Anthropometric indices as determinants of haemorheological cardiovascular disease risk factors in Nigerian adults living in a semi-urban community.

BACKGROUND: Some epidemiological studies have found anthropometric indices to be related to cardiovascular disease risk factors. Fibrinogen--an acute phase reactant protein--is central in the haemostatic system. Its associations with cardiovascular diseases have been well documented. A possible association between measures of body fat and fibrinogen has been reported. AIMS: To study the relationship of fibrinogen (PFC), plasma viscosity (PV) and haematocrit (HCT) with measures of obesity (body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR)) in apparently healthy Nigerians living in Ilisan-Remo, a semi-urban community. SUBJECTS AND METHODS: The study population comprised of apparently healthy mono-ethnic Nigerians living in Ilisan-Remo town. Obesity was measured using the body mass index, waist circumference, waist-to-hip ratio and waist-to-height ratio. Blood samples were analyzed for rheological parameters (plasma fibrinogen, plasma viscosity, haematocrit and the erythrocyte sedimentation rate (ESR) using standard methods. RESULTS: A total of 122 subjects were studied, 46 males (mean age 57+/-15.7 years) and 76 females (mean age 58.92+/-17.99 years). The mean systolic blood pressure was 138.5 mmHg for males and 135.2 mmHg for females respectively. The independent variables (BMI, waist-to-hip ratio) were divided into 2 groups using the 75th percentile cut off. In the BMI group, the diastolic blood pressure, haematocrit and plasma viscosity were significantly higher in males (p<0.0001) in the >75th percentile group but not in females. Using the waist circumference; plasma viscosity and diastolic blood pressure were higher in males (p<0.0001) in the >75th percentile group. In females the haematocrit and blood viscosity were significantly higher (p=0.0074, p=0.0434) respectively in the >75th percentile group. Using stepwise multiple regression analysis, the waist circumference and BMI were found to be significant determinant for systolic and diastolic blood pressure. The BMI was significant determinant for the haemorheological cardiovascular disease (HCVD) risk factors except fibrinogen. While the waist circumference was a significant predictor of all the haemorheological cardiovascular disease risk factors (p<0.0001). CONCLUSION: While the BMI and the WHR may be good predictors of CVD (cardiovascular disease) risk factors, we have shown that the waist circumference may be a better predictor of haemorheological cardiovascular disease risk factors than the BMI in Nigerians.

Using serial haemorheological parameters to assess clinical status in sickle cell anaemia patients in vaso-occlussive crisis.

In a prospective study using standard methods, haemorheological parameters were assessed in 10 sickle cell anaemia patients in pain crises. Patients were investigated for possible changes in determinants of rheology in the course of painful episodes: blood samples were taken for plasma fibrinogen concentration (PFC); plasma viscosity (PV); haematocrit (Hct), whole blood viscosity (WBV) and the erythrocyte sedimentation rate (ESR) using standard methods. Samples were collected on presentation to the emergency unit and daily for 4 consecutive days. Whole blood viscosity and plasma fibrinogen concentration were significantly higher at onset of crises when compared with baseline values (p<0.01 and p<0.0001), respectively. Plasma fibrinogen and blood viscosity peaked within 24 h of onset of crisis and started declining 48-72 h later. These parameters approached baseline values by the 4th day of painful crisis.There was no significant change in the haematocrit and the erythrocyte sedimentation rate during the period of painful crisis despite change in whole blood viscosity and fibrinogen. In conclusion, this study showed elevated haemorheological parameters in sickle cell anaemia patients in VOC, it also demonstrated an acute rise in these parameters at onset of crisis and a return to almost baseline levels within 96 h of onset of painful episodes.

Haemorheological changes in African breast cancer patients.

Several studies have indicated the existence of thrombo-embolic complications in cancer patients and that this could be associated with changes in heamorheological parameters. Packed cell volume (PCV), heamoglobin (Hb), relative plasma viscosity (RPV) and plasma Fibrinogen concentration (PFC) were measured in 50 healthy control women, 50 age-matched women with breast cancer, and 10 women with histophathologically proven benign breast tumour. There were significant differences between the controls and breast cancer patients in all the parameters measured (p < 0.05). However, patients with cancer have significantly higher RPV and PFC (P < 0.001) respectively than controls. There was significant mean difference between pre and post mastectomy in fibrinogen concentration (p < 0.05) and this was observed over the 5-week study period. Since increased fibrinogen may give rise to increase fibrin formation which has been asserted as an independent cardiovascular risk factor for thromb-oembolic complications, African patients with breast cancer may well be predisposed to thrombotic complications during illness. The theological assessment may offer valuable benefit for the management and early diagnosis of breast cancer in African women.

Haemorheological changes in African breast cancer patients

Several Studies have indicated the existence of thrombo-embolic complications in cancer patients and that this could be associated with changes in heamorheological para- meters. Packed cell volume (PCV); heamoglobin (Hb); relative plasma viscosity (RPV) and plasma Fibrinogen concentration (PFC) were measured in 50 healthy control women; 50 age-matched women with breast cancer; and 10 women with histophathologically proven benign breast tumour. There were significant differences between the controls and breast cancer patients in all the parameters measured (p0.05). However; patients with cancer have significantly higher RPV and PFC (P0.001) respectively than controls. There was significant mean difference between pre and post mastectomy in fibrinogen concentration (p0.05) and this was observed over the 5-week study period. Since increased fibrinogen may give rise to increase fibrin formation which has been asserted as an independent cardiovascular risk factor for thromb-oembolic complications; African patients with breast cancer may well be predisposed to thrombotic complications during illness. The rheological assessment may offer valuable benefit for the management and early diagnosis of breast cancer in African women

Haemorheological variables in Nigeria pulmonary tuberculosis patients undergoing therapy.

Haemorheological changes in response to therapy have not been fully determined in pulmonary tuberculosis patients living in developing countries. This study was aimed at monitoring haemorheological parameters in newly diagnosed pulmonary tuberculosis patients undergoing therapy. Haemorheological parameters were studied in 40 tuberculosis patients (17 males and 23 females, mean age 33.4+/-1.4 years, range 23-45 years) undergoing treatment and 10 newly diagnosed patients (5 males and 5 females mean age 33.0+/-2.1 years) along with 50 apparently healthy controls age and sex matched. There were significantly lower packed cell volume (PCV), platelet count (PC), and total white blood cell count (p<0.0001). Whole blood viscosity (WBV), plasma viscosity (PV), erythrocyte sedimentation rate (ESR), and plasma fibrinogen (PF) were significantly higher in pulmonary tuberculosis patients than controls (p<0.0001). The packed cell volume was significantly increased by the 8th week of therapy (p<0.01), there was a significant reduction in the erythrocyte sedimentation rate from the 4th week of therapy (p<0.0001). There was no significant change in blood viscosity by the 4th week of therapy (p>0.05), while the plasma fibrinogen showed significant reduction from the 4th week of therapy till 8th week of therapy (p<0.01 and p<0.0001 respectively). We conclude that thrombocytopaenia, stasis and hyperfibrinogenemia may predispose African PTB patients to bleeding and thrombotic disorders. Haemorheological parameters may be useful indices in assessing response to therapy and drug compliance in pulmonary tuberculosis patients living in developing countries.

Haemostatic variables and their relationship to body mass index and blood pressure in adult Nigerians with the sickle cell trait.

Several studies had assessed the rheological and haemostatic parameters in both sickle cell anaemia(HbSS) and haemoglobin AA(HbAA) subjects. The effect of the heterogeneous state on these parameters has not been fully determined. Our aim was to assess the haemorheological and haemostatic parameters and there relationship to body mass index in individuals with the sickle cell trait. Fifty eight males (41 HbAA and 17 HbAS) who were neither smokers nor drinkers were studied. Body mass index was calculated as weight in Kg divided by height in m(2), blood samples were analysed for haematocrit, erythrocyte sedimentation rate, platelets, fibrinogen and factor VII by standard methods. There were no significant differences in the levels of haemostatic and cardiovascular risk factors between the HbAA and HbAS individuals. Fibrinogen correlated positively with BMI (r=0.6014, p=0.0107), systolic blood pressure (r=0.4820, p=0.0570), diastolic blood pressure (r=0.4699, p=0.0570) in HbAS individuals. The body mass index also correlated positively with diastolic blood pressure (r=0.5182, p<0.05), and systolic blood pressure (r=0.6189, p<0.01). Positive associations were also found between fibrinogen and body mass index (r=0.5012, p=0.0008), and fibrinogen and haematocrit (r=0.3696, r=0.0174) respectively in HbAA subjects. We conclude that the lack of significant difference in both haemorheological and cardiovascular risk factors in HbAS and HbAA subjects has further supported the observation that HbAS is a benign condition under physiological settings. Also the positive associations of fibrinogen with other cardiovascular risk factors have further underscored the central role of fibrinogen as an independent risk factors in the development of cardiovascular diseases.

Knowledge and attitude of youth (ages 15-25 years) to HIV/AIDS and to routine HIV screening.

BACKGROUND: AIDS is still an incurable disease and is very costly to control. Since the first case of Acquired Immune Deficiency Syndrome (AIDS) in Nigeria was reported in 1986, the human immune deficiency virus (HIV) infection has attained epidemic proportion. In an effort to control this rapid spread, certain preventive measures have been developed. In spite of these and the campaigns to control it, the knowledge and attitudes of youths towards HIV/AIDS leaves much to be desired. OBJECTIVE: To determine knowledge and attitude of youths (15 - 25 years) of HIV/AIDS and to Routine HIV Screening. STUDY DESIGN: The study was cross-sectional. SETTING: The study was carried out at the University of Benin Teaching Hospital, Benin City, Nigeria, between January and December 2003. RESULTS: Five thousand three hundred and twenty STUDY POPULATION: The knowledge and attitude of youths (15 - 25 years) of HIV/AIDS and to routine HIV screening was assessed, using anonymous questionnaires, among 9500 respondents, 4950 males and 4550 females. 5750 respondents were from the University of Benin with a population of 20,000 students while 3750 were from some of the Secondary Schools (post primary Schools) randomly selected in Benin City, Nigeria. The University of Benin Teaching Hospital where the work was done is adjacent to the University of Benin. The Secondary Schools selected where the work was done were within a radius of 20 kilometers of the Teaching Hospital and were 5 in numbers with average of 750 students selected per school. Subjects (56%) indicated that they have heard about HIV/AIDS, 4180 (44%) had no knowledge of HIV/AIDS at all. 2240 of 5320 (42.1%) had some knowledge; 1593 (29.9%) had adequate knowledge and only 1487 (28.0%) had sufficient knowledge. 6365 (67%) did not believe it exists and as a result they are not bothered by it. 825 of the 3750 secondary school students had multiple sexual partners. Majority had single partners for those who had at all. While among the University students 2990 (52%) had multiple sexual partners, while others had between one and two sexual partners. Only 36210 (38%) believe it is real and a killer disease frightened about it and are already changing their sexual behaviours; 1900 (20%) believe it is a western propaganda to enslave the developing world. Three thousand nine hundred and ninety respondents (42%) would agree to routine HIV screening and 5510 (58%) would not agree to routine screening. The reasons adduced for rejecting routine HIV screening included psychological trauma, not necessarily high cost of and lack of anti-retroviral drugs, infringement on fundamental human rights, fear of living with positive screening, stigmatization and victimization at place of work if positive. CONCLUSION: Intensive massive awareness campaign through Radio, Televisions jingles and education about HIV/AIDS of the population is recommended to alter their current negative attitude to routine HIV testing and increase their knowledge about HIV/AIDS and perhaps help to change their sexual behaviours.

Body mass index in type 2 diabetes mellitus complications: hypertensive diabetics and diabetic nephropathy.

BACKGROUND: It is widely reported that obesity is one of the major risk factors for developing type 2 Diabetes Mellitus, and also carries with it a higher risk of diabetic complications. OBJECTIVE: Body Mass Index was examined in type 2 diabetes mellitus complications and the prevalence of overweight and obesity were determined. PATIENTS AND METHODS: fifty-two type 2 diabetic patients were studied. 13 patients with diabetic nephropathy, 16 were hypertensive diabetics while 23 were normotensive diabetics. The weight, height and blood pressure of the patients were measured and the BMI were calculated. RESULTS: The mean BMI was highest in the diabetic nephropathy patients (27.9+/-1.0) and lowest in the hypertensive diabetics (25.5+/-5.2) P=0.0001. The prevalence of overweight and obesity were 31 and 46 respectively in diabetic nephropathy compared with 19 and 12.5 respectively in diabetics with hypertension. CONCLUSION: Overweight and obesity are more common in diabetics with nephropathy compared with normotensive and hypertensive diabetic patients.

Fibrinolytic activity in children with Plasmodium falciparum malaria.

BACKGROUND: Malaria infection is still one of the major causes of morbidity and mortality among the under five year children in tropical Africa. Clinical and laboratory methods of assessing the risk factors for severity in order to adequately manage these children, therefore needs to be identified so that prompt and adequate treatment can be instituted early. Fibrinolytic activity has been postulated as one of the risk factors associated with severity of malaria infection. OBJECTIVE: To measure fibrinolytic activity euglobulin lysis time, (ELT) and fibrinogen levels in 50 Nigerian children with Plasmodium falciparum infection. DESIGN: A cross sectional study. SETTING: University of Benin Teaching Hospital, Benin City, Nigeria between January and December 2002. SUBJECTS: Fifty Nigerian children who were admitted with Plasmodium falciparum malaria infection in the paediatric wards of the hospital were recruited into the study. Thirty-four apparently healthy children who did not have malaria fever but who came for growth monitoring exercise and had some investigations done as part of this exercise were used as control for the study. The fibrinolytic activity in all the 84 children (both that had malaria infection and those who did not have malaria infection) were estimated by measuring the euglobulin lysis time (ELT). The fibrinogen levels in all the children were also estimated. The packed cell volume of the children was determined and some severely anaemic children had blood transfusions. RESULTS: Euglobin lysis time (ELT) was found to be higher in children with Plasmodium falciparum malaria infection (430 +/- 149) than in the controls (158 +/- 21.7, P< 0.01). Fibrinogen levels of 3.40 +/- 0.98 in children with malaria infection were high when compared to 2.21 +/- 0.81 in the controls. The children with malaria infection therefore had a decreased fibrinolytic activity and a proportionately high fibrinogen level. The average packed cell volume of the children with malaria infection was 29.64 +/- 2.13 while in the control it was 36.41 +/- 3.24. The study also showed that 50% of children with malaria had severe anaemia and subsequently had blood transfusions. Twenty percent of those who had transfusions died while being transfused. CONCLUSION: Children who have malaria infection have decreased fibrinolytic activity and proportionately high fibrinogen level which may contribute to the possible thromboembolic process in these children and hence higher risk of mortality from Plasmodium falciparum malaria infection.

Fibrinolytic activity in Nigerian diabetics with renal insufficiency.

Diabetics have reduced fibrinolytic activity while chronic renal failure patients are prone to both haemorrhagic diathesis and reduced fibrinolysis. In the quest to find out what obtains when diabetics develop renal impairment, fibrinolytic activity was studied in 51 known diabetics consisting of 9 diabetics with normal renal function, 13 with mild renal impairment and 29 in chronic renal failure. No patient had end-stage renal disease and none was on dialysis therapy. Plasma fibrinogen concentration (PFC) was measured using clot weight method and euglobulin lysis time (ELT) as a measure of fibrinolytic activity was also measured. Our results show that PFC and ELT did not differ significantly in the different groups of diabetics. There was also no correlation between the serum creatinine of all diabetics and PFC on one hand and ELT on the other hand. We conclude that Nigerian diabetics probably still benefit from enhanced fibrinolysis before they reach end-stage renal disease.

Serial haemorheological changes in malnourished African children.

Malnutrition is a major cause of mortality and morbidity in the developing nations, and it is a problem which concerns about half of the worlds children. A total of 50 malnourished children were monitored along with 50 apparently healthy controls, aged 4-9 years for a period of four weeks after admission using haemorheological parameters as monitoring indices for recovery. The malnourished children had significant lower body weight, upper arm circumference and triceps skin fold thickness (P < 0.001). Plasma fibrinogen (PF), plasma viscosity (PV) and packed cell volume (PCV), were estimated. The PF (p < 0.001), PCV (P < 0.001) and PV (p < 0.001) values were significantly lower in the malnourished patients compared with controls. These parameters rose significantly throughout the four weeks of treatment. There was significant positive linear correlation between PCV vs fibrinogen (r = 0.665, P < 0.00137), PCV vs plasma viscosity (r = 0.575, P<0.00797), and fibrinogen vs plasma viscosity, (r = 0.581, P < 0.00718) in the malnourished patients. We suggest that rheological parameters could be a useful indices for monitoring response in African malnourished patients to treatment.

Leucocyte counts in pregnant Nigerian women with sickle cell trait.

White blood count (WBC) with differential counts and packed cell volume (PCV) were studied in 100 pregnant and 30 non-pregnant control women aged 18-45 years. Eighty of the pregnant women were homozygous HbAA and 20 heterozygous HbAS. The non-pregnant women's PCV, lymphocyte and eosinophils counts were significantly higher (p < 0.005) while their leucocytes neutrophil counts were significantly lower (p < 0.005) compared with HbAA and HbAS pregnant women. However, HbAS pregnant women had higher leucocyte, lymphocyte and eosinophil counts compared with HbAA, but these were not significant. There were no variations in basophil and monocyte counts. HbAA pregnant women had no change in PCV but significant changes occurred in leucocyte and neurophil counts with increase in the second trimester with decreasing lymphocyte and eosinophil counts in the second and third trimesters. However, HbAS pregnant women had significant increase in PCV in their first trimester, leucocyte and neutrophil counts in their third trimester but no variation in lymphocyte, eosinophil and basophil and monocyte counts. The increased leucocyte and neutrophil counts in the second trimester in HbAA and third trimester in HbAS may be due to genetic factor and/or oestrogen secretion reaching production peak at different periods of pregnancy. The relative increase in these haematological indices in HbAS women may be a protective mechanism against infection during pregnancy.

The influence of a vegetarian diet on haemostatic risk factors for cardiovascular disease in Africans.

Dietary habits have been implicated in the occurrence of cardiovascular diseases. Elevated plasma fibrinogen levels and decreased fibrinolytic activity have been identified as major independent cardiovascular risk factors. In this study, we compared the blood pressure, plasma fibrinogen concentration, and fibrinolytic activity of 40 nonvegetarians (NON-VEGs) with 36 vegetarians (8 VEGs and 28 SEMI-VEGs). The latter group consisted of students and lecturers of the Adventist Seminary Institute of West Africa, Ilishan Remo. All subjects had blood pressures below 140/90 mmHg, no underlying haemostatic disorders and were not on any medical treatment. The NON-VEGs had significantly decreased fibrinolytic activity (p<0.001) and increased plasma fibrinogen levels (p<0.001) compared with the SEMI-VEGs and VEGs. There were no significant differences between the blood pressure levels of the three groups, although the NON-VEGs had lower diastolic blood pressures. It is concluded that black African Seventh-Day Adventists who follow a vegetarian diet may be protected against premature cardiovascular disease because of beneficial dietary effects on plasma fibrinogen levels and fibrinolytic activity.

Haemorheological and fibrinolytic activity in hypertensive Nigerians.

Hypertension is the most significant cardiovascular risk factor to emerge in developing countries. 64 hypertensives (40 old hypertensives and 18 newly diagnosed hypertensives) and 40 age and sex matched normotensives controls were studied. Plasma fibrinogen concentration (PFC), euglobulin lysis time (ELT) and relative plasma viscosity (RPV) and relative whole blood viscosity (RWBV) were estimated. The PFC, RPV, RWBV and ELT were significantly higher in new and old hypertensives (P < 0.005), respectively, compared with controls, while the RPV was significantly higher (P < 0.005) in new hypertensives than old hypertensives. The significantly higher PFC, RPV and ELT in new hypertensives correspond to higher BP in the new hypertensives than old hypertensives. There were consistence significance levels in PFC, RPV and ELT in both female hypertensives and controls (P < 0.005), respectively, with higher BP in male than female. Though there were no significant mean differences between the hypertensive patients in the first two years of the disease, there were cumulative consistent increase in fibrinogen levels and euglobulin lysis time from two years; while RPV shows inconsistence variation until the 5th year. We conclude that a defective rheology and fibrin-clearing mechanism may contribute to aetiology of vascular complications in hypertensive patients especially in the long term.

Plasma viscosity in nephrotic Nigerians.

A simple and reproducible 'syringe viscometer' method was used to determine plasma viscosity, an important haemorheological parameter, in 27 (14 M, 13 F) nephrotic Nigerian patients. The plasma fibrinogen (PFC) and immunoglobulin levels (IgG, IgM, IgA) were also determined in these patients. Similar determinations were carried out in 30 (15 M, 15 F) age- and sex-matched healthy control subjects for comparison. The nephrotic patients had significantly higher relative plasma viscosity (RPV), PFC and IgM levels (2.02+/-0.17 vs. 1.66+/-0.19, 6.48+/-2.59 vs. 2.26+/-0.91 g/l; 316.2+/-169.0 vs. 186.0+/-59.5 IU/ml, p < 0.001, respectively). However, IgG and IgA levels were significantly less (151.1+/-88.7 vs. 205.7+/-77.6 IU/ml, p < 0.05, and 95.8+/-41.5 vs. 127.3+/-31.3 IU/ml, p < 0.01, respectively). In the nephrotic patients, plasma fibrinogen and IgM levels had a significant positive correlation with RPV (r=0.444, p < 0.05, and r=0.452, p < 0.02, respectively). The observed increased plasma viscosity in our nephrotic patients could on the long term predispose them to increased risk for cardiovascular morbidity.

Blood pressure and blood lipid levels among vegetarian, semi-vegetarian, and non-vegetarian native Africans.

BACKGROUND: Several epidemiological studies have implicated hypercholesterolemia and hypertriglyceridaemia as a dietary risk factor in the etiology of vascular disease. To date, there are virtually no blood lipid data available for Negroid Black African Seventh-Day Adventist vegetarians. This study was undertaken to gain a preliminary and better understanding of the relationships between BP, blood lipids, and diets in adults at the Seventh-Day Adventist Seminary of West Africa, Ilisan-Remo, Nigeria. METHODS: Three randomly selected groups of the Nigerian populace with different dietary habits were investigated. The Seventh-Day Adventist Seminary of West Africa was the study area. Anthropometric measurements, blood pressure, serum cholesterol, triglycerides, and serum glucose were estimated using standard methods. FINDINGS: The vegetarians (VEGs) had significantly lower body weight 75.0 +/- 1.9 kg than the semi-vegetarians (SEMI-VEGs) 77.3 +/- 1.8 kg (p < 0.05). There was no significant difference between the blood pressure (BP) of the three groups studied, although the VEGs exhibited lower systolic BP. The VEGs had significantly lower serum total cholesterol and triglycerides (p < 0.05), than non-vegetarians (NON-VEGs). The SEMI-VEGs had blood triglycerides values in between NON-VEGs and VEGs levels but these were not significant. There were no differences in blood glucose in the three groups. CONCLUSIONS: The vegetarian diet as well as the African natural diet are associated with lower levels of important cardiovascular disease risk factors. The significantly lower cardiovascular disease risk factors in vegetarian African Adventists could be a protective measure against the development of premature IHD and CVD incidence.

Haemorheological changes and fibrinolytic activity in adult asthmatic patients with sickle cell trait (HbAS).

Haemorheological parameters and euglobulin lysis time (ELT) were assessed in eighty-one adult asthmatic patients, 27 in stable state (19 with genotype AA and 8 heterozygous AS), 27 during attack (13 homozygous AA and 13 heterozygous AS) and 27 normal healthy individuals as control group (16 homozygous AA and 11 heterozygous AS). Packed cell volume (PCV), plasma fibrinogen concentration (PFC) and plasma viscosity (PV) were significantly higher in asthmatic patients during attack and stable state (p < 0.001), respectively, than controls. ELT was higher in controls (p < 0.001) than in asthmatic patients during attack. Asthmatic patients during attack have higher PCV, PV, PFC and ELT (p < 0.001), respectively, than patients in stable state. The female have significantly higher PCV (p < 0.001) than male in the control group. Male asthmatic patients have higher PCV and PFC during attack (p < 0.001). Controls with haemoglobin AA have higher PCV (p < 0.001) and lower PFC (p < 0.001) and ELT (p < 0.001) than the control group with haemoglobin AS. Asthmatic patients in stable state have lower PFC (p < 0.001) and plasma viscosity (PV) than AS. The disturbances of fibrinolysis and haemorheology may be a contributory factor in the pathology and aetiology of intermittent bronchospasm episodes during attack.

Effects of oral contraceptives on coagulation factors in African women.

Despite overwhelming evidence that the use of oral contraceptive pills (OCP) may lead to thrombotic episodes, no studies have been performed to investigate the effect of OCP on the coagulation profile in African women. We assessed the levels of fibrinogen, factors VIIc, and VIIIc as well as the fibrinolytic activity in 100 African women on OCP. Fibrinogen levels were significantly increased (p<0.001) and factors VIIc, VIIIc, and fibrinolytic activity significantly decreased (p<0.001) when compared with those of healthy women not on OCP. We conclude that the combination of hyperfibrinogenaemia and decreased fibrinolytic activity combined with a decrease in factor VIIc and VIIIc levels reflects a hemostatic imbalance in African women on OCP that needs to be investigated.