Bacterial Contamination of Blood and Blood Components: Reducing the Risks in Nigeria

Introduction: Administration of blood and blood products is very life-saving. However, the safety of blood transfusion in resource-limited nations is questionable unlike in many developed nations of the world. The risk of viral transmission has been significantly curtailed, but bacterial transmission and infection continue to be a significant challenge in transfusion medicine. Bacterial screening is not usually carried out on platelets and other components of blood in Nigeria except on rare occasions after transfusion reaction due to bacterial contamination is highly suspected. Aims: To discuss the risk of bacterial contamination of blood components in a resource-limited setting like Nigeria and measures that can be instituted to reduce it. Results: the sources and risks of bacterial blood contamination in Nigeria were reviewed and discussed as well as steps that can be taken to limit such. Conclusion: Bacterial screening of blood and blood components prior to administration is rarely done in Nigeria and since the donor's arm is the primary potential source of contamination, efforts should be made to have a pool of altruistic non-remunerated blood donor to limit the risk.

Association of Plasma Lead with Iron Indices and Complete Blood Count among Male Bricklayers in Ibadan, Oyo State.

Background: Analysis of cement dust by various investigators has revealed that its contents include mercury (Hg), copper (Cu), chromium (Cr), cadmium (Cd), Nickel (Ni), Manganese (Mn) and lead (Pb). Few studies done among cement factory workers in Nigeria showed conflicting results in haematological parameters which could not be related to any particular heavy metals. This necessitated the need for this study. Objective: This study aims to relate lead level with iron indices and complete blood count among bricklayers. Methods: Comparative cross sectional study among 45 bricklayers and 45 age and sex matched tailors. Questionnaire was administered to find out occupational practice. Plasma was analyzed for lead by Atomic Absorption spectrometer (AAS) while serum was analyzed for ferittin and iron by ELISA and photometric method respectively. Total Iron Binding Capacity (TIBC) and percentage Transferin saturation (%TFS) were derived by calculation while complete Blood Count (CBC) was determined using a Sysmex Kx21 auto-analyser. Results: Eighty seven percent of the bricklayers practice their profession without protective coverings. There was a significant increase in the plasma level of lead (p=.00) but decrease in ferrittin among bricklayers compared with controls (p=.00). Bricklayers with blood lead level above acceptable level (5 µg/dl) had significantly reduced ferittin (p=0.04). Conclusion: In this study showed a relatively lower serum ferritin level among bricklayers which was more pronounced with increasing lead level. This may suggest depletion of iron store with increasing lead level. The use of protective measures such as gloves, facemasks and protective garments when in contact with cement and regular medical checkups to prevent depletion of iron store and its consequences are hereby suggested.

Evaluation of Protein C in Nigerian Patients with Sickle Cell Anaemia in Steady State.

Background: Sickle cell disease which is considered to be a hypercoagulable state has a worldwide distribution. Protein C is a naturally occurring anticoagulant with anti inflammatory and fibrinolytic properties. Objective: To evaluate the level of Protein C in Nigerian Patients with sickle cell anaemia (SCA) in steady state. Methods: This is a comparative cross sectional study carried out in Ibadan on 40 HbSS patients in steady state attending Haematology clinic at University College Hospital, Ibadan and 40 age and sex matched healthy normal HbAA control. Protein C was assayed with Amax Destiny Coagulometer using clot based method. Liver function test (LFT) was done with Hitachi 912. Results: A significant decrease in Protein C was found in HbSS patients in steady state (median value 62.8%) compared with HbAA control Subjects (74.6%) (p = 0.00). There was no significant difference in the LFT of the HbSS patients and the control HbAA subjects, P > 0.05 in all the parameters measured. (Alanine Transaminase (ALT), P = 0.82; Albumin, P = 0.12; Total Protein, P =0.37). Conclusion: The low Protein C level observed in HbSS patients in steady state may not be due to hepatic dysfunction as LFT in the subjects were found to be normal.

A Cross-sectional Survey of the Willingness of Tertiary Hospital Staff to Donate Blood in Sagamu, Nigeria

Background: Available donor blood rarely meets the demand in sub-Saharan Africa due to obstacles to blood donation. Willingness to donate blood is adjudged an important step to the actual practice of donating blood.Objective: To assess the willingness of the members of staff of the hospital to donate blood and determine factors affecting their willingness or otherwise.Methods: This was a descriptive cross-sectional study. A proportional allocation of participants was carried out at the various departments in the hospital using self-administered questionnaire. Results: Overall, 183 (73%) of the 246 respondents expressed willingness to donate blood, 111(45%) of whom have been asked to donate blood in the past. Only 91(37%) had donated blood in the past. Significantly higher proportion of health staff showed the willingness to donate blood generally and voluntarily compared to non-health staff. Significantly higher proportion of respondents with tertiary education showed the willingness to donate blood. Two hundred and eighteen (88.8%) were willing to donate blood to help the patient in need while fear of exposure to HIV infection, needle prick and dizziness constituted the major factors discouraging blood donation (19.9%, 18.7% and 18.3% respectively.Conclusion: Willingness to donate blood was mostly based on the primordial motivation of helping the patient in need which does not translate to blood donation. There is a need to improve awareness and advocacy on blood donation among hospital staff and the general population

Challenges of pancreatic cancer management in a resource scarce setting

Backgrounds: Of all forms of gastrointestinal malignancy; adenocarcinoma of the pancreas is associated with the worst survival. Management of pancreatic cancer is associated with some challenges. This study is aimed at determining the hospital incidence; sociodemographic characteristics; managements and management's outcome of carcinoma of pancreas at our hospital. We also discuss the management challenges encountered with these patients. Material and methods: We reviewed 96 pancreatic cancer patients seen at Awolowo University Teaching Hospital Complex; Ile -Ife; Nigeria; from July 1989 to July 2007. Results: There were ninety six patients diagnosed with cancer of the pancreas but only 80 patients had histological proof of pancreatic cancer. This account for 2.1of all malignancies seen and 238/100000 total admissions during the study riod. The median age is 55.0. There were 62 (64.6) male and 34 (35.4) female with male to female ratio been 2:1. Duration of symptoms in the patients ranges from 4 weeks to 109 weeks. Only three (3.1) patients has mor located in a particular anatomical sub site: two head of pancreas and one tail of the pancreas. Other patients had extensive tumor involving the head and body of the pancreas. Two patients had creaticoduodenectomy; one had resection of the tumor at the tail of pancreas and 45 patients had triple bypass. Patients with low serum albumin and serum sodium and elevated transaminases at presentation; had poorer prognosis than other patients. Conclusion: Pancreatic cancer is not uncommon in our center with male preponderance. Most patients present with advanced condition only amenable to palliative measures. There are significant challenges in the area of diagnosis; screening; treatment and research