Current sickle cell disease management practices in Nigeria.

BACKGROUND: Although Nigeria has the highest burden of sickle cell disease (SCD) worldwide, there is still variable and poor utilisation of standard-of-care practices for SCD patients in the country. METHODS: This was a questionnaire survey of doctors in some dedicated SCD clinics in Nigeria in order to document the facilities available and common management practices. RESULTS: There were responses from 18 clinics based in 11 institutions. The number of patients being followed in each centre ranged from 15 to approximately 11 000. All clinics provided malaria prophylaxis and folic acid routinely to their patients. Only eight clinics prescribe penicillin prophylaxis. Eight prescribe hydroxyurea to patients who can afford it when indicated. All of the centres except three have electronic cell counters, but all had access to haemoglobin electrophoresis. Three had high-performance liquid chromatography machines installed but none was being routinely used. One institution had a functioning molecular biology laboratory. There is no official newborn screening programme in the country. All had access to microbiology and chemistry laboratories. Nine institutions had CT, six had MRI and three had transcranial Doppler facilities. CONCLUSION: The care available for SCD in Nigeria is still suboptimal and there is an urgent need for concerted effort to tackle the problem, but to make a significant impact on the burden of the disease would require more focus at the primary care level. Some steps to achieving this are outlined.

Serum Iron and Total Iron Binding Capacity levels among the ABO blood groups in Enugu, South Eastern Nigeria.

Iron deficiency anaemia is a common tropical disease. Iron plays a very important role in the human body. The understanding of the different blood groups ability to retain iron in their system can give an insight into their ability to handle the disease Iron deficiency anaemia. Serum Iron, Total Iron Binding Capacity (TIBC) and Percentage Transferrin Saturation (percentage TS) levels were studied in 2260 apparently healthy Nigerian volunteers in Enugu, Eastern Nigeria. The ABO blood groups of the subjects were also determined. They were aged between 10 and 25 years, males were 1808 and females 452 (M/F ratio- 8:2). In all the results obtained, the females had lower values. Serum iron [microMol/L] was highest in the group A (26.3 +/- 7.2 - males, 18.7 +/- 5.2 -females) and lowest in group 0 (22.0 +/- 4.7 - males, 15.6 +/- 4.5 - females). Groups B and AB had values of 23.0 +/- 5.2 (males) 16.3 +/- 3.2 (females) and 23.3 +/- 3.8 (males), 16.5 +/- 6.8 (females) respectively. The TIBC value (microMol/L) was highest in group A (60.2 +/- 9.0 - males, 42.7 +/- 6.0 - females) and lowest in group 0 (51.8 0 +/- 14.2 - males, 36.8 +/- 12.2 - females), while the values for groups B and AB were 54.7 +/- 7.5 (males), 38.8 +/- 2.5 (females) and 54.4 +/- 4.8 (males), 38.6 +/- 3.8 (females) respectively. The percent TS was highest in group A (43.7 +/- 2.0 - males, 31.0 +/- 1.0 - females) and lowest in those of B (42.0 +/- 1.4 - males, 29 +/- 0.4 - females) while groups AB and 0 had values of 42.8 +/- 1.0 (males), 30.4 +/- 3.0 (females) and 42.5 +/- 1.9 (males), 30.2 +/- 4.8 (females) respectively. There were significant differences between the intra group comparisons of the results of groups A and O only in the serum iron and TIBC parameters. No significant differences were observed in the percentage TS among the different blood groups. The values obtained for the percentage distribution of the different blood groups agrees with already established values for the population. Since the values obtained for the parameters studied all fall within the normal range, this work provides useful data on the environment of South Eastern Nigeria.