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Background: Several studies have shown that various anticoagulants used for collection of blood samples produce varying effects on haematological analyses. Tripotassium ethylenediamine tetra-acetic acid (K3EDTA), sodium citrate and lithium heparin remain the most used anticoagulants employed in hematological analysis. There is paucity of data on the effect of these anticoagulants on haematological parameters in humans in Ghana. We assessed the suitability of K3EDTA, sodium citrate and lithium heparin for routine Full Blood Count (FBC) investigation. Method: A laboratory-based analytical cross-sectional study was conducted using blood samples from 55 conveniently sampled apparently healthy tertiary students from January 2021 to October 2021. Blood samples were taken from each participant into 3 anticoagulant tubes: K3EDTA, sodium citrate and lithium heparin and FBC parameters estimated using the Mindray automated haematology analyzer. One-way ANOVA Kruskal-Wallis test, Mann-Whitney U, Intra-class correlation coefficient (ICC) analysis, Bland-Altman's plot and Lin's concordance correlation coefficient were used where appropriate to ascertain the level of variation, consistency, and agreements among and between results. Normality testing using Shapiro-Wilk test statistic revealed non-Gaussian distribution of data, hence, were presented as median, minimum, and maximum. Data generated were analyzed using STATA v15 and MedCalc v20 where appropriate for statistical analysis. P-values <0.05 were considered statistically significant. Results: The study comprised 34 males and 21 females. The median age for males (23 years: min = 20, max = 34) was statistically comparable (p = 0.2652) to that of females (22 years: min = 18, max = 34). We observed excellent consistency in the estimation of MCV (ICC = 0.94), MCH (ICC = 0.98), MCHC (ICC = 0.91), GRAN# (ICC = 0.92) and LYMPH% (ICC = 0.91) across the three anticoagulants. Heparin and K3EDTA largely agreed on most of the FBC parameters, 50.0% (7/14) including HGB, MCV, MCH, PLT, LYMPH#, GRAN# and GRAN%. Meanwhile using K3EDTA as a standard, heparin produced almost perfect agreement only in the assessment of RBC (CCC = 0.992) while a substantial agreement was observed in the assessment of HGB (0.971), HCT (0.958) and MCH (0.987). Citrate agreed substantially with K3EDTA in the assessment of LYMPH% (CCC = 0.964) and moderately in the assessment of MCV (CCC = 0.948) and MCH (0.913). Overall, compared to K3EDTA, heparin was highly precise and accurate in the estimation of HGB, RBC, HCT and MCH while citrate determined MCV and MCH more accurately and precisely. Conclusion: Citrated blood consistently produced lower FBC values compared to heparin and K3EDTA and hence suggests not reliable in the assessment of FBC among humans. Heparin agreed largely with K3EDTA in the estimation of FBC parameters and may be used as a better alternative anticoagulant in the absence of K3EDTA however with great caution.
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BACKGROUND: Hepatitis B virus (HBV) infection has been suggested to play a role in various adverse birth outcomes. The study determined the prevalence as well as knowledge of hepatitis B virus infection among pregnant women in the Ningo-Prampram District of the Greater Accra Region of Ghana. MATERIALS AND METHODS: A cross-sectional study using simple random sampling technique was used to recruit 213 pregnant women receiving antenatal care in three different health facilities (Prampram Polyclinic (PPC), Dangme Community Hospital (DCH), and Old Ningo Health Center (ONHC)) in the Ningo-Prampram District of Ghana from November 2018 to January 2019. A semi-structured questionnaire was used to collect data which included participants' HBsAg test results, sociodemographic and gynaecological characteristics, and their level of knowledge on HBV infection. Knowledge of the participants on HBV infection was classified as either excellent, good, or poor based on their cumulative percentage scores from the questionnaire according to Al Rubaish system of classification. RESULTS: Overall low-intermediate prevalence of HBV infection was 3.3%; however, PPC recorded the highest prevalence of 4.0% while DCH and ONHC recorded 2.82% and 2.50%, respectively. Statistically significant association was observed between HBV infection and the health facility. Majority (77.40%) of the study participants had poor knowledge on HBV infection while only 14 (6.57%) had excellent knowledge on HBV. Regarding excellent knowledge, 8 (11.0%) among the participants were demonstrated by the majority of those who received antenatal care from DCH. Generally, knowledge on HBV and the infection was poor among the study participants. Knowledge on HBV infection was found to be associated with residential status (p = 0.006), educational level (p < 0.001), occupation (p < 0.001), and gestational period (p < 0.001). Participant's knowledge was also significantly associated with the health facility (p = 0.027). CONCLUSION: HBV infection among pregnant women is prevalent in the Ningo-Prampram District even though the prevalence is not very high. The majority of pregnant women in the Ningo-Prampram District inadequate knowledge on HBV infection and it mode of transmission. Intensive public health education on the HBV infection is required in the district to help prevent and manage future transmissions as well as inform the population about the negative side effects of the virus and the need to prevent it by way of vaccination.
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BACKGROUND: It is estimated that one out of every three Ghanaians has hemoglobin genotype mutation. This change in genetic make-up may result in genotypes such as HbAS, HbSS, and HbSC. Many children in low- and middle-income countries die even before they are diagnosed with sickle cell disease (SCD). In Africa, there are limited data on the incidence and prevalence of SCD and the Volta region of Ghana is no exception. AIM: The aim of this study was to determine the prevalence of SCD and to assess the hemoglobin variants among patients attending Ho Teaching Hospital. METHODS: A retrospective study design was used to extract information from the Hospital Administration and Management Systems (HAMS) on the hemoglobin electrophoresis results and corresponding full blood count results of the SCD and sickle cell anemia (SCA) patients as well as patients who were asked to do Hb electrophoresis irrespective of their sickling status. Data were collected for the period January 2016 to December 2018. Sickle cell disease status was determined using the Hb genotypes from the Hb electrophoresis results. The full blood count was used to categorize the severity of anemia based on the hemoglobin concentration in the SCA and SCD patients. RESULTS: A total of 1,523 subjects were included in the study of which the prevalence for sickle cell disease was 16.7%. The SCD genotypes included HbS (6.2%), HbSC (7.9%), and HbSF (2.6%). Hemoglobin C disease (HbCC) constituted 0.3% out of the total prevalence of SCD. The prevalence of anemia was 99.2%, with the severest form in HbS. Also, majority of the SCD patients had severe anemia. Difference in the severity of anemia was found to be significant among both male (P=0.006) and female (P=0.004) participants with SCD. CONCLUSION: Patients receiving health care at the Ho Teaching Hospital had different hemoglobin variants with HbAS recording the highest prevalence. The high incidence of hemoglobin AS implies the possibility of having an increased population of individuals with sickle cell disease in future if measures are not put in place to improve screening, counseling, and education of the public about the health threat SCD poses.
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BACKGROUND: Malaria is known to cause severe health consequences due to its marked effects and alteration on the haematological parameters of infected individuals. This study evaluated the haematological profile of adult individuals infected with the malaria parasite. METHODS: A retrospective study was conducted using archived data of malaria positive cases from January 2017 to March 15, 2019. Data retrieved included subjects' demographics, malaria parasite count, malaria parasite species, and full blood count parameters. A total of 236 malaria positive subjects were included in the study. RESULTS: The study showed that more females were infected with the malaria parasite than males (69.07% and 30.93%, respectively). A total of 87.3% of the study population were infected with Plasmodium falciparum as compared to 12.7% infected with Plasmodium malariae. The commonest haematological abnormalities that were seen in this study were lymphopenia (56.78%), anaemia (55.51%), thrombocytopenia (47.46%), eosinopenia (45.76%), neutropenia (29.24%), monocytosis (21.19%), and leucocytosis (17.37%) in the infected subjects. The mean platelet count of P. falciparum-infected subjects was decreased as compared to the mean platelet count of P. malariae-infected subjects. There was a significant (P value <0.05) decrease in the number of platelet count with every unit increase in parasite density. CONCLUSION: Study participants infected with malaria demonstrated vital changes in haematological parameters with anaemia, thrombocytopenia, lymphopenia, monocytosis, and eosinopenia being the most important predictors of malaria infection especially with P. falciparum species.P. falciparum-infected subjects was decreased as compared to the mean platelet count of.
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BACKGROUND: Malaria remains a major cause of morbidity and mortality worldwide and particularly in sub-Saharan Africa where it is endemic. As such, it is important that a proper diagnosis is made before treatment is initiated. Malaria parasite count plays a key role in the diagnosis and management of malaria. Variations in ratings by laboratory personnel can impact negatively on the treatment regimen for malaria-infected patients. The study is thus aimed at evaluating and comparing the proficiency and parasitaemia counts by two different categories of laboratory staff at the LEKMA Hospital, Ghana. MATERIALS AND METHODS: A total of 200 confirmed malaria-positive samples were used in the study. Six thick and thin films were prepared from each sample and uniquely labelled. Two of the six slides were given to two WHO-accredited malaria microscopists to examine and report their respective parasite count/µl (parasite count/WBC × 8000). These were used as the reference for the two categories of laboratory staffs: rater A being diploma holders (Technical Officers referred to as untrained rater) and rater B being degree holders (Medical Laboratory Scientist referred to as trained rater) at the LEKMA Hospital. RESULTS: In comparison to the expected outcome, the parasite count by the rater group A (190 (151-239)]) and the rater group B (177 (140-224)) demonstrated significant positive correlation (r = 0.995, p < 0.0001 vs. r = 0.995, p < 0.0001, respectively) with the expected outcome in the cases of heavy parasitaemia. A statistically significant difference (p < 0.05) between counts by the different raters in low parasitemia was observed in this study. A persistent nosedive inter-rater agreement from k = 0.82 to k = 0.40 with increasing density cutoff was observed in this study. CONCLUSION: The study observed that the degree of inter-rater agreement of parasite density count by various categories of laboratory personnel is almost perfect. However, the parasite count between raters varied significantly with very low levels of parasitemia but better correlated with heavy parasitemia.
