Prevalence of hepatitis B virus core antibodies among blood donors in Nigeria: Implications for blood safety.

Background: Anti-hepatitis B core antibody (anti-HBc) testing improves transfusion safety by detecting past and current hepatitis B virus (HBV) infection while detecting hepatitis B surface antigen (HBsAg) in serology-negative HBV infection. However, occult HBV infection (OBI) (serum or liver HBV DNA-positive but HBsAg-negative) remains unaddressed among replacement blood donors - family members or friends who donate to replace blood transfused to a relative. Objective: This study assessed risk factors for a positive anti-HBc test among donors with OBI and determined the anti-HBc-positive status of replacement donors. Methods: The study was conducted at the University College Hospital Blood Bank, Ibadan, Nigeria, using blood samples collected from blood donors between April 2019 and May 2019. Donors were screened for HBsAg by rapid diagnostic test (RDT) and enzyme-linked immunosorbent assay (ELISA) and anti-HBc by ELISA, while HBV DNA was detected using a semi-nested polymerase chain reaction. Results: Of the 274 participants, 15 (5.5%) were HBsAg-positive by RDT and 36 (13.1%) by ELISA, while 133 (48.5%) were anti-HBc positive. Out of 232 HBsAg-negative donors, 107 (46.1%) were anti-HBc positive. Of the 107 HBsAg-negative but anti-HBc-positive samples, only one (0.93%) was HBV DNA-positive. The HBV DNA-positive donor was HBsAg-negative by both RDT and ELISA tests. Conclusion: This study establishes a potential risk for HBV transmission from isolated anti-HBc-positive donors to blood recipients. HBc immunoglobulin (antibody) M testing to identify blood units requiring further screening with polymerase chain reaction to detect OBI can prevent HBV transmission through blood transfusion.

Anti-sickling activities of two isolated compounds from the root of Combretum racemosum P. beauv. (Combretaceae).

ETHNOPHARMACOLOGICAL RELEVANCE: Evaluation of plants such as Combretum racemosum with claimed traditional use in the management of sickle cell anaemia in Nigeria and other parts of West Africa could serve as a useful research strategy in the search for potential anti-sickling drugs and templates. AIM OF THE STUDY: This study aimed at evaluating the antisickling potential of C. racemosum by activity-guided purification and isolation of its active constituents. MATERIALS AND METHODS: Crude methanol extract of the root of C. racemosum and the fractions obtained by partitioning with chloroform, ethyl acetate, and aqueous were investigated for anti-sickling activity against sodium metabisulphite induced sickling of sickle cell haemoglobin (HbSS). Repeated chromatographic separations were conducted on the most active chloroform fraction to purify and isolate bioactive compounds for further tests for anti-sickling activity. The characterization of the isolated compounds was done by mass spectrometry (FD+MS) and nuclear magnetic resonance (1HNMR) spectroscopy. RESULTS: The chloroform fraction (FA) (% sickled erythrocyte ranged from 3.0 to 34.1) exhibited better anti-sickling activity than aqueous (% sickled erythrocyte ranged from 38.9 to 51.5) as well as the crude methanol (% sickled erythrocyte ranged from 19.1 to 30.4). Hence, the phytochemical investigation was focused on the chloroform fraction, which led to the identification of two ellagic acid derivatives (3,3',4'-tri-O-methyl ellagic acid (A) and 3,3'-di-O- methyl ellagic acid (B). The two isolated compounds possessed good, comparable anti-sickling activities with compound A exhibiting a slightly better in vitro activity. CONCLUSION: This paper reports for the first time anti-sickling principles from C. racemosum and therefore, provided some justification for the ethnomedicinal use of the plant in the management of sickle cell disease.

Acute leukemia in sickle cell disease patients in a tertiary health facility in Nigeria: a case series.

BACKGROUND AND OBJECTIVES: Sickle cell disease(SCD) is a disorder of red cells resulting from the co-inheritance of haemoglobin S (HbS) with another abnormal haemoglobin. The diagnosis of acute leukaemia is uncommon in our patients with sickle cell disease more so the patients have high morbidity and mortality due to the sickling process. Acute leukemia is a malignant clonal disorder of haemopoietic precursor cells resulting in accumulation of immature blood cells in the bone marrow and blood. The objective of the case series was to highlight the challenges of diagnosis and management of SCD patients with acute leukaemia, the importance of peripheral blood film review and propound a possible risk factor. METHODS: Records of 58 patients diagnosed and managed for acute leukaemia over a 7 year period at the University College Hospital, Ibadan were reviewed. The diagnosis of acute leukaemia was based on clinical features in addition to peripheral and bone marrow smears findings. Microsoft excel version 2013 was used for statistical analysis. RESULTS: Five (8.6%) of the patients with acute leukaemia also had sickle cell disease: 3 males and 2 females were described. Recurrent fever and anaemia were the most consistent presenting features in the patients. All the patients were not on any routine medications meant for SCD patients and had poor history of clinic attendance prior to the diagnosis of acute leukaemia. The diagnosis of acute leukaemia was not made until the patients were seen by a haematologist. The principal tool of diagnosis in all the patients was peripheral blood film review. Two patients were discharged against medical advice. The treatment period ranged between one month and one year in the remaining three patients. CONCLUSION: SCD patients are not exempted from developing acute leukaemias and the diagnoses of the two conditions overwhelms the social and economic support of patients and care givers. The study also underscores the relevance of high level of suspicion and prompt review of peripheral blood film of SCD patients particularly when patients present with unremitting symptoms associated with anaemia and fever.

Knowledge, attitude and practice of good nutrition among women of childbearing age in Somolu Local Government, Lagos State.

Women of child-bearing age (especially pregnant and lactating women) are in the most nutritionally-vulnerable stages of the life cycle. The aim of this study was to assess the knowledge, attitude and practice of good nutrition among women of childbearing age in Somolu Local Government (LG), Lagos state. This study was a crosssectional descriptive survey of 244 women of childbearing age (15-49 years). Excellent knowledge and good attitude towards good nutrition was observed among 61.89% and 86.89% respectively. During pregnancy, greater than 80% took folic acid, iron supplements and increased daily consumption of fruits and vegetables while 43.59% avoided eggs, fish, meat and chocolate beverage because of taboos. Seven days prior to interview, over 90% had consumed fast foods, 56.15% and 50.01% of the respondents ate fruits and vegetables every day to ≥4 times in a day respectively. A majority of the respondents knew and had a good attitude towards good nutrition supporting studies from Kenya and Northern Nigeria. This, however, did not translate to good practice for about half of the respondents.

Knowledge, attitude and practice of good nutrition among women of childbearing age in Somolu Local Government, Lagos State

Women of child-bearing age (especially pregnant and lactating women) are in the most nutritionally-vulnerable stages of the life cycle. The aim of this study was to assess the knowledge, attitude and practice of good nutrition among women of childbearing age in Somolu Local Government (LG), Lagos state. This study was a crosssectional descriptive survey of 244 women of childbearing age (15-49 years). Excellent knowledge and good attitude towards good nutrition was observed among 61.89% and 86.89% respectively. During pregnancy, greater than 80% took folic acid, iron supplements and increased daily consumption of fruits and vegetables while 43.59% avoided eggs, fish, meat and chocolate beverage because of taboos. Seven days prior to interview, over 90% had consumed fast foods, 56.15% and 50.01% of the respondents ate fruits and vegetables every day to ≥4 times in a day respectively. A majority of the respondents knew and had a good attitude towards good nutrition supporting studies from Kenya and Northern Nigeria. This, however, did not translate to good practice for about half of the respondents

Negative peri-donation events among whole blood donors in a blood bank in Ibadan, Nigeria.

The existence and sustenance of the blood bank depends on blood donors. It is imperative that the donation experience is satisfactory for the donors. Therefore this study was carried out to determine the frequency of undesirable events experienced by the blood donor as part of donor haemovigilance. This was a retrospective descriptive study of the events that occurred amongst the blood donors of the blood bank of a tertiary institution. The blood donor incident book was reviewed for the period of six months. Negative undesirable events occurred in 2% of the donor populations, of which 45.8% could not complete the blood donation process while only 16.7% completed the blood donation process. Mild vasovagal attack occurred in 0.2% of the donor population. Undisclosed deferrable risk factors/ behaviours were identified by the phlebotomist in the bleeding room which made donors unfit for donation even though they had passed the donor screening criteria. This accounted for 20.8% of those with negative experience. Guidelines are required to identify donors that are not likely to complete donation to avoid wastage of time, blood, resources and reduce undesirable experiences.

Negative peri-donation events among whole blood donors in a blood bank in Ibadan, Nigeria

The existence and sustenance of the blood bank depends on blood donors. It is imperative that the donation experience is satisfactory for the donors. Therefore this study was carried out to determine the frequency of undesirable events experienced by the blood donor as part of donor haemovigilance. This was a retrospective descriptive study of the events that occurred amongst the blood donors of the blood bank of a tertiary institution. The blood donor incident book was reviewed for the period of six months. Negative undesirable events occurred in 2% of the donor populations, of which 45.8% could not complete the blood donation process while only 16.7% completed the blood donation process. Mild vasovagal attack occurred in 0.2% of the donor population. Undisclosed deferrable risk factors/ behaviours were identified by the phlebotomist in the bleeding room which made donors unfit for donation even though they had passed the donor screening criteria. This accounted for 20.8% of those with negative experience. Guidelines are required to identify donors that are not likely to complete donation to avoid wastage of time, blood, resources and reduce undesirable experiences

Trends in transfusion-transmitted viral infections from 2001 to 2006 in Ibadan, Nigeria.

OBJECTIVE: Screening of blood before transfusion is an effective strategy to reduce transfusion-transmitted viruses. However, reports on viral marker trends among the donor population are scarce. This study looked at trends in the seroprevalence of hepatitis B (HBV) and C (HCV) and human immunodeficiency virus (HIV). METHOD: This is a retrospective study among blood donors at a tertiary hospital in Nigeria. We used the blood bank records to calculate yearly seroprevalence rates for HBV, HCV and HIV per 100 donations from 2001 to 2006. RESULTS: A total of 33,682 prospective donors were screened, of which 13.2% were positive for HBsAg. The overall seroprevalence rates for HIV and HCV were 7.66% and 3.69%, respectively. HIV seroprevalence rose from 4.25% in 2001 to peak at 12.64% in 2003, before a steep drop to 6.35% in 2004 and a gradual decline to 5.70% in 2006 (p < 0.05). CONCLUSION: The seroprevalence rates for HIV and HBsAg fluctuated greatly during the study period while the seroprevalence of HCV was consistent. The screening kits used may be partly responsible for these fluctuations. Innovative programs for donor education, with the use of a formal questionnaire in donor selection, are recommended to ensure a safe donor population.