Glutathione, glutathione peroxidase and some hematological parameters of HIV-seropositive subjects attending clinic in University of Calabar teaching hospital, Calabar, Nigeria.

BACKGROUND: Despite the numerous intervention programmes, HIV still remains a public health concern with a high impact in Sub-Saharan Africa region. Oxidative stress has been documented in HIV subjects as viral infection promotes prolonged activation of immune system, hence, production of increased reactive oxygen species. METHODS: We studied 180 subjects. Of these, 60 were HIV-infected on antiretroviral therapy (ART), 40 were ART naïve HIV-infected and 80 were apparent healthy non HIV-infected subjects. The complete blood count was performed by automated hemoanalyzer, the CD4+ T-cell count was performed by cyflow cytometer, while the antioxidant assay was performed using ELISA technique. RESULT: All evaluated parameters; glutathione (GSH), glutathione peroxidase (GPX), CD4+ T-cell count, haemoglobin (Hb), total white blood cell count (WBC) and platelet count were significantly (P < 0.05) reduced in the HIV-infected subjects. All assessed parameters were found to be significantly (P < 0.5) reduced in the HIV-infected subjects that are ART naive when compared with those on ART. HIV-infected subjects with CD4+ T-cell count < 200 cells/mm3 had significantly (P < 0.05) reduced values in all assessed parameters when compared to those with CD4+ T-cell count ≥200 cells/mm3. GSH and WBC were found to be significantly (P < 0.05) increased in the female HIV-infected subjects when compared with the male counterpart. Anemia prevalence of 74 and 33% were recorded for the HIV-infected and control subjects, respectively. Gender and ART treatment were found to be associated with anemia in HIV. Male HIV-infected subjects on ART were found to be more likely to have anemia. CONCLUSION: Antioxidants; GSH and GPX were found to be significantly reduced in HIV infection. Further probe showed that the antioxidant status was improved in the HIV-infected group on ART.

Evaluation of prothrombin time and activated partial thromboplastin time in hypertensive patients attending a tertiary hospital in calabar, Nigeria.

Introduction. Several biomedical findings have established the effects of hypertension on haemostasis and roles of blood coagulation products in the clinical course of hypertension. Methods. This cross-sectional study aimed at determining effects of hypertension on prothrombin time (PT) and activated partial thromboplastin time (APTT) in hypertensive patients in comparison with normotensive subjects attending a tertiary hospital in Calabar. Forty-two (42) hypertensive patients and thirty-nine (39) normotensive control subjects were investigated for PT and APTT using Quick one-stage methods. Results. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) correlated positively with APTT (r = 0.3072, r = 0.4988; P < 0.05) in hypertensive patients. DBP, SBP, PT, and APTT were significantly higher in hypertensive patients when compared to normotensive subjects (P < 0.05). DBP correlated negatively with duration of illness (r = -0.3097; P < 0.05) in hypertensive patients and positively with age of normotensive subjects (r = 0.3523; P < 0.05). Conclusion. The results obtained indicated that measurements of PT and APTT may serve as indices for evaluating hemostatic abnormalities in hypertensive patients and guide for antihypertensive therapy. However, to have better understanding of hemostatic activities in hypertension, it is recommended to conduct D-dimer, platelet factors, and protein assays.

Depression of platelet counts in apparently healthy children with asymptomatic malaria infection in a Nigerian metropolitan city.

Asymptomatic malaria infection is a common feature of malaria endemic regions in the tropics. In this prospective cross sectional survey, involving 240 children aged 1 to 8 years (Boys = 117, Girls = 123; Ratio 1:1.05), the median platelet count was 115 x 10(9)/L (IQR 97.5-190). Thirty-three out of 240 (13.75%) of the children had thrombocytopenia (platelet count < 100 x 10(9)/L). Malaria parasite was found to exert significant reduction in platelet count. This reduction was more pronounced in children under 5 years and also at higher parasite counts. An inverse relationship was established between parasite density and platelet count (y = -0.017x + 96.2, r = -0.2). Thrombocytopenia is not only a feature of acute malaria infection but also that of asymptomatic malaria infection in the tropics and might be a useful indicator of malaria in children.

Iron deficiency anaemia and evaluation of the utility of iron deficiency indicators among healthy Nigerian children.

The hemoglobin (Hb), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TS) and serum ferritin (SF) values of 240 apparently healthy children were determined in a prospective cross-sectional study conducted in Port Harcourt, Nigeria. Standard colorimetric and enzyme immunoassay procedures were used for the estimation all variables. The mean values of all parameters in this study population were; Hb (11.2 +/- 1.83 gldl), TIBC (361.4 +/- 245.7 ugldl, log(c) SI (1.807 +/- 0.45), log(c) SF (1.51 +/- 0.47) and TS (29.3 +/- 18.5%). There was an age-dependent statistical significant difference in the Hb, TIBC and TS values (P < 0.01). Sex was not found to exert any significant influence on the parameters except TIBC. TS had the highest sensitivity and efficiency values of 48 and 95%, respectively. Positive predictive value (PPV), likelihood ratio (LR(+)) and post-test probability values were highest with SF (58%, 3.3 and 62.2%, respectively) as a diagnostic indicator. Hb values correlated positively and significantly with TS (P < 0.01), log(c) SI and log(c) SF concentrations (P < 0.05). Log(c) SF also correlated positively and significantly with Hb and TIBC (P < 0.05). The overall prevalence of iron deficiency anaemia among these children was 33.75%. We conclude that there is a high prevalence of iron deficiency anaemia among apparently healthy children under the age of five years in this part of the world and these results may justify the need for the introduction of a broad intervention programme for this highly vulnerable group. This study is also in support of the hypothesis that SF is the best test for diagnosing or excluding iron deficiency anaemia. The combination of SF, Hb and TS determinations may prove more useful in a resource-limited moderate setting.

Comparative analysis of malaria parasite density using actual and assumed white blood cell counts.

AIM: To compare malaria parasite densities, calculated using the white cell counts (WBC) of individual children with a standard WBC count of 8.0 x 10(9)/L. METHODS: In a cross-sectional study, the prevalence of malaria WBCs and malaria parasite densities were estimated in 240 healthy Nigerian children aged 1-8 years. RESULTS: Of 240 children, 75 (31.25%) were infected with malaria, 69 (28.75%) with P. falciparum and 9 (3.75%) with other species. The mean (SD) WBC count was 5.1 (2.0) x 10(9)/L. There was an age-related significant difference in the mean WBC counts (t=2.000, p<0.05), with values higher in the under-5s [5.6 (2.0) x 10(9)/L] than in the > or =5-years group [5.0 (1.8) x 10(9)/L]. No significant difference was observed with regard to gender and malaria infection. The mean (SD) parasite densities of P. falciparum obtained using the assumed value of 8.0 x 10(9)/L [1936 (1119.5)] was significantly higher than the parasite densities estimated using the individual WBC counts [1140 (862.8) for P. falciparum] (p<0.0001). CONCLUSION: Parasite density estimation using the assumed count of 8.0 x 10(9)/L might result in over-estimation of the parasite burden. The WBCs of individual patients should always be estimated when parasite density is required.

Autologous blood transfusion--a review.

The discovery of HIV and other transfusion-transmissible infections has increased the demand for alternatives to allogeneic blood transfusion. One such alternative is autologous transfusion. This review presents an analysis of autologous transfusion. We conclude that autologous transfusion should form part of a strategy to minimise the risk associated with allogeneic transfusion in Nigeria and other developing countries.