Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria ­ A multi-facility study of 34 tertiary hospitals

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

Effect of Hepatitis B Virus Co-Infection on CD4 Cell Count and Liver Function of HIV Infected Patients

Background: Human immunodeficiency virus (HIV)and Hepatitis B virus (HBV) share similar routes of transmission; making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naive patients and investigate the effect of co-infection on CD4 count and liver function. Study design: This was a hospital based descriptive cross sectional study of one hundred consecutive therapy-naive HIV-infected individuals. The CD4 count; Hepatitis B surface antigen; Serum albumin; total Protein; and liver enzymes were determined using standard techniques. Results:The prevalence of HIV and HBV co-infection was 37. The mean serum ALT and ALP were significantly higher in the co- infected patients (Pvalues 0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT; AST and ALP of mono and co-infected patients with CD4 count200/?l were significantly higher than those with count ? 200 cells/?l. (p-value of 0.01). The mean ALT and AST of the co -infected patients and all patients with CD4 count 200 cells/?l were higher than the normal reference range. Conclusion : Approximately one third of HIV positive patients had hepatitis B virus co-infection. Coinfection and CD4 count 200 cells/?l are likely to result in abnormal ALT and AST. We recommend that co-infected patients and those with CD4 count 200 cells/?l should be given non-hepatotoxic antiretroviral drug

Postpartum sexual abstinence and breastfeeding pattern in Sagamu, Nigeria

This was a prospective study involving 371 mothers. The mean age of the mothers was 27.5 (.3.6) years with a mean years at school (Educational years) of 11.3 (2.9) years. All the mothers had previously breastfed at one of their infants for at least 6 months, while the mothers also breastfed their last child for an average (mean) of 10.3 (4.0) months. The overall mean of previous live births was 1.9 (0.8). In the first month postpartum, 84.6% of the mothers abstained from sexual intercourse, but by the 4th-5th month the proportion had dropped to 18.1%, with just 2.1% of the study population abstaining from sexual intercourse at 11-15 months post-partum. Forty seven (13.5%), 30 (8.6% ) and 3 (0.9 % ) mothers in social classes 2,3 and 1 respectively have resumed sexual intercourse at 4-5 months, while only 12(3.4%) and 4(1.1%) in social classes 2 and 3 respectively continued with sexual intercourse at 11-15 months. More mothers resumed sexual intercourse from 1 to 15 months post-partum when they breast fed for 6-10 minutes and 11-15 minutes than those who breast fed for 1-5 minutes, 16-20 minutes and 21-25 minutes. Also more mothers within the 25-29 years age group resumed sexual intercourse from the first month to the fifteenth month post-partum than mothers in the other age groups. (Afr Reprod Health 2008; 12[1]:96-100)

Comparative Analyses of Childhood Deaths in Sagamu; Nigeria : Implications for the Fourth MDG

Background. The fourth Millennium Development Goal (MDG) aims at reducing childhood deaths in the developing world by 2015. Objective. To examine the pattern of childhood deaths in a Nigerian tertiary hospital which served at least three states of the federation between 1996 and 2015. Method. A retrospective study of paediatric deaths between January 1996 and December 2005. Subjects admitted in the pre- MDG period were compared with those admitted during the MDG period. Results. Of 10 451 paediatric patients admitted; 1 320 (12.6) died but only 1 225 were studied. The male-to-female ratio was 1.4:1. Although the yearly mortality rate ranged from 10.7to 14.9; the overall mortality rate for the pre-MDG period was similar to that for the MDG period (p=0.135). Most deaths (69.1) occurred within 48 hours of hospitalisation. Of the 1 225 patients who died; 57.3were neonates. These neonatal deaths were commonly due to prematurity (34.6); perinatal asphyxia (30.8) and septicaemia (24.8); while severe anaemia was the most common cause of death among infants (20.1) and toddlers (25.1). Severe malaria; severe anaemia; and tetanus formed 33.3of all deaths among children older than 5 years. There was no significant difference in the role of prematurity (p=0.298) and measles (p=0.927) as causes of death before and during the MDG periods. HIV/AIDS (p=0.046) became more common as a result of the HIV pandemic; while severe malaria (p=0.041) became less common as a cause of death during the same period. Conclusion. The childhood mortality rate remained high over the 10-year study period. The deaths were mostly caused by infectious and other preventable conditions. The utilisation of specific target-orientated interventions; such as integrated management of childhood illnesses (IMCI); and primary health care may reduce the number of childhood deaths before 2015

Clinical trial of pap-salt solution in the treatment of dehydrated children

In a randomised clinical trial; the efficacy of pap-salt solution (PSS) was compared with the WHO oral rehydration salt (ORS) solution in 212 children; aged between six months and five years. All the children who received PSS were successfully treated and there was no difference (p0.05) in the pre- and post-treatment values of the serum electrolytes in the two groups of children. Pap-salt solution was acceptable to the patients; readily available and much cheaper than the ORS solution. PSS is; therefore; recommended for the rehydration of children with mild and some degree of dehydration in situations where ORS solution is not available

Infantile achalasia in Down's Syndrome

A 3-year old girl with clinical features of Down's syndrome presented with persistent vomiting of undigested food and recurrent cough. Although her karyotype was not carried out; radiographs of the pelvis and hands revealed characteristic features of Down's syndrome. An investigative barium swallow to diagnose the cause of the vomiting showed achalasia which is a rare association with Down's syndrome