African Journal of Laboratory Haematology and Transfusion Science

Distribution Of Sickle Cell Trait in ABO/Rhesus Blood Types Among Voluntary Blood Donors in Bungoma County, Kenya.

WK Thomas, EO Omwenga, WI Emonyi — Thu, 17 Apr 2025 00:00:00 +0000

Background: Sickle cell trait is a haematological inherited disorder wide spread in several geographical regions. Individuals carrying sickle cell trait genes are asymptomatic and are eligible for blood donation; however, blood donated by these individuals is contraindicated in patients suffering sickle cell anaemia, acidosis and neonates.

Materials and methods: A cross - sectional study carried out in Bungoma County from January to March 2019 enrolled 350 individuals who were screened for haemoglobin S and ABO/Rhesus blood types. Agglutination techniques were applied for ABO/Rhesus blood grouping and hemoglobin S screening was processed by Sodium metabisulphite and Sickle SCAN methods. Participants consented to the study while ethical approvals were sought from relevant authorities. Results: The prevalence of sickle cell trait among blood donors was 14.29%. Sickle cell distribution in Blood groups O, A, B and AB was 12.8%, 14.5 %, 17.7 % and 12.8 % respectively, also there was no relationship between ABO blood groups and sickle cell trait, χ2 = 2.029, P = 0.566.

Conclusion. The Sickle cell trait is prevalent in the blood donor population, and therefore, there is need to screen blood donors or donated blood for haemoglobin S before transfusing vulnerable patients.

Occurrence of Occult Hepatitis B Virus infection in Frequently Transfused Sickle Cell Anaemia Patients in Port Harcourt, Nigeria.

D Blessing, SU Ken-Ezihuo, ZA Jeremiah — Thu, 17 Apr 2025 00:00:00 +0000

Introduction: Hepatitis B virus (HBV) infection is a major global health issue, with over two billion people infected, 250 million of whom live with the virus. Screening tests for hepatitis B surface antigen (HBsAg) have considerably reduced the transmission of HBV infection among blood recipients. However, they fail to detect occult HBV infection (OBI). This study was conducted to determine the prevalence of OBI in frequently transfused sickle cell anaemia patients in Port Harcourt, Nigeria.

Materials and Methods: Ethical approval was obtained from the University of Port Harcourt Teaching Hospital’s Research and Ethics Committee. A total of 50 individuals with sickle cell anaemia participated in this study. Haemoglobin electrophoretic pattern was determined by Cellulose acetate membrane haemoglobin electrophoresis, and qualitative determination of the 5 HBV markers was performed using lateral flow chromatographic immunoassay. Data generated from this study was presented as frequencies and percentages. Fisher's Exact tests were used to test for significant associations between variables, using GraphPad Prism 9, San Diego, CA. Statistical significance was defined as a p-value of less than or equal to 0.05 at 95% confidence interval.

Result: Most participants were under 18, with 39 individuals (78%) falling into this category. The remaining 11 participants (22%) were aged 18 years or older. The mean age of the study population was 13.5 years. Occult Hepatitis B Infection was detected in 5 participants (10%). The remaining 45 participants (90%) tested negative for Occult Hepatitis B Infection. None of the 20 participants who received fewer than five blood transfusions tested positive for OBI (0%). In contrast, among the 30 participants who had received five or more transfusions, 5 tested positive (16.7%), and 25 tested negative (83.3%). The difference in OBI prevalence based on the number of blood transfusions was not statistically significant. (p = 0.0746). Among participants under 18 years of age (39 individuals), 1 tested positive for OBI (2.6%), while 38 tested negative (97.4%). In contrast, among participants aged 18 years and older (11 individuals), four tested positive for OBI (36.4%), and seven tested negative (63.6%). The difference in OBI prevalence between these age groups was statistically significant (p = 0.0063). Gender has no significant effect on the prevalence of occult hepatitis B (P= 0.6418). The difference in OBI prevalence between vaccinated and unvaccinated individuals was not statistically significant (p = 0.5457).

Conclusion: The prevalence of occult hepatitis B was higher in participants aged 18 or older. Multiple transfusion was identified as a factor for the high OBI prevalence among this study population. OBI screening should be considered for frequently transfused sickle cell anaemia patients.

The Impact of Hepatitis-B envelope Antigen and Viremia load on Hematological Parameters and Liver enzymes in Chronic HBV Infection

KO Oyeleke, AA Oladipo, IE Suleiman — Thu, 17 Apr 2025 00:00:00 +0000

Introduction: Hepatitis B viral (HBV) infection is a major cause of chronic liver diseases and failure. While the general impact of HBV on the liver has been extensively studied, there is a relative paucity of information regarding the specific effect of its envelope-antigen (HBeAg) and viremia load on hematopoiesis. Thus, this study aimed to bridge the gap.

Materials and Method: A hospital-based cross-sectional study was conducted between July and October 2024 at Obafemi Awolowo Teaching Hospital, Ile-ife. 73 HBV participants were categorized based on their viremia load and HBeAg status. Standard laboratory procedures were adopted to evaluate various biomarkers. Continuous and categorical data were expressed in mean ± SD and percentage. The study used statistical analysis software, SPSS version 26.

Results: Both HBeAg and high viremia load are associated with transaminase elevation. Lymphocyte and platelet counts were significantly reduced, neutrophil-to-lymphocyte ratio (p=0.044) and platelet-to-lymphocyte ratio (p=0.007) were elevated in HBeAg+. On the other hand, platelet count was reduced considerably (p=0.000) with a high viremia state.

Conclusion: HBeAg+ was associated with increased systemic and hepatic necrotic inflammation. However, a high viremia state was only associated with thrombocytopenia. Thus, regular monitoring of hematological parameters is vital to reduce the consequence of extra-hepatic complications.

Leveraging World Blood Donor Day for Increased Voluntary Unpaid Blood Donation: insights from 2024 Commemoration in Bayelsa State

Thu, 17 Apr 2025 00:00:00 +0000

Voluntary unpaid blood donation (VUBD) is the recommended strategy to ensure a regular supply of safe blood and blood products for countries’ transfusion needs. World Blood Donor Day (WBDD) was established to create awareness about blood donation and to promote VUBD. This paper describes the activities carried out in Bayelsa state Nigeria to commemorate WBDD 2024. Residents of Bayelsa and neighbouring states of Delta and Rivers were informed and educated about the need for voluntary blood donation using the platform of the church, hospital and mass media. At the Federal Medical Centre Yenagoa where a live event took place on 14 June, the WBDD, 102 persons volunteered to donate out of which 16 were found suitable and eventually donated. The main reasons for deferral were high blood pressure, low haemoglobin and pregnancy. World Blood Donor Day rapidly increased the number of voluntary blood donation, but there is a need to sustain the campaign beyond the day to ensure the public is adequately reminded and mobilised to continue to donate voluntarily and regularly.

Association between Haemoglobin Patterns, Platelet Lymphocyte Ratio, and Neutrophil Lymphocyte Ratio in Diabetic and Non-Diabetic Individuals in Port Harcourt, Nigeria.

BW Moore-Igwe, Q-E Wejinya — Thu, 17 Apr 2025 00:00:00 +0000

Introduction: Due to elevated blood sugar, diabetes mellitus is the most common metabolic disease with diverse etiologies. The purpose of this study is to assess the relationship between diabetics' haemoglobin electrophoretic pattern, platelet lymphocyte ratio (PLR), and neutrophil lymphocyte ratio (NLR). This cross-sectional study was conducted on a total of 100 participants, 50 of whom had been diagnosed as having diabetes and the remaining 50 were non-diabetic patients who were chosen from a consenting population at a private hospital in Port Harcourt, Rivers State.

Materials and Methods: The subjects were 50 years of age and older. The whole blood count 3-part analyzer was used to examine the blood samples to obtain the PLR and NLR values, and an electrophoresis machine was employed to ascertain the participants' haemoglobin electrophoretic pattern.

Results: Thirty-five (35) of 100 participants had the genotype AA, while 15 had the electrophoretic pattern AS. Regarding PLR value, there was no statistically significant difference between the diabetic group and the control group PLR value (p = 0. 0.4418) and NLR value (p = 0.7540) at 108.6 ± 40.4 102.7±36.3, respectively. No significant relationship occurred between Absolute Lymphocyte Count and Absolute Neutrophil Count (p = 0.7711) and (p =0.7815) at (2.41 ± 0.83) (2.46 ± 0.81) and (3.10 ± 1.73) (246.1 ± 86.4) for both study subjects and control subjects respectively. Platelet Count at 246.1 ± 86.4 and 242.4 ± 75.9 for both groups was also insignificant statistically (p =0.8246).

Conclusion: The study found no statistically significant difference between the groups. Further testing utilizing other hematological indicators would be required, in addition to considering the stage of diabetes, family history, environment, and lifestyle.

The prevalence and hematological impact of Hepatitis B and C, with a focus on anemia, platelet abnormalities, and blood cell morphology in patients at the University of Port Harcourt Teaching Hospital.

BW Moore-Igwe, GE Gilbert — Thu, 17 Apr 2025 00:00:00 +0000

Introduction: Hepatitis B (HBV) and Hepatitis C (HCV) are bloodborne diseases associated with high rates of illness and mortality, primarily affecting the liver. Hematological parameters play a crucial role in assessing liver health, particularly in diagnosing cirrhosis and hepatocellular carcinoma, as indicated by various research studies highlighting the link between hematological abnormalities and liver diseases. This study aimed to estimate the prevalence of anaemia among patients with Hepatitis B and Hepatitis C receiving care at the University of Port Harcourt Teaching Hospital (UPTH).

Materials and Method: A cross-sectional, hospital-based study was conducted during routine screening of patients with HBV and HCV using rapid diagnostic tests. The study included 85 subjects: 40 cases with Hepatitis B, 20 cases with Hepatitis C, and 25 control subjects (healthy individuals). Blood samples were collected from both case and control groups.

Results: Significant differences were observed among the HBV-positive group compared to the control group. Platelet count (PLT), lymphocytes (LYM), and neutrophils (NEUT) exhibited significant variations at p‹0.05. However, there were no significant differences in hematological parameters between the HCV-positive group and the HCV-negative (control) group at p‹0.05. Morphological variations in blood cells were noted in both HBV and HCV-positive subjects, as well as control subjects. Specifically, 31 HBV-positive subjects showed a microcytic normochromic film appearance, while 9 exhibited a microcytic hypochromic film appearance. Similarly, 12 HCV-positive subjects displayed a microcytic normochromic film appearance, with 8 showing a microcytic hypochromic film appearance. All control subjects exhibited a normocytic normochromic film appearance, except for one who had normocytic hypochromic cells. Thrombocytopenia, indicating platelet depletion due to hypersplenism, was prevalent among HBV patients, highlighting its role as a contributing factor to thrombocytopenia in this group. Proliferation of diseases, drug therapy, and iron deficiency were associated with microcytic anaemia.

Conclusion: The study reveals a higher prevalence of Hepatitis B and C among females, with all HBV-positive subjects showing poikilocytosis, a significant marker of infection. The presence of normocytic hypochromic cells in a control subject warrants further investigation. Further research with larger sample sizes and diverse populations would be beneficial for more definitive conclusions and understanding of broader implications.

Knapsack Spraying of Agrochemicals and Risk of Immunothrombosis Among Farmers in Food Production and Marketing in Cross River State, Nigeria

CD Nnadi, EC Akwiwu, JO Akpotuzor, FN Nnadi — Thu, 17 Apr 2025 00:00:00 +0000

Introduction: Knapsack sprayers for agrochemicals are employed on a large scale by small, medium, and largescale farmers due to many favorable reasons. However, there are concerns regarding lack of information as well as inadequate education among farmers handling agrochemicals. Much of these concerns are based on previous reports from other localities suggestive of serious health risks.

Methods: Study participants constituted of equal numbers of agrochemical-exposed farmers and controls totaling one hundred and thirty persons. Blood sample was collected from each participant into appropriate sample bottles. Blood cell counts were carried out by haemocytometry and microscopy, while blood cell ratios were calculated. Results are expressed as Mean ±SD following student t-test analysis of data on SPSS version 22.0. Statistical significance was drawn at a p≤ 0.05.

Results: The farmers exposed to agrochemicals had significantly higher values than control subjects in the following parameters; neutrophil count (2.65±1.10x10⁹/l vs 2.13±0.61x10⁹/l), eosinophil count (0.15±0.12x10⁹/l vs 0.05±0.04 x10⁹/l), basophil count (0.02±0.01x10⁹/l vs 0.01±0.01 x10⁹/l) and platelets count (250.74±78.19x10⁹/l vs 152.31±35.43 x10⁹/l), while lymphocyte count was lower (2.31±0.46 x10⁹/l vs 2.55±0.68 x10⁹/l). Comparatively, the two derivatives were also higher in the farmers; NLR (1.17±0.40 vs 0.86±0.27) and PLR (111.42±38.49 vs 61.11±11.54). Persons with more than 5 years of exposure had lower lymphocyte count (2.18±0.39x10⁹/l vs 2.42±0.49x10⁹/l) but higher platelets count (280.42±73.90x10⁹/l vs 223.68±72.87x10⁹/l) and PLR (130.31±36.48 vs 94.19±31.97).

Conclusion: Farmers engaging in knapsack spraying of agrochemicals are at risk of developing immunothrombotic conditions. Longer duration of exposure exerts a significant increase in the platelet-lymphocyte ratio.

Management of Anaemia during Pregnancy: Insights into Pathophysiology and Public Health Implications in Sub-Saharan Africa

Thu, 17 Apr 2025 00:00:00 +0000

Anaemia during pregnancy remains a significant public health concern, particularly in sub-Saharan Africa (SSA), where it is a leading cause of maternal and perinatal morbidity and mortality. Anaemia affects nearly half of all pregnant women in SSA, with iron deficiency, malaria, and HIV among the primary contributors. The condition exacerbates maternal risks, including postpartum haemorrhage and preeclampsia, while increasing the likelihood of adverse fetal outcomes such as preterm birth and low birth weight. Effective management requires a multifaceted approach, including iron and folate supplementation, malaria prophylaxis, and dietary fortification programmes . Novel strategies, such as improved formulations of iron supplements and genetic screening for haemoglobinopathies, are showing promise in addressing this complex condition. Despite advances, significant knowledge gaps persist, particularly regarding long-term outcomes and barriers to care. Addressing these gaps through further research and tailored policies is vital to improving maternal health outcomes in SSA and achieving global health targets

Distribution of Haemoglobin Genotypes, Awareness, Motivators, and Barriers to Genotype Testing Among Health Science Students at Maflekumen Higher Institute Tiko, South West Region of Cameroon

CL Deng, CN Sawah, FB Tangi, AE Bate, NB Atekwane, SJ Labu, AA Ewang — Thu, 17 Apr 2025 00:00:00 +0000

Background:Haemoglobin genotype testing is a crucial preventive measure against sickle cell disease (SCD) which encompasses all conditions associated with sickling of the red blood cells including sickle cell anemia, sickle cell trait and compound heterozygous. While students enrolled in health science programs are expected to be aware of genotype testing, various factors influence their decision to undergo screening. This study aimed to determine the distribution of haemoglobin genotypes, assess awareness of genotype testing and identify motivators and barriers to early genotype testing among health science students at Maflekumen Higher Institute, Tiko.

Materials and methods: A cross sectional study was conducted among health science students from December 2024 to January 2025. Haemoglobin genotype screening was performed using the sickle SCAN and data on their awareness, motivators, and barriers to testing were collected using a semi-structured questionnaire. The data was analyzed using the Statistical Package for Social Sciences version 25.0 software application. The Chi square statistical test was employed to assess the association between variables. A p value <0.05 was considered statistically significant.

Results:The majority (81.3%) of the 134 participants were females and 57.5% were in their second year of studies. Haemoglobin genotype distribution showed that 84.3% of participants had normal adult human haemoglobin (HbAA) and 15.7% had the sickle cell trait (HbAS), with no cases of sickle haemoglobin S (HbSS), sickle haemoglobin C (HbSC) and sickle haemoglobin C trait (HbAC) detected. The distribution of haemoglobin genotypes was not influenced by socio-demographic factors such as gender (p=0.06), age group (p=0.71), level of study (p=0.62) or marital status (p=0.46). The awareness of haemoglobin genotype testing was high (95.5%), with significant differences by level of study (p=0.009) as students in their first year of study had the lowest awareness (66.7%). The primary motivators for undergoing testing were personal curiosity (51.5%) and relationship or marriage considerations (43.3%). Other motivators to genotype testing identified were affordable cost of testing (14.2%), family history of sickle cell disease (13.4%), institution requirement (12.7%) and peer influence (3.0%). The key barriers identified were high cost of the testing (48.1%), lack of awareness (35.1%), and limited access to testing services (20.9%). Other barriers to testing were no perceived need to know genotype (6.7%), fear of results (2.2%) and religious/cultural beliefs (1.5%).

Conclusion: The study demonstrates that while awareness of haemoglobin genotype testing is high among health science students, barriers to testing such as cost of testing and lack of accessibility persist. This study underscores the need of policies that integrate haemoglobin genotype screening into students’ health programs, subsidize cost of testing and establish on campus screening facilities.

Long-lasting antibody responses in COVID-19: natural infection versus vaccination.

J Alalibo, BW Moore-Igwe, ZA Jeremiah — Thu, 17 Apr 2025 00:00:00 +0000

Introduction: The COVID-19 pandemic caused by the SARS-CoV-2 virus was a devastating global occurrence that has prompted extensive efforts to diagnose and control its spread. Vaccination eventually emerged as a key strategy to mitigate the impact of the virus, yet several questions emerged on the efficacy of the vaccination in sustaining immunity in infected and non-infected subjects. There were also controversies that vaccination does not offer any advantage over herd immunity. This study was aimed at detecting the presence of SARS-CoV 2 Nucleocapsid IgM and IgG in vaccinated and unvaccinated subjects to bridge this knowledge gap.

Materials and Methods: This case-control study involved 80 subjects, including COVID-19-positive subjects, COVID-19-vaccinated subjects, and non-vaccinated COVID-19-negative subjects. Four milliliters (4ml) of blood were collected from each subject by standard venipuncture to assess SARS-CoV 2 Nucleocapsid IgM and IgG using an ELISA procedure. The data generated from this study were represented as percentages and mean ± SD where necessary. Inferential statistical analyses were performed using chi-square and unpaired t-tests with the aid of GraphPad Prism Software Version 9. Statistical significance was defined as a p-value of less than 0.05 at a 95% confidence interval.

Results: Using the calculated cut-off values from the test and controls, nucleocapsid IgG antibodies were detected in 11(50%) of the unvaccinated COVID-19 positive subjects and 3(7.9%) in the vaccinated positive COVID-19 subjects. Eleven (11) (50%) of those who tested negative for SARS-CoV-2 had the IgG antibodies detected in their serum as well giving a 50/50 situation, while surprisingly, 35(92.1%) of the vaccinated subjects tested negative for IgG antibodies (χ²=13.81, P=0.002). Nucleocapsid IgM antibodies were detected in 19(86.4%) of COVID-19 positives and only 3(13.6%) among COVID-19 negatives. The vaccinated IgM antibodies were detected in 38(100%) COVID-19-positive subjects while zero percent was detected among those who were COVID-19-negative (χ²=5.455, P=0.01). Overall, IgG antibodies were detected in 14 (23.3%) COVID-19-positive subjects and IgM in 57 (95%) COVID-19 subjects.

Conclusion: Distinct antibody response patterns were observed, with natural infection resulting in a more balanced distribution of IgG positivity compared to a pronounced skew towards negativity in the vaccinated group. The high prevalence of IgM in vaccinated individuals indicates a robust early immune response post-vaccination, suggesting the efficacy of vaccines in priming the immune system.

Donor Health Monitoring: Strategies for Preventing Short- and Long-term Effects of Apheresis

Thu, 17 Apr 2025 00:00:00 +0000

Apheresis is a vital procedure in transfusion medicine and therapeutic applications, enabling the collection of specific blood components or the therapeutic removal of pathological substances. While generally safe, apheresis presents notable challenges related to donor health, particularly in the context of repeated donations. Short-term complications, including hypocalcaemia, vasovagal reactions, and localised venous access issues, can cause immediate discomfort and procedural disruptions. Long-term effects, such as iron deficiency, bone density reduction, and potential immune dysregulation, also pose significant risks to frequent donors. Donor health monitoring is important in preventing these adverse effects by carrying out pre-donation screening, monitoring, and follow-up protocols. Despite these measures, challenges and research gaps remain, particularly concerning the long-term impacts of repeated apheresis on donor immune function and overall health. This review explores evidence-based strategies to mitigate these effects, and ensure donor safety while sustaining a reliable supply of blood products.

Evaluation of Coagulation Markers in Pregnant Women Attending Antenatal Care at a Teaching Hospital in Aba, Nigeria.

R Agor, OC Okamgba, CM Chima, IW Nwankwo, A Ilesanmi, I Chukwudi — Thu, 17 Apr 2025 00:00:00 +0000

Introduction: Pregnancy may alter the haemostatic sstem, which is directed at protecting the maternal subjects from haemorrhage during pregnancy and postpartum and the foetal subjects during implantation. This study was set to investigate the effect of pregnancy on the haemostatic system. It is with a predisposition to coagulopathy

Materials and Methods : The study was conducted in Abia State University Teaching Hospital, Aba. A total of 72 healthy subjects, 40 pregnant women and 32 nonpregnant women that served as control, were recruited for the study. The subjects were between 20 – 45 years. The haemostatic parameters studied were Prothrombin time, Platelet count and Antithrombin III. The Prothrombin time was measured by manual method, Platelet count by auto hematology analyzer, and Antithrombin III using an Enzyme-linked immunosorbent assay technique. Data were analysed using Student’s t-test, ANOVA, Pearson’s correlation coefficient, and p values set at < 0.05.

Results: Mean±SD 12.34±1.27 s, 173.95±50.22×10^9/L for Prothrombin time and Platelet count respectively were shortened and statistically significant when compared with 13.48±0.68s, 258.00±35.77 ×10^9/L for Prothrombin time and Platelet count respectively for the control (p<0.05). Mean±SD of Prothrombin time in 3rd trimester (11.44±1.17 s) was significantly shortened in comparison with 12.92±1.11s and 12.94±0.84s for 1st and 2nd trimesters respectively (p<0.05). Mean ±SD 1836.29±386.47ng/ml for Antithrombin III for 1st trimester was statistically lower when compared with 2590.59±739.78ng/ml, and 3772.01±902.11ng/ml for 2nd and 3rd trimesters, respectively. No correlation existed between Platelet count and Antithrombin III (r = 0.30, p = 0.058).

Conclusion: The findings of this study showed that pregnancy alters haemostatic indices but may not necessarily predispose to clinical coagulopathy.

Assessment Of The Antioxidant and Antianemic Properties Of Hydro-Methanolic Extracts of Indigofera Pulchra In Wistar Rats

Y Layibo, MDI Kueviakoe, EA Akpalo, H Magnang, K Mawussi, A Agbonon — Thu, 17 Apr 2025 00:00:00 +0000

Introduction: Anemia is a multifactorial condition that can be associated with hemolysis and oxidative insults related to various diseases worldwide and in subtropical regions of Africa. Decoctions of Indigofera pulchra are used to treat anemia that may be associated with oxidative insults. In this study, we evaluated the antioxidant and antihemolytic properties of hydro-methanolic extracts of this plant.

Materials and methods: DPPH and FRAP tests were performed to assess the antioxidant activities of the extracts. Hemoglobin level, reticulocyte count, and erythrocyte osmotic fragility were evaluated in different groups of phenylhydrazine-induced anemic Wistar rats receiving orally distilled water (negative control), folic acid and iron (positive control), and different doses of the extract.

Results: The IC50 value for the DPPH radical scavenging activity of I. pulchra extract was 295.5 ± 50.8 μg/mL and 16-fold higher than quercetin’s (P-value = 0.032). The FRAP of I. pulchra extracts yielded 40.8 ± 2.5 mmol FeSO4/g corresponding to an EC50 of 180± 26.0 μg/mL which was 7.4-fold higher than the FRAP EC50 value of quercetin (P-value < 0.001). There was no significant effect of the extract on phenylhydrazine-induced anemia and erythrocyte osmotic fragility in rats.

Conclusion: Despite its use in traditional medicine and observed antioxidant activity, Indigofera pulchra extracts showed no significant antianemic effect.