Prevalence of Hepatitis B surface antigen among biomedical students of African descent in Usmanu Danfodiyo University, Sokoto, Nigeria.

BACKGROUND: Hepatitis B (HB) is a serious global public health problem that put health professionals particularly at risk. OBJECTIVE: The aim of this study was to investigate the prevalence of Hepatitis B surface antigen (HBsAg) among Biomedical Students of African descent attending Usmanu Danfodiyo University Sokoto in North-Western Nigeria. METHODS: The Onsite HBsAg (CTK Biotech, USA) was used to detect the presence of hepatitis B surface antigen. RESULTS: We tested 186 consecutively-recruited students consisting of 147 males and 39 females aged 18-35 years (mean age 26 ± 2.0 years). Of the 186 students tested, 25 (13.4%) were positive for HBsAg. The prevalence of HBsAg was significantly higher among students in the 21-25 years age group. Hepatitis B vaccination uptake among students was 7%. Majority of subjects were single 173(93.1%) compared to married 13 (6.9%). Ethnic distribution of the subjects indicated that 104(55.9%) were Hausa compared to Yoruba 32 (17.2%), other ethnic groups 21(11.3%), Fulani 20(10.8%) and Igbo 9(4.8%). CONCLUSIONS: This study indicates a high prevalence of hepatitis B virus infection among Biomedical students in Sokoto, North Western, Nigeria. Finding from this study is enough justification for the implementation of a policy to routinely test students entering into the biomedical professions for Hepatitis B virus infection. There is the need to provide hepatitis B vaccination universally to all those who are found negative prior to commencement of their biomedical training. There is also need to educate students entering biomedical professions and healthcare workers on the modes of transmission and prevention, importance of being compliant with protective vaccination as well as the need to observe universal precaution and infection control guidelines during their training and future professional practice.

Defining Iron Deficiency Anaemia in Pregnancy: the Diagnostic Role of Serum Iron Indicators and C-reactive Protein

Background: Definition of iron deficiency anaemia could be problematic in areas where iron deficiency co-exists with infection. Aim: This study was aimed at providing the prevalence of anaemia in pregnancy in Port Harcourt and to examine the diagnostic role of serum iron indicators and C- reactive protein in defining iron deficiency anaemia. Methods: Iron status indicators; serum iron; TIBC; percentage transferrin saturation; serum ferritin; haemoglobin concentration and C-reactive protein were assessed in 1;371 pregnant women and 60 age-matched non-pregnant controls using standard colorimetric; immunoassay and serologic procedures. Results: Iron deficiency anaemia was present in 5of our apparently healthy non-pregnant women and in 8.9of the pregnant women. Iron deficiency (ferritin 12 ng/ml) accounted for 15of anaemia in the control group and 18.0of anaemia in the pregnant women. Elevated C-reactive protein (20 mg/l) was found to be common with the anaemic pregnant women (40.2) compared with 6.7among non-pregnant control group (p0.0001). The Hb; serum iron; TIBC;transferrin saturation and serum ferritin levels in anaemic pregnant women were found to be significantly lower than the non-pregnant control group (p0.0001) while the C-reactive protein level in the anaemic pregnant women was significantly higher than the non-pregnant control group (p0.0001). Conclusion: The prevalence of iron deficiency anaemia among apparently pregnant women in this locality is high. Part of the contributory factor may be infection or inflammation; hence; ferritin alone may not reliably define anaemia in pregnancy. A combination of haemoglobin concentration; transferrin saturation and serum ferritin concentration should form a regular practice in order to assist in reducing the incidence of anaemia in pregnancy

Exposure of petrol station attendants and auto mechanics to premium motor sprit fumes in Calabar, Nigeria.

A population-based-cross-sectional survey was carried out to investigate the potential risk of exposure to premium motor spirit (PMS) fumes in Calabar, Nigeria, among Automobile Mechanics (AM), Petrol Station Attendants (PSA) and the general population. Structured questionnaire was administered on the randomly chosen subjects to elicit information on their exposure to PMS. Duration of exposure was taken as the length of work in their various occupations. Venous blood was taken for methaemoglobin (MetHb) and packed cells volume (PCV). Mean MetHb value was higher in AM (7.3%) and PSA (5.8%) than in the subjects from the general population (2.7%). PCV was lower in PSA (30.8%), than AM (33.3%) and the subjects from the general population (40.8%). MetHb level was directly proportional, and PCV inversely related, to the duration of exposure. The study suggested increased exposure to petrol fumes among AM, PSA, and MetHb as a useful biomarker in determining the level of exposure to benzene in petrol vapour.

Childhood asymptomatic malaria and nutritional status among Port Harcourt children.

OBJECTIVE: Our study in Port Harcourt children with asymptomatic malaria aimed at assessing the baseline anthropometric indices of nutritional status, and whether their nutritional status (especially under nutrition) offers any advantage for living in malaria endemic areas. DESIGN: Cross-sectional study was used. SETTING: Rumueme Community in Port Harcourt, Nigeria. SUBJECTS: Apparently healthy children aged 1-8 years of both sexes (Boys = 117, Girls = 123; Ratio 1:1.05), 240 children from randomly selected households within the study community participated in the study. RESULTS: Of the 240 children, 66 (27.5%) were infected with malaria (P falciparum). Children below 5 years had a higher parasitaemic rate (36.36%) than those in 5-8 years group (21.27%). Our baseline data showed that 17.5% were underweight (WFA Z < -2), 3.75% were stunted (HFA Z < -2) and 22.5% were wasting (WFH Z < -2). Children who are underweight were found to be at higher risk of acquiring malaria infection than the well nourished children (RR = 1.02, chi2 = 0.320, p < 0.02, 95% CI 0.34-2.37). Under nutrition was more prominent in the children below 5 years than the older children (RR = 3.625, chi2 = 10.36, p < 0.006, 95% CI 1.81-5.43). The haemoglobin value of parasitized children (10.8 +/- 1.9 g/dl) was significantly lower than the non-parasitized group (11.3 +/- 1.7 g/dl,) (p < 0.01). CONCLUSION: We concluded that the presence of under nutrition places children (especially below 5 years of age) at higher risk of malaria related morbidity. Children in malaria endemic areas need adequate nutrition to withstand the negative impact of malaria.

Absolute lymphocyte count as a marker for CD4 T-lymphocyte count: criterion for initiating antiretroviral therapy in HIV infected Nigerians.

BACKGROUND: Few laboratories in resource-constrained countries can afford to perform laboratory-monitoring tests required for the implementation of HIV therapy. In this case control study, we have investigated the relevance of absolute lymphocyte count as a surrogate marker for CD4 lymphocyte count as a criterion for initiating HAARTin HIV-infected Nigerians. METHODS: A total of 100 consecutive recruited HIV-infected, previously antiretroviral naive persons and 30 HIV-negative individuals blood samples were run for absolute lymphocyte and CD4 lymphocyte counts and results were compared by a model of linear regression analysis. RESULTS: An overall modest correlation was observed between absolute lymphocyte count and CD4 lymphocyte (r = 0.51) and at CD4 lymphocyte threshold relevant for clinical management of HIV-infected; <200, 200-350 and >350 cells/microL (r = 0.41, 0.30 and 0.21) respectively. Mean absolute lymphocyte count of 1.60 +/- 0.77 x 10(9)/L, 1.88 +/- 1.11 x 10(9)/L and 2.04 +/- 0.54 x 10(9)/L was equivalent respectively to CD4 of <200, 200-350 and >350 cells/microL. CONCLUSIONS: This study indicates a modest correlation between absolute and CD4 lymphocyte counts of HIV-infected Nigerians and at CD4 lymphocyte count threshold significant for clinical management of HIV-infected. Absolute lymphocyte count can become a minimal inexpensive alternative to CD4 lymphocyte count in conjunction with WHO staging and clinical status of patient in determining the optimal time to initiate therapy particularly in resource limited settings where other expensive methods of CD4 enumeration are unavailable.

Methaemoglobin profile in malaria infected children in Calabar.

BACKGROUND: Malaria infection interferes with haemoglobin by disruption of red blood cells and by conversion of haemoglobin to methaemoglobin. This study was to determine the relationship between malaria and the concentration of methaemoglobin using malaria patients. METHODS: Severe malaria-infected children of ages 11 months to 15 years recruited from the children emergency room of University of Calabar Teaching Hospital (UCTH) were used for the study while 62 age--sex matched apparently healthy school children and children that visited the child welfare clinic of UCTH were screened and used as controls. Malaria detection and identifications using WHO procedure were employed. Methaemoglobin (Met Hb) levels were determined using the method of Evelyn and Malloy. RESULTS: The mean MetHb value for malaria-infected children was higher (3.2 +/- 0.8%) than that of the non- malaria infected subjects (1.5 +/- 0.5%). The difference was significant (p < 0.001). Patients with severe malaria parasitaemia had markedly raised MetHb values of 4.0 +/- 0.9% as compared to the values for mild/moderate infected cases (2.9 +/- 0.6%). The difference was statistically significant (p < 0.001). CONCLUSION: This study has demonstrated high level of MetHb value in subjects with severe malaria parasitaemia. It's role in the symptomatology and complications of malaria infection, especially in malaria anaemia should be examined in details. Routine estimation of MetHb in malaria patients is suggested.

Glucose-6-phosphate dehydrogenase (G-6-PD) levels in jaundiced neonates in Calabar.

BACKGROUND: Glucose-6-phosphate dehydrogenase (G-6-PD) is an enzyme in the first step of the hexose-monophosphate shunt required for the generation of nicotinamide adenine dinucleotide phosphate (NADPH). Red blood cells of neonates with deficient G-6-PD are potentially susceptible to acute severe haemolysis and may result in haemolytic jaundice. This study was to determine the association between neonatal jaundice and G-6-PD activity and the degree of deficiency of this enzyme among the affected neonates. METHODS: G-6-PD levels in jaundiced neonates admitted into the Special Care Baby Unit (SCBU) of the University of Calabar Teaching Hospital were assayed between May 2000 and April 2001 using Biotic (London) diagnostic assay kit method. Data was analyzed using SPSS (base 705) data Editor (Microsoft Windows 95). RESULTS: A total of 102 jaundiced neonates between ages 1 and 10 days were studied. Out of the 102 jaundiced neonates, 39 (38.2%) were G-6-PD deficient with G-6-PD concentration of 48.89 +/- 72 mU/10(12) erythrocyte compared to 129.51 +/- 0.92 mU/10(12) erythrocyte in the remaining 63 subjects. The prevalence rate of G-6-PD deficiency among jaundiced neonates was 38% which is significantly high (p < 0.05) considering the study sample size. There was no significant difference (p > 0.05) in G-6-PD level in the males and females. CONCLUSION: G-6-PD activity is low in a number of jaundiced patients. Routine assay of G-6-PD in jaundiced patients is recommended.

Frequency of foetal haemoglobin and haemoglobin values in various haemoglobin genotypes in Calabar, Nigeria.

The frequency of foetal haemoglobin (HbF) and haemoglobin (Hb) levels were determined among 108 subjects with different haemoglobin genotypes in Calabar, between March and October, 1996. Hb-genotype was determined using the cellulose acetate method, while HbF and Hb were estimated using the modified Betke alkaline denaturation method and cyanmethaemoglobin techniques respectively. Haemoglobin genotype SS individuals had the highest mean HbF concentration of (3.05 +/- 1.61) as compared to AA and AS subjects with means of 0.195 +/- 0.25 and 1.072 +/- 0.98 respectively. This relationship was statistically significant (P < 0.02). On the other hand, AA subjects had the highest mean haemoglobin concentration (12.79 +/- 1.19) while SS subjects had the lowest (10.65 +/- 2.06). This study has indicated the persistence of HbF into adult life in this locality. Since HbF is associated with natural anti-sickling properties, its role as a monitoring factor in the management of sickle cell anaemia is examined in detail.