RELATIONSHIP BETWEEN SICKLE CELL NEPHROPATHY AND SOME BIOCHEMICAL MARKERS OF HAEMOLYSIS AMONGST PATIENTS WITH SICKLE CELL ANAEMIA IN KANO, NORTHWESTERN NIGERIA.

Introduction: Advancements in the care of patients with sickle cell anaemia have led to significant improvement in survival with many patients reaching adulthood. As they age, long-term complications of the disease manifest in them, notable amongst which is nephropathy which is one of the leading causes of morbidity and mortality in them. There is limited information about sickle cell nephropathy and some biochemical markers of haemolysis that can detect it early in our setting. This study aimed to determine the relationship between some indirect markers of haemolysis and sickle cell nephropathy. Methodology: The study was a descriptive cross-sectional one where 204 adolescent and adult patients with sickle cell anaemia attending the clinic of AKTH Kano were recruited. An interviewer-administered questionnaire was utilized. Blood samples were taken for determination of serum bilirubin, LDH, and reticulocyte count. Spot urine was used to quantitatively determine albumin to creatinine ratio. Data collated was analyzed using SPSS version 22.0. P-value <0.05 was considered significant. Result: Two hundred and four (204) participants were enrolled in to the study. Their mean age was 19.6±5years. Females were the majority 131/204 (64.2%). The median (IQR) serum lactate dehydrogenase, bilirubin, direct bilirubin, and reticulocyte count were 607.0(487.3-758.5) U/L, 54.5(37.0-119.0) umol/L, 16.0(11.3-29.0) umol/L and 4.0(3.0-8.4%) respectively. Sickle cell nephropathy was found in 29/204 (14.2%). There were positive significant associations between sickle cell nephropathy with raised serum bilirubin and serum lactate dehydrogenase (p-value = 0.02 and 0.032 respectively). Conclusion: Sickle cell nephropathy is common amongst patients with sickle cell anaemia and raised serum bilirubin and lactate dehydrogenase are predictors of sickle cell nephropathy.

Correlation between Red Cell Distribution Width and Glycaemic Control among Adults with Type II Diabetes Mellitus at Aminu Kano Teaching Hospital, North-Western Nigeria.

BACKGROUND: Red Blood Cell Distribution Width (RDW) measures the degree of variation in red blood cell size and it is a good predictor of complications in many conditions such as diabetes mellitus (DM). This study aimed to determine the relationship between RDW and glycaemic control in patients with type II DM. MATERIALS AND METHODS: It was a cross-sectional comparative study where patients with type II DM and apparently healthy non-DM volunteers were recruited. Blood samples were collected and analysed for RDW, Fasting Plasma Glucose (FPG) level and Glycated Haemoglobin (HbA1c). Data were analyzed using Statacorp version 13. RESULTS: A total of 180 participants were enrolled (90 cases, 90 controls). The mean (±SD) ages of cases and controls were 42 (± 11.94) and 34 (± 9.5) years, respectively. Females constituted the majority (49/90; 54.4%) in both groups. The cases had higher RDW than the controls (15.5 ± 1.0% versus 14.3 ± 1.7 %, p=0.630). The correlation between RDW and HbA1c revealed a weak statistically significant relationship (r=0.096, p=0.03) while a weak negative relationship was observed between the RDW and FPG (r = -0.006, p=0.956) which was not statistically significant. However, a negative finding showed a positive correlation between RDW and MCH (p-value = 0.003) and MCHC (p-value = 0.0002). CONCLUSION: Red cell distribution width has a direct relationship with HbA1c in patients with DM. Therefore, we recommend that clinicians pay attention to this detail while evaluating patients with DM.

CONTEXTE: La largeur de distribution des globules rouges (LDG) mesure le degré de variation de la taille des globules rouges et constitue un bon prédicteur des complications dans de nombreuses affections telles que le diabète sucré (DS). Cette étude visait à déterminer la relation entre la largeur de distribution des globules rouges et le contrôle de la glycémie chez les patients atteints de diabète de type II. MATÉRIELS ET MÉTHODES: Il s'agit d'une étude comparative transversale dans laquelle ont été recrutés des patients atteints de diabète de type II et des volontaires non diabétiques apparemment en bonne santé. Des échantillons de sang ont été prélevés et analysés pour déterminer le temps de travail quotidien, le taux de glucose plasmatique à jeun et l'hémoglobine glyquée (HbA1c). Les données ont été analysées à l'aide de la version 13 de Statacorp. RÉSULTATS: Au total, 180 participants ont été recrutés (90 cas, 90 témoins). Les âges moyens (±SD) des cas et des témoins étaient respectivement de 42 (± 11,94) et 34 (± 9,5) ans. Les femmes constituaient la majorité (49/90;54,4%) dans les deux groupes. Les cas avaient un TDR plus élevé que les témoins (15,5 ± 1,0 % contre 14,3 ± 1,7 %, p=0,630). La corrélation entre le TDR et l'HbA1c a révélé une faible relation statistiquement significative (r=0,096, p=0,03), tandis qu'une faible relation négative a été observée entre le TDR et la glycémie (r= -0,006, p=0,956), qui n'était pas statistiquement significative. Cependant, une corrélation positive a été observée entre le RDW et la MCH (valeur p=0,003) et la MCHC (valeur p=0,0002). CONCLUSION: La largeur de distribution des globules rouges a une relation directe avec l'HbA1c chez les patients atteints de diabète. Par conséquent, nous recommandons aux cliniciens de prêter attention à ce détail lors de l'évaluation des patients atteints de diabète. Mots clés: Largeur de distribution des globules rouges (RDW), Hémoglobine glyquée (HbA1c), Diabète sucré (DM).

Risk Factors and Pattern of Lower Limb Deep Venous Thrombosis in Gombe, North-Eastern Nigeria.

BACKGROUND: Deep venous thrombosis (DVT) is one of most common causes of morbidity and mortality among hospitalized patients. Many risk factors ranging from inherited to acquired are associated with increased risk of DVT. AIMS: The aim of the study was to review the pattern and risk factors of DVTs in Gombe. METHODS: This study was a retrospective review of Doppler ultrasound confirmed lower limb DVT that were managed in the Department of Haematology, Federal Teaching Hospital Gombe, North-eastern Nigeria over a 4-year period (January 2018 to December 2021). Data obtained was analyzed using SPSS version 28. RESULTS: Ninety (90) patients were seen and managed during the study period, most were females, (56.7%; n =51) with an age range of 18 to 92 years and mean of 47.3±17.8 years. Young adults (18-45 years) were in the majority (n=45; 50%), followed by the middle aged (46-60 years) (n=28; 31.1%) and then elderly (>60 years) (n=17; 18.9%). Twenty-five patients (27.8%) had proximal DVT, thirteen (14.4%) distal while 49 (57.8%) had extensive DVT. The most affected side is the left lower limb (64.4%; n=58). Most of the patients had provoked DVT (n=65; 72%) with immobilization, recent surgery, bone fracture and stroke as the leading provoking factors. Among those with provoked DVT, young adults were the majority (n=34; 38%), followed by those in the middle-aged group (n=21; 23%) and then the elderly (n=10; 8%). CONCLUSION: Our study showed the preponderance of left sided DVT and the majority of the cases were provoked affecting young adults.

CONTEXTE: La thrombose veineuse profonde (TVP) est l'une des causes les plus courantes de morbidité et de mortalité chez les patients hospitalisés. De nombreux facteurs de risque, qu'ils soient héréditaires ou acquis, sont associés à un risque accru de thrombose veineuse profonde. OBJECTIFS: L'objectif de l'étude était d'examiner les caractéristiques et les facteurs de risque de la TVP à Gombe. MÉTHODES: Cette étude était un examen rétrospectif des TVP des membres inférieurs confirmées par échographie Doppler qui ont été prises en charge dans le département d'hématologie de l'hôpital universitaire fédéral de Gombe, au nord-est du Nigéria, sur une période de 4 ans (janvier 2018 à décembre 2021). Les données obtenues ont été analysées à l'aide de SPSS version 28. RÉSULTATS: Quatre-vingt-dix (90) patients ont été vus et pris en charge au cours de la période d'étude, dont la plupart étaient des femmes, (56,7% ; n =51) avec une tranche d'âge de 18 à 92 ans et une moyenne de 47,3±17,8 ans. Les jeunes adultes (18­45 ans) étaient majoritaires (n=45 ; 50%), suivis par les personnes d'âge moyen (46­ 60 ans) (n=28 ; 31.1%) et les personnes âgées (>60 ans) (n=17 ; 18.9%). Vingt-cinq patients (27,8 %) présentaient une TVP proximale, treize (14,4 %) une TVP distale et 49 (57,8 %) une TVP étendue. Le côté le plus touché est le membre inférieur gauche (64,4% ; n=58). La plupart des patients présentaient une TVP provoquée (n=65 ; 72%), l'immobilisation, une intervention chirurgicale récente, une fracture osseuse et un accident vasculaire cérébral étant les principaux facteurs de provocation. Parmi les patients présentant une TVP provoquée, les jeunes adultes étaient majoritaires (n=34 ; 38%), suivis du groupe d'âge moyen (n=21 ; 23%) et des personnes âgées (n=10 ; 8%). CONCLUSION: Notre étude a montré la prépondérance de la TVP du côté gauche et la majorité des cas ont été provoqués en affectant les jeunes adultes. Mots-clés: Thrombose veineuse profonde, Schéma, Gombe, Facteurs de risque.

Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria - A multi-facility study of 34 tertiary hospitals.

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

Acute Leukaemias in Bauchi State, Northeastern Nigeria: Pattern of Presentations and Clinical Entities.

BACKGROUND: Acute leukaemias are very aggressive diseases that run a rapidly fatal course if not promptly diagnosed and appropriately treated. The clinical presentations range from bone marrow failure such as anaemia, neutropenia or thrombocytopenia to features of organ infiltrations such as lymphadenopathy, splenomegaly, etc, but presentations may be non-specific. Misdiagnosis is very common with delay in diagnosis and prompt treatment being the causes of high morbidity and mortality in acute leukaemias. This study aims to determine the pattern of presentation and various clinical entities of acute leukaemias in Bauchi State, North-Eastern Nigeria. SUBJECTS, MATERIALS AND METHODS: This was a three year retrospective study in which records of cases of acute leukaemias diagnosed in the Haematology Department of Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi from the bone marrow aspiration cytology register from 1st January, 2018 to 31st December, 2020 were collected. Data on socio-demographic characteristics of the patients that include age, gender, diagnosis as well as subtypes of some of the malignancies diagnosed were also collated. The collated data were analyzed using SPSS Version 20.0. A p-value of < 0.05 was considered significant. RESULTS: Twenty-nine cases of acute leukaemias were diagnosed during the period under review. Majority of cases had acute lymphoblastic leukaemia (ALL) 19/29 (65.5%) while acute myeloid leukaemia (AML) was seen in 10/29 (34.5%). The mean ± SD age of the patients was 22.2±9.2 years with a range 6 months to 60 years. Males constituted 75.9% (22/29) of the cases of acute leukaemias diagnosed. The male to female ratios for AML and ALL were 2:1 and 2.6:1 respectively. The mean±SD ages for AML and ALL were 27±9.2years and 17.3±11.3 years respectively. The most common form of presentation of acute leukaemia in this study is recurrent anaemia necessitating blood transfusion while proptosis and epistaxis were the least forms of presentation. CONCLUSION: Acute lymphoblastic leukaemia is the commonest form of acute leukaemias while recurrent anaemia is the commonest form of clinical presentations in our setting. Early referral of patients with clinical features suggestive of acute leukaemias is recommended.

CONTEXTE: Les leucémies aiguës sont des maladies très agressives qui exécuter un cours rapidement mortel s'il n'est pas diagnostiqué rapidement et de manière appropriée Traités. Les présentations cliniques vont de l'insuffisance médullaire tels que l'anémie, la neutropénie ou la thrombocytopénie aux caractéristiques d'infiltrations d'organes telles que lymphadénopathie, splénomégalie, etc., mais les présentations peuvent être non spécifiques. Les erreurs de diagnostic sont très courantes le retard dans le diagnostic et le traitement rapide étant les causes demorbidité et mortalité élevées dans les leucémies aiguës. Cette étude vise à :déterminer le modèle de présentation et les diverses entités cliniques de leucémies aiguës dans l'État de Bauchi, au nord-est du Nigéria. SUBJETS, MATÉRIAUX ET MÉTHODES: Il s'agissait d'une étude rétrospective de trois ans dans laquelle des enregistrements de cas de leucémies aiguës diagnostiqués dans le département d'hématologie d'Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi du registre de cytologie par aspiration de la moelle osseuse du 1er janvier 2018 au31 décembre 2020 ont été collectés. Données sociodémographiques caractéristiques des patients qui incluent l'âge, le sexe, le diagnostic comme ainsi que des sous-types de certaines des tumeurs malignes diagnostiquées ont également été rassemblé. Les données rassemblées ont été analysées à l'aide de SPSS version 20.0. Une valeur de p < 0,05 a été jugée significative. RÉSULTATS: Vingt-neuf cas de leucémies aiguës ont été diagnostiqués au cours de la période considérée. La majorité des cas avaient des cas aigus leucémie lymphoblastique (LAL) 19/29 (65,5 %) en myéloïde aiguëune leucémie (LAM) a été observée chez 10/29 (34,5 %). L'âge moyen ± du DS deles patients étaient âgés de 22,2 ±9,2 ans avec une fourchette de 6 mois à 60 ans.Les hommes constituaient 75,9 % (22/29) des cas de leucémies aiguës diagnostiqué. Les ratios hommesfemmes pour la LAM et la LAL étaient de 2:1 et2.6:1 respectivement. Les âges moyens ±SD pour la LAM et la LAL étaient les suivants:27±9,2 ans et 17,3±11,3 ans respectivement. Le plus commun la forme de présentation de la leucémie aiguë dans cette étude est récurrente anémie nécessitant une transfusion sanguine pendant la proptose et l'épistaxis étaient les formes les moins présentes. CONCLUSION: La leucémie lymphoblastique aiguë est la plus courante forme de leucémies aiguës tandis que l'anémie récurrente est la plus courante forme de présentations cliniques dans notre cadre. Orientation précoce des patients avec des caractéristiques cliniques suggérant des leucémies aiguës est recommandé. Mots-clés: Leucémie aiguë, Modèle de présentation, État de Bauchi.

Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria ­ A multi-facility study of 34 tertiary hospitals

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

Burden and Correlates of Anaemia among Patients with Diabetes Mellitus in a Tertiary Health Facility in Northwestern Nigeria.

BACKGROUND: Anaemia is a common disorder occurring in about 33% of the global population. It is an important cardiovascular risk factor and a key indicator of some chronic complications of Diabetes Mellitus (DM). This study aimed to determine the burden of anaemia and its correlation with some clinical and biochemical parameters among patients with DM attending a tertiary health facility in Zaria, Northwestern Nigeria. SUBJECTS, MATERIALS AND METHODS: This was a case-control study in which 168 participants were enrolled (84 DM patients, 84 controls). It was conducted in the Endocrinology and Metabolic clinics of Ahmadu Bello University Teaching Hospital, Zaria. Consenting DM patients were enrolled consecutively and subsequently, sex- and age-matched with non-diabetic controls. Data on age, gender and Haemoglobin (Hb) concentrations were collated for all study participants. Additional data on type of DM, duration of DM once diagnosis, treatment, type of treatment, history of hypertension, chronic kidney disease, peripheral neuropathy, and Fasting Blood Sugar (FBS) were collated for all cases. Data were collated and analyzed using SPSS version 21. Level of significance was set at <0.05. Ethical approval for the study was obtained from the Institutional Health Research Ethics Committee and informed consent was obtained from the all the participants. RESULTS: Females constituted 39/84(46.4%) of each arm of the study. The mean ± SD of age for both cases and controls was 53.7 ± 8.9 years. The mean ± SD duration of DM, treatment for DM and FBS were 8.4 ± 5.7 years, 5.0 ± 3.6 years and 6.1 ± 2.5mmol/L respectively. Cases had significantly lower Hb concentration compared to controls (12.1±2.2g/dl vs. 13.1 ± 1.4g/dl, t= -3.446, p = 0.001). Overall prevalence of anaemia among cases and controls was 36/84(42.9%) vs. 26/84(31.0%) Z = 1.6, p = 0.110. Among cases, haemoglobin concentration had very weak, inverse and non-statistically significant relationships with age, duration of DM diagnosis, duration of therapy and FBS levels. There was a significant relationship between anaemia on one hand and type of DM and treatment on the other. The odds of DM patients with history of CKD or uncontrolled FBS having anaemia were OR= 0.600 (95% CI 0.196, 1.836) and OR=1.755 (95% CI 0.737, 4.181) respectively. CONCLUSION: The burden of anaemia amongst patients with DM is high in Zaria, Northwestern Nigeria, and it is associated with poor glycaemic control. Hence, the need to include haematological assessment as part of routine care of patients with DM.