Background: Transfusion-transmissible infections (TTIs) in blood donors increase the risk of acquisition of these infections in blood and blood products recipients. Sensitive screening methods reduce the risk of transmission of TTIs to blood and products recipients. Objectives: The study sought to determine the prevalence of TTIs among voluntary non-remunerated blood donors (VNRBDs) and examine the need for the use of advanced donor screening methods to ensure blood infection safety.. Materials and Methods: This was a cross-sectional study conducted at the National Blood Transfusion Service (NBTS). Consenting VNRBD aged 18–65 years, were consecutively recruited during routine blood drives organized by the NBTS, between August and October 2016 after completing a structured questionnaire. Samples from donated blood units were screened for Human immunodeficiency virus (HIV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), and syphilis using the fourth-generation ELISA. Results: The data obtained from 865 participants were analyzed. One hundred and eighty-two (21%) participants tested positive for TTIs. The prevalence of HBV, HCV, HIV, and syphilis among the participants was 14.7%, 4.6%, 1.8%, and 1.6%, respectively. Coinfection was found in 8.7% of the study participants. A statistically significant association was established between the sex of the participants and TTIs (χ2= 6.217, P = 0.0013). Conclusion: The prevalence of TTIs among VNRBD was high. Due to its attendant consequences on blood infection safety and implication on donor retention, there is a need for adoption of sensitive screening assays to ensure blood safety.

Background Chronic leukemia is the most common leukemia subtype seen among adults in Jos, Nigeria, with few reported isolated cases of ocular morbidity. There are no published comprehensive data on adult leukemic ophthalmopathy from this region. Aim The aim of this study was to determine the prevalence, pattern, and causes of visual impairment (VI) among adult patients with chronic leukemia in Jos, North-Central Nigeria. Patients and methods The study included adult patients diagnosed with either chronic myeloid leukemia or chronic lymphocytic leukemia, confirmed by bone marrow biopsy, in two tertiary hospitals in Jos, North-Central Nigeria, between January 2016 and June 2017. Visual acuity was assessed and categorized using the International Classification of Diseases. Detailed ocular examination was carried out and causes of vision loss were noted. Results A total of 104 eyes of 52 patients were examined within the study period. The mean age of the patients was 45±17.7 years, and 35 (67.3%) patients were males. The majority (63.4%) of the participants had chronic myeloid leukemia. Ocular disorders were present in 32 (61.5%) of all patients, and 10 (19.2%) patients were visually impaired. Of these, nine (90.0%) had moderate VI due to refractive errors, cataract, glaucoma, and disk swelling; and one (10.0%) person was bilaterally blind from exudative retinal detachment and vitreous hemorrhage. Only 27% of all causes of VI were leukemia specific and included disk swelling, exudative retinal detachment, and vitreous hemorrhage. Conclusion Although ocular disorders were frequent among adults with chronic leukemia in Jos, the magnitude of vision loss from chronic leukemia-specific ocular disorders was low.

BACKGROUND:Post-tonsillectomy hemorrhage (PTH) is one of the more life-threatening /lethal complications and the leading malpractice claims/convictions in Oto-laryngological practice.OBJECTIVE:A Study on PTH reduction strategy in Jos, North Central Nigeria.STUDY DESIGN:Prospective Cohort Study.METHODS:Participants who met the criteria under GA had dissection Tonsillectomy ± Adenoidectomy between August 1, 2017-July 31, 2019 at the Jos University Teaching Hospital, Nigeria, were enrolled. Data analysis was by SPSS version 21.0 Chicago, IL, USA.RESULTS:We studied 96 participants with a M:F = 1.7:1. Age range was 9months-51years with a Median = 3.0years. Snoring-83(86.5%), Nasal obstruction - 71(74.0%), Mouth breathing -18(18.8), OSA(S) - 17(17.7%) were main features. Seventy-Eight (81.2%) were Grade III & IV and 71(75.0%) had Adenoid Nasopharyngeal Ratio >0.5. Mean INR was 1.22 ± 0.24 where 28(29.2%) were abnormal. Post-operative blood loss was 10ml - 250ml with Median = 35ml. There was a correlations between the Brodsky's grading with Tonsil volume and between Tonsil grade with volume of blood loss. An estimated 76.0% had the surgery within 60mins. We practice 'awake' extubation. Incidence of Primary PTH of 3.1% with no secondary PTH or mortality.CONCLUSION:We established that blood loss was directly proportional to the tonsil size which brings new insights in PTH prevention. Our use of specific agents for GA, technique/ expertise, pillar infiltration with Lignocaine, 'awake extubation, liberal post-operative analgesia with systemic antibiotics may be responsible for the low incidence of PTH in this series.

The outcome of acute myeloid leukaemia (AML) has remained a major concern even in developed countries.In resource poor countries, it is envisaged that the outcome will be far worse because of late presentations, lack of appropriate diagnostic facilities and supportive care.However, data to validate this is lacking and many of these countries lack an effective cancer registry.This study determined the clinician's perspective of the outcome of care of AML patients in Nigeria and their attitudes to the care of these patients.Structured self-administered questionnaire was used to assess the clinician's perception of outcomes of care, contributory factors and attitude to care of AML patients.Ninetyeight percent of clinicians reported that the outcome of care was suboptimal; 73.3% and 90.6% of the clinicians reported having less than 31% of AML patients surviving induction and post-induction therapies, respectively.Sixty-six-point one percent (66.1%), 50% and 62.7% of the clinicians have never used immunophenotyping, cytogenetic or molecular studies, respectively, in the management of AML patients under their care.Access to blood components other than Red cells was low; 23.3% had access to apheresis platelets and 55% to fresh frozen plasma.Forty-six percent of clinicians will either give half dose of chemotherapy or offer only supportive care.This reported early death rate is three times higher than that reported in developed countries with only 9% likely to survive the first year of induction compared to about 32.9% in Ontario.Approximately 28 units of pooled or apheresis derived platelet may be required in course of therapy but just 10% of clinicians have access to platelet apheresis.Lack of diagnostic facilities, blood components and clinicians' attitudes are contributing factors to the extremely poor outcomes of patients with AML in Nigeria.

Background: Anemia is prevalent in our setting for myriads of reasons hence iron supplementation has become a routine in the antenatal clinics; other regimens are practiced in other climes. Aims: This study aimed at comparing the efficiency of the twice-weekly as against the daily iron supplementation on hematologic indices in healthy pregnant women. Study design: This was a longitudinal prospective study Place and duration of study: this study was carried out at antenatal clinic at the Jos university teaching hospital Jos plateau state of Nigeria over a period of 14 weeks. Methodology: A total of 120 pregnant women were assigned by simple random sampling to receive either daily or twice weekly iron supplementation. Their blood samples were assessed by determining hemoglobin concentration, mean corpuscular volume and serum ferritin as baseline at booking visit from 16-24 weeks of gestation and follow up at 4, 8 and 14 weeks. All data generated was analyzed using EPI info computer software version 3.5.2. The level of statistical significance was set at P<0.05. Results: The twice weekly supplementation showed similar effects with the daily regimen with regards to the trends in Hb and serum ferritin. More women (77.1%) on twice weekly regimen had Hb>10g/dl at the 14 week visit compared with daily regime and this was statistically significant P=0.031. Conclusion: These findings suggest that both regimens have about the same effect on hematological parameters during pregnancy. Therefore, in non-anemic pregnant women twice weekly iron supplementation may be used.

Context: ABO and Rh blood groups play significant roles in health and diseases, one of which is blood group incompatibility, a common cause of neonatal hyperbilirubinemia. Aims: The aim of the study is to determine the frequency of ABO and Rh blood group incompatibilities among icteric neonates and their mothers for the purpose of instituting intervention for better neonatal outcomes. Settings and Design: This study was conducted at the Special Care Baby Units (SCBUs) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BHUTH), and Plateau State Specialist Hospital (PSSH), Jos, Nigeria, from March 2013 to February 2014. It was a descriptive cross-sectional study that includes all jaundiced neonates admitted into the SCBUs and neonates who developed jaundice on admission in the neonatal wards. Subjects and Methods: A total of 150 icteric neonates admitted into the SCBUs of the JUTH, PSSH, and the BHUTH were recruited for this study with their parent's consent. Blood samples were collected from the neonates and their mothers in ethylene diaminetetra-acetic acid and plain bottles for ABO and Rh blood grouping, direct antihuman globulin test, and serum bilirubin (SB) assays. Statistical Analysis Used: Data obtained were analyzed using Epi Info Version 6 software. The results were reported in tables and frequencies, categorical variables were expressed as proportions, whereas continuous variables were expressed as mean ± standard deviation and were analyzed using Student's "t"-test. The level of statistically significant relationship was set at P ≤ 5% (P ≤ 0.05). Results: Thirty-four (22.7%) mother–neonate pair had ABO incompatibility with 14 mothers (9.3%) with blood group O, having neonates with blood group A and a mean SB of 249.5 ± 131.4 μmol/L. Three (2.0%) mothers were Rh D negative while their neonates were Rh D positive and showed a positive direct antihuman globulin test with a mean SB of 322.1 ± 246.7 μmol/L. Conclusions: Blood group O and Rh D-positive blood groups predominate while ABO and Rh incompatibilities present a risk for hyperbilirubinemia among icteric neonates in Jos, Nigeria.

Introduction:The diagnosis of certain subtypes of leukaemia is rarely made and descriptions in the literature are scantily found.Aim: This report aimed to describe a case of acute eosinophilic leukaemia, highlighting the management challenges in Jos.Case Report: A 36-year-old female tailor presented in the emergency and accident unit of the hospital with fever, epistaxis and menorrhagia.She was transfusion for anaemia before presentation.She was bleeding from the nose, pale and febrile.Full blood count revealed severe anaemia, thrombocytopenia and eosinophilic leucocytosis.Bone marrow aspiration (BMA) cytology showed myeloid hyperplasia with eosinophilic myeloblasts.Supportive hydration, blood transfusion, ant-microbial agents and allopurinol were administered.The patient was counselled and Daunorubicin and Cytosine arabinoside (DA) regimen was commenced.Evaluation on days 14 and 28 revealed only improvement in clinical and laboratory features.Induction of remission was embarked upon again with DA regimen.On day 14 of re-induction, the haemogram remained essentially the same.She was maintained on the regiment for eight cycles when symptoms of fever and mucosal bleeding (gum) resumed, accompanied by raised WBC, severe thrombocytopenia, neutropenia and anaemia.She was on intravenous saline, fresh whole blood transfusion and antibiotic.Drugs regimen was changed to cyclophosphamide, vincristine, methotrexate and prednisolone.Conclusion: Rare forms of leukaemia when seen in the developing nations are faced with management limitations.

Background: Maintaining a constant supply of blood in the blood bank is essential to the practice of medicine today. Safe supplies can only be achieved by continual recruitment and retention of voluntary blood donors which is based on effective and efficient education/intervention. Aim: The study was aimed at assessing the knowledge, attitude and practice of blood donation amongst adults in Mushin local government of Lagos and determining the factors which affect the practice of blood donation. Study Design: This was a cross-sectional study involving 360 adults recruited using a multistage sampling technique. A structured pre-tested questionnaire was used to collected data on knowledge, attitude and practice. Data analysed using SPSS version 21. Frequency and percentages were calculated for categorical data and mean was determined for continuous data. Association was determined by unconditional logistic regression. Statistical significance was considered at P=0.05. Results: The mean age of respondents was 35.08± 11.6years and males accounted for 54.89% (194) of study population. Two hundred and forty three (67.5%) had adequate knowledge of blood donation while 315(87.5%) had a favourable attitude. Only 63(17.5%) had ever donated blood before. Males, who had adequate knowledge (AOR=7.128, CI=2.55-19.91), tertiary education (AOR=6.433, CI=2.084-19.85) and between the ages of 41-50years (AOR=6.027, CI=2.655-13.680) had greater odds of donating blood. Fear was the major deterrent to donation blood. Conclusion: The practice of blood donation was low. Key determinants for the practice of blood donation were male sex, adequacy of knowledge, tertiary education and age between 41 and 50years. Keywords: Voluntary non remunerated donors, knowledge, attitude, practice, blood donation

Blood transfusion is an important therapeutic intervention in sickle cell anaemia (SCA). Persons with SCA requiring repeated blood transfusions are at risk of contracting transfusion transmissible infections (TTIs) such as human immunodeficiency virus (HIV). Blood meant for transfusion is usually screened for TTIs to ascertain its safety before transfusion. The study investigated the role of blood transfusion in the spread of HIV among patients with sickle cell anaemia and effectiveness of the screening methods used to prevent HIV acquisition through blood transfusion in Jos. Consenting consecutive patients with sickle cell anaemia attending the Haematology clinic of Jos University Teaching Hospital between November, 2013 and July, 2014 had their blood samples screened for human immunodeficiency virus (HIV) after completing a questionnaire. One hundred and eleven (111) SCA patients aged between 17 and 52 years participated. Seventy six (68.5%) had history of blood transfusion while thirty five (31.5%) had no previous blood transfusion. Nine (8.1%) of them were positive for HIV, which comprised of 3 (8.6%) of the non-transfused and 6 (7.9%) of the transfused (p = 0.911). Blood transfusion though an important risk factor for acquisition of HIV infection, did not play a significant role in this study. Current pre transfusion HIV screening techniques were effective but further improvement in the safety of blood supply can be assured through the use of highly sensitive HIV screening methods and newer technologies. Key words: Sickle cell anaemia, HIV, blood transfusion.

Introduction: Despite collection of blood from apparently healthy individuals for allogeneic transfusion, blood givers are often faced with untoward reactions during or after blood donation. Aim: This study was to determine the rate of adverse reactions among voluntary blood donors at the National Blood Transfusion Service in Jos. Methods: All blood donors recruited by the centre between October 2012 and September 2014 were counseled and consent to participate in the research was obtained prior to donation. The age, sex, weight and blood pressure and the venue of donation were documented. The type of donation reaction during and or after donation were timed and documented. The haemoglobin level and haemoglobin phenotypes were determined. Results: Eleven thousand six hundred and fifty-five (63%) male and 37% females were studied. The overall rate of adverse effects was 2.05% with significantly higher rate of occurrence among donors aged 18-25 years (p˂0.0001), female donors (p=0.0001), weight 40-49 Kg (p=0.001), blood group B (p=0.002) haemoglobin phenotype AA (P=0.001). The rate of adverse reactions was also higher among first-time donors (p=0.002), indoor donations (p=0.001). All adverse effects documented in our donors occurred during donation (4%) and within 21 (96%) after donation. Dizziness affected 90% while severe reaction (faint) occurred in 3% of adverse reactors. Ingested meal was the vomits of all donors who vomited. Conclusion: Though adverse effects to blood donation is low in our centre, there is need for preparedness, donor education, prediction and mitigation of occurrences.

BACKGROUND:Syphilis is one of the mandatory transfusion transmissible infections to be tested for in any unit of blood for homologous transfusion. The paucity of voluntary blood donors in Nigeria has compelled health care providers to rely on paid and family replacement donors for blood.AIMS:This study was carried out to determine the prevalence of syphilis among blood donors at a centralized Transfusion Service in North Central Nigeria.METHOD:Records of blood donors at the North Central Zonal Centre of the National Blood Transfusion Service in Jos, from April 2007 to March 2010 were analyzed for sero-positivity to Treponema pallidum and co-infections with other transfusion transmissible infections.RESULTS:9,500 blood donors where received at the Transfusion Service Centre in Jos within the study period. The overall prevalence of syphilis among blood donors was 0.9%. New voluntary non remunerated donors constituted 69.9% with a syphilis sero-positivity of 0.9% and 0.2% co-infection. Retained voluntary non remunerated donors accounted for 19.5% with syphilis sero-positivity of 0.2%. Family replacement donors made up 10.6% of total blood units screened with a 2.0% anti-syphilis positive reaction and 1.0% co-infection.CONCLUSION:The prevalence of syphilis among blood donors in a centralized transfusion service may be low.