Is Human Immunodeficiency Virus Still Transmissible Through Blood Transfusion in Children with Sickle Cell Anaemia in Jos, Nigeria.

Aims: To compare the prevalence of HIV infection amongst transfused and non-transfused children with sickle cell anaemia (SCA) in Jos, Nigeria and explore the factors affecting it. Study Design: This was a prospective case control study. Place and Duration of Study: Department of Paediatrics (Sickle Cell Clinic), Jos University Teaching Hospital, Jos, Nigeria, between January 2008 and March 2009. Methodology: A total of 200 transfused children with SCA (117 males and 83 females) were recruited consecutively and screened for HIV using rapid test kits. A questionnaire was used to ascertain the details of blood transfusion and other relevant clinical information. Two hundred age and sex matched non-transfused children with SCA attending the same clinic were recruited as controls. Results: The prevalence of HIV infection amongst transfused children with SCA was 2%, compared to 0% in the control group (P=.04). The four HIV positive cases were transfused in private hospitals with blood of unknown screening status. The number of blood transfusions was not a significant factor in acquiring HIV infection (P=.78); however remunerative blood donation increased the risk of acquiring HIV through blood transfusion (AOR=6.28; 95% CI (1.82-9.92); P=.01). Conclusion: HIV is still transmissible through blood transfusion and screening of blood before transfusion is still not completely practiced in Jos, Nigeria. Policies on proper screening of blood before transfusion and voluntary blood donation should therefore be enforced at all levels of healthcare.

Diabetes Co-existing with Chronic Liver Disease : Clinical Features and Reponse to Therapy

Background and objectives : Diabetes mellitus (DM) and chronic liver disease (cirrhosis) may co-exist in the same individual. Diabetes may cause non-alcoholic steatohepatitis with necroinflammatory changes and granuloma formation leading to hepatic fibrosis. Cirrhosis of the liver from alcohol and hepatitis C infection; on the other hand; may give rise to insulin resistance or may result in progressive impairment of insulin secretion leading to DM. We studied the clinical features and response to therapy of diabetic patients with the two conditions to determine if there are differences in the clinical features and effects of the chronic liver disease (CLD) on the management of DM. Methods: This was a prospective study conducted at the Diabetes Clinic at the Jos University Teaching Hospital (JUTH) over a period of two years. Newly diagnosed diabetics with features of CLD (cirrhosis) were enrolled into the study after obtaining a consent. Age; sex; body mass index (BMI); family history of diabetes were recorded; as well as symptoms and signs of DM or CLD. Serum fasting blood glucose (FBS); prothrombin time ratio (PTR); and serum fasting lipids (serum lipoproteins and serum triglycerides) were measured. Urinalysis was done. The responses to therapy were classified as very rapid; rapid and gradual based on our previous unpublished observations that diabetic patients with CLD responded briskly to antidiabetes therapy. Result : 26 patients (19 men; and 7 women) were seen with both diseases agreed to participate in the study. This accounted for 8.6of the diabetic population attending the diabetes clinic. The mean age of the patients was 54.6 (9.2 ) years spanning a range of 34-75 years. Mean BMI was 21.6 (6) kg/m2. The mean serum albumin concentration was 25.5 (8.5) g/l; mean FBS was 15.5 (3.4) mmol/l and PTR was 1.6 (0.43). Urinalysis showed glycosuriain all patients with only one patient showing trace of ketonuria. Clinical features of DM and CLD were few each. There was a brisk response to insulin therapy so that one needs to be cautious with insulin administration.Conclusion : Diabetes in patients with CLD has similar but fewer features compared to patients with type 2 DM. CLD affects the response to therapy; particularly insulintherapy and calls for caution; as these patients may be sensitive to therapy

Familial polycystic kidney disease in Nigeria: A report of two cases

A case of familial polycystic kidney disease is reported. Although isolated cases of adult polycystic kidney disease have been reported in our environment; no case to our knowledge has been reported with a familial link. Polycystic kidney disease is said to be rare in Africans. Although it commonly terminates in chronic renal failure; it hardly features in the aetiopathogenesis of end stage renal disease requiring some form of renal replacement therapy in African series. This; some workers believe may be due to misdiagnosis and under reporting. This report is to show that it may not be as rare as suspected; and that the familial link shown in the advanced countries is also applicable here. Case 1 was diagnosed in the course of evaluation of her clinical disease. Case 2; an aunt of Case 1; was diagnosed following investigation of a casual complaint of a painless abdominal mass in the wake of her senior brother's death from haemorrhagic stroke