African Journal of Laboratory Haematology and Transfusion Science

Evaluating the Accuracy of Hepatitis C Virus Rapid Test Kits versus Polymerase Chain Reaction in Screening Prospective Blood Donors in Rivers State, Nigeria

BE Echonwere-Uwikor — 2024-12-20

Background: Rapid Diagnostic Tests can provide a good alternative for screening for hepatitis C virus in resource-poor settings. Rapid diagnostic test kits are cheaper, quicker, and require less skill and instrumentation. Method: A cross-sectional study design was used for this study.

Materials and Methods: 200 potential blood donors were recruited from Rivers State University Teaching Hospitals, University of Port Harcourt Teaching Hospital, Rukpoku, Ozuoba, and Iriebe Model Primary Health Care Centres in Port Harcourt. Their samples were collected and serologically tested using four different rapid diagnostic test kits for the hepatitis C virus. One hundred and fifty (150) samples had discrepant results with the four different rapid diagnostic tests (ROSTEC, Skytec, Tell, and LabACON), and 50 were negative with the four different rapid diagnostic test kits, and they served as control. The 150 samples that showed discrepant results were sent for confirmation using a polymerase chain reaction. The study aimed to evaluate the accuracy of hepatitis c virus rapid test kits versus polymerase chain reaction (real-time polymerase chain reaction) in screening potential blood donors in rivers state.

Results: The comparison of performance characteristics of rapid diagnostic kits used for the screening of hepatitis C among prospective blood donors shows that the different kits used had different sensitivity, specificity, and accuracy. The Skytech rapid diagnostic kit had a sensitivity of 57%, specificity of 50%, and accuracy of 53%. There was a positive predictive value of 36 and a negative predictive value of 71. The Rostec rapid diagnostic kit had a sensitivity, specificity, and accuracy of 73%, 84%, and 77%, respectively, with a positive and negative predictive value of 35 and 72. The Tell rapid diagnostic kit had a sensitivity of 92%, a specificity and accuracy of 79% and 71%. There was a positive predictive value of 75 and a negative predictive value of 81. The Lab Acon rapid diagnostic kit had a sensitivity of 88%, a specificity of 61%, and an accuracy of 93%. The Lab Acon rapid diagnostic kit had a positive predictive value of 70 and a negative predictive value of 78. The Tell rapid diagnostic kit had the highest sensitivity among the four kits, with the Skytech rapid diagnostic test kit having the lowest sensitivity. The specificity for the four different kits was Rostec> Tell > Lab Acon > Skytec.

Conclusion: The Rostec diagnostic test kit had the highest specificity but the third lowest specificity. The most accurate diagnostic test kit among the four in the study was the Lab Acon diagnostic test kit, and the least was the Skytech rapid diagnostic test kit. Therefore, rapid diagnostic test kits are reliable and feasible for screening hepatitis C virus in resource-poor settings.

Serological and Molecular Compatibility Methods Among Sickle Cell Disease Blood Recipients and Their Donors in a Tertiary Hospital, in North Central Nigeria: a Comparative Study

MA Kareem — 2024-12-20

Introduction: Sickle Cell Disease (SCD) is an autosomal recessive genetic blood disorder characterised by abnormal, rigid, sickle cell shape in a hypoxic environment. Most SCD patients require a safe and compatible blood transfusion during crises; hence, there is a need for DNA genotyping blood to avoid haemagglutination in multiple transfused patients. This study compared molecular genotyping to serological compatibility testing methods among sickle cell disease patients attending General Hospital, Ilorin.

Methodology: Fifty sickle cell disease recipients and fifty blood donors in general hospital Ilorin were randomly selected. 5mls of blood sample was collected from each group. Serological compatibility testing was performed on each sample by standard tube agglutination methods. Molecular compatibility testing was done by extracting the genomic DNA followed by polymerase chain reaction techniques. The products were separated by Gel electrophoresis, results were interpreted and analysed.

Results: The Mean age of the Sickle cell disease recipients is 7.6 (± 4.3) years. Their Mean Body weight is 23.6 (± 8.2) Kg. About 30 (60%) of the SCD patients have been transfused at least twice before with 50 (16%) history of blood transfusion reaction. Most of the recipients (52%) are of O Rh D positive blood group while the donors are (56%). All the recipients had a negative Indirect Antiglobulin Testing, with 100% compatible for serological and 80% for Molecular procedures. There are (n=10) discrepancies between serological phenotyping and molecular RHCDE genotyping. Which (n=4) were due to Rh D antigens, (n=4) were also due to RhCE antigens and (n=2) were due to both RhCDE antigens. However, there was complete compatibility between serological and molecular compatibility of (n=40) sickle cell disease.

Conclusion: Molecular compatibility testing offers superior sensitivity, specificity, and accuracy when compared to serological compatibility testing methods and should be considered the gold standard when transfusing sickle cell disease patients.

Assessment of Some Haematological and Systemic Inflammatory Markers among Pregnant Women with Hypertension at the University of Port Harcourt Teaching Hospital, Nigeria

BE Echonwere-Uwikor — 2024-12-20

Introduction: Hypertension in pregnancy is one of the most common and potentially life-threatening complications of pregnancy. Pregnancy is known to be associated with various physiological changes ranging from increased plasma volume and red blood cell mass, leucocytosis, and adaptive immunological modifications to the relative hypercoagulable state of pregnancy. This syndrome has been recognized for centuries but aetiology remains uncertain, limiting effective intervention. This study aimed to assess some haematological and systemic inflammatory markers among hypertensive pregnant women attending antenatal care in selected health centres in Port Harcourt, Rivers State.

Materials and Methods: A cross-sectional study was employed for the study, which comprised 150 pregnant women, 75 normotensive pregnant women as control, and 75 hypertensive pregnant women, all between the ages of 18 and 43 years. Socio-demographic data was obtained from pregnant women using a well-structured questionnaire. Three (3) ml of venous blood was collected aseptically from the participants and dispensed into ethylene diamine tetraacetic acid (EDTA) anticoagulant bottle for full blood count (FBC) assessment using a Three (3) part Haematology autoanalyzer. The data generated from this study was analyzed using GraphPad Prism software version 6.00, USA. Data was presented as means and standard deviation, and the two means were compared using student t-test analysis.

Results: Among the 75 hypertensive women studied, 27 (36%) were classified as having stage 1 hypertension and 48 (64%) as stage 2 hypertension. The systolic and diastolic blood pressure status of women in the hypertensive group was significantly higher than those of women in the normotensive control group (p<0.001). Mean values of haematologic parameters measured for women in the hypertensive group was as follows: Hb (10.74±2.13), PCV (32.64±6.15), RBC (5.25±9.71), MCV (79.85±11.02), MCH (26.81±7.87), MCHC (31.31±4.13), for WBC (8.29±16.81), Platelets (198.85±78.02), Neutrophils (57.85±14.52), Lymphocytes (35.28±14.52), Monocytes (3.76±1.87), and Eosinophils (2.15±1.99). Similar reading was noted for these parameters among the normotensive control, except for RBC, Neutrophils whose values decreased, and Eosinophils increased in hypertensive women. In the association of severity of hypertension with haematologic parameter assayed, it was observed that only monocyte level differed significantly between the 2 stages of hypertension. The mean monocyte level was significantly higher among stage 1 hypertensive patients than stage 2 hypertensive patients (4.04±2.25 and 3.60±1.59, respectively; t=0.949, p=0.038). MCH was shown to correlate significantly inversely with the severity of hypertension in the normotensive control group (R=-0.256, p=0.002).

Conclusion: During pregnancy, the occurrence of hypertension poses additional challenges to the haematopoietic system with resultant changes in haematological parameters, hence, simple, readily available clinical and laboratory parameters as indicators of the likely outcome of pregnancies complicated by hypertension are needed.

Determination of Some Haemostatic Parameters and Anthropometric Indices in Cervical Cancer Patients in Port Harcourt.

AC Isomah — 2024-12-20

Introduction: Cervical cancer is the second common female malignant tumor worldwide that seriously threatens female’s health. This study was aimed at determination of some haemostatic parameters and some anthropometric indices in cervical cancer subjects in Port Harcourt. This study was a case control study. There were two groups: Group A served as a test group, women that are histologically confirmed positive for cervical cancer, while Group B served as a negative control, women that were histologically confirmed negative for cervical cancer.

Materials and Methods: A total of 40 participants (20 histologically confirmed cervical cancer positive subjects and 20 histologically confirmed cervical cancer negative subjects) within the age of 40-70 years were recruited for this study. The demography and informed consent of the study subjects was obtained with the use of a well-structured questionnaire. Four milliliters (4mls) of blood sample were collected using vacutainers from each participant. Weight was recorded with the use of a mechanical scale; height was taken using stadiometer and body mass index (BMI) was calculated. Von Willebrand Factor (vWF), thrombomodulin, FVIII, Tissue plasminogen activator and D-dimer were analysed using ELISA technique. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were analyzed using the manual method, and fibrinogen was analyzed using the coagulation method. The graph pad prism version 8.0.2.263 was used for data analysis. P<0.05 was considered significant. Results were presented as mean ± standard deviation (х±SD) in Tables and Figures.

Results: A statistically significant increase in the mean prothrombin time (PT) (p=0.0002) and APTT (p=0.0156) was observed among cervical cancer subjects when compared with the control subjects across all age brackets. There was also a significant increase in thrombomodulin (p<0.0001), tissue plasminogen activator (tPA) (p<0.0001), vWF (p<0.0001), FVIII (p<0.0001), and D- dimer (p<0.0001), in cervical cancer patients when compared with the controls.

Conclusion: This study concludes that there are coagulation and fibrinolytic derangements in subjects with cervical carcinoma.

Haematological measurement of the quality of life of COVID-19 patients in a Port Harcourt isolation centre.

Q Elechi — 2024-12-20

Introduction: COVID-19 has been associated with various hematological abnormalities, including lymphopenia, thrombocytopenia, and changes in white blood cell counts, linked to disease severity and patient outcomes. Using hematological indices, this study assessed patients' quality of life in the COVID-19 centre, Port Harcourt.

Materials and Methods: A cross-sectional study was conducted involving fifty-five (55) COVID-19-positive patients and fifty-five (55) control subjects aged between twenty (20) and sixty-five (65) years at the Port Harcourt COVID-19 isolation center. Blood samples were collected from all consenting participants for haematological investigations. Key haematologic parameters were measured, including Haemoglobin (HGB), Packed Cell Volume (PCV), Total White Blood Cell count (TWBC), Granulocyte percentage, Lymphocyte percentage, Mid-cell percentage, and Platelet count. Sysmex XP-300 Automated Haematology Analyzer was used for the analysis.

Results: The findings indicated significant derangements in haematological parameters. Specifically, granulocytes, which constituted mainly of the neutrophils, are significantly increased in patients with COVID-19(51%) when compared with controls (45%) (p = 0.02). Lymphocytes are significantly reduced in the COVID-19 subjects (42%) when compared with the control subjects (49%)(p = 0.01). No significant differences existed in the hemoglobin level, PCV, TWBC count, and Platelet count of the COVID-19 subjects compared to the control subjects. (p = 0.55), (p = 0.19), (p = 0.13) and (p = 0.41) respectively.

Conclusion: The study indicated relative neutrophilia and lymphopenia among COVID-19 subjects.