ABSTRACT
AIM: Elevated HbF, among other biological and environmental factors, is responsible for decrease in mortality in sickle cell anaemia (SCA). This study determined the levels of HbF in adult SCA patients in steady state compared with HbAA controls. HbF was discussed in line with the clinical course of the disease so as to emphasize the relevance of hydroxyurea in the management of adult SCA patients. MATERIALS AND METHODS: The HbF levels of 66 confirmed SCA patients and 31 HbAA controls were estimated using Betke method and HbF percentage was calculated using formula: %HbF percentage = A413 filtrate x 100A413 standard x 20. RESULT: A statistical significant difference in the mean of the levels of HbF in patients (5.16±4.04) compared to controls (1.04±0.44) (p = 0.000) was observed. The mean levels of HbF for males (4.71±3.49) compared to that of females (4.99) were statistically similar (p =0.773). It was also observed that the mean HbF level appears to be declining as age advances. SCA patients were classified to three categories viz: HbF <2% (21.2% SCA patients); HbF of 2.1% -10%, (68.2% SCA patients); and HbF of 10.1% -16%, (10.6% SCA patients). CONCLUSION: Substantial proportion of our patients actually will require treatment with hydroxylurea to stimulate HbF production especially those with HbF percentage of <2 and some with HbF percentage of 2.1 - 10%. HPFH may be considered rare since only 10. 6% had HbF at the range of 10.1-16%. This study showed that in treating our SCA patients in Nigeria we need to adopt and encourage the use of HbF activating agents like hydroxyurea or any other safe agent that will be found to stimulate HbF production in SCD patients.
ABSTRACT
BACKGROUND: Over 20 million persons are infected with HTLV-I/II globally. The virus is endemic in Africa and it is also transmitted sexually. Continued identification of high risk groups is important for the control of the disease. OBJECTIVES: To determine the prevalence of HTLV infection amongst two highly sexually active groups, pregnant women and CSWs in South Western Nigeria. METHODS: Serum samples were tested for the presence of HTLV-I/II antibodies using the Vironostika HTLV-I/II micro ELISA system. RESULTS: A total of 364 serum samples collected from pregnant women, commercial sex worker (CSW) and secondary school students (control group) from Ibadan. While only 4 (5.1%) of 78 secondary school students (average age: 13 years) were reactive for HTLV infection, 20 (16.7%) of 120 pregnant women (average age: 26 years) and 38 (22.9%) of 166 CSWs (average age: 23 years) were found to have antibodies against HTLV in their sera. The results of this study thus show that HTLV infection is active in the population although higher in pregnant women (although not statistically significant) and CSWs (p>0.05). Pregnant women and CSWs are therefore at a higher risk of HTLV transmission than other members of the population. CONCLUSION: Routine screening for HTLV infection may go a long way to understanding the epidemiology of HTLV infection in Nigeria and subsequently provide tools for its prevention and control.
