10, respectively, P = 0.303) were not significantly higher than in the control group (12.98 ± 1.30 g/dL and 39.76 ± 4.41, respectively, P = 0.119). Mean serum ferritin was 102.46 ± 80.26 ng/mL in the control group and 41.46 ± 40.33 ng/mL in the study group (P = 0.001). Mean serum ferritin for women in the study group (28.02 ± 25.00 ng/mL) was significantly lower than for women in the control group (56.35 ± 34.03 ng/mL, P = 0.014). Similarly, men in the study group had a lower mean serum ferritin (48.57 ± 45.17 ng/mL) than men in the control group (145.49 ± 87.74 ng/mL, P = 0.00). The mean serum transferrin receptor value was higher in the study group (1.56 ± 0.88 µg/mL) than in the control group (1.19 ± 0.38 µg/mL, P = 0.033). CONCLUSION: These findings suggest that hemoglobin concentration, packed cell volume, and serum iron levels are not significantly affected by regular blood donation and that regular blood donors appear to have reduced iron stores compared with controls.

Cord blood haemoglobin and ferritin concentrations in newborns of anaemic and non-anaemic mothers in Lagos, Nigeria.

BACKGROUND: Pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers were determined, and cord blood haemoglobin and serum ferritin concentrations of their newborns were compared. This is to establish the mean values for pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers and the cord blood haemoglobin and serum ferritin concentrations of their newborns at term. MATERIALS AND METHODS: A case-control study was done involving 142 pregnant women and their newborns. They were divided into two groups - the anaemic group (n = 65) and the non-anaemic (n = 77) group. Five millilitres of blood was collected from each woman and 2 ml was collected from the cord of their newborns into ethylenediaminetetraacetic acid (EDTA) bottle and plain bottle for full blood count analysis and ferritin assay, respectively. RESULTS: The mean pre-delivery haemoglobin concentrations of the women in anaemic group and non-anaemic group were 9.5 ± 1.01 g/dl and 12.15 ± 1.07 g/dl, respectively, and their mean serum ferritin concentrations were 64.45 ± 138.76 µg/l and 32.83 ± 35.36 µg/l, respectively. The mean cord blood haemoglobin concentrations for anaemic and for non-anaemic groups were 12.54 ± 2.54 g/dl and 13.44 ± 2.23 g/dl (P = 0.02), respectively, and the mean cord blood serum ferritin concentrations (non-anaemic, 69.38 ± 78.88 µg/l; anaemic, 7.26 ± 115.60 µg/l) (P = 0.00) were higher in the newborns of non-anaemic than of anaemic mothers. Significant association was found between maternal anaemia and cord blood ferritin concentrations (P = 0.025). CONCLUSION: Maternal anaemia has significant effects on cord blood haemoglobin and serum ferritin concentrations.

Hematological profile of normal pregnant women in Lagos, Nigeria.

BACKGROUND: Hematological profile is considered one of the factors affecting pregnancy and its outcome. Anemia is the most common hematological problem in pregnancy, followed by thrombocytopenia. Leukocytosis is almost always associated with pregnancy. The study reported here was designed to evaluate the overall mean values of seven major hematological parameters and their mean values at different trimesters of pregnancy. SUBJECTS AND METHODS: This examination was a cross-sectional study of 274 pregnant women who registered to attend the Lagos University Teaching Hospital or Lagos State University Teaching Hospital antenatal clinics between their first and third trimester. Blood (4.5 mL) was collected from each participant into a tube containing the anticoagulant ethylenediaminetetraacetic acid (EDTA). A full blood count was performed on each sample and the results were analyzed. RESULTS: Overall, the values obtained were (mean ± standard deviation [SD]): hematocrit level, 30.16% ± 5.55%; hemoglobin concentration, 10.94 ± 1.86 g/dL; white blood cells, 7.81 ± 2.34 × 10(9); platelets, 228.29 ± 65.6 × 10(9); cell volume 78.30 ± 5.70 fL, corpuscular hemoglobin, 28.57 ± 2.48 pg; and corpuscular hemoglobin concentration, 36.45 ± 1.10 g/dL. When grouped by trimester, the mean ± SD value of packed cell volume at first trimester was 32.07% ± 6.80%; of second trimester, 29.76% ± 5.21%; and of third, 33.04% ± 3.88%. The mean ± SD hemoglobin concentration values were 11.59 ± 2.35 g/dL, 10.81 ± 1.72 g/dL, and 10.38 ± 1.27 g/dL for women in their first, second, and third trimester, respectively. Mean ± SD white blood cell concentration for first, second, and third trimesters were 7.31 ± 2.38 × 10(9), 7.88 ± 2.33 × 10(9), and 8.37 ± 2.15 × 10(9), respectively, while the mean ± SD platelet values for first, second, and third trimesters were 231.50 ± 79.10 × 10(9), 227.57 ± 63 × 10(9), and 200.82 ± 94.42 × 10(9), respectively. A statistically significant relationship was found to exist between packed cell volume and white blood cell count with increase in gestational age (P = 0.010 and 0.001, respectively). However, there was no statistically significant association between platelet count and increase in gestational age (P = 0.296). CONCLUSION: These findings reinforce the need for supplementation and provide additional information on hematological reference values in pregnancy in Nigeria.