Annals of Medical Laboratory Science

Agreement between the CKD-EPI serum creatinine- and cystatin C- based eGFR equations in pregnant and non-pregnant women: A cross-sectional study in Ghana

2025-01-11T18:21:22+00:00

Introduction: The serum cystatin C (sCys)-based estimated glomerular filtration rate (eGFRcys) is usually preferred to that of serum creatinine (eGFRcrt). However, the former is relatively more costly and may not be suitable for low- and middle-income countries such as Ghana. The study sought to determine the agreement between the sCrt- and sCys-based eGFR in pregnant and non-pregnant.

Materials and Methods: This was a cross-sectional study conducted from May 2020 to April 2022 in the Upper East Regional and War Memorial Hospitals. The study involved 281 women, 50 of whom were non-pregnant (nonP) and 231 of whom were normotensive pregnant (NP). Serum Crt and Cys were measured using a routine biochemistry analyzer and ELISA, then used to calculate the eGFR based on the CKD-EPI equations.

Results: A percentage difference in eGFR (bias) <40% was considered a measure of high agreement between the two methods. The sCrt was significantly higher (P<0.001), while eGFRcrt was significantly lower (P=0.001) in the normotensive pregnant women. The eGFRcys were significantly higher than eGFRcrt and the combined (eGFRcrt+cys) in both non-pregnant and pregnant women (P<0.001). There was no high agreement between eGFRcrt and eGFRcys (bias: -61% to -76%). Reduced eGFR (<60 mL/min/1.73m2) was detected only by effort with a frequency of 4.7% and 2.0% in pregnant and non-pregnant women, respectively.

Conclusion: There is a marked difference in eGFR based on Crt and Cys in pregnant and non-pregnant women. The sCrt—and sCys-based CKD-EPI equations need to be validated in a given population before use.

Assessment of Microbial Contaminants in Municipal Area Council Boreholes, Abuja, Nigeria.

2025-01-11T18:42:54+00:00

Introduction: This study evaluated microbial contamination in borehole water across fifteen locations within the Abuja Municipal Area Council (AMAC), FCT.

Materials and Methods: Thirty water samples were collected and analyzed for microbial parameters, including total bacterial count (TBC), Escherichia coli, Salmonella, Shigella, yeasts, molds, and parasites.

Results: Results indicated significant microbial contamination, with key locations such as Wuse and Durumi showing TBC levels exceeding 14,000 CFU/ml, far above the WHO and NIS recommended 100 CFU/ml limit. Yeast and mold contamination was also prominent, particularly in Jabi. Data analysis was performed using SPSS and Python, revealing that 80% of the sampled boreholes failed to meet microbial safety standards.

Conclusion: The findings emphasize the need for immediate interventions, including water treatment, routine microbial monitoring, improved sanitation around boreholes, and public health campaigns to raise awareness of the risks associated with untreated borehole water. These steps are crucial for mitigating contamination risks and ensuring regional water safety.

Comparative analysis of raw and treated water in some selected areas in Abuja, Nigeria.

2025-01-11T18:56:52+00:00

Introduction: This study presents a comparative analysis of the quality of raw and treated water in selected areas within the Abuja Municipal Area Council of the Federal Capital Territory, Nigeria. With the global challenge of ensuring access to safe drinking water as emphasized by Sustainable Development Goal 6 (SDG 6), this research addresses the significant public health concerns related to waterborne diseases arising from the consumption of untreated or inadequately treated water. The study aimed to determine the effectiveness of local water treatment processes in reducing contaminants and to assess compliance with national and international water quality standards.

Materials and Methods: A total of forty samples were collected from four different areas in AMAC namely Garki, Gwarimpa, Kubwa, and Lugbe. These samples underwent physicochemical and microbiological testing to evaluate parameters such as pH, turbidity, alkalinity, conductivity, Nitrate, Nitrate, Hardness and the presence of contaminants including Total bacteria count, Total coliform count, yeast, and mould.

Results: The result of the analysis showed that the pH values across the zones had a mean range of 6.47-7.26 for raw water and 6.21-6.89 for treated water. Conductivity was between 156.7-418.6 µS/cm for raw water and between 28.6-117.9 µS/cm for treated water. Other parameters including nitrate, alkalinity, nitrite, chloride, Carbon dioxide, and hardness reduced post-treatment.

Conclusion: There was no significant difference between raw and treated water although findings also indicated that untreated water sources exhibited higher levels of contaminants, posing potential health risks, while treated water generally met regulatory standards. However, the effectiveness of treatment varied across different areas. This research underscores the necessity for improved water treatment infrastructure and monitoring practices to safeguard public health in Abuja Municipal Area Councils, Federal Capital Territory. Abuja.

The Relationship Between G6PD Variations and Malaria In Calabar, Nigeria

2025-01-11T19:11:01+00:00

Introduction: This study was carried out to ascertain the burden of malaria based on the G6PD status of the participants. A total of 225 inhabitants were recruited for this study.

Materials and Methods: Participants were tested for malaria infection using microscopic and serological techniques.

Results: The prevalence of malaria infection in the study was 27.1%. The polymerase chain reaction (PCR) technique detected G6PD and its variations. The prevalence rate of G6PD deficiency in the entire study population was 15.1%, and the difference between malaria-positive subjects who were G6PD deficient and those with normal G6PD was significant. The study indicated a male sex bias in the prevalence of G6PD deficiency in the population studied.

Conclusion: This study recorded a significant association between G6PD variation, a human genetic factor, and malaria disease.

Assessment of Blood Transfusion needs for Breast Cancer Patients receiving Chemotherapy at University of Calabar Teaching Hospital, Calabar

2025-01-11T19:21:13+00:00

Introduction:Haematological derangements are commonly reported in breast cancer patients. These abnormalities can manifest both before and during cancer treatment. Depending on the degree of reduction in cellular elements of blood, blood transfusion is often required to correct severe situations. Different regions of the world as well as local settings have peculiar patterns regarding transfusion needs.

Materials and Methods: This cross-sectional study adopted purposive sampling technique to enroll 55 breast cancer patients who were accessing chemotherapy at the University of Calabar Teaching Hospital in Calabar, Southern Nigeria. The ABO and Rhesus grouping were carried out by standard tube method. Blood transfusion requests were followed up at the Blood Transfusion Services section of Haematology Laboratory of the Hospital.

Results: Those with blood group O were 61.8% followed by blood group A which recorded 21.8%, while blood group B was 16.4%. None of the subjects belonged to blood group AB. All the participants were Rhesus ‘D’ positive. Out of the 55 enrolled subjects, 37 of them which constituted 67.3% received whole blood transfusion during this study, while 18 of them making up 32.7% were not transfused. The indications for transfusion among the transfused ones showed that majority (62%) of the transfused persons had cytopenia while those who had anaemia alone were 38%. The extent of blood cell deficit varied among transfused subjects. consequently, some of the subjects received single transfusion, while others received multiple transfusion to enable them receive the chemotherapy dose. Transfusion of 2 units ranked highest as received by 41%, followed closely by 1 unit transfusion for 35% of the subjects.

Conclusion: Blood transfusion needs for breast cancer patients receiving chemotherapy was mainly within two units of blood.

Role of HbA1c in The Diagnosis of Hemoglobinopathies

2025-01-11T19:32:38+00:00

Introduction: Hemoglobinopathies are common genetic disorders resulting from qualitative (hemoglobinopathies) or quantitative (thalassemias) abnormalities affecting hemoglobin. The Hb S variant is of particular concern, as it causes severe sickle cell syndromes. Screening for these conditions is essential, especially in regions such as Morocco, where consanguinity increases the prevalence of genetic disorders.

Patients and Methods: This study included 17 patients, aged between 23 and 70 years, who were followed at the Cheikh Zaid University Hospital in Rabat from 2018 to 2022. Among them, six were from Morocco, and eleven were from sub-Saharan Africa. All patients underwent comprehensive hemoglobin testing and HbA1c measurement. Two primary methods were used for analysis. The first was alkaline agarose gel electrophoresis with the Hydrasys® analyzer, which identifies normal hemoglobins (A, A2) and abnormal variants (S, D, C, E). The second was high-performance liquid chromatography (HPLC) using the D-10® and G7® analyzers. Although primarily designed for HbA1c measurement, these analyzers can also detect hemoglobin variants. The D-10® identifies the Hb S variant but may occasionally confuse it with Hb D.

Results : Electrophoresis identified Hb S as the only abnormal variant. One patient had homozygous sickle cell disease (S/S), and ten were heterozygous carriers (A/S). The remaining six patients showed no hemoglobin abnormalities. The D-10® analyzer detected the Hb S variant in several patients but misidentified one case as Hb D. Additionally, the G7® analyzer detected some variants, although it lacked clear differentiation. The correlation between HPLC and electrophoresis for HbA and HbS measurements was generally acceptable. However, the correlation for HbA was weaker, likely due to differences in the detection of specific hemoglobin fractions.This study highlights that while HPLC is primarily used for diabetes management, it also serves as a valuable complementary tool for the incidental detection of hemoglobin variants, such as Hb S. This approach is particularly useful in asymptomatic patients, enabling the early identification of carriers and sickle cell syndromes. Integrating HPLC with electrophoresis could improve patient care and reduce diagnostic delays, especially in high-prevalence regions such as Morocco. However, it is important to account for HPLC’s limitations, including its inability to distinguish certain variants accurately.

Conclusion: In conclusion, although HPLC is not specifically intended for the diagnosis of hemoglobinopathies, it represents a useful complementary tool. It facilitates the detection of variants such as Hb S, guiding further diagnostic investigations. A combined strategy using both HPLC and electrophoresis could enhance patient care and minimize diagnostic delays, particularly in regions with high prevalence. Special attention should be given to HPLC’s limitations, notably its difficulty in distinguishing between certain hemoglobin variants.

Neutrophil-Lymphocyte Ratio and Platelet Indices Value as Predictive Markers of Anaemia of Chronic Diseases and Inflammation

2025-01-11T19:47:38+00:00

Background: Anaemia of chronic diseases (ACD) is a prevalent condition among patients with chronic illnesses. Neutrophil-lymphocyte ratio (NLR) and platelet indices (PI) have been suggested as potential biomarkers for ACD. This study aimed to assess the predictive value of NLR and PI in patients with chronic diseases attending hospitals in South-Western Nigeria.

Materials and Methods: A cross-sectional comparative study was conducted among 87 participants, including individuals diagnosed with HIV, HBV, chronic kidney disease (CKD), diabetes mellitus (DM), and a control group. Blood samples were collected, and NLR and PI were measured using an automated blood counter (Sysmex KX-21N). Statistical analysis was performed using ANOVA and unpaired t-tests, with significance set at p ≤ 0.05.

Results: The mean NLR values showed no statistically significant difference between anaemic and non-anaemic subjects (p > 0.05). ROC analysis indicated limited discriminatory power for NLR (AUC = 0.577) and PLR (AUC = 0.536) as diagnostic tools for anaemia. Platelet indices, including PLT, MPV, PDW, and P-LCR, also revealed no significant differences between study groups.

Conclusion: The study found that NLR and PI have limited utility as predictive markers for ACD. Further studies are recommended to explore alternative biomarkers and refine diagnostic tools for ACD in chronic disease patients.

Inflammatory Markers in Participants with Anaemia of Chronic Diseases: A Study Conducted in South West Nigeria

2025-01-11T20:01:35+00:00

Background: Anaemia of chronic diseases (ACD) is a frequent complication in individuals with chronic diseases, often associated with inflammatory markers such as hepcidin. This study aimed to evaluate the inflammatory markers and haematological parameters in individuals with ACD across various chronic diseases in Southwest Nigeria.

Materials and Methods: This cross-sectional study was conducted between April and June 2023 at Babcock University Teaching Hospital (BUTH), Ilishan, and General Hospital, Ijebu Ode, Ogun State, Nigeria. A total of 87 participants with confirmed chronic diseases were recruited using a sample size derived from the Cochran formula. Blood samples were collected and assayed for hepcidin using ELISA and complete blood counts (CBC) were conducted. Statistical analysis was performed using SPSS version 18, employing descriptive statistics, ANOVA, and Pearson’s correlation. Significance was set at P < 0.05.

Results: Among 87 participants, the prevalence of anaemia varied across diseases, with 54.5% of chronic kidney disease (CKD) patients being moderately anaemic, and 75% of diabetic patients presenting mild anaemia. Comparisons of red blood cell indices showed significant differences in RBC count (P = 0.000) and haemoglobin levels (P = 0.000) between anaemic participants and non-anaemic controls. Leucocyte indices showed no significant variation across the study groups.

Conclusion: The findings indicate a significant prevalence of anaemia among individuals with chronic diseases, particularly CKD and diabetes mellitus. The presence of anaemia correlates with alterations in red blood cell indices, and mild variations in leucocyte indices suggest inflammatory activity. The use of hepcidin as an inflammatory marker in ACD requires further investigation.

Comparative Study of Iron-related Parameters in Pregnant Women of Advanced and Younger Maternal Age groups in Calabar, Nigeria

2025-01-11T20:12:27+00:00

Introduction: Gestational anaemia is at the forefront of the many health challenges confronting maternal health. It often stems from micronutrient deficiencies particularly found in low-income countries. Iron deficiency has been observed as the most common micronutrient deficiency. Iron deficiency anaemia in pregnancy is associated with adverse outcomes such as preterm birth, low birth weight, and maternal complications such as fatigue. While population differences may exist in this regard, the effect of aging on iron-related parameters of pregnant women needs to be studied.

Methods The pregnant women consisted of equal numbers of those at advanced maternal age (from 35 years of age) and younger subjects. Blood sample was appropriately obtained from each subject for assessment of red cell and iron parameters. Microhaematocrit and cyanmethaemoglobin methods were employed for the measurement of packed cell volume and haemoglobin concentration respectively, while the iron parameters were assayed by colorimetric methods. Transferrin saturation was mathematically derived. Results are expressed as Mean±SD, while student t-test was used for analysis of data on SPSS version 22.0. Statistical significance was drawn at a p≤ 0.05.

Results: Pregnant women of advanced maternal age had significantly lower mean values than the younger pregnant women for serum iron (12.68 ± 1.76 µmol/L compared to 16.26 ± 2.22 µmol/L), transferrin saturation (21.37±4.69% compared to 32.04±7.51%), packed cell volume (0.34 ± 0.03l/l compared to 0.37 ± 0.03l/l) and haemoglobin concentration (114.16 ± 10.42g/l compared to 126.32 ± 11.68g/l). The TIBC was significantly higher in those at advanced age than the younger ones (60.29 ± 4.71 µmol/L, compared to 51.90 ± 5.20 µmol/L).

Conclusion: Pregnant women of advanced maternal age had lower circulating iron and red blood cell values than younger pregnant women.

Coagulation parameters and immune cell counts in pregnant women of advanced maternal age

2025-01-11T20:26:29+00:00

Introduction: Haemostasis and immunity are vital aspects of health greatly affected in pregnancy. Pregnancy-induced hypercoagulability and upregulated immune response are believed to be beneficial at some level, but are capable of triggering immunothrombosis. Advanced maternal age is considered a risk factor for several health complications associated with pregnancy. To this end, a comparative investigation of cellular immune response and coagulation are warranted.

Methods: This study was conducted among pregnant women attending antenatal clinic at University of Calabar Teaching Hospital. Pregnant women of advanced maternal age were recruited alongside equal number of younger pregnant women. Blood sample was collected from each participant into appropriate sample bottles. Standard manual methods were also employed for prothrombin time, activated partial thromboplastin time and relative plasma viscosity tests. Platelet and total white blood cell counts were carried out by haemocytometry, while differential white blood cell counts were carried out by microscopy. Results are expressed as Mean ±SD following student t-test analysis of data on SPSS version 22.0. Statistical significance was drawn at a p≤ 0.05.

Results: Pregnant women of advanced maternal age had significantly shortened (p=0.006) PT (11.56±1.01secs) and lower (p=0.009) INR (0.95±0.07) compared to the younger pregnant women (12.52±1.33secs and 1.02±0.10 respectively). Pregnant women of advanced age had significantly higher (p=0.001) mean values than younger pregnant women in the following parameters; platelet count (258.40±38.35x109/l vs 180.76±37.74x109/l), total WBC count (11.44±2.98x109/l vs 8.03±2.21x109/l), neutrophils count (6.44±1.69x109/l vs 4.53±1.33x109/l), lymphocyte count and (4.59±1.30x109/l vs 3.19±0.95x109/l).

Conclusion: The present study observed higher hypercoagulability and immune response in older pregnant women compared to the younger ones.

Assessment of MicroRNA-451, P-Selectin, Haemoglobin Levels, and Platelet Counts in Steady-State Individuals with Haemoglobin-S Variants in Jalingo, Nigeria

2025-01-11T20:40:59+00:00

Background: Sickle cell disease (SCD) is a prevalent monogenic disorder characterized by abnormal hemoglobin and associated with various clinical complications. Homozygous sickle cell (HbSS) erythrocytes have differential expression of many erythrocytic microRNAs (miRNAs). Elevated levels of miR-451 and let-7i-5p have been reported in HbSS and HbAS erythrocytes. P-selectin, a member of a family of adhesive proteins, plays an essential role in the initial recruitment of leukocytes and in the recruitment and aggregation of platelets to the site of injury during inflammation. This interaction is thought to contribute to the inflammation of SCD. This study aimed to assess the levels of microRNA-451, P-Selectin, hemoglobin concentration, and platelet counts in individuals with different hemoglobin-S variants in steady-state conditions in Jalingo, Nigeria.

Materials and Methods: This cross-sectional study was conducted at Federal Medical Centre Jalingo in Taraba state, Northern Nigeria. Ethical approval was obtained from the Ethics Review Committee of Federal Medical Centre Jalingo, Taraba State. One hundred and twenty subjects were recruited for the study, stratified as 40 HbSS in steady state, 40 HbAS, and 40 HbAA. Blood samples were appropriately collected for the analysis of haemoglobin-S variants(alkaline cellulose acetate method),haemoglobin concentration (Hematology Auto-Analyzer), miRNA-451 (Real Time PCR) and P-selectin (ELISA technique). Statistical analysis was done using SPSS version 22 Software. A p-value of ≤ 0.05 was considered significant.

Results: The study found that HbSS subjects had significantly higher levels of microRNA-451, P-selectin, and platelet counts than HbAS and HbAA subjects, with p-values <0.0001. Hemoglobin concentrations were significantly lower in HbSS individuals. HbAS subjects had elevated microRNA-451 and P-selectin levels compared to HbAA subjects, but with similar platelet counts. A moderate negative correlation (r = -0.335, p < 0.035) was observed between microRNA-451 and P-selectin levels

Conclusion: The results indicate that microRNA-451 and P-selectin are significantly elevated in HbSS individuals, which may contribute to the pathophysiology of sickle cell disease

Comparative Analysis of Prothrombin Time and Activated Partial Thromboplastin Time in Cord blood and Maternal Venous Blood Samples.

2025-01-11T20:53:22+00:00

Introduction: The umbilical cord blood is known to contain potentially lifesaving cells called stem cells that are capable of self-renewal and differentiation offering therapeutic benefits for patients worldwide. The Activated Partial Thromboplastin Time (APTT), Prothrombin Time (PT) and International Normalized Ratio (INR) tests are used clinically to assess the integrity of the intrinsic, extrinsic and common pathways as well as monitor anticoagulant therapy and diagnose coagulation disorder. The difference in the level of APTT, PT and INR in cord blood and venous blood are yet to be accessed thus this study aimed to determine the difference between these parameters in cord blood and venous blood samples from mothers.

Materials and Methods: The study utilized eighty (80) blood samples comprising of 40 cord blood obtained directly from the umbilical cord immediately after delivery and 40 venous blood obtained from same pregnant women before delivery. 3ml of blood each were obtained aseptically from the vein and umbilical cord using a syringe and immediately dispensed into sample containing 333mls of tri-sodium citrate anticoagulant with proper mixing and centrifugation to obtain platelet poor plasma for analysis. The APTT, PT and INR values were analyzed and calculated manually using the spectrum reagent test kit following manufacturers instructions. The data obtained were analysed using Graph-Pad Prism version 8. Descriptive Analysis were done using Mean and Standard Deviation and p-value was set at p<0.05.

Results: The value of APTT, PT and INR was 30.5 ± 9.5s, 14.6 ± 2.9s and 1.18 ± 0.41 respectively for cord blood samples and 38.6 ± 9.9s, 17.8 ± 2.3s, 1.39 ± 0.49 for venous blood samples respectively. A comparison of the values of APTT, PT and INR between cord blood and venous blood samples showed that APTT, PT and INR were higher in venous blood samples compared to cord blood samples (p=0.0004, p=0.0047, p=0.0142) respectively. The reference ranges for APTT, PT and INR for cord blood was established in this study to be within 27–34 seconds, 14–16 seconds and 1.1–1.3 respectively and found to be within already established normal reference ranges.

Conclusion: APTT, PT and INR values are higher in venous blood compared to cord blood samples. APTT, PT and INR are found to be within normal reference range in cord blood samples. The elevated APTT, PT and INR in venous blood is an indication that during parturition, bleeding is inevitable and as such APTT, PT and INR baseline values be accessed and incorporated as an integral part of routine antenatal tests for proper management of spontaneous or excessive bleeding complications during delivery.