Evaluation of Prevention of Mother to Child Transmission Programme at a Tertiary Healthcare Facility in Southwestern Nigeria.

Most children acquire human immunodeficiency virus (HIV) infection through mother-to-child transmission (MTCT). The risk of MTCT of HIV is generally 15%-40% without prophylaxis. MTCT has been responsible for approximately 370,000 infant HIV infections worldwide, with Nigeria accounting for 30% of cases. The study evaluated the effectiveness of a prevention program for MTCT of HIV infection by determining the rate of MTCT of HIV in infants who underwent the program by reviewing health records of mother-infant pairs at the Olabisi Onabanjo University Teaching Hospital. This cross-sectional study conducted over 12 years used medical records of 545 mother-infant pairs. The rate of MTCT of HIV infection was 2.9% in this study compared to 7.1% reported by the center earlier. The rate of MTCT of HIV infection was the lowest among mother-infant pairs who received prophylaxis. Ages at recruitment are a strong determinant of the risk of infection. Late usage of the MTCT prevention service is a risk for HIV infection in exposed infants.

Blood cellular markers of inflammation in Breast Cancer and response to Neoadjuvant Chemotherapy

Background:Breast cancer is the most common female malignancy in Nigeria. Neoadjuvant chemotherapy is the first line treatment for locally advanced breast cancer. The advancement of many cancers is accompanied by inflammation, and inflammatory cells play an essential role in the progression.Objective:To determine if haematological parameters can predict the responsiveness of breast cancer to neoadjuvant chemotherapy regime.Method:A prospective cohort study of all breast cancer patients who had neoadjuvant chemotherapy betweenJuly 2017 andDecember 2018was carried out. Haematological parameters of red cell count (RCC), white cell count(WCC), neutrophil count (NC), lymphocyte count (LC), platelet count (PC), red cell distribution width (RCDW), mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were measured. Response to chemotherapy was assessed by measuring the longest diameter of the lump and largest lymph node and applying the UICC criteria.Results: Thirty-five females with breast cancer with the age range of 33-82 years and mean age of 48± 11yearswere studied. The overall clinical response rate was 80% consisting of 40% complete clinical response, 40% partial clinical response, 8.6% stable disease and 11.4% progressive disease. Eleven (78.6%) with PLR values below average had good clinical response while 21.4% of those with PLR value above average had a good clinical response(χ2= 8.4, p =0.006)Conclusion: The study showed that PLR is associated with complete clinical response to neoadjuvant chemotherapy and should be used as part of routine assessment before chemotherapy

A case of acute megakaryoblastic leukaemia (FAB M7), a rare type of acute myeloid leukemia (AML), in a teenager.

Acute Megakaryoblastic Leukaemia (AML, M7) is a rare type of acute myeloid leukemia (AML) evolving from primitive megakaryoblasts. It accounted for 1.2% of newly diagnosed AML according to Eastern Cooperative Oncology Group (ECOG) trials between 1984 and 1997. Patients may present with a broad variety of symptoms including low-grade fever, easy bruising, and life-threatening conditions. We report a rare case of AML, M7 in a 19-year-old lady who presented with weakness and fatigue. She was diagnosed as a case of AML, M7 on the basis of peripheral blood finding, bone marrow examination report, radiological findings and immunophenotyping.

Prevention practices influencing frequency of occurrence of vaso-occlusive crisis among sickle cell patients in Abeokuta South Local Government Area of Ogun State, Nigeria.

BACKGROUND: Africa is the most affected continent with 200,000 new born affected by sickle cell anemia annually with of 5% of under five deaths. Nigeria has the largest sickle cell gene pool in the world with about 2% of all babies born to Nigerian parents. This study therefore sets out to assess the prevention practices influencing the frequency of occurrence of vaso-occlusive crisis among patients in Ogun State. METHODS: This study is a descriptive cross-sectional study conducted in Abeokuta South Local Government Area Ogun State. A consecutive non randomized sampling of all the sickle cell patients that attend the selected facilities was recruited into the study. Data were collected with the use of questionnaires which were interviewer administered. A total of 415 patients were recruited into the study. Statistical analyses were conducted using SPSS for Windows version 20.0. RESULT: Two- third [64.8%] of study participants have crisis twice or more in a month. The frequency of crisis was statistically significantly associated with the age of the child [p = 0.006], use of anti-malaria prophylaxis [p = 0.006], analgesics [p = 0.0001], taking of plenty fluid [p = 0.001] and soothing herbs [p = 0.0001]. Lifestyle factors such as giving balance diet [p = 0.217], restriction from strenuous activities [p = 0.08], and attending Clinic appointments regularly [p = 0.126] were not statistically associated with reduction in the frequency of crisis. Logistic regression analysis shows that predictors of frequent crisis were individuals who were using prophylaxis antimalarial drugs [OR = 0.12, CI = 0.05-0.33] and analgesics [OR = 0.15, C.I = 0.06-0.34]. CONCLUSION: The study reveals that majority of the participants have high frequency of crisis in a month. Drug prophylaxis rather than lifestyle factors may be more important in the prevention of vaso-occlusive crisis among sickle cell patients.

CD4+ T Lymphocytes count in sickle cell anaemia patients attending a tertiary hospital.

BACKGROUND: Sickle cell haemoglobin (HbS) is the commonest abnormal haemoglobin and it has a worldwide distribution. Reports have shown that patients with sickle cell anaemia (HbSS) have an increased susceptibility to infection leading to increased morbidity and mortality. Impaired leucocyte function and loss of both humoral and cell-mediated immunity are some of the mechanisms that have been reported to account for the immunocompromised state in patients with sickle cell disease. This study was carried out to determine the CD4+ T lymphocytes count in patients with sickle cell anaemia. MATERIALS AND METHODS: A comparative cross-sectional study of 40 sickle cell anaemia patients in steady state (asymptomatic for at least 4 weeks) attending haematology clinic and 40 age and sex-matched healthy HbA control were recruited into the study. Both HbS patients and the controls were HIV negative. The blood samples obtained were analyzed for CD4+ T cell by Flow cytometry. RESULTS: The study found that there was no significant difference in the number of CD4+ T lymphocyte count between individuals with sickle cell anaemia and HbA (1016 ± 513 cells/µL vs 920 ± 364cells/µL). CONCLUSION: It is recommended that the functionality of CD4+ T lymphocyte should be considered rather than the number in further attempt to elucidate the cellular immune dysfunction in patients with sickle cell anaemia.