Anémie chez les donneurs de sang volontaires après vérification de l'hémoglobine pré-don au Centre de Transfusion Sanguine de Libreville / Anemia in voluntary blood donors after verification of pre-donation hemoglobin at the Libreville Blood Transfusion Center

Introduction : La nécessité de disposer de produits sanguins labiles (PSL) de qualité est un impératif de la transfusion sanguine. Le don de sang n'est pas sans risque pour le donneur. Ce qui soulève la question de la perte de fer par spoliation sanguine. Ce constat a conduit à la réalisation de cette étude dans le but de rechercher l'anémie chez le donneur de sang volontaire jugé apte après évaluation de l'hémoglobine pré-don et d'en déterminer la cause. Patients et méthodes : Il s'agissait d'une étude transversale prospective réalisée au Centre National de Transfusion Sanguine (CNTS) de Libreville. La population d'étude était constituée de donneurs de sang, nouveaux ou anciens, volontaires en bonne santé chez qui les examens suivant ont été réalisés pour le diagnostic de l'anémie et celui de la carence en fer tout en excluant d'autre étiologies: l'hémogramme, le dosage de la Protéine C Réactive (CRP), le fer sérique, la ferritine, l'hepcidine et le test de diagnostic du paludisme (TDR).Résultats : Sur l'ensemble des deux cent quinze volontaires inclus, trente - quatre (15,8%) présentaient une anémie parmi lesquels douze femmes et vingt- deux hommes d'un âge moyen de 32,8 ±8,0. Le nombre de dons effectués était corrélé à la survenue de l'anémie selon le genre et l'âge du donneur. Il en a été de même pour les valeurs de la ferritine, du fer sérique.Conclusion : Le nombre important d'anémie est lié à un seuil bas de l'hémoglobine pré-don. Le caractère microcytaire hypochrome de l'anémie laisse supposer une origine ferriprive.

Introduction: The need to have quality labile blood products (LBP) is an imperative of blood transfusion. Blood donation is not without risk for the donor. This raises the question of the loss of iron by blood spoliation. This finding led to the realization of this study with the aim of looking for anemia in voluntary blood donors deemed suitable after evaluation of the pre-donation hemoglobin and to determine the cause.Patients and methods: This was a prospective cross-sectional study carried out at the National Blood Transfusion Center (CNTS) in Libreville. The study population consisted of blood donors, new or old, healthy volunteers in whom the following examinations were carried out for the diagnosis of anemia and that of iron deficiency while excluding other etiologies: blood count, C-Reactive Protein (CRP), serum iron, ferritin, hepcidin and malaria diagnostic test (RDT). Results: Of the two hundred and fifteen volunteers included, thirty-four (15.8%) presented anemia, including twelve women and twenty-two men with an average age of 32.8 ±8.0. The number of donations made was correlated with the occurrence of anemia according to the sex and age of the donor. It was the same for the values of ferritin, serum iron. Conclusion: The large number of anemia is linked to a low threshold of pre-donation hemoglobin. The hypochromic microcytic character of the anemia suggests an iron deficiency origin.

Cord blood haemoglobin and ferritin concentrations in newborns of anaemic and non-anaemic mothers in Lagos, Nigeria

Background: Pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers were determined, and cord blood haemoglobin and serum ferritin concentrations of their newborns were compared. This is to establish the mean values for pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers and the cord blood haemoglobin and serum ferritin concentrations of their newborns at term. Materials and Methods: A case­control study was done involving 142 pregnant women and their newborns. They were divided into two groups - the anaemic group (n = 65) and the non-anaemic (n = 77) group. Five millilitres of blood was collected from each woman and 2 ml was collected from the cord of their newborns into ethylenediaminetetraacetic acid (EDTA) bottle and plain bottle for full blood count analysis and ferritin assay, respectively. Results: The mean pre-delivery haemoglobin concentrations of the women in anaemic group and non-anaemic group were 9.5 ± 1.01 g/dl and 12.15 ± 1.07 g/dl, respectively, and their mean serum ferritin concentrations were 64.45 ± 138.76 µg/l and 32.83 ± 35.36 µg/l, respectively. The mean cord blood haemoglobin concentrations for anaemic and for non-anaemic groups were 12.54 ± 2.54 g/dl and 13.44 ± 2.23 g/dl (P = 0.02), respectively, and the mean cord blood serum ferritin concentrations (non-anaemic, 69.38 ± 78.88 µg/l; anaemic, 7.26 ± 115.60 µg/l) (P = 0.00) were higher in the newborns of non-anaemic than of anaemic mothers. Significant association was found between maternal anaemia and cord blood ferritin concentrations (P = 0.025). Conclusion: Maternal anaemia has significant effects on cord blood haemoglobin and serum ferritin concentrations

Beta thalassaemiatriat in Western Nigeria

Background: Genes for thalassaemia; haemoglobin S; Glucose-6-phosphate dehydrogenase which confer resistance to malaria are found in high frequencies in Nigeria; 25of the population being carriers of the sickle cell trait while another 25are hemizygous for the G6PD gene. The frequency of alpha thalassaemia is equally high among Nigerians but there is little information on beta thalassaemia in this population. A recent study however suggest a high prevalence of beta thalassaemia in the same population; hence the need for this study. Methods: Haemoglobin A2 and HbF were determined in healthy adults who have haemoglobin A genotype by elution after electrophoresis and alkaline denaturation methods respectively. Results: The mean HbA2 among the subjects was 3.3(range 2.0-5.6) while the mean HbF was 2.6(range 0.4-8.8). Twenty-six percent of the subjects had HbA2 values higher than 3.9while 86had HbF values greater than 1; twenty-four percent had elevated HbA2 and HbF. The mean HbA2 value was 2.7among those with HbF 1; 3.6among those with HbF 1-3and 3.1among those with HbF 3. Conclusion: These findings confirm that the frequency of beta thalassaemia in western Nigeria is higher than previously thought and that many of the individuals studied may be silent carriers of the beta thalassaemia trait. Its presence may also have been masked by the high prevalence of alpha thalassaemia in the same environment. It is therefore important to consider beta thalassaemia trait as a differential diagnosis in patients who present with haemolytic anaemia in this environment

Fetal hemoglobin during infancy and in sickle cell adults

Background: Fetal hemoglobin has been implicated in the modulation of sickle cell crisis though it is functional during infancy. Objective:The purpose of this study was to determine the waning time of fetal hemoglobin (HbF) and its persistence in later life. Method: Ninety infants aged 0-12 months; admitted at hospital; were tested for their HbF levels.Adult patients numbering 690 were also examined for their sickle cell status and a sickle positive patient of SS type with HbF had her family members recruited and their sickle cell types determined. Results:The results revealed that HbF was highest (98) at birth; decreasing at 5per week till 6 months when it wane off.Ten infants aged 6 -12 months had HbF persisting at a level of 10or more.Adult patients examined showed proportions of their sickle cell types as AS forming 51;AC 20; SS 19; and SC 10.An SS adult patient with mild sickle cell crisis had an ASF father who had no crisis and a mother and brother with AS each who had severe crisis. Conclusion:These findings suggest that HbF wanes off during infancy but persist in some adults and may modulate crisis in these adults.This has implications in sickle cell management