The magnitude and associated factors of coagulation abnormalities among liver disease patients at the University of Gondar Comprehensive Specialized Hospital Northwest, Ethiopia, 2022.

BACKGROUND: Liver disease is any condition that affects the liver cells and their function. It is directly linked to coagulation disorders since most coagulation factors are produced by the liver. Therefore, this study aimed to assess the magnitude and associated factors of coagulation abnormalities among liver disease patients. METHODS: A cross-sectional study was conducted from August to October 2022 among 307 consecutively selected study participants at the University of Gondar Comprehensive Specialized Hospital. Sociodemographic and clinical data were collected using a structured questionnaire and data extraction sheet, respectively. About 2.7 mL of venous blood were collected and analyzed by the Genrui CA51 coagulation analyzer. Data were entered into Epi-data and exported to STATA version 14 software for analysis. The finding was described in terms of frequencies and proportions. Factors associated with coagulation abnormalities were analyzed by bivariable and multivariable logistic regression. RESULT: In this study, a total of 307 study participants were included. Of them the magnitude of prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) were 68.08% and 63.51%, respectively. The presence of anaemia (AOR = 2.97, 95% CI: 1.26, 7.03), a lack of a vegetable feeding habit (AOR = 2.98, 95% CI: 1.42, 6.24), no history of blood transfusion (AOR = 3.72, 95% CI: 1.78, 7.78), and lack of physical exercise (AOR = 3.23, 95% CI: 1.60, 6.52) were significantly associated with prolonged PT. While the presence of anaemia (AOR = 3.02; 95% CI: 1.34, 6.76), lack of vegetable feeding habit (AOR = 2.64; 95% CI: 1.34, 5.20), no history of blood transfusion (AOR = 2.28; 95% CI: 1.09, 4.79), and a lack of physical exercise (AOR = 2.35; 95% CI: 1.16, 4.78) were significantly associated with abnormal APTT. CONCLUSION: Patients with liver disease had substantial coagulation problems. Being anemic, having a transfusion history, lack of physical activity, and lack of vegetables showed significant association with coagulopathy. Therefore, early detection and management of coagulation abnormalities in liver disease patients are critical.

Human blood platelets and viruses: defense mechanism and role in the removal of viral pathogens.

Platelets are small non-nucleated cell fragments and the second most abundant cell that play crucial role in managing vascular integrity and regulating hemostasis. Recent finding shows, beyond its hemostatic function platelets also play a main role in fighting against pathogen including viruses. With their receptors, platelet interacts with viral pathogen and this interaction between platelets and viral pathogens result in activation of platelets. Activated platelet releases different molecules that have antiviral activity including kinocidins and other platelet microbicidal peptides. In addition, activated platelet has antiviral role by different mechanism including; phagocytosis of viral pathogen, produce reactive oxygen species and interact with and activate other immune cells. In other side, antiplatelet treatments are one of defending mechanism of viral pathogen. This narrative review summarizes what is known regarding the role of human platelets in fighting viral pathogen.

Basic Coagulation Profiles and Platelet Count Among Schistosoma mansoni-Infected Adults Attending Sanja Primary Hospital, Northwest Ethiopia.

PURPOSE: To assess basic coagulation profiles and platelet count among Schistosoma mansoni-infected and non-infected adults. PATIENTS AND METHODS: A comparative cross-sectional study was conducted from February to April 2019 at Sanja Primary Hospital, northwest Ethiopia. A total of 200 adults (100 cases and 100 controls) were enrolled using convenient sampling technique. Both wet mount and Kato-Katz techniques were performed using a stool sample. The venous blood sample was collected to perform platelet count, basic coagulation and serological tests. The data were coded and entered into EpiData Manager (v4.4.2.1) and analyzed using SPSS version 20. Nonparametric tests were used during data analysis. P-value less than 0.05 was considered as statistically significant. RESULTS: Prothrombin time (PT), activated partial thromboplastin time (APTT) and international normalization ratio (INR) were significantly higher while the platelet count was significantly lower in S. mansoni-infected than healthy adults (P <0.001). There were statistically significant differences in the median [IQR] value of PT, APTT, INR and platelet count between light, moderate and heavy infected groups (P <0.05). Infection intensity had a positive correlation with basic coagulation profiles and a negative correlation with platelet count (P <0.05) of S. mansoni-infected adults. CONCLUSION: The prevalence of coagulation abnormality was higher in S. mansoni-infected adults than healthy controls. Coagulation test and platelet count should be used to monitor and manage schistosomiasis-related complications.

Basic Coagulation Parameters among Human Immunodeficiency Virus-Infected Adults in Gondar, Northwest Ethiopia: A Comparative Cross-Sectional Study.

OBJECTIVE: We aimed at assessing the basic coagulation parameters of HIV-infected adults at the University of Gondar Hospital antiretroviral therapy clinic. METHODS: A comparative cross-sectional study was conducted from February to May 2017. A total of 300 study participants, consisting of 100 HAART-naïve HIV-infected adults, 100 HIV-infected adults who were taking HAART, and 100 HIV-seronegative apparently healthy adults, were included. Basic coagulation functional assays such as PT, APTT, and INR were determined by coagulation analyzer. CD4 cells and platelet count were analyzed by FACS count and SYSMEX K-21N automated analyzer, respectively. The data were entered, cleaned, and edited using Epi Info version 7 and analyzed using SPSS version 20. Kruskal-Wallis H, Dunn-Bonferroni pairwise comparison test, and Spearman's rank-order correlation analysis were used for inferential statistics. The results were expressed by a median and presented in tables. P value < 0.05 was considered as statistically significant. RESULTS: PT, APTT, and INR were significantly higher, whereas platelet count was significantly lower in HIV-infected adults (both who were taking HAART and HAART-naïve) than HIV-seronegative adults (P < 0.001). PT and INR were significantly higher, and platelet count was significantly lower in HAART-naïve HIV-infected adults than HIV-infected adults who were taking HAART. In Spearman's rank-order correlation analysis, APTT has shown a significant negative correlation with a CD4 count in HAART-naïve HIV-infected adults. CONCLUSION: HIV-infected adults are more likely to develop coagulation abnormality than HIV-seronegative subjects. Coagulation parameters need to be checked regularly to monitor coagulation disorders in HIV-infected adults.

Prevalence of anemia and associated factors among school children in Gondar town public primary schools, northwest Ethiopia: A school-based cross-sectional study.

BACKGROUND: Anemia is a global public health problem affecting 305 million school children (SC) worldwide. It has deleterious effects in SC, including lower school achievement due to impaired cognitive development and physical growth, fatigue and poor attention span, and increased morbidity because of reduced resistance to infection. Hence, the aim of this study was to assess the prevalence and associated factors of anemia among SC attending public primary schools in Gondar town, northwest Ethiopia. METHODS: A school-based cross sectional study was conducted on a total of 523 SC aged from 6-14 years old. Multi-stage sampling followed by systematic random sampling techniques were employed to select study participants. Data on socio-demographic and socio-economic characteristics, and dietary status of children were collected using pre-tested structured questionnaire through face-to-face interview of children's caregivers. Anthropometric measurements were taken. Hemoglobin (Hb) concentration was determined by using HemoCue 301+analyser. Stool and blood samples were collected in the school premises, and examined for intestinal and hemoparasites, respectively. Data were entered into Epi Info version 3.5.3 and transferred to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression models were fitted to identify associated factors of anemia. P-value < 0.05 was considered as statistically significant. RESULT: Of the total SC participated in the study, 269 (51.4%) were males. The median (inter quartile range (IQR)) age was 12 (10-13) years, and 332 (63.5%) of them were in the age group 11-14 years. About 81 (15.5%; 95%CI: 12.4%, 18.7%) of them were anemic: 56 (69.1%) and 25 (38.9%) of them were mildly and moderately anemic, respectively. Low maternal education (AOR = 2.30; 95%CI: 1.11, 4.78), stunting (AOR = 2.22; 95%CI: 1.30, 3.80), severe food insecurity (AOR = 5.11; 95%CI: 1.53, 17.13), and soil-transmitted helminthic (STH) infection (AOR = 7.13; 95%CI: 3.16, 16.86) were found significantly associated with anemia. CONCLUSION: Anemia among SC was found to be a mild public health problem. It was strongly associated with low maternal education, food insecurity, stunting and intestinal helminthic infection. Focused policies and strategies towards the above factors should be designed to reduce anemia among SC.