Haematology and Blood Transfusion- Scholarly Publications

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    Open Access
    A Survey of Knowledge and Practices of Transfusion Medicine among Medical Doctors in Private Practice in Ibadan, Nigeria
    (Journal of Biomedical Research & Clinaical Practice, 2021) Ogbenna A.A; Salami I.O; Adewoyin A.S; Ajetunmobi I.A
    Comprehensive knowledge of blood transfusion practices among clinicians has an important role in provision of safe blood but continuous education and the academic rigor is not as versatile in private sector as in tertiary hospitals. The objective of this study is to evaluate the knowledge of clinicians in private practice in Ibadan on transfusion medicine. Eighty-one medical doctors from the 5 urban local government areas were enlisted in a multistage sampling technique. Self-administered questionnaires were employed and data analyzed using SPSS. Majority of clinicians were between the ages of 30-40 years (43.2%), had practiced for 0-5 years (42.0%) and prescribed blood transfusion at least once a month (44.4%). Male: female ratio was 4:1. The proportion of correct answers to the questions about age, minimum weight, Systolic Blood Pressure and Diastolic Blood pressure as criteria for selection of blood donor were as; 56.8%, 72.8 %, 71.6% and 81.5%, respectively. The proportion of correct answers to the questions on contraindications for the transfusion of platelet and cryoprecipitate were as; 54.3% and 9.9 %, respectively. The overall Knowledge score ranged from 22.0% to 93.0% (Mean= 49.0%; SD=37.7%). The mean knowledge score of indications and contraindications for transfusion of blood components are 79.2% and 34.2%, respectively. The study demonstrated significant gaps in knowledge of transfusion medicine. This can be closed by a more deliberate review of medical curricula, continuous medical education by professional groups and relevant stakeholders, as well as, a state-wide clinical audit of transfusion services
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    Open Access
    Abnormal Haematological Profile caused by Potassium Bromate in Wistar Rats is corrected by Parkia Biglobosa Seed
    (Niger. J. Physiol. Sci., 2024) Uche, C.L; Ugwu, N.I; Airaodion, A.I; Ogbenna, A.A; Okite, U.P; Jibiro, P; Chikezie, K; Esonu, C.E; Agu, F.U; Oladele, F.C; Onyekachi, O.I.N; Abali, I.O
    Many biological tissues and organs are affected by the toxicity of potassium bromate (KBrO3). The purpose of this study was to evaluate the Parkia Biglobosa (P. Biglobosa) seed's ability to treat KBrO3-induced haematological parameters derangement. After becoming accustomed to the lab, 24 Wistar rats were randomly assigned to groups A, B, C, and D. Group A was given distilled water to drink. Each of the groups in B, C, and D got 100 mg/kg of KBrO3. Also, for 28 days prior to sacrifice, groups C and D received 100 and 200 mg/kg of P. biglobosa, respectively. Blood was drawn, and the haemogram was examined using a haematology autoanalyzer. When KBrO3 was added compared to the control, the results showed a substantial decrease in both haemoglobin concentration, packed cell volume (PCV), and red blood cell count from 17.26±2.84 g/dL, 39.73±2.58%, 5.12±0.83 x 1012/L to 13.25±1.25 g/dL, 27.93±1.44%, and 3.47±0.22 x 1012/L, respectively. The effect of KBrO3 was dose-dependently counteracted by P. biglobosa treatments of 100 and 200 mg/kg body weight. However, there was no discernible difference in the MCV, MCH, and MCHC values between the control and test groups. Similar to how P. biglobosa reduced the effects of KBrO3 in a dose-dependent manner, P. biglobosa also induced a substantial decrease in white blood cell count, its differentials, and platelet counts (P≤0.05). KBrO3-induced deranged haematological parameters were mitigated by Parkia biglobosa in a dose dependent manner. Care must be taken with the consumption of this addictive due to its numerous toxic effects. However, consumption of P. biglobosa, a tropical homemade food is recommended for families to benefit from the barrage of its health benefits. This will also alleviate the toxic effect of KBrO3 if consumed inadvertently. Human clinical trial is needed to substantiate these findings.
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    Open Access
    Anti-Inflammatory properties of the fruit of allanblanckia floribunda oliv. (Guttiferae)
    (Botany Research International, 2009) Ayoola, GA.; Akpanika, GA.; Awobajo, FO.; Sofidiya, MO.; Osunkalu, VO.; Coker, HAB.; Odugbemi, TO.
    The present study aims to investigate the anti-inflammatory properties of the fruits of Allanblackia floribunda Oliv. [Guttiferae]. The fruits are traditionally used in the treatment of anti-inflammatory conditions. The methanolic extracts of the fruits (100-400 mg/kg, p.o) inhibited carrageenan induced paw oedema in rats in a dose dependent manner. At 400 mg/kg A. floribunda(AF) produced an inhibition of 76.9% compared to 64.3% for indomethacin (10 mg/kg). Acetylsalicylic acid(100 mg/kg - ASA) did not show significant activity in the inhibition of the neurogenic phase, butwas more active thanA. floribunda in the inhibition of the inflammatory phase of formalin-induce pain.A. floribunda was not active as an anti-inflammatory agent up to 2 h in the histamine-induced rat paw oedema but a significant reduction in paw size was observed after 2 h. This suggests that AF was more active in the later phase of the inflammatory process. AF also reduced hot plate latency in a dose dependent manner. Hot plate latency of 26.8 s was recorded for AF at 400 mg/kg compared to 18.12 s for normal saline and 30.6 s for ASA. LD,, value was determined in Swiss albino mice as 20 g/kg and so can be regarded as relatively safe.
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    Open Access
    Antioxidant supplementation for sickle cell disease (Protocol)
    (Cochrane Database of Systematic Reviews, 2020) Bolarinwa, A.B; Oduwole, O; Okebe, J; Ogbenna, A.A; Otokiti, O.E; Olatinwo, A.T
    Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and safety of antioxidant supplementation for improving health outcomes in people with SCD.
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    Open Access
    Antioxidant supplementation for sickle cell disease (Review)
    (Cochrane Database of Systematic Reviews, 2024) Bolarinwa, A.B; Oduwole, O; Okebe, J; Ogbenna, A.A; Otokiti, O.E; Olatinwo, A.T
    Background Sickle cell disease (SCD) refers to a group of genetic disorders characterized by the presence of an abnormal haemoglobin molecule called haemoglobin S (HbS). When subjected to oxidative stress from low oxygen concentrations, HbS molecules form rigid polymers, giving the red cell the typical sickle shape. Antioxidants have been shown to reduce oxidative stress and improve outcomes in other diseases associated with oxidative stress. Therefore, it is important to review and synthesize the available evidence on the eKect of antioxidants on the clinical outcomes of people with SCD. Objectives To assess the eKectiveness and safety of antioxidant supplementation for improving health outcomes in people with SCD. Search methods We used standard, extensive Cochrane search methods. The latest search date was 15 August 2023. Selection criteria We included randomized and quasi-randomized controlled trials comparing antioxidant supplementation to placebo, other antioxidants, or diKerent doses of antioxidants, in people with SCD. Data collection and analysis Two authors independently extracted data, assessed the risk of bias and certainty of the evidence, and reported according to Cochrane methodological procedures. Main results The review included 1609 participants in 26 studies, with 17 comparisons. We rated 13 studies as having a high risk of bias overall, and 13 studies as having an unclear risk of bias overall due to study limitations. We used GRADE to rate the certainty of evidence. Only eight studies reported on our important outcomes at six months. Vitamin C (1400 mg) plus vitamin E (800 mg) versus placebo Based on evidence from one study in 83 participants, vitamin C (1400 mg) plus vitamin E (800 mg) may not be better than placebo at reducing the frequency of crisis (risk ratio (RR) 1.18, 95% confidence interval (CI) 0.64 to 2.18), the severity of pain (RR 1.33, 95% CI 0.40 to 4.37), or adverse eKects (AE), of which the most common were headache, nausea, fatigue, diarrhoea, and epigastric pain (RR 0.56, 95% CI 0.31 to 1.00). Vitamin C plus vitamin E may increase the risk of SCD-related complications (acute chest syndrome: RR 2.66, 95% CI 0.77 to 9.13; 1 study, 83 participants), and increase haemoglobin level (median (interquartile range) 90 (81 to 96) g/L versus 93.5 (84 to 105) g/L) (1 study, 83 participants) compared to placebo. However, the evidence for all the above eKects is very uncertain. The study did not report on quality of life (QoL) of participants and their caregivers, nor on frequency of hospitalization. Zinc versus placebo Zinc may not be better than placebo at reducing the frequency of crisis at six months (rate ratio 0.62, 95% CI 0.17 to 2.29; 1 study, 36 participants; low-certainty evidence). We are uncertain whether zinc is better than placebo at improving sickle cell-related complications (complete healing of leg ulcers at six months: RR 2.00, 95% CI 0.60 to 6.72; 1 study, 34 participants; very low-certainty evidence). Zinc may be better than placebo at increasing haemoglobin level (g/dL) (MD 1.26, 95% CI 0.44 to 1.26; 1 study, 36 participants; low-certainty evidence). The study did not report on severity of pain, QoL, AE, and frequency of hospitalization. N-acetylcysteine versus placebo N-acetylcysteine (NAC) 1200 mg may not be better than placebo at reducing the frequency of crisis in SCD, reported as pain days (rate ratio 0.99 days, 95% CI 0.53 to 1.84; 1 study, 96 participants; low-certainty evidence). Low-certainty evidence from one study (96 participants) suggests NAC (1200 mg) may not be better than placebo at reducing the severity of pain (MD 0.17, 95% CI -0.53 to 0.87). Compared to placebo, NAC (1200 mg) may not be better at improving physical QoL (MD -1.80, 95% CI -5.01 to 1.41) and mental QoL (MD 2.00, 95% CI -1.45 to 5.45; very low-certainty evidence), reducing the risk of adverse eKects (gastrointestinal complaints, pruritus, or rash) (RR 0.92, 95% CI 0.75 to 1.14; low-certainty evidence), reducing the frequency of hospitalizations (rate ratio 0.98, 95% CI 0.41 to 2.38; low-certainty evidence), and sickle cell-related complications (RR 5.00, 95% CI 0.25 to 101.48; very low-certainty evidence), or increasing haemoglobin level (MD -0.18 g/dL, 95% CI -0.40 to 0.04; low-certainty evidence). L-arginine versus placebo L-arginine may not be better than placebo at reducing the frequency of crisis (monthly pain) (RR 0.71, 95% CI 0.26 to 1.95; 1 study, 50 participants; low-certainty evidence). However, L-arginine may be better than placebo at reducing the severity of pain (MD -1.41, 95% CI -1.65 to -1.18; 2 studies, 125 participants; low-certainty evidence). One participant allocated to L-arginine developed hives during infusion of L-arginine, another experienced acute clinical deterioration, and a participant in the placebo group had clinically relevant increases in liver function enzymes. The evidence is very uncertain whether L-arginine is better at reducing the mean number of days in hospital compared to placebo (MD -0.85 days, 95% CI -1.87 to 0.17; 2 studies, 125 participants; very low-certainty evidence). Also, L-arginine may not be better than placebo at increasing haemoglobin level (MD 0.4 g/dL, 95% CI -0.50 to 1.3; 2 studies, 106 participants; low-certainty evidence). No study in this comparison reported on QoL and sickle cell-related complications. Omega-3 versus placebo Very low-certainty evidence shows no evidence of a diKerence in the risk of adverse eKects of omega-3 compared to placebo (RR 1.05, 95% CI 0.74 to 1.48; 1 study, 67 participants). Very low-certainty evidence suggests that omega-3 may not be better than placebo at increasing haemoglobin level (MD 0.36 g/L, 95% CI -0.21 to 0.93; 1 study, 67 participants). The study did not report on frequency of crisis, severity of pain, QoL, frequency of hospitalization, and sickle cell-related complications. Authors' conclusions There was inconsistent evidence on all outcomes to draw conclusions on the beneficial and harmful eKects of antioxidants. However, Larginine may be better than placebo at reducing the severity of pain at six months, and zinc may be better than placebo at increasing haemoglobin level. We are uncertain whether other antioxidants are beneficial for SCD. Larger studies conducted on each comparison would reduce the current uncertainties.
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    Open Access
    Assessment of MTR Rs1805087 SNP as Possible Modifier of Sickle Cell Disease Severity in a Nigerian Population
    (West African Journal of Medicine, 2022) Osunkalu V.O; Ogbenna A.A; Davies N.O; Olowoselu F.O; Aiyelokun O.E; Akinsola O.J; Taiwo I.A
    ABSTRACT BACKGROUND: Sickle cell disease is the commonest genetic disorder in Nigeria, affecting 2–3% of an estimated population of 160 million people. The role of genetic mutations in folate cycle genes, and the variable phenotypic expressions constituting disease severity, needs to be critically examined. OBJECTIVE: This study was carried out to establish the pattern of methionine synthase gene mutations (rs1805087 SNP), and its possible association with disease severity in adults with sickle cell anaemia in Lagos, Nigeria. METHODOLOGY: This is a cross-sectional study of seventy (70) subjects with sickle cell disease (HbSS) matched for age and gender with known apparently healthy haemoglobin genotype AA (HbAA) subjects, as cases and controls respectively. Structured questionnaires were used to obtain demographic, clinical and other phenotypic data needed to compute disease severity. Pattern of MTR A2756G gene mutation and homocysteine assay (Hcy) were assessed by Polymerase Chain Reaction and Enzyme- linked Immunosorbent Assay respectively. Full blood count analysis of participants was done using the KX-21 Automated Analyzer (Sysmex Corporation, Japan). RESULTS: The mutant genotypes MTR 2756 AG/GG were recorded in 46.4% (n =55) of subjects with disease severity score >7. Elevated plasma homocysteine (HHcy) was significantly associated with disease severity among HbSS subjects (OR=17.2, CI: 3.490-86.079; p=0.0001). Conversely, no significant association was observed with the mutant genotypes MTR 2756 AG/GG and disease severity (p>0.05). CONCLUSION: While HHcy is significantly associated with phenotypic expression of HbSS, the MTR 2756 SNPs did not appear to independently influence homocysteine level or disease severity in HbSS subjects.
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    Open Access
    Association of alpha-thalassemia and Glucose-6-Phosphate Dehydrogenase deficiency with transcranial Doppler ultrasonography in Nigerian children with sickle cell anemia
    (Wiley Periodicals, LLC, 2021) Ojewunmi, OO; Adeyemo, TA; Oyetunji, AI; Benn, Y; EKPO, MG; Iwalokun, BA
    Background: Stroke is a devastating complication of sickle cell anemia (SCA) and can be predicted through abnormally high cerebral blood flow velocity using transcranial Doppler Ultrasonography (TCD). The evidence on the role of alpha-thalassemia and glucose-6-phosphate dehydrogenase (G6PD) deficiency in the development of stroke in children with SCA is conflicting. Thus, this study investigated the association of alpha-thalassemia and G6PD(A−) variant with abnormal TCD velocities among Nigerian children with SCA. Methods: One hundred and forty-one children with SCA were recruited: 72 children presented with normal TCD (defined as the time-averaged mean of the maximum velocity: < 170 cm/s) and 69 children with abnormal TCD (TAMMV ≥ 200 cm/s). Alpha-thalassemia (the α-3.7 globin gene deletion) was determined by multiplex gap-PCR, while G6PD polymorphisms (202G > A and 376A > G) were genotyped using restriction fragment length polymorphism—polymerase chain reaction. Results: The frequency of α-thalassemia trait in the children with normal TCD was higher than those with abnormal TCD: 38/72 (52.8%) [α-/α α: 41.7%, α -/α -:11.1%] versus 21/69 (30.4%) [α-/α α: 27.5%, α -/α -:2.9%], and the odds of abnormal TCD were reduced in the presence of the α-thalassemia trait [Odds Ratio: 0.39, 95% confidence interval: 0.20–0.78, p = 0.007]. However, the frequencies of G6PDA− variant in children with abnormal and normal TCD were similar (11.6% vs. 15.3%, p = 0.522). Conclusion: Our study reveals the protective role of α-thalassemia against the risk of abnormal TCD in Nigerian children with SCA.
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    Open Access
    Asymptomatic malaria infection among children with Sickle Cell Anaemia: The role of IL-10 and possible predisposing factors
    (PAMJ, 2020) Oyetunji, AI; Amoo, AJ; Adeyemo, TA; Ojewunmi, OO
    Introduction: malaria is a major contributor to morbidity and mortality of under five children with Sickle cell anaemia (SCA) in malaria endemic regions. Asymptomatic malaria infection carriers constitute a reservoir for malaria transmission which could be detrimental in patients with SCA despite the use of malaria chemoprophylaxis. This study, therefore, determined the prevalence of asymptomatic malaria, levels of IL-10 and association between asymptomatic malaria infection, possible predisposing factors and levels of IL-10 in children living with Sickle cell anaemia. Methods: a case-control study was conducted involving children aged 2-16 years; 60 children with SCA in steady state and 40 control subjects with HbAA. Blood samples were collected by veni-puncture and asymptomatic malaria infection was detected using Rapid diagnostic test (RDT), Giemsa-stained thin and thick blood films and nested Polymerase Chain Reaction (PCR) technique. Serum IL-10 levels were determined using ELISA method. Results: among patients with SCA, two samples (3.3%) were positive for RDT, three samples (5%) were positive for microscopy, and four samples (6.7%) were positive for nested PCR technique. None of the patients in the control group was positive for Plasmodium falciparum detection using the three diagnostic methods. The mean ± (SD) of IL-10 levels in SCA patients with asymptomatic malaria (9.14(1.08)pg/ml) was significantly higher than those without asymptomatic malaria (4.8(2.62) pg/ml) (P<0.0001). Conclusion: this study demonstrated accurate diagnosis of asymptomatic malaria infection using PCR-based technique. We established that asymptomatic malaria is present in steady state SCA children and is associated with elevated IL-10 levels.
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    Open Access
    An audit of request forms submitted in a multidisciplinary diagnostic center in Lagos
    (PanAfrican Medical Journal, 2015) Oyedeji, O.A; Ogbenna, A.A; Iwuala, S.O
    Introduction: Request forms are important means of communication between physicians and diagnostic service providers. Pre-analytical errors account for over two thirds of errors encountered in diagnostic service provision. The importance of adequate completion of request forms is usually underestimated by physicians which may result in medical errors or delay in instituting appropriate treatment. The aim of this study was to audit the level of completion of request forms presented at a multidisciplinary diagnostic center. Methods: A review of all requests forms for investigations which included radiologic, laboratory and cardiac investigations received between July and December 2011 was performed to assess their level of completeness. The data was entered into a spreadsheet and analyzed. Results: Only 1.3% of the 7,841 request forms reviewed were fully completed. Patient's names, the referring physician's name and gender were the most completed information on the forms evaluated with 99.0%, 99.0% and 90.3% completion respectively. Patient's age was provided in 68.0%, request date in 88.2%, and clinical notes/ diagnosis in 65.9% of the requests. Patient's full address was provided in only 5.6% of requests evaluated. Conclusion: This study shows that investigation request forms are inadequately filled by physicians in our environment. Continuous medical education of physicians on the need for adequate completion of request forms is needed.
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    Open Access
    An audit of request forms submitted in a multidisciplinary diagnostic center in Lagos
    (Pan African medical journal, 2015-04-29) Oyedeji, O.A.; Ogbenna, A.A.; Iwuala, S.O.
    Introduction: Request forms are important means of communication between physicians and diagnostic service providers. Pre-analytical errors account for over two thirds of errors encountered in diagnostic service provision. The importance of adequate completion of request forms is usually underestimated by physicians which may result in medical errors or delay in instituting appropriate treatment. The aim of this study was to audit the level of completion of request forms presented at a multidisciplinary diagnostic center. Methods: A review of all requests forms for investigations which included radiologic, laboratory and cardiac investigations received between July and December 2011 was performed to assess their level of completeness. The data was entered into a spreadsheet and analyzed. Results: Only 1.3% of the 7,841 request forms reviewed were fully completed. Patient's names, the referring physician's name and gender were the most completed information on the forms evaluated with 99.0%, 99.0% and 90.3% completion respectively. Patient's age was provided in 68.0%, request date in 88.2%, and clinical notes/ diagnosis in 65.9% of the requests. Patient's full address was provided in only 5.6% of requests evaluated. Conclusion: This study shows that investigation request forms are inadequately filled by physicians in our environment. Continuous medical education of physicians on the need for adequate completion of request forms is needed.
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    Open Access
    Blood Coagulation Normalization Effect of Parkia Biglobosa Seed on Potassium Bromate-induced Coagulopathy
    (West African Journal of Medicine, 2023) Ugwu N.I; Uche C.I; Ogbenna A.A; Okite U.P; Chkezie K; Ejikem P.I; Ugwu C.N; Otuka O.A.I; Ezirim E.O; Onyekachi O.I.N; Nwobodo M.U; Abali I.O; Iwuoha C.E; Airaodion A.I
    ABSTRACT BACKGROUND: Potassium bromate (KBrO3) has been reported to be toxic, adversely affecting many body tissues and organs. The aim of this study was to determine the blood coagulation effect of Parkia biglobosa (P. biglobosa) seed on potassium bromate induced coagulopathy. METHODOLOGY: P. biglobosa was extracted with soxhlet extractor with ethanol as the solvent. Twenty-four adult male Wistar rats were acclimatized under laboratory conditions and were randomly grouped into A, B, C and D. Group A was given distilled water orally. Animals in groups B, C and D were administered 100 mg/kg body weight of potassium bromate, but groups C and D were also treated with 100 and 200 mg/kg body weight of P. biglobosa respectively. Both potassium bromate and P. biglobosa were freshly prepared on daily basis and administered to rats by oral gavage for 28 days. At the end of the treatment period, blood samples were collected in sodium citrate bottles and were used for analysis of Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Thrombin Time (TT), fibrinogen and vitamin K levels using standard methods. RESULTS: Administration of potassium bromate increased Prothrombin Time (PT) from 11.67±2.15 seconds (in control animals) to 19.53±2.83 seconds. Treatment with 100 and 200 mg/kg body weight of P. biglobosa seed extract neutralized this effect in a dose-dependent manner. Likewise, KBrO3 was observed to have significantly elevated Activated Partial Thromboplastin Time (APTT) from 29.67±3.93 to 41.10±4.79 seconds and Thrombin Time (TT) from 15.36±2.06 to 25.43±2.83 seconds when compared with those in the control group. The result further showed that exposure of animals to KBrO3 significantly declined the levels of fibrinogen (from 4.05±0.72 to 2.59±0.30 g/dL) and vitamin K (from 3.18±0.73 to 1.84±0.18 ng/mL) when compared with the untreated animals. The effect of KBrO3 on PT, APTT, TT, Fibrinogen and vitamin k were attenuated by P. biglobosa in a dose-dependent manner. CONCLUSION: The results of this investigation demonstrated that potassium bromate caused prolongation of PT, aPTT and TT and decreased levels of fibrinogen and vitamin K, but P. biglobosa treatment counteracted these effects. Thus, it is recommended that these results be investigated in clinical trials in human volunteers.
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    Open Access
    Blood transfusion service in a tertiary hospital in sub- Saharan Africa during the COVID 19 pandemic: Experience from Lagos University Teaching Hospital, Nigeria
    (African Society for Blood Transfusion, 2021) Adeyemo, TA; Bolarinwa, AB; Olatinwo, AT; Oyewole, A; Akanmu, AS
    Blood transfusion services are as pivotal to the health system during a pandemic as before the pandemic. The effect of a pandemic on transfusion services depends on the nature, potential for community spread and risk of transfusion transmissibility. As the total number of cases and deaths from COVID-19 rises, and to prevent the community spread of the SARS‐CoV‐2 virus, governments worldwide, as well as the Nigerian government, announced national lockdowns. Lockdowns have affected blood transfusion services. In Nigeria, blood transfusion services are still decentralized and tertiary health centres run independent transfusion units. The Lagos University Teaching Hospital blood transfusion unit was also impacted by the pandemic and the consequent lockdown. The major challenges experienced are in recruitment of voluntary blood donors, follow‐up of donors and patients with concomitant reduction in blood and blood component supply derived from family replacement donation, inventory and consumable management, staff safety and adequacy for emergency work. These challenges were compounded by the inadequate infrastructure and policies at the outset of the pandemic. Countries in sub-Saharan Africa should invest in health infrastructure and their transfusion services and encourage local manufacture of basic laboratory reagents and consumables. The blood transfusion services and units should put in place strategic continuity of operations plans (COOP) to respond adequately to challenges generated during a pandemic which should focus on shortage, wastage and supply of blood and components in a cost‐effective manner and human resource management.
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    Open Access
    Blood Usage by Speciality in Health Institutions in Abia State: Documentation, A Major Challenge
    (Clinics in Nursing, 2024) Uche, C.L; Ezirim, E.O; Ogbenn, A.A; Chikezie, K; Owojiyugbe, T.O; Iwuoha, E.C; Ndukwe, P.E; Eke, O.K; Abali, I.O; Ndukwe, C.O; Ngwudo, S; Agu, F.U; Airaodion, A.I
    Background: Efficient blood usage is essential for optimal healthcare delivery. However, poor documentation remains a significant challenge in accurately assessing blood usage by specialty. This study explores blood utilization across specialties in health institutions in Abia State, Nigeria, highlighting the challenges in documentation and the distribution patterns of blood use. Materials and Methods: This cross-sectional, retrospective study was conducted over six months, involving 13 health institutions in the three senatorial zones of Abia State: Abia North, Abia South, and Abia Central. Health facilities that met inclusion and exclusion criteria were included. Data were collected using a semi-structured, interviewer-administered questionnaire and blood bank records from January to June 2022. Analysis was performed using SPSS version 23, with descriptive statistics and frequency distributions presented for demographic and categorical data. Results: A total of 4,724 blood donations were documented, with government institutions contributing the majority (51.9%) of collections. Internal Medicine utilized the highest proportion of blood (51.04%), followed by Accident and Emergency (16.81%), Obstetrics and Gynecology (14.67%), Surgery (8.30%), and Paediatrics (9.20%). The absence of computerized documentation in all institutions and lack of standardized record-keeping hindered efficient data retrieval. Conclusion: Internal Medicine accounted for the highest blood usage among specialties, while Paediatrics used the least. Documentation inconsistencies and manual record-keeping practices present significant barriers to reliable blood usage tracking. Enhancing data documentation and implementing computerized systems in health institutions are recommended to improve accuracy and efficiency.
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    Open Access
    Blood Usage by Speciality in Health Institutions in Abia State: Documentation, A Major Challenge
    (Clinics in Nursing, 2024) Uche, C.L; Ezirim, E.O; Ogbenna, A.A; Chikezie, K; Owojiyugbe, T.O; Iwuoha, E.C; Ndukwe, P.E; Eke, O.K; Abali, I.O; Ndukwe, C.O; Ngwudo, S; Agu, F.U; Airaodion, A.I
    Background: Efficient blood usage is essential for optimal healthcare delivery. However, poor documentation remains a significant challenge in accurately assessing blood usage by specialty. This study explores blood utilization across specialties in health institutions in Abia State, Nigeria, highlighting the challenges in documentation and the distribution patterns of blood use. Materials and Methods: This cross-sectional, retrospective study was conducted over six months, involving 13 health institutions in the three senatorial zones of Abia State: Abia North, Abia South, and Abia Central. Health facilities that met inclusion and exclusion criteria were included. Data were collected using a semi-structured, interviewer-administered questionnaire and blood bank records from January to June 2022. Analysis was performed using SPSS version 23, with descriptive statistics and frequency distributions presented for demographic and categorical data. Results: A total of 4,724 blood donations were documented, with government institutions contributing the majority (51.9%) of collections. Internal Medicine utilized the highest proportion of blood (51.04%), followed by Accident and Emergency (16.81%), Obstetrics and Gynecology (14.67%), Surgery (8.30%), and Paediatrics (9.20%). The absence of computerized documentation in all institutions and lack of standardized record-keeping hindered efficient data retrieval. Conclusion: Internal Medicine accounted for the highest blood usage among specialties, while Paediatrics used the least. Documentation inconsistencies and manual record-keeping practices present significant barriers to reliable blood usage tracking. Enhancing data documentation and implementing computerized systems in health institutions are recommended to improve accuracy and efficiency.
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    Open Access
    Building the Nigerian Palliative Care Workforce: An Interdisciplinary Distance Learning Training Program
    (Annals of Global Health, 2022) Ogbenna A.A; Drane D; Crowe A.N; Oyedele O; Hauser J; Soyannwo O; Ogunseitan A; Doobay-Persaud A
    Background: Education and capacity building in palliative care are greatly needed in Nigeria. Currently, two institutions integrate palliative care into the undergraduate medical curriculum and no post graduate training exists. A team from the University of Lagos in Nigeria and Northwestern University in the US collaborated to design, implement, and evaluate a 12-hour virtual palliative care training program for Nigerian health professionals. Objective: This study investigated the impact of the first session of the training program on healthcare professionals’ knowledge, skills, attitudes, and confidence in palliative care. Methods: The Education in Palliative and End-of-Life (EPEC) curriculum and the Kenya Hospices and Palliative Care Association (KEHPCA) curriculum were used as foundations for the program and adapted for the Nigerian context. Delivered online, the training focused on goals of palliative care, whole patient assessment, communication skills, pain management, psychosocial issues, palliative care in COVID, oncology, and HIV. A mixed-methods evaluation based on Kirkpatrick’s evaluation framework was used and data were gathered from surveys and focus groups. Findings: Thirty-five health professionals completed the training. The training had a positive impact on knowledge, skills, and attitudes. Confidence in providing end-of-life care increased from 27.3% to 92.9% while confidence in prescribing medication to relieve symptoms at the end of life increased from 42.9% to 92.0%. Performance on multiplechoice knowledge tests increased by 10% (p < 0.01). All participants stated that they would recommend the program to a peer while 96.4% reported the program was relevant to the Nigerian context. Qualitative analysis suggested that the training would help participants provide more holistic care for patients, communicate better, and change how they interacted with families. Topics to be addressed in future training were identified. Conclusions: This virtual training can be an important element in palliative care capacity building in Nigeria and represents a model for global health collaboration.
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    Open Access
    Care seeking determinants among adolescents in Lagos, Nigeria
    (Sierra Leone J Biomed Res, 2010-06) Onajole, AT.; Dolapo, CD.; Osunkalu, VO.; Uwem, E.; Adenike, E.; Odiakosa, A.; Okpechi Felix-Mary, U.
    Adolescents often lack basic reproductive health information, knowledge, and access to affordable confidential health services for reproductive health. This cross-sectional descriptive study aimed to examine the careseeking determinants of adolescents accessing the adolescentfriendly services at the Action Health Incorporated Adolescent Clinic in Lagos, Nigeria. A structured interviewer administered questionnaire was used to elicit information about demographics; past medical history; family history; reproductive/sexual history. The study was explained to the adolescents and their consent was obtained before interviewing them. Data analysis was done using SPSS Version 15. A multiple logistic regression was used to model the relationship between client facility-use status and selected individual characteristics. Odd ratio and confidence interval were computed, and a level of significance of 0.05 was chosen. The mean age of the adolescent was 16.3 ± 2.8 years. A high proportion (77.5%) of them reported not to be sexually active. Thelogistic regression model identified preferred/adopted contraceptive during last visit (OR = 0.60, 95% CI = 0.35 to 1.00), sexual status (OR = 0.40, 95% C.I= 0.27 to 0.60) and religion OR = 2.04, 95% C.I = 1.43 to 2.92) as determinantsof adolescents’ booking for a re-visit to the clinic. The determinants of adolescents’ booking for re-visit to Action Health Incorporated clinic were preferred/adopted contraceptive during last visit, sexual status and religion. The implication of this may be that those who did not book for re-visits felt that they were not adequately benefiting from the services rendered at the clinic. More varieties of adolescentfriendly services that meet the needs of all adolescents should be included at the clinic
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    Open Access
    Case Report on Hodgkin Lymphoma and Decompensated Chronic Liver Disease in a Patient With Chronic Hepatitis B Virus Infection: A Cause or an Effect?
    (American Journal of Clinical Pathology, 2018) Bolarinwa, A.B; Adebayo, L.A; Otokiti, O; Ogbenna, A.A
    Chronic hepatitis B infection has been associated with the development of non-Hodgkin lymphoma (NHL), but its role in the etiology of Hodgkin lymphoma (HL) has been sparsely reported. This case report highlights the possibility of hepatitis B infection playing a major role in the etiology of Hodgkin disease and the complexity of managing HL in the presence of a decompensated liver disease. The chemotherapy in a patient with Hodgkin lymphoma and a liver disease requires dose adjustment and may reactivate a latent hepatitis infection. Our patient is a 23-year-old male who presented with symptomatic anemia, multiple cervical lymphadenopathies, abnormal liver function, and chronic HBV infection. A histologic diagnosis of nodular sclerosing HL was made following an excisional biopsy. There was a progressive liver disease with bleeding from the gums, generalized petechial and ecchymotic rashes, thrombocytopenia, prolonged PT (INR >5), deepening jaundice, and markedly elevated bilirubin and liver enzymes. He had blood component support, and tenofovir 300 mg daily was initiated. Liver functions improved, but liver enzymes were still four times the upper limit of normal when chemotherapy was commenced. He had dose-adjusted ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine) chemotherapy with gradual improvement in the liver function and resolution of lymphadenopathy. It is unclear whether HBV infection is a nidus for Hodgkin lymphoma in this patient as it is for non-Hodgkin lymphoma or if the progression of Hodgkin disease leads to the flare of this. The outcome in this patient also buttresses the fact that, with appropriate dose adjustment, chemotherapy can be administered in the settings of decompensated liver disease.
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    Open Access
    Challenges of Blood Transfusion Services in Abia State: A Study on Infrastructure and Manpower
    (J. General Medicine and Clinical Practice, 2024) Uche, C.L; Owojiugbe, T.O; Abali, I.O; Eke, O.K; Ogbenna, A.A; Ngwudo, S; Ndukwe, C.O; Iwuoha, E.C; Ndukwe, P.E; Ezirim, E.O; Chikezie, K; Agu, F.U; Airaodion, A.I
    Background: Blood transfusion services are vital to healthcare delivery, yet many health institutions face challenges related to infrastructure and manpower. This study aims to assess the availability and adequacy of blood transfusion equipment and staff in healthcare institutions across Abia State, Nigeria. Materials and Methods: A cross-sectional, retrospective study was conducted over six months in 13 public and private health institutions across the three senatorial zones of Abia State: Abia North, Abia South, and Abia Central. Data were collected using a semi-structured, pretested interviewer-administered questionnaire, supplemented by blood bank records, covering the period from January to June 2022. The study assessed the availability of dedicated blood transfusion staff, the existence of blood transfusion committees, quality policies, and the types of blood screening methods used. Statistical analysis was performed using SPSS version 23, with results expressed in frequencies, percentages, and means. Results: The majority of institutions were secondary (77%) and had poor availability of blood transfusion equipment (92.3%), with only 38.5% having a dedicated blood bank and 84.6% possessing benchtop centrifuges. Critical equipment such as apheresis machines, cold centrifuges, -20°C freezers, and platelet agitators were entirely absent. In terms of manpower, 92.3% of blood banks had dedicated staff, but none reported adequate staffing. Only 7.7% had a consultant haematologist, and 23.1% employed trained phlebotomists. Screening methods for HIV, hepatitis B, hepatitis C, and VDRL relied entirely on rapid tests, with no ELISA use reported. Conclusion: The study highlights significant challenges in blood transfusion services in Abia State, with inadequate infrastructure and insufficient manpower being key issues. Urgent interventions are needed to improve equipment availability and staffing to ensure safe and effective blood transfusion services.
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    Open Access
    Challenges of Blood Transfusion Services in Abia State: A Study on Infrastructure and Manpower
    (Journal of General Medicine and Clinical Practice, 2024) Uche, C.L; Owojiugbe, T.O; Abali, I.O; Eke, O.K; Ogbenna, A.A; Ngwudo, S; Ndukwe, C.O; Iwuoha, E.C; Ndukwe, P.E; Ezirim, E.O; Chikezie, K; Agu, F.U; Airaodion, A.I
    Background: Blood transfusion services are vital to healthcare delivery, yet many health institutions face challenges related to infrastructure and manpower. This study aims to assess the availability and adequacy of blood transfusion equipment and staff in healthcare institutions across Abia State, Nigeria. Materials and Methods: A cross-sectional, retrospective study was conducted over six months in 13 public and private health institutions across the three senatorial zones of Abia State: Abia North, Abia South, and Abia Central. Data were collected using a semi-structured, pretested interviewer-administered questionnaire, supplemented by blood bank records, covering the period from January to June 2022. The study assessed the availability of dedicated blood transfusion staff, the existence of blood transfusion committees, quality policies, and the types of blood screening methods used. Statistical analysis was performed using SPSS version 23, with results expressed in frequencies, percentages, and means. Results: The majority of institutions were secondary (77%) and had poor availability of blood transfusion equipment (92.3%), with only 38.5% having a dedicated blood bank and 84.6% possessing benchtop centrifuges. Critical equipment such as apheresis machines, cold centrifuges, -20°C freezers, and platelet agitators were entirely absent. In terms of manpower, 92.3% of blood banks had dedicated staff, but none reported adequate staffing. Only 7.7% had a consultant haematologist, and 23.1% employed trained phlebotomists. Screening methods for HIV, hepatitis B, hepatitis C, and VDRL relied entirely on rapid tests, with no ELISA use reported. Conclusion: The study highlights significant challenges in blood transfusion services in Abia State, with inadequate infrastructure and insufficient manpower being key issues. Urgent interventions are needed to improve equipment availability and staffing to ensure safe and effective blood transfusion services.
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    Open Access
    Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria
    (Pan African medical journal, 2016-08-30) Oluyemi, A; Awolola, N; Oyedeji, O.A
    Introduction: Colorectal polyps are known precursors of colorectal cancers. The increase in utilization of colonoscopy in Nigeria has meant a rise in the recently reported incidence of these lesions. The aim of this study is to evaluate the clinicopathological profile of colorectal polyps biopsied during the inaugural 12 month period of colonoscopy from a private endoscopy suite in Nigeria. Methods: This is a retrospective review of all the clients who had polyps diagnosed at colonoscopy over a 12 month period (August 2014 –July 2015) at a private endoscopy suite in Lagos, Nigeria. This analysis of prospectively collected data was performed using clinical information from the endoscopy logs and pathology database system of a private endoscopy suite based in Lagos, Nigeria. Results: A total of 125 colonoscopies were carried out over the stated period. Of these, 14 individuals had a total of 18 polyps- 4 clients (28.6% of the persons with polyps) had two polyps each. The polyp detection rate was 11.2% while the polyp per colonoscopy rate was 14.4%. Of these clients, males were 10 in number; giving a male to female ratio of 2.5:1. Their ages ranged from 37 to 77 years (mean= 57.3 years). The presenting complaint at colonoscopy was hematochezia in 11 (78.6%), new onset constipation in 2 (14.2%) and peri-anal pain in 1 patient (7.1%).The polyps were distributed as follows; 2 (11.1%) in the ascending colon, 1 (5.6%) each in the transverse and descending colons, 8 (44.4%) in the sigmoid colon, 6(33.3%) located in the rectum. Hence, there was left sided (15 of 18= 83.3%) preponderance. Pathologically, tubular (adenomatous) polyp with or without low grade dysplastic changes was diagnosed in 6 of the 18 polyps (giving an adenoma detection rate of 4.8%), 4 (22.2%) were inflammatory polyps, 1 (5.6%) was malignant and another had the rare inflammatory fibroid polyp. Five (27.8%) of the specimens were reported as non-specific colitis. Conclusion: The study supports the present wisdom that polyps are clearly less prevalent in our environment when compared to the Western world. The increased prevalence with advancing age, in male subjects and of left sided lesions, is also in keeping with previous results from our environment. A case is also advanced for the increased deployment of endoscopy as a tool for the detection of these polyps and ultimately, the reduction of colorectal cancer in our population.