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

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

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