The clinical and laboratory features of plasma cell neoplasialn the University of Port Harcourt Teaching Hospital.

OBJECTIVE: To analyze the clinical and laboratory features of Multiple Myeloma at presentation in a tertiary centre in Port Harcourt Southern Nigeria. METHODS: The medical records of all patients diagnosed for plasma cell neoplasia within a 10 year period at the University of Port Harcourt Teaching Hospital were reviewed retrospectively. Clinical presentation, investigation results, support and specific therapy used were documented. RESULTS: A total 20 patients were diagnosed with multiple myeloma, 70% were male, the mean age was 61.30 +/- 8.8 years, 50% of them had pathological fractures. The mean duration before presentation was 11.89 +/- 11.7 months (Median = 7 months) and associated with poor outcome. The most common method treatment was chemotherapy with Melphalan and Predisolone. CONCLUSION: MM is a disease of the elderly that can negatively impact on the quality of life due to the complications associated with it. A long duration of symptoms before presentation is a common problem and it has been associated with substantial morbidity and mortality in this study.

Some haematological reference values for pre-primary and primary school aged children in Port Harcourt, Nigeria.

BACKGROUND: Published reports of haematological reference values for pre-primary and primary school aged residents of Port Harcourt, Nigeria are relatively scanty. AIM: To determine the reference ranges of some haematological parameters for pre-primary and primary school aged children resident in Port Harcourt, Nigeria. METHODS: A total of 250 pre-primary school subjects consisting of 124 males and 126 females aged between 1 to 5 years and 536 primary school children consisting of 262 males and 274 females aged between 6 and 13 years resident in Port Harcourt, Nigeria were randomly recruited into the study. 3-5 ml of venous blood was collected with minimum stasis and the values of the following haematological parameters determined by the indicated methods: Haematocrit was determined using Hawksley micro-capillary tubes centrifuged at 3000 rpm for 10 minutes. Red blood cells, white blood cells [including a differential count] and platelet cells were counted manually using the improved Neubauer counting chamber. Erythrocyte Sedimentation Rate (ESR) was determined using the Westergren method. Haemoglobin concentration was determined by the cyanmethaemoglobin method. RESULTS: The reference ranges for haematocrit, total white blood cell, differential neutrophils and lymphocyte counts, platelet cell counts and erythrocyte sedimentation rates; haemoglobin concentration and red cell counts are presented for male and female pre-primary and primary school children in Port Harcourt. There were no significant gender variations in the values of these parameters in both pre-primary and primary school children. However, primary school subjects, irrespective of sex, were found to have significantly higher values of lymphocyte differential counts and erythrocyte sedimentation rates and significantly lower platelet counts and total white cell counts and differential neutrophils counts compared to their pre-primary school counterparts [p<0.05]. There were no significant differences in the values of haematocrit between the two subject groups; though the values in primary school subjects were marginally higher. CONCLUSIONS: The present study reports values and reference ranges of some haematological parameters for pre-primary and primary school aged children in Port Harcourt, Nigeria; no significant gender variations were observed in these parameters. The results indicate that significant differences exist in the values of some of the haematological parameters under investigation between pre-primary and primary school subjects. This suggests a distinction in the haematological parameters of both populations.

Familial Acute Lymphoblastic Leukaemia

Background: Acute lymphoblastic leukaemia (ALL) is known to be the most common malignancy in children. However; the true incidence of familial ALL is not known; coupled with scanty data on familial ALL in the Niger Delta Area of Nigeria. Aim: To present a report of the management two cases of ALL from the same parents; whose sibling also died as a diagnosed case of ALL. Case report: The first case was a 30-month female who presented with recurrent febrile illness; repeated blood transfusions and hospitalizations in several private hospitals before being referred to the Department of Paediatrics and Child Health; University of Port Harcourt Teaching Hospital; Port Harcourt. A diagnosis of ALL type 1 was made. She was managed with cyclophosphamide; oncovin; methotrexate and prednisolone (COMP). Induction regimen; antimalarials and transfusion of sedimented red blood cells for severe anaemia were administered. There was remission before the child was lost to follow-up. The second case was a 15-month female sibling of the first case who presented essentially with severe anaemia; generalized weakness; repeated blood transfusions; peripheral lymphadenopathy and a non-tender hepatomegaly. Bone marrow aspiration showed features also suggestive of ALL type 2 variant with over 30abnormal lymphoblastic and leukaemic cell infiltrate. She was subsequently put into remission through an induction regimen of COMP plus intrathecal methotrexate and Hydrocortisone. She however relapsed and died 8 months from the time of presentation. Conclusion: Familial ALL in siblings is reported. The interplay of the associated risk factors of genetic; parental; socio-economic and environmental influences on the incidence of familial leukaemia in this environment is discussed

Haematological Parameters and Haemoglobin Genotype in Maternal and Cord Blood Pairs in Port Harcourt; Nigeria

Background: The study was conducted to ascertain the pattern of haematological parameters and haemoglobin genotype in maternal and cord blood pairs in the Port Harcourt area of the South-South geopolitical zone of Nigeria. Methods: One hundred and three (103) postpartum women and their newborns were randomly recruited into the study. Five millilitres (5ml) of blood was taken from the mothers and their respective babies and analyzed for haematological parameters and haemoglobin genotype. Results: Haemoglobin concentration (Hb) in mothers was 10.90-14.45 g/dl (PCV; 32.42-43.92Hb in cord blood was 12.50-17.68 g/dl (PCV; 37.5-52.90). Average total white blood cell count (WBC) in mothers was 3.32-10.70 X 109/l and in cord blood; 4.10-13.10X109/l. Haemoglobin genotype revealed that AS was higher in maternal blood (17.5vs 4.8) while AA was higher in cord blood (94.2vs 82.5). Conclusion: The study adds to the data base of reference haematological values in Nigeria; especially the South-South zone and suggests that the frequency of the AS genotype may be undergoing a gradual reduction in subsequent generations as malaria is being controlled makings its relative advantage less important. Testing of prospective couples and counselling of AS individuals is still very important

Prevalence of HIV Infection among Secondary School Students in two cities in South-South Nigeria

Background: Human immunodeficiency virus (HIV) disease will remain a topical issue on health in Third world countries. Its spread amongst the youths is worrisome. These youths are the future hope of our nation .If the spread of HIV is not checked; its impact can deplete a nation's economy and reduce the work force. This study was done to determine the seroprevalence of HIV infections among secondary school adolescents. Methods: A total of 491 blood samples collected from adolescents in 8 secondary schools in Port Harcourt and Calabar were used for the study. School health authority and parents of these students gave permission for the student's involvement. The test kit used for the study was the Trinity Biotech capillus HIV-1/HIV-2. Confirmatory tests were done for positive samples using another rapid assay test kitThe BDI HIV 1 and 2 test device Bremangos Diagnostic Inc. Canada. Results: Eight (3.1) out of 262 females and 5(2.2) of 229 males were retroviral positive. Females showed a slightly higher seroprevalence rate than their male counterparts. This was however not statistically significant (P0.05). Conclusion: HIV can affect all age groups even the young. Females are more disposed to contracting the disease than males. HIV awareness should be taken down to our secondary schools

Pattern of abnormal liver enzymes in HIV patients presenting at a Nigerian Tertiary Hospital.

AIM: To demonstrate the pattern of abnormal liver enzymes in HIV patients presenting at the University of Port Harcourt Teaching Hospital, Port Harcourt. BACKGROUND: Abnormalities of liver function tests (LFT) have been shown to be common in HIV/AIDS in developed countries. Studies have shown that these abnormalities may be due to direct inflammation induced by the HIV virus on the liver cell. It may also be due to gall bladder disease and infection with bacterial, viral or other opportunistic agents. PATIENTS AND METHODS: We reviewed the clinical notes and biochemistry results of HIV positive patients presenting at the HIV clinic from January 2003 to October 2003. Efforts were made to elicit symptoms suggestive of hepatobiliary disease. Their hepatitis B surface antigen status and their hepatitis C status were obtained. Attempts were made to determine the pattern of liver injury in each patient seen. RESULTS: A total of one hundred and twenty -nine (129) cases were recruited. The mean age was 35.6 +/- 9.0 years with a male to female ratio of 1.1 : 1. One hundred and thirteen patients (87.6%) had abnormalities of their LFT'S. Sixteen of these (14.5%) were classified as cholestatic liver injury while ninety-four (85.5%) were classified as having hepatocellular injury. Three patients (2.3%) were HbSAg positive while one (0.8%) was hepatitis C antibody positive. None of the patients was on anti retroviral drugs at the time of recruitment. CONCLUSION: We therefore conclude that abnormalities of liver enzymes are common in patients with HIV in this environment. It is therefore important to characterise the nature of this abnormality and to institute appropriate management. However further studies are required in this field of HIV related liver disease in our locality.

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.

Disseminated intravascular coagulopathy in a neonate: management challenges.

BACKGROUND: Newborns are vulnerable to developing disseminated intravascular coagulopathy (DIC) following infections because of immaturity of their coagulation system. This case report highlights the diagnostic and management challenges encountered in neonates with DIC. METHOD/RESULT: The case notes of an eight day old male who presented with a three-day history of fever, convulsion, excessive crying, refusal to suck and intermittent gum bleeding was reviewed. On examination, he had signs of meningeal irritation and a grade 4 machinery murmur maximal at the 2nd left intercostal space. Investigations showed severe thrombocytopenia and deranged coagulation profile. He received intravenous antibiotics as well as three exchange blood transfusions to correct his coagulation profile and improve his clinical condition before discharge. The underlying cause of his condition was presumably an intrauterine infection. CONCLUSION: The survival of neonates with DIC depends on vigorous treatment of the underlying disorders so as to curtail the triggers of blood coagulation as well as replacement of the consumed coagulation factor.

Condom Use amongst Oil Workers in Niger Delta Region of Nigeria

Background: Spread of sexually transmitted diseases (STDs) amongst oil workers in the Niger Delta region even with the use of condom is worrisome. To ascertain the awareness of the mode of transmission of STDs and commitment to prevention amongst oil workers in the Niger Delta region; the level of use of condom was studied. Method: A cross-sectional study using questionnaires administered to 180 oil workers over a period of three months (January to March 2006) was carried out. Result: A total of 165 respondents questionnaires from 138 males and 27 females were analyzed. Of this number; 144 were married and 21 single. Sixty - five (39.4) respondents used the condom occasionally. Respondents in the 35 44 years bracket used condom most [68 (41.2)]. Extra marital relationship was the reason given by most of the respondents [43 (26.1)] for using the condom. Most of the participants purchased their condoms from the chemist shops [106 (64.2)]. Condom accident [82 (49.7)] accounted for the high risk of infection. Rupture/bursting was responsible for most [70 (85.4)]. Conclusion: There is increased awareness of condom use within the educated sexually active oil workers. About 70of purchased condom is from Chemist shops. National agency for food and drug administration and control therefore should ensure that good quality condoms are dispensed in these outlets

Haematological values in pregnant women in Port Harcourt, Nigeria.

BACKGROUND: Conflicting results have been documented regarding the statistical significance of variations in some haematological parameters at different trimesters of pregnancy. Environmental factors, ethnic and tribal peculiarities have variously been implicated. The values of eight important haematological parameters: Haematocrit (Hct), Haemoglobin concentration (Hbc), Red Blood Cell (RBC) count, White Blood Cell (WBC) count, Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC) and Erythrocyte Sedimentation Rate (ESR) were therefore determined in healthy pregnant subjects receiving antenatal care at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. METHOD: Cross-sectional prospective study involving 130 pregnant subjects aged between 18 and 43 years. The subjects were divided into three groups consisting of 46 subjects in the first trimester, 36 subjects in the second trimester and 48 subjects in the third trimester of pregnancy. The height, weight and body mass index of all subjects were also determined. RESULTS: Results obtained for the haematological parameters indicate that only Haematocrit (Hct) showed significant differences amongst the three groups; highest amongst subjects in the third trimester and lowest amongst subjects in the second trimester (p < 0.05). Haemoglobin concentration (Hbc), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), and Erythrocyte Sedimentation Rate (ESR) were found to be highest amongst subjects in the second trimester; Red Blood Cell (RBC) count and White Blood Cell (WBC) count were highest amongst subjects in the first trimester of pregnancy. These differences were however, not statistically significant (p > 0.05). Among the anthropometric parameters studied, only weight showed significant differences in the three groups of pregnant subjects (p < 0.05); being highest amongst subjects in the third trimester and lowest in subjects in the first trimester. CONCLUSION: The present study provides additional baseline data for basic haematological parameters in healthy pregnant Nigerian women. This would be of immense benefit especially in the antenatal assessment of pregnant Nigerian women.

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.

An assessment of high risk sexual behaviour and HIV transmission among migrant oil workers in the Niger Delta area of Nigeria.

BACKGROUND: A cross--sectional behavioural survey undertaken amongst migrant oil-workers of an oil exploration outfit operating in the Niger-Delta of Nigeria with the aim of assessing the interplay of migrancy, high-risk sexual behaviour and HIV transmission. METHOD: A total of 300 randomly selected migrant oil workers were assessed using structured questionnaires to evaluate key high - risk sexual behavioral parameters such as multiplicity of sexual partners, bisexuality (closet homosexuality), high grade sexual behaviour and lesbianism. Sampling period was two months with a control cohort of 200. RESULT: The prevalence of high risk sexual behaviour (HRSB) amongst the migrant oil workers was found to be 7.7% while low-risk sexual behaviour (LRSB) was 92.3%. There was no record of HRSB in the control group. We did not also encounter any lesbian sexual orientation in this study. The distribution of HRSB amongst the migrant oil workers showed that the commonest variety was bisexuality (closet homosexuality) with 10(43.5%) followed by high-risk sexual behaviour 7(30.4%), while the least common was multiplicity of sexual partners with 6 (26.1%). Furthermore, majority of these individuals 19 (82.6%) were above the age of 35 years. The index of condom-use and acceptance was high. Here 14 (60.9%) found condom-use convenient while 13 (56.5%) regularly used the condom. CONCLUSION: This study confirms the existence of HRSB among migrant oil workers in the Niger delta. It is therefore advisable to focus interventionist and prevention programmes on this group which appear to be pivotal in the transmission and spread of HIV/AIDS in this environment.

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.

Splenic changes in sickle cell anaemia.

BACKGROUND: The spleen is one of the most frequently affected organ in Sickle cell anaemia (SCA). This has been attributed to its complex anatomy and prominent reticuloendothelial functions which include clearance of unwanted particulate matter in blood ( culling), defense against infection and reservoir for blood cells. This paper aims to highlight the current information on the changes that occur in the spleen of Sickle Cell Disease patients in this environment. METHOD: A review of relevant literature on the subject of splenic changes in Sickle Cell Disease sourced by manual library and medline search. RESULTS: The essential splenic change in SCA is splenomegaly and subsequent shrinkage in size (autosplenectomy), which maybe due to several factors. These include: high levels of irreversible sickle cells, decreased HbF associated with increased intravascular sickling and chronic Malaria infection secondary to hyperplasia of the reticulo-endothelial system and increased antibody production especially IgG and IgM. Finally, the clinical complications of these splenic changes such as increased susceptibility to infection, acute splenic sequestration and hypersplenism are also reviewed in this paper. CONCLUSION: In view of the above changes, it is important to ensure regular monitoring and follow-up in order to prevent complications, recurrent crisis and death.

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.

Adherence to Antiretroviral Therapy among HIV-infected Subjects in a Resource-Limited Setting in the Niger Delta of Nigeria

Since the early days of antiretroviral therapy; adherence has emerged a milestone to success. The objective of this study was to evaluate the factors militating against adherence to antiretroviral therapy among HIV-infected individuals in the resource - limited setting of the Niger Delta of Nigeria. A structured interviewer- administered questionnaire from consecutively recruited 187 HIV-infected patients on combination antiretroviral therapy of two-nucleoside analogue; stavudine and lamivudine and one non-nucleoside (nevirapine) was used. Association between the independent variables and adherence were analyzed using chi square analysis. This study observed an adherence level of 49.2and identified the following as factors associated with nonadherence: cost of antiretrovirals; educational status; medication adverse effect; occupational factors; and high pill burden of prescribed regimen (p 0.05). There is an urgent need for universal access and sustainability of antiretroviral therapy particularly in resource - limited settings. There is need for supervised medication delivery. Efforts should be made towards simplifying the therapeutic regimen to reduce the pill burden and substitution with treatment combination and strategies that minimize negative adverse effects; coupled with the re-intensification of patient's education and counseling

Haematological reference values for healthy adults in Port Harcourt; Nigeria

Background: Published reports of the basic haematological parameters of apparently healthy subjects in Port Harcourt; Nigeria are relatively scanty. This has resulted in an apparent unavailability of laboratory reference values for haematological parameters for the population. Aim: To determine the reference values of some basic haematological parameters in apparently healthy adult subjects in Port Harcourt; Nigeria. Methods: Two hundred and fifty apparently healthy adults consisting of 150 males and 100 females; aged between 15 and 55 years; residing in Port Harcourt were randomly selected via a cross sectional prospective study. The following haematological parameters were determined by the indicated methods: haematocrit (Hct) was determined using Hawksley micro-capillary centrifugation; haemoglobin concentration (Hbc) was determined using the cyanmethaemoglobin method; red blood cell count and white blood cell count were both determined manually using the improved Neubauer counting chamber; mean corpuscular volume (MCV); mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were calculated from the appropriate haematological parameters; erythrocyte sedimentation rate (ESR) was determined using the Westergren method. Results: The reference values; modes and ranges of all haematological parameters determined are presented. The mean values of haematocrit; haemoglobin concentration; red blood cell count; white blood cell count; mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) were found to be significantly higher in male subjects; while the mean values of mean corpuscular haemoglobin concentration (MCHC) and ESR were found to be significantly higher in female subjects (p 0.05). Conclusion: The present study reports reference values of basic haematological parameters for healthy adult residents of Port Harcourt; Nigeria. Significant gender variations possibly exist in the basic haematological parameters of the population under investigation

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.

An evaluation of the Beckman-Coulter AcT 3-part differential haematology analyzer in a tertiary hospital laboratory.

BACKGROUND: The Beckman-Coulter AcT differential haematology analyzer was evaluated to compare its haemoglobin (HGB), haematocrit (HCT), platelet (PLT), total white cell count (WBC) values and differential leukocyte count (DLC) with the reference manual methods used in our laboratory. METHODS: Samples drawn into 5 millilitres k3 EDTA bottles were selected on a random basis from our routine workload over a 4-week period. Fifty patient samples were analyzed on the AcT diff Coulter analyzer. The same patient samples were then reanalyzed using the reference manual method for comparison. Haemoglobin (cyanmethhaemoglobin method), haematocrit (micro-haematocrit method), total WBC (Turk's Method), platelet (Brecker-Cronkite method) were carried out and blood films were stained with leishman stain, and a 100-cell manual differential count was performed under oil immersion. RESULTS: The Beckman Coulter AcT 3 diff haematology analyzer was shown to have excellent precision and accuracy for HGB and HCT with coefficient of correlation > 0.974. WBC and PLT had low coefficient of correlation of 0.208 and 0.034 respectively. The DLC parameters was shown to have good correlation coefficients for neutrophils > 0.876 and lymphocytes > 0.84. Monocytes showed a low correlation of 0.082 without clinical significance. CONCLUSION: The clinical sensitivity of the instrument in relation to the population evaluated was good. In all, the study results indicate that the AcT 3-part haematology analyzer could improve the overall laboratory productivity with flagged abnormal results being confirmed by the manual reference method.