Common hepatitis B virus genotypes among blood donors in Lagos, Nigeria.

Background: Hepatitis B virus (HBV) infection is one of the public health diseases causing global health problems. It is a leading cause of cirrhosis and hepatocellular carcinoma. Blood transfusion is a major route of its transmission and screening of blood is suboptimal in our environment. Occult HBV infection describes the presence of HBV DNA in blood or liver tissue in patients who are hepatitis B surface antigen (HBsAg) seronegative. This study documented the common genotypes of HBV a blood-borne infection in the population of blood donors in Lagos. Methods: This was a cross-sectional study carried out at the blood donor clinics of ten Lagos State Government-owned hospitals in Lagos State. A total of 1400 participants were recruited consecutively from November 2020 to June 2021. All participants' samples were screened using Diaspot Rapid Test Kit (RTK) and Dialabenzyme enzyme-linked immunosorbent assay (ELISA) kit. Furthermore, some of the plasma samples were used for HBV DNA extraction and genotyping using the real time-polymerase chain reaction. Statistical analysis was carried out using the Statistical Package for the Social Sciences (SPSS) software version 26 and P value was considered significant at ≤0.05. Results: The sero-prevalence of HBsAg using RTK and ELISA was 19.9% and 22.4%, respectively. The prevalence of occult HBV infection was 5.2%. A total of 278 and 313 HBsAg RTK and ELISA positive samples were obtained, respectively. HBV genotype result had A (46.6%) as the most prevalent followed closely by B (44.7%), E (23.8%), D (20.9%) and C (11.2%). Conclusion: HBV infection has a high prevalence among blood donors. ELISA is a more sensitive screening tool and its use should be advocated nationally. HBV genotype A is the most prevalent genotype from our study.

Towards 2030 Target for Hepatitis B and C Viruses Elimination: Assessing the Validity of Predonation Rapid Diagnostic Tests versus Enzyme-linked Immunosorbent Assay in State Hospitals in Kaduna, Nigeria.

INTRODUCTION: Sub-Saharan Africa accounts for 25% of the estimated global 325 million people with chronic hepatitis B and C virus infections. Weak blood transfusion systems facilitate the spread of both hepatitis B and C virus infections. This is worsened by the absence of sustainable quality assurance programs and perennial shortage of sensitive screening kits. We aim to compare the validity of rapid diagnostic tests (RDTs) with the World Health Organization-recommended quality-assured enzyme-linked immunosorbent assay (ELISA) screening method for these viruses. MATERIALS AND METHODS: We conducted a cross-sectional study on consecutive blood donor samples. Two hundred and sixty-four blood donor samples screened for hepatitis B and C viruses using RDTs were retested at a National blood transfusion service, Kaduna, Nigeria. Data were analyzed using OpenEpi version 3.01 to determine the sensitivity, specificity, and predictive values of RDTs versus ELISA. RESULTS: The sensitivities of the RDTs at 95% confidence interval (CI) were low - 40% (19.8-64.3) and 50.0% (18.8-81.2) - for hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) antibody, respectively. The specificities and 95% CI were high - 99.9% (97.8-99.9) and 100.0% (98.5-100) for HBsAg and HCV antibody, respectively. CONCLUSION: Predonation RDTs screening of blood donor samples for hepatitis B virus and HCV in hospital donation units performed poorly compared to quality-assured ELISA screening in Kaduna. The risk of transmitting viral hepatitis through blood transfusion still exists. We recommend quality-assured ELISA screening of all donated units for HBsAg and HCV antibody to reduce the risk of these transfusion-transmitted infections.

The Prevalence of Occult Hepatitis B Infection among Blood Donors in Lagos, Nigeria.

BACKGROUND: In occult hepatitis B virus (HBV) infection, the HBV DNA is present in the blood or liver tissue in patients negative for hepatitis B surface antigen (HBsAg) with or without anti-HBV antibodies. Thus, the absence of HBsAg in the blood only reduces the risk of transmission and is not sufficient enough to ensure the absence of HBV infection. AIM: This study was aimed at determining the prevalence of occult HBV infection among blood donors in Lagos. STUDY DESIGNS: A cross-sectional study was done among 101 consenting blood donors at Lagos State University Teaching Hospital, Ikeja, between November 2016 and January 2017. MATERIALS AND METHODS: HBV DNA analysis and viral load were done at the Molecular Laboratory of National Sickle Cell Centre, Idi Araba, Lagos, for all the HBsAg negative blood donors screened by rapid kit at Ikeja. RESULTS: The prevalence of occult HBV DNA among the participants was 3% consisting of 3% prevalence of HBV DNA surface antigen and 0% prevalence for precore and core of the HBV DNA. CONCLUSION: The low prevalence (3%) of occult HBV seen in our study does not make it cost-effective to routinely screen blood donors or the general population for HBV infection using DNA polymerase chain reaction.

On artherogenic index of plasma in sickle cell anaemia patients.

INTRODUCTION: Sickle cell anaemia (SCA) is an inherited abnormality of haemoglobin associated with reduced life expectancy. Patients' complications include dyslipideamia. This study was aimed at determining the artherogenic index of plasma (AIP) in sickle cell anaemia patients and compares the value to HbAA controls value. A high AIP is strongly predictive of elevated cardiovascular risk. METHODS: A comparative study was conducted among SCA patients attending the haematology clinic, Lagos State University Teaching Hospital (LASUTH) and HbAA Phenotype controls. A total of 304 participants were recruited consisting of equal numbers of SCA and HbAA controls. Single lipid profiles were done; logarithms of triglycerides/high density lipoprotein were calculated to obtain AIP and lipid profile ratios established for all participants. RESULTS: There were lower mean values of Total Cholesterol (TC), High Density Lipoprotein(HDL) and Low Density Lipoprotein (LDL) amongst SCD participants than controls and higher mean values of triglycerides (TG) and Very Low Density Lipoprotein (VLDL) in SCD p < 0.05. The AIP in SCD ranges from -0.62 to 1.32 while that of controls ranges from -0.56 to 0.61.The mean AIP were 0.14 ± 0.29 and -0.009 ± 0.26 in SCD and controls respectively. P value = 0.002. CONCLUSION: AIP value is higher in sickle cell anaemia than controls, the former have lower mean values of TC, HDL and LDL and higher mean values of TG and VLDL.

Towards 2030 target for hepatitis B and C viruses elimination: assessing the validity of predonation rapid diagnostic tests versus enzyme-linked immunosorbent assay in state hospitals in Kaduna, Nigeria

ntroduction: Sub-Saharan Africa accounts for 25% of the estimated global 325 million people with chronic hepatitis B and C virus infections. Weak blood transfusion systems facilitate the spread of both hepatitis B and C virus infections. This is worsened by the absence of sustainable quality assurance programs and perennial shortage of sensitive screening kits. We aim to compare the validity of rapid diagnostic tests (RDTs) with the World Health Organization-recommended quality-assured enzyme-linked immunosorbent assay (ELISA) screening method for these viruses. Materials and Methods: We conducted a cross-sectional study on consecutive blood donor samples. Two hundred and sixty-four blood donor samples screened for hepatitis B and C viruses using RDTs were retested at a National blood transfusion service, Kaduna, Nigeria. Data were analyzed using OpenEpi version 3.01 to determine the sensitivity, specificity, and predictive values of RDTs versus ELISA. Results: The sensitivities of the RDTs at 95% confidence interval (CI) were low ­ 40% (19.8­64.3) and 50.0% (18.8­81.2) ­ for hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) antibody, respectively. The specificities and 95% CI were high ­ 99.9% (97.8­99.9) and 100.0% (98.5­100) for HBsAg and HCV antibody, respectively. Conclusion: Predonation RDTs screening of blood donor samples for hepatitis B virus and HCV in hospital donation units performed poorly compared to quality-assured ELISA screening in Kaduna. The risk of transmitting viral hepatitis through blood transfusion still exists. We recommend quality-assured ELISA screening of all donated units for HBsAg and HCV antibody to reduce the risk of these transfusion-transmitted infections

Lipid profile and disease severity in sickle cell disease patients in Lagos State, Nigeria

Background: Sickle cell anaemia is an autosomal recessive disorder that arises due to the substitution of glutamic acid with valine. This occurs at position 6 of the haemoglobin b chain, resulting in the synthesis of abnormal haemoglobin and the consequent production of the characteristic sickled red blood cells. Studies have documented several alterations in lipid homeostasis in this population. Both hyper and hypolipidaemias are known to be associated with increased morbidity and mortality and it is therefore imperative to evaluate their relationships with sickle cell anaemia. Aim: The aim of this study was to establish baseline serum lipid levels in sickle cell anaemia patients in LASUTH and correlate this with severity scores in the patients. Subjects and Methods: Serum Total cholesterol (TC), Triglycerides (TG), Low density lipoproteins (LDL), High density lipoproteins (HDL) and Very low density lipoproteins (VLDL) were measured in 57 Haemoglobin SS (HbSS) patients in steady state. All patients used had been fasting for at least 10 hours prior to sample collection. The LDL/HDL was also calculated. Their disease severity was calculated using an objective scoring method. Results: Our results showed that there was no significant correlation between serum lipid levels and disease severity score

Prognostic Factors and Outcome of Management of Ischemic Priapism in Zaria, Nigeria.

OBJECTIVES: The objective of this study was to determine the nuances of management, prognostic factors, and outcome of ischemic priapism in patients seen at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. PATIENTS AND METHODS: We retrospectively studied the case notes of all patients managed for ischemic priapism in the Ahmadu Bello University Teaching Hospital, Zaria, over a period of 10 years (2006-2015). The data extracted included patients' age, occupation, duration of painful penile erection, and previous episodes. Addition information including precipitating factors, hemoglobin genotype, treatment, and complications was also retrieved. Data obtained were analyzed using SPSS version 20. RESULTS: The records of a total of forty patients managed for priapism over the period under review were retrieved. Thirty-three (82.5%) of these patients had an operative intervention. The mean age was 23.7 years with a range of 8-53 years. Sixty percent of patients were young adults in their third decade of life. The minimum duration of erection at presentation was 18 h and a maximum period of 10 days with a mean of 105.5 h (4 days). Thirty-three patients (82.5%) had sickle cell anemia (HbSS). Erectile dysfunction (ED) accounted for 60% of all forms of postpriapism complications. Five patients (12.5%) had residual tumescence from fibrosis, and three patients had recurrence outside the immediate postoperative period. Duration of symptoms before surgical intervention, SSA and previous episodes were the most important prognostic factors. CONCLUSION: Priapism is a disease of the young, mostly sickle cell anemic patients. Late presentation remains the norm in our environment, hence a higher incidence of ED. The distal penile shunt is an effective means of achieving detumescence even with failed conservative management. Favorable outcome is highly dependent on the duration of erection and early intervention.

An Assessment of Knowledge, Awareness, and Attitude of Undergraduates toward Sickle Cell Disease in Lagos, Nigeria.

BACKGROUND: Sickle cell anaemia is an autosomal recessive disorder which occurs as a result of the substitution of glutamic acid with valine at the 6th position of the haemoglobin beta chain, resulting in the synthesis of abnormal haemoglobin and the consequent production of the characteristic sickled red blood cells. Sickle cell anaemia is the homozygous form where two HbS genes are inherited, whilst in Sickle cell disease, the HbS is inherited along with another abnormal haemoglobin eg HbE, HbC, etc. AIMS AND OBJECTIVES: This study was aimed at assessing the awareness and knowledge of sickle cell disease among students in a tertiary institution, as well as their attitude to the disease. MATERIALS AND METHODS: This was a cross-sectional quantitative interviewer administered questionnaire study, involving 200 undergraduates of the Lagos State University Ojo Campus, Lagos. Information collected include socio-demographic information, as well as questions to assess the awareness, knowledge and attitude to Sickle Cell Disease. Data obtained were analyzed using SPSS version 16.0. RESULTS: The total knowledge score was 20 and depending on the total score of the respondents, knowledge levels were grouped as poor (0-6), fair (6-13) and good (14-20). Of the 200 respondents, 37.5% had good knowledge of SCD, despite high level of awareness (92.5%). The knowledge level of the respondents based on the score revealed a mean score 12.05 + 3.14 indicating fair general knowledge of the respondents. 67.5% of respondents were aware of their haemoglobin phenotypes. More than half (59%) of the respondents knew someone living with sickle cell disease and 154 (77%) agreed that haemoglobin phenotype would play a significant role in their choice of a life partnzer. CONCLUSION: The awareness of SCD among the students is high but this awareness did not translate to good overall knowledge about the disease. This underscores the importance of increased public health education on SCD, in order to increase the knowledge about SCD.

Prognostic factors and outcome of management of ischemic priapism in Zaria, Nigeria

Objectives: The objective of this study was to determine the nuances of management, prognostic factors, and outcome of ischemic priapism in patients seen at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Patients and Methods: We retrospectively studied the case notes of all patients managed for ischemic priapism in the Ahmadu Bello University Teaching Hospital, Zaria, over a period of 10 years (2006­2015). The data extracted included patients' age, occupation, duration of painful penile erection, and previous episodes. Addition information including precipitating factors, hemoglobin genotype, treatment, and complications was also retrieved. Data obtained were analyzed using SPSS version 20. Results: The records of a total of forty patients managed for priapism over the period under review were retrieved. Thirty-three (82.5%) of these patients had an operative intervention. The mean age was 23.7 years with a range of 8­53 years. Sixty percent of patients were young adults in their third decade of life. The minimum duration of erection at presentation was 18 h and a maximum period of 10 days with a mean of 105.5 h (4 days). Thirty-three patients (82.5%) had sickle cell anemia (HbSS). Erectile dysfunction (ED) accounted for 60% of all forms of postpriapism complications. Five patients (12.5%) had residual tumescence from fibrosis, and three patients had recurrence outside the immediate postoperative period. Duration of symptoms before surgical intervention, SSA and previous episodes were the most important prognostic factors. Conclusion: Priapism is a disease of the young, mostly sickle cell anemic patients. Late presentation remains the norm in our environment, hence a higher incidence of ED. The distal penile shunt is an effective means of achieving detumescence even with failed conservative management. Favorable outcome is highly dependent on the duration of erection and early intervention

Turbines and Terrestrial Vertebrates: Variation in Tortoise Survivorship Between a Wind Energy Facility and an Adjacent Undisturbed Wildland Area in the Desert Southwest (USA).

With the recent increase in utility-scale wind energy development, researchers have become increasingly concerned how this activity will affect wildlife and their habitat. To understand the potential impacts of wind energy facilities (WEF) post-construction (i.e., operation and maintenance) on wildlife, we compared differences in activity centers and survivorship of Agassiz's desert tortoises (Gopherus agassizii) inside or near a WEF to neighboring tortoises living near a wilderness area (NWA) and farther from the WEF. We found that the size of tortoise activity centers varied, but not significantly so, between the WEF (6.25 ± 2.13 ha) and adjacent NWA (4.13 ± 1.23 ha). However, apparent survival did differ significantly between the habitat types: over the 18-year study period apparent annual survival estimates were 0.96 ± 0.01 for WEF tortoises and 0.92 ± 0.02 for tortoises in the NWA. High annual survival suggests that operation and maintenance of the WEF has not caused considerable declines in the adult population over the past two decades. Low traffic volume, enhanced resource availability, and decreased predator populations may influence annual survivorship at this WEF. Further research on these proximate mechanisms and population recruitment would be useful for mitigating and managing post-development impacts of utility-scale wind energy on long-lived terrestrial vertebrates.

Using motion-sensor camera technology to infer seasonal activity and thermal niche of the desert tortoise (Gopherus agassizii).

Understanding the relationships between environmental variables and wildlife activity is an important part of effective management. The desert tortoise (Gopherus agassizii), an imperiled species of arid environments in the southwest US, may have increasingly restricted windows for activity due to current warming trends. In summer 2013, we deployed 48 motion sensor cameras at the entrances of tortoise burrows to investigate the effects of temperature, sex, and day of the year on the activity of desert tortoises. Using generalized estimating equations, we found that the relative probability of activity was associated with temperature (linear and quadratic), sex, and day of the year. Sex effects showed that male tortoises are generally more active than female tortoises. Temperature had a quadratic effect, indicating that tortoise activity was heightened at a range of temperatures. In addition, we found significant support for interactions between sex and day of the year, and sex and temperature as predictors of the probability of activity. Using our models, we were able to estimate air temperatures and times (days and hours) that were associated with maximum activity during the study. Because tortoise activity is constrained by environmental conditions such as temperature, it is increasingly vital to conduct studies on how tortoises vary their activity throughout the Sonoran Desert to better understand the effects of a changing climate.