Sustainability of newborn screening for sickle cell disease in resource-poor countries: A systematic review.

Sickle cell disease (SCD) is a worldwide genetic blood disorder. Roughly 400,000 babies are born with SCD each year worldwide. More than 75% of these births occur in sub-Saharan Africa. The establishment of sustainable newborn screening NBS programs is an excellent approach to improving the health of persons living with SCD. The need to set up such programs in Africa cannot be overemphasized. However, initial implementation does not guarantee sustainability. More than 500 children with sickle cell anaemia (SCA) die every day due to lack of access to early diagnosis and related treatment. We systematically highlighted suggestions proffered so far, for the sustainability of NBS in low income, high burden countries. We searched online databases, PubMed, and Google Scholar for literature on sustainability of newborn screening (NBS) published between 2012 and 2022. Articles were included if they reported as outcome; sustainability, government participation, scaling up and expansion of NBS, improved patient enrolment in the newborn screening programe. Articles not suggesting same were excluded. Data were extracted from published reports. Primary outcome was government participation and enhanced patient enrolment in the NBS programe. Thematic content analysis was applied using inductive and deductive codes. We came up with 9 major themes. This study is registered with PROSPERO with registration number as CRD42023381821. Literature search yielded 918 articles (including manual searching). After screening, nine (9) publications were suitable for data extraction and analysis. Two more articles were added by manual searching, making a total of eleven (11) articles. The most frequently addressed core elements of sustainability in these papers were complete integration of services into national health care systems for sustainability of NBS programs in Low-income high-burden countries, funding and engagement from government partners from the very beginning of program development should be prioritized. Screening should be tailored to the local context; using DBS on HemoTypeSC could be a game changer for scaling up and expanding the newborn screening program in Sub-Saharan Africa.

Analysis of haematological effects of Picralima nitida.

The protective effects of the leaf powder of Picralima nitida in male rats were evaluated to establish its haematopoietic potential. To achieve this, albino rats (n = 30), weighing 120 - 160g were grouped into 5, labelled A to E. Groups C and D were intraperitoneally induced for anaemia with 0.1mg/kg body weight (b.wt) of phenyl hydrazine for 7 day. Groups A and B and C and D orally received 200 and 400 mg/kg b.wt of Picralima nitida leaf extract respectively for 14 days. Group E served as the control. Blood sample (5.0ml) was collected from each rat on days 8 and 15 and dispensed into ethylene diamine tetra acetic acid containers for haemogram using haematology auto analyser. The result showed that on day 8, Picralima nitida leaf extract produced a significant (P<0.05) increase in haemoglobin (Hb) and haematocrit (Hct) when compared with the control. On day 15, Picralima nitida leaf extract produced a significant (P<0.05) increase in the red blood cell (RBC), Hb and Hct when compared with the experimental control. The results indicate time-dependent haematopoiesis.

Assessment of hepatic functions, hematopoietic cytokines and haematological parameters in people occupationally exposed to volatile petroleum hydrocarbons.

Humans are occupationally exposed to volatile petroleum hydrocarbons through inhalation and ingestion. To access the effect of exposure to volatile hydrocarbons, hematopoietic cytokines, haematological parameters and hepatic functions were assayed for in 100 subjects. Male participants showed significant increase (p < 0.05) in erythropoietin, interleukin-3, alanine transaminase (ALT), alkaline phosphatase (ALP), mean cell hemoglobin concentration (MCHC), mean cell volume (MCV) and significant decrease (p < 0.05) in mean cell hemoglobin (MCH). Female participants showed significant increase (p < 0.05) in interleukin-3, ALT, AST, ALP, MCHC, MCV and significant decrease (p < 0.05) in MCH, platelets, hemoglobin and hematocrit compared to their controls. Exposure to volatile petroleum hydrocarbons raised the absolute red blood cell indices and liver enzymes and could stimulate combined increase in the release of erythropoietin and interleukin-3 leading to ineffective hematopoiesis.

Ahaptoglobinaemia in a Nigerian Cohort.

Ahaptoglobinaemia have been indicated in blacks from West Africa. Owing to the clinical and biologicimportance of haptoglobin (hpt), this work explores the situation in a Nigerian cohort since there are no published values ofhaptoglobin levels of individuals in this locality. The study was aimed at determining the amount of haptoglobin in the bloodof normal healthy Nigerians. Haptoglobin was quantitatively estimated in one hundred and fifty-two apparently healthyindividuals using highly sensitive immunoassay technology. Blood grouping and haemoglobin genotype were assayed forall subjects to know if they influence haptoglobin levels. The association between haptoglobin and blood group was alsoestablished. Serum levels of haptoglobin among all subjects analyzed revealed a marked decrease in their haptoglobin levelswhen compared to other reference intervals. A further association between haptoglobin and gender did not reveal a statisticalsignificant relationship (p>0.05). However, there was a significant different when haptoglobin levels of different bloodgroups and haemoglobin genotype when compared. Our data suggest that serum levels of haptoglobin are significantly lowerin healthy Nigerians. The lower limit was remarkably lower than the internationally acceptable Caucasian reference rangesuggesting a clear necessity for establishing reference African values.

The relationship between serum cortisol, adrenaline, blood glucose and lipid profile of undergraduate students under examination stress.

BACKGROUND: Stress is an extremely adaptive phenomenon in human beings and cortisol is a known stress hormone. Examination has been described as a naturalistic stressor capable of affecting human health. OBJECTIVES: To estimate the relationship between serum cortisol, adrenaline, fasting blood glucose (FBG) and lipid profile during examination stress. METHODS: Two hundred and eight (208) apparently-healthy undergraduate students (aged, 24 ± 6 years) were involved in the study. Exactly 5 mls of venous blood was collected from each subject 1-3 hours before a major examination. A second assessment was done on the same students 3-4 weeks before any examination (control samples). Cortisol and adrenaline were assayed using ELISA techniques, FBG was assayed using enzymatic method while lipid parameters were assayed using standard enzymatic-spectrophotometric methods. RESULTS: There was statistically significant increase in serum cortisol, adrenaline, Total cholesterol, HDL-cholesterol and LDL-cholesterol levels in students under examination stress compared to the non examination period (p=0.001, 0.013, 0.0001, 0.0001 and 0.0001, respectively). FBG showed no significant increase. There was also significant positive correlation (r=0.297, p=0.032) between serum cortisol and TC/HDL ratio (cardiac risk factor) before examination stress but not during the stress period. CONCLUSIONS: Significant positive correlation was observed between cortisol and TC/HDL ratio before examination stress.

Myeloprotective activity of crude methanolic leaf extract of Cassia occidentalis in cyclophosphamide-induced bone marrow suppression in Wistar rats.

BACKGROUND: Myelosuppression is the most common dose-limiting side effect of chemotherapy. Cassia occidentalis plays a vital role in preventing health disorders, but its hematological effects have not been documented much. This study is designed to investigate the myeloprotective activity of the crude methanolic leaf extract of C. occidentalis in cyclophosphamide-induced bone marrow suppression. MATERIALS AND METHODS: Twenty-eight Wistar rats aged two to three months, weighing 120-170 g were used for the study. The rats were divided into four groups of seven rats each, labeled A to D. Groups A and B were administered with 3 mg/kg of cyclophosphamide intraperitoneally daily for three days to induce bone marrow suppression, after which groups B and C were orally fed with 250 mg/kg body weight of the crude leaf extract once daily for 14 days. Group D served as control without receiving the extract. On Day 15, blood samples (3.0 ml) were collected from each rat through the retro-orbital plexus of the median canthus into K3-EDTA containers for hematological analysis using standard operative procedures. Data were analyzed with Pearson's correlation test and multivariate analysis of variance using Statistical Package for Social Sciences (SPSS) version 17 and results were expressed as mean ± SD. The level of significance was determined at 95% confidence level. RESULTS: Myelosuppression was achieved in Group A rats. Group B rats showed a significant increase in hemoglobin (Hb), hematocrit (Hct), and total white blood cell count (TWBC) compared with Group A. The Group C rats revealed a significant increase (P < 0.05) in Hb, Hct and TWBC when compared with control. CONCLUSIONS: Crude methanolic leaf extract of C. occidentalis may possess myeloprotective properties when orally administered in cyclophosphamide-induced bone marrow suppression.