Anaemia Prevalence More Than Doubles in an Academic Year in a Cohort of Tertiary Students: A Repeated-Measure Study in Cape Coast, Ghana.

BACKGROUND: The stress of academic life may predispose young adults to poor dietary habits, which could potentially precipitate nutritional deficiencies, such as iron deficiency. This study evaluated factors predictive of optimal iron stores as well as changes in haematological parameters over the course of an academic year in a cohort of tertiary students. MATERIALS AND METHODS: The repeated-measure cohort study recruited 117 undergraduate students from September 2018 to May 2019. Venous blood samples were drawn for full blood count estimation, qualitative glucose-6-phosphate dehydrogenase (G6PD) status, haemoglobin variants, and blood group determination during the first 2 weeks of semester 1. However, anthropometric parameters as well as full blood counts were determined for each participant during the first week and last week of semesters 1 and 2. Additionally, semistructured questionnaires were used to capture sociodemographic data. Also, serum ferritin was estimated for each participant using enzyme-linked immunosorbent assay. RESULTS: Overall, 23.1% and 15.5% of participants inherited G6PD defect (G6PDd) or haemoglobin variants, respectively. However, group O (68/117; 58.1%) was the predominant ABO blood group and an overwhelming 90.6% (106/117) inherited Rh D antigen. The prevalence of anaemia increased from 20% at the beginning of the first semester to 45.1% at the latter part of the second semester. G6PDd participants had significantly higher median serum ferritin than G6PD normal participants (p = 0.003). Also, a significantly higher proportion of females were iron depleted (25% vs. 2.3%) or iron deficient (14.3% vs. 9.3%) compared to males. Moreover, being male, G6PD deficient, or 21-25 years was associated with increased odds of participants having optimal serum ferritin levels. CONCLUSION: The progression of anaemia prevalence from mild to severe public health problem over the course of one academic year should urgently be addressed.

Poor haemoglobin-haematocrit agreement in apparently healthy adult population; a cross-sectional study in Cape Coast Metropolis, Ghana.

BACKGROUND: This study estimated total body water (TBW), daily water intake (DWI) and haemoglobin-haematocrit relationship in adults in a tropical environment where active lifestyles could precipitate plasma volume contraction. METHODS: This cross-sectional study recruited 170 participants, and was carried out between February 2018 and May 2018 at University of Cape Coast. Semi-structured questionnaires were used to obtain demographic data and DWI. Five ml of venous blood sample was drawn for full blood count, haemoglobin variant determination, serum sodium and potassium levels. TBW was estimated using Chumlea's anthropometric equation. Statistical significance was set at p < 0.05 under two-tail assumption. RESULTS: Whereas 72.3% had low haematocrit, only 22.4% were anaemic per haemoglobin cut-off demonstrating a poor haemoglobin-haematocrit correlation. Also, whereas 30% of participants had low TBW, 22.9% had hypernatraemia, with 97.1% reporting DWI of <3 L. Bland-Altman plot showed that calculated haematocrit (HCT = Hb∗3) underestimated HCT by a factor of 1.788 (p = 0.0314). A scatter-plot showed a trend towards higher haematocrit-haemoglobin deviations as haemoglobin increased. Furthermore, 32.6% of participants with normal haemoglobin levels had low TBW. Moreover, whereas haemoglobin and serum K+ significantly positively correlated to TBW, serum Na+ was inversely related to TBW. CONCLUSION: The low DWI is suggestive that measuring plasma volume and/or haemoglobin mass may be required to correctly diagnose anaemia.

Poor iron store recovery in voluntary blood donors in the northern zone of Ghana; a five-month three-centre cohort study.

OBJECTIVE: In Ghana, although iron deficiency is endemic, post blood donation iron supplementation is not routine. We sought to determine whether at five months post-donation of a single unit of whole blood, donors were able to recover iron stores. MATERIALS AND METHODS: This three-centre cohort study recruited 164 blood donors at the Lawra, Nandom, and Bimbila communities in the northern zone of Ghana. Venous blood samples were drawn at baseline to estimate full blood count (FBC), haemoglobin variants, qualitative G6PD status, and serum ferritin. Five months post-donation, venous blood samples were drawn for a repeat measurement of FBC and serum ferritin. Data were analysed using SPSS and GraphPad prism to assess recovery of iron stores. RESULTS: Whereas 26.8 % had inherited haemoglobin variants, 18.9 % of the donors had qualitative G6PD deficiency. Overall, mean difference between pre-donation and five months post donation iron stores significantly differed from zero (p < 0.001; one sample t-test). After five months post donation, 76.8 % of the blood donors could not achieve pre-donation iron stores. Whereas 6.1 % and 8.5 % blood donors had depleted iron stores and iron deficient erythropoiesis at baseline, these increased to 9.8 % and 21.3 % respectively at five-month post donation. Moreover, at five months post donation, 11 % of these blood donors would have been disqualified per haemoglobin screening cut off of 12.5 g/dl. CONCLUSION: Reliance on food intake to replenish iron store lost per blood donation may not adequately assure donor health in the study area; iron supplementation should be considered.

The hydroxyl moiety on carbon one (C1) in the monoterpene nucleus of thymol is indispensable for anti-bacterial effect of thymol.

BACKGROUND: Thymol, a natural monoterpene phenol is not only relevant clinically as an anti-microbial, anti-oxidant and anti-inflammatory agent but also holds the prospect as a natural template for pharmaceutical semi-synthesis of therapeutic agents. It is a major component of essential oils from many plants. Evidence abound linking overall bioactivity of thymol to its monoterpene nucleus, specifically, the hydroxyl (-OH) substituent on carbon number one (C1) on the monoterpene nucleus. Other studies have posited that the overall bioactivity of thymol is not substantially altered by chemical modification of - OH on the C1 of the monoterpene nucleus. In view of this, it is still unclear as to whether removal or modification of the -OH on C1 of the monoterpene nucleus relates generally or context-dependently to bioactivity of thymol. OBJECTIVE: The present study investigated anti-bacterial effects of ester-and-ether substituted derivatives of thymol on S. aureus, P. aeruginosa and E. coli. MATERIALS AND METHODS: twelve ester-and-ether substituted derivatives of thymol (6TM1s and 6TM2s) were synthesized and characterized by using HPLC, Mass spectrometry, and IR techniques. Anti-bacterial activity of the 12 thymol derivatives was evaluated using broth macrodilution and turbidimetric methods against pure clinical isolates (S. aureus, P. aeruginosa and E. coli). Standard anti-biotics used were Thymol Streptomycin and flucloxacillin, while DMSO was used as vehicle for thymol derivatives. MIC and MBC were determined. RESULTS: Thymol produced broad-spectrum growth inhibition on all isolates. At equimolar concentrations, thymol and reference drugs produced concentration-dependent growth inhibition against the isolates (Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli) compared to DMSO. Although the growth inhibitory effects of the ester-and-ether derivatives of thymol was significant (P ≤ 0.05) compared to DMSO, it was however insignificant (P ≥ 0.05) compared to thymol and reference antibiotics. Comparatively, at equimolar concentrations, ester-substituted derivatives of thymol, particularly the branched chain derivative (TM1C) produced more effective growth inhibition on the isolates than the ether-substituted derivatives of thymol. Thymol was twice as potent (MIC and MBC, 500 µg/ml) than both ester-and-ether substituted derivatives of thymol (MIC and MBC, > 1000 µg/ml) on all the three clinical isolates. Increase in side chain bulkiness of -OH moiety on the monoterpene nucleus of thymol decreased growth inhibition on isolates. CONCLUSION: Thymol has demonstrated broad-spectrum anti-bacterial effects attributable to the hydroxyl moiety on C1 of the monoterpene nucleus. Structural modification of the hydroxyl moiety on C1 of the monoterpene nucleus of thymol with either ether-or-ester substitutions yielded no significant anti-bacterial effects.