Department of Haematology and Blood Transfusion

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Open Access
Coagulation profile in normal full-term neonate in the first week of life in Lagos-Nigeria
(International Journal of Medical Research & Health Sciences, 2016) Garba, N; Ogbenna, A.A; Adediran, A; Fajolu, I.B
Normal reference values of haemostatic profile are frequently needed to assist in diagnosis and management of bleeding disorders. Because of the anatomical and physiological differences between neonates and adults, it is essential to know the reference range of coagulation profile in neonates in the first week of life. The aim of this study is to establish a normal reference range for coagulation profile in normal full-term neonates in the first week of life in Lagos-Nigeria. This is a cross-sectional study carried out among normal full-term neonates born in Lagos Island Maternity Hospital and Lagos University Teaching Hospital. Neonates’ demographic data were documented. Citrated plasma was collected and tested for Prothrombin Time (PT), Partial Thromboplastin Time with Kaolin (PTTK) and Thrombin Time (TT) using Coatron M2 Coagulation Analyzer (TECO GmbH in Germany). Reference values were established for neonates in the 1st week of life by using the formula of Mean ± 2 Stan dard Deviation (SD) that is at 95% confidence level. Comparative analysis was carried out between the mean values of neonates and adults established mean values. The Mean ± Stan dard Deviation of PT, PTTK and TT at the first week of life were 13.41 ± 1.33 seconds, 43.38 ± 6.75 seconds and 24.01 ± 3.03 seconds respectively. Using the formu la of Mean ± 2SD, the reference ranges of PT, PTTK and TT were 10.7-16.07seconds, 29.88-56.88 seconds and 17.95-30.07 seconds respectively. Statistically significant difference was observed when mean values of PT, PTTK and TT of neonates at the 1st week of life were compared with adults established values done in the country and elsewhere in the world (p-value < 0.05). This research provides a reference range of PT, PTTK and TT for the management of neonates in the 1st week of life in Lagos, Nigeria. It indicates that reference values of PT, PTTK and TT in neonates during the 1st week of life are different from that of adults as described in literature. Therefore we cannot use adult reference values of PT, PTTK and TT to manage neonates during the 1st week of life.
Open Access
Cord blood haemoglobin and ferritin concentrations in newborns of anaemic and non-anaemic mothers in Lagos, Nigeria
(Nigerian Medical Journal, 2013-02) Adediran, A; Gbadegesin, A; Adeyemo, TA; Akinbami, A; Osunkalu, VO; Ogbenna, A; Akanmu, AS
Background: Pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers were determined, and cord blood haemoglobin and serum ferritin concentrations of their newborns were compared. This is to establish the mean values for pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers and the cord blood haemoglobin and serum ferritin concentrations of their newborns at term. Materials and Methods: A case–control study was done involving 142 pregnant women and their newborns. They were divided into two groups - the anaemic group (n = 65) and the non-anaemic (n = 77) group. Five millilitres of blood was collected from each woman and 2 ml was collected from the cord of their newborns into ethylenediaminetetraacetic acid (EDTA) bottle and plain bottle for full blood count analysis and ferritin assay, respectively. Results: The mean pre-delivery haemoglobin concentrations of the women in anaemic group and non-anaemic group were 9.5 ± 1.01 g/dl and 12.15 ± 1.07 g/dl, respectively, and their mean serum ferritin concentrations were 64.45 ± 138.76 μg/l and 32.83 ± 35.36 μg/l, respectively. The mean cord blood haemoglobin concentrations for anaemic and for non-anaemic groups were 12.54 ± 2.54 g/dl and 13.44 ± 2.23 g/dl (P = 0.02), respectively, and the mean cord blood serum ferritin concentrations (non-anaemic, 69.38 ± 78.88 μg/l; anaemic, 7.26 ± 115.60 μg/l) (P = 0.00) were higher in the newborns of non-anaemic than of anaemic mothers. Significant association was found between maternal anaemia and cord blood ferritin concentrations (P = 0.025). Conclusion: Maternal anaemia has significant effects on cord blood haemoglobin and serum ferritin concentrations.
Open Access
Cord blood haemoglobin and ferritin concentrations in newborns of anaemic and non‐anaemic mothers in Lagos, Nigeria
(Nigerian Medical Journal, 2013) Adediran, A; Gbadegesin, A; Adeyemo, T.A; Akinbami, A; Osunkalu, V; Ogbenna, A.A; Akanmu, A.S
Background: Pre‐delivery haemoglobin and serum ferritin concentrations of anaemic and non‐anaemic mothers were determined, and cord blood haemoglobin and serum ferritin concentrations of their newborns were compared. This is to establish the mean values for pre‐delivery haemoglobin and serum ferritin concentrations of anaemic and non‐anaemic mothers and the cord blood haemoglobin and serum ferritin concentrations of their newborns at term. Materials and Methods: A case–control study was done involving 142 pregnant women and their newborns. They were divided into two groups – the anaemic group (n = 65) and the non‐anaemic (n = 77) group. Five millilitres of blood was collected from each woman and 2 ml was collected from the cord of their newborns into ethylenediaminetetraacetic acid (EDTA) bottle and plain bottle for full blood count analysis and ferritin assay, respectively. Results: The mean pre‐delivery haemoglobin concentrations of the women in anaemic group and non‐anaemic group were 9.5 ± 1.01 g/dl and 12.15 ± 1.07 g/dl, respectively, and their mean serum ferritin concentrations were 64.45 ± 138.76 μg/l and 32.83 ± 35.36 μg/l, respectively. The mean cord blood haemoglobin concentrations for anaemic and for non‐anaemic groups were 12.54 ± 2.54 g/dl and 13.44 ± 2.23 g/dl (P = 0.02), respectively, and the mean cord blood serum ferritin concentrations (non‐anaemic, 69.38 ± 78.88 μg/l; anaemic, 7.26 ± 115.60 μg/l)(P = 0.00) were higher in the newborns of non‐anaemic than of anaemic mothers. Significant association was found between maternal anaemia and cord blood ferritin concentrations (P = 0.025). Conclusion: Maternal anaemia has significant effects on cord blood haemoglobin and serum ferritin concentrations.
Open Access
Haemoglobin and ferritin concentrations of pregnant women at term
(Obstetric Medicine, 2011) Adediran, A; Gbadegesin, A; Adeyemo, T.A; Akinbami, A.A; Akanmu, A.S; Osunkalu, V; Ogbenna, A.A; Oremosu, A
Background: Anaemia in pregnancy is defined as haemoglobin (Hb) concentrations of less than 11 g/dL while low ferritin is defined as serum ferritin (SR) levels of less than 10 mg/L. Hb and ferritin concentrations of pregnant women at term were determined to establish their mean values and to determine the prevalence of anaemia in our locality. Methods: Haemoglobin and ferritin levels of 170 non-smoking and HIV-negative pregnant women were determined at term. The majority 143 of 170 (84.1%) of the pregnant women recruited for the study, booked at the beginning of the second trimester and received 200 mg elemental iron in three divided doses and 5 mg folic acid daily which were commenced at booking. Five millilitres of blood were collected from each patient at term into EDTA bottles for full blood count analysis and another 5 mL into plain bottles for SR assay. Results: The mean Hb and ferritin values were 10.9+1.9 and 47.84+98.39 mg/L, respectively. The prevalence of anaemia at term was 46.4%. Only 11.2% (19 of 170) of pregnant women at term had low SR (iron stores). A statistically significant relationship was found between women’s education and SR (P 1⁄4 0.032). Booking status also correlated directly with SR and haemoglobin concentrations, while increasing age and parity did not. Conclusion: About half of the patients were anaemic. Iron deficiency is not the major cause of anaemia in pregnancy in this study because the majority of the pregnant women had normal iron stores. Education and booking status are possible factors that con- tribute to anaemia.
Open Access
Hematological profile of normal pregnant women in Lagos, Nigeria
(Dovepress - International Journal of Womens Health, 2013-05-03) Akinbami, A.A; Ajibola, S.O; Rabiu, K.A; Adewunmi, A.A; Dosunmu, A.O; Adediran, A; Osunkalu, V.O; Osikomaiya, B.I; Ismail, K.A
Background Hematological profile is considered one of the factors affecting pregnancy and its outcome. Anemia is the most common hematological problem in pregnancy, followed by thrombocytopenia. Leukocytosis is almost always associated with pregnancy. The study reported here was designed to evaluate the overall mean values of seven major hematological parameters and their mean values at different trimesters of pregnancy. Subjects and methods This examination was a cross-sectional study of 274 pregnant women who registered to attend the Lagos University Teaching Hospital or Lagos State University Teaching Hospital antenatal clinics between their first and third trimester. Blood (4.5 mL) was collected from each participant into a tube containing the anticoagulant ethylenediaminetetraacetic acid (EDTA). A full blood count was performed on each sample and the results were analyzed. Results Overall, the values obtained were (mean ± standard deviation [SD]): hematocrit level, 30.16% ± 5.55%; hemoglobin concentration, 10.94 ± 1.86 g/dL; white blood cells, 7.81 ± 2.34 × 109; platelets, 228.29 ± 65.6 × 109; cell volume 78.30 ± 5.70 fL, corpuscular hemoglobin, 28.57 ± 2.48 pg; and corpuscular hemoglobin concentration, 36.45 ± 1.10 g/dL. When grouped by trimester, the mean ± SD value of packed cell volume at first trimester was 32.07% ± 6.80%; of second trimester, 29.76% ± 5.21%; and of third, 33.04% ± 3.88%. The mean ± SD hemoglobin concentration values were 11.59 ± 2.35 g/dL, 10.81 ± 1.72 g/dL, and 10.38 ± 1.27 g/dL for women in their first, second, and third trimester, respectively. Mean ± SD white blood cell concentration for first, second, and third trimesters were 7.31 ± 2.38 × 109, 7.88 ± 2.33 × 109, and 8.37 ± 2.15 × 109, respectively, while the mean ± SD platelet values for first, second, and third trimesters were 231.50 ± 79.10 × 109, 227.57 ± 63 × 109, and 200.82 ± 94.42 × 109, respectively. A statistically significant relationship was found to exist between packed cell volume and white blood cell count with increase in gestational age (P = 0.010 and 0.001, respectively). However, there was no statistically significant association between platelet count and increase in gestational age (P = 0.296). Conclusion These findings reinforce the need for supplementation and provide additional information on hematological reference values in pregnancy in Nigeria. Keywords: anemia, thrombocytopenia, hematology, normal pregnancy, trimester
Open Access
Homocysteine Levels in Nigerian Women with Pre-eclampsis/Eclampsia
(Sierra Leone Journal of Biomedical Research, 2009-08) Osunkalu, VO; Akanmu, AS; Adediran, A; Abudu, O
Hyperhomocysteinaemia has been linked in various studies worldwide to the occurrence of cardiovascular disorders and endothelial cell injury. In Nigeria with one of the highest maternal/neonatal mortality and morbidity, it is significant to explore means of predicting pregnancy-induced hypertension. This study was carried out at the Lagos University Teaching Hospital which is a major referral center in the South-western part of Nigeria. It was set to determine the mean plasma homocysteine levels and corpuscular haemoglobin in pre-eclamptic/eclamptic Nigerian women. A total of 150 subjects consisting of 100 primigravidae and 25 diagnosed cases of pre-eclampsia/eclampsia and 25 non-pregnant females were enrolled in the study. 60 primigravidae were lost to follow up or had incomplete data. The mean value of homocysteine in the control group, and eclamptic group was 7.5±3.4 μmol/L and 16.1±6.5 μmol/L respectively. There is positive and significant correlation between plasma homocysteine in the eclamptic group and the mean MCV (r=0.97, p=0.01), and between plasma homocysteine, systolic and diastolic blood pressure of the eclamptic group (r=0.944, p=0.0001; r=0.98, p=0.0001). The study further supports earlier findings of increased homocysteine levels in the occurrence of pre-eclampsia/eclampsia.
Open Access
Impact of HIV Infection and Zidovudine Therapy on RBC Parameters and Urine Methylmalonic Acid Levels
(Interdisciplinary Perspectives on Infectious Diseases, 2016-01-13) Adediran, A; Osunkalu, VO; Wakama, T; Olabode, S; Akinbami, A; Ebele, U; A, AS
Background. Anaemia is a common complication of human immunodeficiency virus (HIV) infection. The aim of this study was to investigate the impact of HIV infection and zidovudine on red blood cells (RBC) parameters and urine methylmalonic acid (UMMA) levels in patients with HIV infection. Material and Methods. A cross-sectional study involving 114 subjects, 94 of which are HIV-infected nonanaemic and 20 HIV negative subjects (Cg) as control. Full blood count parameters and urine methylmalonic acid (UMMA) level of each subject were determined. Associations were determined by Chi-square test and logistic regression statistics where appropriate. Results. Subjects on zidovudine-based ART had mean MCV (93 fL) higher than that of control group (82.9 fL) and ART-naïve (85.9 fL) subjects and the highest mean RDW. Mean UMMA level, which reflects vitamin B12 level status, was high in all HIV-infected groups but was significantly higher in ART-naïve subjects than in ART-experienced subjects. Conclusion. Although non-zidovudine therapy may be associated with macrocytosis (MCV > 95 fL), zidovudine therapy and ART naivety may not. Suboptimal level of vitamin B12 as measured by high UMMA though highest in ART-naïve subjects was common in all HIV-infected subjects.
Open Access
Impaired Appropriateness of Erythropoietin in Anaemic HIV Infected Patients
(International Blood Research and Reviews, 2016) Olu-Taiwo, A; Amusu, A.O; Olatunya, O.S; Adediran, A; Ajayi, E.A; Ogbenna, A.A; Akanmu, A.S
This study was carried out to determine the degree of erythropoietin response in anaemic HIV infected persons. Methods: A total of 120 subjects were studied. These comprised of the study group made up of 40 HIV infected treatment naive patients who had anaemia with Haemoglobin level <10g/dL and 80 control subjects who were age and sex matched. The controls consisted of 20 HIV infected nonanaemic individuals, 40 non-HIV infected anaemic individuals, and 20 non-HIV infected nonanaemic individuals. Blood samples were collected for haemoglobin estimation, white cell count and platelet count by automated counter. The CD4+ cell count was done by semi-automated flow cytometer. The viral load was quantitated using PCR- based diagnostic tests and serum erythropoietin level was estimated using ELISA technique. All patients gave written informed consent with ethical approval by the hospital ethics and research committee. Results: The study groups consisted of 40 males and 80 females. The mean age of male HIV anaemic subjects (45.15±5.63, N=13) was significantly higher than that of the female HIV anaemic subjects (34.16±7.21, N=25) p=0.005. The mean CD4+ cell count of HIV non-anaemic subjects (530.55 cells/µL ±423.35) was significantly higher than HIV anaemic subjects (188.18 cells/µL ±157.09) (p=0.0009). Using regression equation the expected serum erythropoietin values for a given haemoglobin level in HIV subjects was estimated. The appropriateness of erythropoietin level was then determined and a ratio of <0.8 was considered inappropriate. Seventy one percent of the HIV anaemic subjects had erythropoietin response ratio less than 0.8. Conclusion: There was a blunted erythropoietin response for the degree of anaemia in HIV compared with HIV negative subjects.
Open Access
Is MTHFR C677T Gene Polymorphism Associated with Hypertension in Nigerians?
(Asian Journal of Cardiology Research, 2021) Adediran, A; Ilyas, A; Osunkalu, V; Ogbenna, A; Wakama, T; Onakade, A; Ocheni, S
Background: Essential hypertension is very common in Nigeria. The cause is unknown. Genetic factors have been postulated by some authors as a possible risk factor. Such genetic factors include the mutation of methylenetetrahydrofolate reductase (MTHFR) gene. Aim: This study aimed to document the allelic and genotype frequencies and distribution among hypertensive and healthy Nigerian population. Materials and Methods: This was a cross-sectional study involving 75 consenting subjects (50 cases and 25 controls) at the Cardiology Clinic of the Lagos University Teaching Hospital, Lagos, Nigeria. Structured interviewer administered questionnaire was used to obtain socio-demographic and clinical history of subjects. About 5mls of venous blood was collected from each subject by a trained phlebotomist into EDTA bottle and stored at 4ºC until ready for analysis. Genomic DNA extraction was done after which polymerase chain reaction was carried out. This was followed by restriction enzyme digestion and agarose gel electrophoresis. The digestion products were then visualized with SYBR Safe (Monitagen) using Sygene bio-imaging system. Results: When compared with hypertensive subjects, normotensive subjects had more CC (84% vs 74%) and CT (16% vs 12%) genotypes. Hypertension was significantly associated with mutant MTHFR genotypes (14% vs 0.0%) (OR = 3.995, 95% C.I: 1.101- 10.034; p=0.033). Except for age (OR= 1.771, 95% CI: 1.036 – 3.029; p=0.037), smoking (OR= 0.000; p=0.999), alcohol consumption (Or= 0.000; p=0.999), and sex (OR= 15.052, 95% CI: 0.196- 115.028; p=0.139) did not attain statistical significance. Conclusion: The 677TT homozygous mutant had the highest risk of association with hypertension in Nigerians.
Open Access
Plasma folate studies in HIV-positive patients at the Lagos university teaching hospital, Nigeria
(Indian Journal of Sexually Transmitted Diseases and AIDS, 2011-05-02) Akanmu, AS; Osunkalu, VO; Adediran, A; Adeyemo, TA; Onogu, E; Akinde, Ralph; Coker, HAB
Introduction: In various studies globally, the prevalence of anemia in persons with HIV infection range from 10 to 20% at initial presentation, and anemia is diagnosed in 70 to 80% of these patients over the course of HIV disease. The etiology of anemia in this group of patients has not been fully established, thus a need to evaluate the role of plasma folate as a possible etiological factor. Objective: This study was set to determine plasma folate levels in newly diagnosed, treatment naïve, HIV-positive patients, and relate this to other hematological changes. Materials and Methods: A total of 200 participants were recruited for this study, of which 100 were HIV positive, treatment naive patients who were recruited at the point of registration and 100 were HIV-negative subjects (controls). 5 ml of venous blood was collected and plasma extracted for folic acid estimation by HPLC. A full blood count, CD4 and Viral load were estimated. Results: Mean ages for control and study group were 38 ± 2.3 and 32 ± 1.7 years, respectively. Mean plasma folate concentration among the study group (5.04 μg/l) was significantly lower than that for the control group (15.89 μg/l; P = 0.0002). Prevalence of anemia among the study group was 72% (144 of 200), with a mean hemoglobin (Hb) concentration of 9.5 g/dl compared with mean Hb of 13.0 g/dl among the control group (P = 0.002). Plasma folate correlated positively with CD4 cell count (r = 0.304, P<0.05) and inversely with the viral load (r = -0.566; P<0.05). Conclusion: Plasma folate level is a predictor of anemia in early HIV infections
Open Access
Seroprevalence of cytomegalovirus antibodies amongst normal pregnant women in Nigeria
(Dovepress - International Journal of Womens Health, 2011-12-16) Akinbami, A.A; Rabiu, K.A; Adewunmi, A.A; Wright, K.O; Dosunmu, A.O; Adeyemo, T.A; Adediran, A; Osunkalu, V.O
Objective Cytomegalovirus (CMV), a ubiquitous virus belonging to the herpes family, is known to be transmitted frequently to developing fetuses in pregnancy. In an immunocompromised state like pregnancy, primary infection through blood transfusion or reactivation of a latent CMV infection can cause severe illness. The study was carried out to determine the seroprevalence of the immunoglobulin G (IgG) antibody to cytomegalovirus amongst pregnant women in correlation with previous exposure to blood transfusion. Methods A cross sectional study was carried out amongst 179 HIV negative pregnant women attending the antenatal clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja, Nigeria. Five mL of blood was collected and stored in a plain bottle, centrifuged on the same day and the serum stored at −20°C. All samples were screened for anti-CMV IgG antibodies using the enzyme linked immunosorbent assay (ELISA). Consenting participants were instructed to fill a semi-structured questionnaire to obtain demographic and other related information. Statistical analysis of the results was done using Pearson’s chi squared test for analytical assessment. Results A total of 97.2% of the pregnant women recruited for this study were anti-CMV IgG positive. Out of the 179 recruited for the study 174 responded to the question on previous history of blood transfusion, 14.9% of the respondents (26 of 174) had a previous history of blood transfusion and all tested positive to the anti-CMVIgG antibody. However, past history of blood transfusion and educational level were found to be insignificant to the risk of acquiring CMV infection. Conclusion The seroprevalence of the CMV antibody amongst pregnant women in this environment is high in relation to findings in other developing countries. There is the need to assess anti-CMV immunoglobulin M antibodies in pregnant women, which is a determinant of active infection. Keywords: CMV, IgG, pregnant women
Open Access
Seroprevalence of Toxoplasma gondii IgG antibody in HIV-infected patients at the Lagos University Teaching Hospital
(Dovepress - International Journal of Womens Health, 2011-09-05) Osunkalu, V.O; Akanmu, S.A; Ofomah, N.J; Onyiaorah, I.V; Adediran, A; Akinde, R.O; Onwuezobe, I.A
Background Toxoplasmosis is caused by infection with a ubiquitous intracellular protozoan parasite, Toxoplasma gondii. With the advent of the HIV pandemic in Nigeria, toxoplasmic encephalitis has become one of the more frequent opportunistic infections and the most commonly implicated cause of focal brain lesions complicating the course of AIDS. Objectives This study was conducted to compare the pattern of seroprevalence of T. gondii (Toxo-IgG) antibodies among HIV-infected persons presenting with neurological complications and those without. Materials and methods Plasma specimens collected from 380 subjects were tested for Toxo- IgG antibodies by enzyme immunoassay technique and CD4 estimation by flow cytometry. Close-ended questionnaires were applied to all respondents to collect relevant data, with ethical approval from the hospital ethical committee. Plasma was obtained from two study groups comprising 300 HIV-positive respondents without neurological presentations, and 80 HIV-positive respondents with neurological complications. Results Seroprevalence of Toxo-IgG antibodies was 58% in the HIV-positive study group without neurological complications (of these, 79.2% were males and 38.5% were females) and 40% in the study group with neurological complications (46.2% of these were males and 28.6% were females). The overall seroprevalence of Toxo-IgG antibodies among the HIV-positive respondents (with and without neurological complications) was 54.2% (206 of 380). Seroprevalence of Toxo-IgG antibodies was lowest among the educated subjects (19% of the respondents with tertiary education) and among females in both study groups. A higher proportion of the subjects with neurological complications had CD4 cell count <100 cells/μL compared with respondents without neurological defects (39% vs 22.7%; P = 0.000), but the seroprevalence of Toxo-IgG antibodies was higher in subjects without neurological complications (45% vs 31.3%; P = 0.000). Conclusion Toxoplasmosis, though an important opportunistic infection in our environment, may not account for the majority of neurological complications observed in patients with HIV infection in our center. Keywords: Toxoplasma gondii antibody (Toxo-IgG), seroprevalence, neurological complication
Open Access
Steady state hemoglobin concentration and packed cell volume in homozygous sickle cell disease patients in Lagos, Nigeria
(Caspian Journal of Internal Medicine, 2012) Akinbami, A; Dosunmu, AO; Adediran, A; Oshinaike, O; Adebola, P; Osunkalu, VO; Arogundade, O; Adelekan, O
Background: Sickle cell disease is a genetic disorder of hemoglobin causing myriad of pathology including anemia. The purpose of this study was to evaluate the baseline values of steady state hemoglobin and packed cell volume as a guide to managing the early recognition of hemolytic crises in sickle cell anemia. Methods: A cross-sectional study was conducted among the sickle cell patients attending the Sickle Cell clinic of Lagos State University Teaching Hospital, Ikeja. A blood sample of 4.5 ml blood was collected from each participant for hemoglobin concentration and packed cell volume. All blood samples were also screened for HIV and hemoglobin phenotypes were done using cellulose acetate hemoglobin electrophoresis at pH 8.6. Results: A total of 98 subjects in steady state were recruited, consisting of 53 (54.1%) females and 45 (45.9%) males. The overall means were 7.92±1.49 and 24.46±4.76; a female mean of 7.73±1.45; 23.89±4.60, and a male mean of 8.14±1.54 and 25.14±4.91 were obtained for hemoglobin and packed cell volume, respectively. Sixty – nine of the 98 (70.40%) subjects have been previously transfused with blood. Conclusion: The mean hemoglobin concentration and packed cell volume in males was higher than females. The overall mean was lower than what was expected for age and sex. Over two-third of sickle cell anemia population had been transfused.

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