Prevalence of Malnutrition and Anaemia in Children ≤ 5 Years of Age in Some Conflict Hit Areas of Meme Division of the South West Region of Cameroon

Malnutrition refers to the deficiency, imbalances, or excesses in a person’s intake of energy or nutrients [1]. Khan defines anaemia as below level of Haemoglobin in red blood shown by a lower number of functioning red blood cells [2]. The crisis in the North West and South West Regions of Cameroon has led to several negative effects on children’s living conditions. There has been an increase in malnutrition and anaemia in the South West Region and Kumba in particular. The main objective of this study was “to examine the prevalence of malnutrition and anaemia in children ≤ 5 years of age in some conflict-hit areas of Meme Division”. A descriptive cross-sectional study was conducted in 2023 from March to June. We recruited 200 children ≤ 5 years into the study from three hospitals. The regional hospital annex in Kumba, Presbyterian General Hospital Kumba and the Ntam Hospital in Kumba. Socio-demographic factors were assessed using questionnaire, nutritional status was assessed by the use anthropometric measurements and an auto haematology analyser was used to determine anaemia. The overall prevalence of malnutrition in the study area was 40.5%. The prevalence of malnutrition varied significantly (P < 0.001) with the study sites. The overall prevalence of anaemia in the study area was 70.5%. The prevalence of anaemia was not significantly associated with the study sites. The prevalence of Malnutrition and Anaemia in children ≤ 5 years of age is very high in the Kumba municipalities. This could be attributed to the ongoing crisis which has caused a lot of social migrations from rural areas to Urban areas which are safer.

Helicobacter pylori infection as a cause of iron deficiency anaemia of unknown origin

AIM: To assess the aetiological role of Helicobacter pylori (H. pylori) infection in adult patients with ironrefractory or iron-dependent anaemia of previously unknown origin. METHODS: Consecutive patients with chronic irondeficient anaemia (IDA) with H. pylori infection and a negative standard work-up were prospectively evaluated. All of them had either iron refractoriness or iron dependency. Response to H. pylori eradication was assessed at 6 and 12 mo from follow-up. H. pylori infection was considered to be the cause of the anaemia when a complete anaemia resolution without iron supplements was observed after eradication. RESULTS: H. pylori was eradicated in 88 of the 89 patients. In the non-eradicated patient the four eradicating regimens failed. There were violations of protocol in 4 patients, for whom it was not possible to ascertain the cause of the anaemia. Thus, 84 H. pylori eradicated patients (10 men; 74 women) were available to assess the effect of eradication on IDA. H. pylori infection was considered to be the aetiology of IDA in 32 patients (38.1%; 95%CI: 28.4%-48.8%). This was more frequent in men/postmenopausal women than in premenopausal women (75% vs 23.3%; P < 0.0001) with an OR of 9.8 (95%CI: 3.3-29.6). In these patients, anaemia resolution occurred in the first follow-up visit at 6 mo, and no anaemia or iron deficiency relapse was observed after a mean follow-up of 21 ± 2 mo. CONCLUSION: Gastric H. pylori infection is a frequent cause of iron-refractory or iron-dependent anaemia of previously unknown origin in adult patients.

The effects of co-infection with human parvovirus B19 and Plasmodium falciparum on type and degree of anaemia in Ghanaian children

Objective:To determin the extent to which parvovirus B19(B19V)and co-infection of B19V and malaria contribute to risk of anaemia in children.Methods:B19V DNA and malaria parasites were screened for 234 children at the PMI,Children's Hospital in Accra.The role of B19V and coinfection with B19V and malaria in anaemia was evaluated by analysing full blood cell counts,malaria and B19V DNA results from these children.Results:The prevalence of B19V,malaria and co-infection with B19V and malaria was 4.7%,41.9%and 2.6%,respectively.Malaria posed a greater risk in the development of mild anaemia compared to severe anaemia(OR=5.28 vrs3.15)whereas B19V posed a higher risk in the development of severe anaemia compared to mild anaemia(OR=4.07 vrs 1.00)from a non-anaemic child.Persons with co-infection with B19V and malaria had 2.23 times the risk(95%CI=0.40-12.54)of developing severe anaemia should they already have a mild anaemia.The degree of anaemia was about three times affected by coinfection(Pillai's trace=0.551,P=0.001)as was affected by malaria alone(Pillai's trace=0.185,P=0.001).B19V alone did not significantly affect the development of anaemia in a non-anaemic child.Microcytic anaemia was associated with B19V and co-infection with B19V and malaria more than normocytic normochromic anaemia.Conclusions:B19V was associated with malaria in cases of severe anaemia.The association posed a significant risk for exacerbation of anaemia in mild anaemic children.B19V and co-infection with B19V and malaria may be associated with microcytic anaemia rather than normocytic normochromic anaemia as seen in cases of B19V infection among persons with red cell abnormalities.

Blood transfusion for the treatment of acute anaemia in inflammatory bowel disease and other digestive diseases

Allogeneic blood transfusion (ABT) is frequently used as the first therapeutic option for the treatment of acute anaemia in patients with inflammatory bowel disease (IBD), especially when it developed due to gastrointestinal or perioperative blood loss, but is not risk-free. Adverse effects of ABT include, but are not limited to, acute hemolytic reaction (wrong blood or wrong patient), febrile non-hemolytic transfusional reaction, bacterial contamination, transfusion-related acute lung injury, transfusion associated circulatory overload, transfusion-related immuno-modulation, and transmission of almost all infectious diseases (bacteria, virus, protozoa and prion), which might result in increased risk of morbidity and mortality. Unfortunately, the main physiological goal of ABT, i.e. to increase oxygen consumption by the hypoxic tissues, has not been well documented. In contrast, the ABT is usually misused only to increase the haemoglobin level within a f ixed protocol [mostly two by two packed red blood cell (PRC) units] independently of the patient' s tolerance to normovolemic anaemia or his clinical response to the transfusion of PRC units according to a "one-by-one" administration schedule. Evidencebased clinical guidelines may promote best transfusion practices by implementing restrictive transfusion protocols, thus reducing variability and minimizing the avoidable risks of transfusion, and the use of autologous blood and pharmacologic alternatives. In this regard, preoperative autologous blood donation (PABD) consistently diminished the frequency of ABT, although its contribution to ABT avoidance is reduced when performed under a transfusion protocol. In addition, interpretation of utility of PABD in surgical IBD patients is hampered by scarcity of published data. However, the role of autologous red blood cells as drug carriers is promising. Finally, it must be stressed that a combination of methods used within wellconstructed protocols will offer better prospects for blood conservation in selected IBD patients undergoing elective surgery.

Efficacy of roxadustat in treatment of peritoneal dialysis patients with renal anaemia

BACKGROUND There are no studies on the use of roxadustat in patients on regular peritoneal dialysis in China.AIM To observe the efficacy and safety of roxadustat in treating renal anaemia in peritoneal dialysis patients.METHODS Patients with renal anaemia who were regularly followed at the Peritoneal Dialysis Center of the First Affiliated Hospital of China Medical University from November 1,2019 to June 30,2020 were selected.A before-and-after self-control design was performed to retrospectively analyse the treatment effects on anaemia in patients treated with recombinant human erythropoietin(EPO)and roxadustat.RESULTS A total of 31 patients with renal anaemia on long-term peritoneal dialysis treated with roxadustat were included.Haemoglobin(Hb)levels were maintained or increased in all patients(100%),and no patients had a decrease in Hb compared with the previous phase.Patients had a mean Hb of 86.2±14.8 g/L with Hb compliance(Hb≥110 g/L)of 16.1%during the EPO phase and a mean Hb of 112.4±18.5 g/L with Hb compliance of 67.7%during the roxadustat phase.No major adverse cardiovascular events occurred in any patient.CONCLUSION The application of roxadustat in peritoneal dialysis patients with renal anaemia can effectively improve the Hb compliance rate.

Effect of a Malaria Control Program on the Prevalence of Malaria, Fever and Anaemia in Children under Five Years in the Hohoe Municipality of Ghana: A Comparative Analysis of Cross-Sectional Surveys

Background: Malaria and anaemia continue to adversely impact the health of children in Ghana. Hohoe is an area of intense and prolonged, seasonal malaria transmission. In 2006, malaria control programme activities which provided In-secticide Treated Bed-Nets (ITNs) to resident children under five years and Artemisinin Combination Therapies (ACTs) for the management of malaria were introduced into the Hohoe Municipality. Before the introduction of the control programme, baseline surveys were carried out in communities in the Hohoe municipality to determine the prevalence of malaria, fever, anaemia, malaria parasite density, gametocytaemia and ITN ownership and use in June and November 2006 ahead of the intervention programme. Similar surveys were conducted in 2010 after the intervention to assess changes in the earlier indicators in the same communities. This report presents an evaluation of the intervention by comparing findings before and after the malaria control interventions. Methods: In 2010, two community-based surveys were carried out in thirty communities among children aged five years and below. The first one was at the beginning of the rainy and high malaria transmission season in June and the other was in November at the end of the rainy season. The surveys were to determine the prevalence of malaria, fever, anaemia and ITN ownership, use and effectiveness among children less than 5 years. Data were collected in the form of interviews using questionnaire and collection of biological samples. Findings were compared to those similar surveys conducted in the same communities and age groups in 2006. Pr-testi was used to analyze two sample tests for proportions and t-test was used for means. Findings: Malaria prevalence decreased by 20% [9.0% vs. 7.2%;p = 0.0.40], fever decreased by 47.8% [2.3% vs. 1.2%;p = 0.008] and anaemia decreased by 32.9% [7.8% vs. 5.3%;p = 0.002]. ITN ownership increased by 67.9% [20.8% vs. 64.8%;p < 0.001], ITN use increased by 64.2% [15.1% vs. 42.2%;p < 0.001] and ITN effectiveness increased by 41.7% [20.0% vs. 34.3%;p < 0.001]. The proportion of children with high density parasitaemia reduced by 17.9% [2.8% vs. 2.3%;p = 0.223]. Gameto-cytaemia decreased by 82.5% [0.8% vs. 0.14%;p = 0.002. Similarly data comparing 2006 and 2010 post-rainy season showed that malaria prevalence decreased by 16.8% [40.4% vs. 33.6%;p < 0.001], fever decreased by 14% [5.0% vs. 4.3%;p = 0.347] and anaemia decreased by 64.2% [12% vs. 4.3%;p < 0.001]. The proportion of children with high density parasitaemia also reduced by 69.5% [10.5% vs. 3.2%;p < 0.001] and gametocytaemia decreased by 78.5% [0.8% vs. 0.17%;p = 0.008]. Conclusion: This study suggested that there was an association between the current intervention and reduction in the prevalence of malaria, fever and anaemia. High parasite density and gametocytaemia prevalence have also significantly reduced over the five years of the introduction of the control measures. There has also been a significant increase in the ownership and use of ITNs.

Prevalence and Factors Associated with Anaemia among Pregnant Women Attending Antenatal Clinic in the Second and Third Trimesters at Pumwani Maternity Hospital, Kenya

Background: Anaemia is one of the most common nutritional deficiency diseases observed globally and affects more than a quarter of the world’s population. Globally, 41.8% pregnant women and close to one third of non-pregnant women (30.2%) are anaemic. Anaemia during pregnancy contributes to 20% of all maternal deaths and it increases the risks of foetal, neonatal and overall infant mortality. In Kenya, according to the Ministry of Health, the prevalence of anaemia among pregnant women is 55.1%. Objective: To determine the prevalence and associated factors of anaemia among pregnant women attending antenatal clinic (ANC) at Pumwani Maternity Hospital (PMH). Methodology: A hospital based cross-sectional study design was conducted from 8th June to 18th August, 2015. Systematic random sampling method was used to select 258 pregnant women. Mothers who attended ANC during the study period and who met the inclusion criteria were interviewed and a capillary blood sample was taken. Hemoglobin level was determined by using HemoCue photometer. Data were cleaned, coded and fed into SPSS Version 20.0 for analysis. Descriptive statistics such as frequency, percentage, mean and standard deviation were used to describe selected variables. Pearson’s chi-square test and odds ratio (OR) with corresponding 95% confidence intervals (CI) computed to find association between independent and dependent variables. Multivariate analysis was done to determine factors significantly and independently predicting anaemia during pregnancy. Results: The present study revealed that the prevalence of anaemia among the pregnant women was 57%. Advanced maternal age (>31 years) (AOR = 2.71;95% CI = 1.25 - 5.88;P = 0.012) more than 18 - 24 years, government/private employed women (AOR = 2.94;95% CI = 1.47 - 5.88;P = 0.002) and self-employed women (AOR = 1.91;95% CI = 1.03 - 3.53;P = 0.039) compared to housewives, not taking iron/folic acid supplementation (IFAS) (AOR = 2.04; 95% CI = 1.14 - 3.64;P = 0.016) and mid-upper arm circumference (MUAC) less than 23 cm (AOR = 2.52;95% CI = 1.36 - 4.67;P = 0.003) were found to be predictors of anaemia. Conclusion: Anaemia among pregnant women is found to be severe public health problem based on the World Health Organization classification of anaemia. Advanced age, employment, not taking IFAS during the current pregnancy and MUAC of less than 23 cm were significantly and independently associated with anaemia during pregnancy. Thus, special attention should be given to pregnant women who are employed and advanced in age. Moreover, they should be educated on the importance of taking iron and folic acid during pregnancy.

Role of malaria induced oxidative stress on anaemia in pregnancy

Objective:To assess the role of oxidative stress on anaemia in pregnancy.Methods:Blood samples were collected from pregnant and non-pregnant women who came for antenatal clinic and medical check at Comprehensive Health Center,Akungba-Akoko and Iwaro General Hospital in Akoko Area of Ondo State,Nigeria.Thick and thin blood films were prepared and used for malaria parasite counts.Haemoglobin level was determined by colorimetric method using Drabkin’s solution.Oxidative status was determined using malondiadelhyde level as an indicator of lipid peroxidation,while ascorbic acid and reduced glutathione levels were measured by standard spectrophotometric methods.Results:Mean parasite density was significantly higher in pregnant women than non-pregnant women(P【0.05).Haemoglobin level was significantly reduced in malaria positive pregnant and non-pregnant women than malaria negative(8.3-10.0 g/dL)(P【0.05).The oxidative status indicated that malondialdehyde(MDA) was significantly increased in pregnant[(2.5±0.7) nmol/mL]than non-pregnant women[(1.8±0.1) nmol/mL] (P【0.05),while Vit C and superoxide dismutase(SOD) levels were significantly reduced in pregnant than non-pregnant women(P【0.05).There was an inverse correlation between Hb and MDA levels in pregnant women studied.Positive correlation was observed between the mean MDA level and parasite density(r = 0.53).The Hb level decreased as the parasite density and MDA level increased in pregnant women.Conclusions:This study shows that oxidative stress, caused by malaria infection could be part of the contributing factors responsible for anaemia in pregnancy.

Relationship between perioperative anaemia and outcomes in older people with hip fractures: A systematic review and meta-analysis protocol

BACKGROUND Hip fractures are common with increasing age and is associated with decline in mobility. Both the fracture and the surgery can lead to blood loss, resulting in anaemia. However, it is uncertain at which time point haemoglobin is most strongly associated with different clinical outcomes after hip fracture. Our hypothesis is perioperative anaemia (admission, postoperative and discharge) during hip fracture surgery is associated with poor clinical outcomes. AIM To determine the effects of perioperative anaemia during hip fracture surgery on mortality, functional status and other clinical outcomes. METHODS Electronic databases will be searched to identify studies evaluating perioperative anaemia and outcomes of hip fracture surgery. Reference lists of included studies will also be searched to identify additional published studies. Eligibility criteria are as follows: Population: People who underwent hip fracture surgery;Exposure: Perioperative anaemia;Comparison: No anaemia before or after hip fracture surgery;Outcome: Mortality, hospital length of stay, postoperative complications, hospital readmission, change of discharge destination, quality of life and functional status. Risk of bias assessment will be assessed using the Cochrane Collaboration’s tool for randomized controlled trials and the modified version of the Epidemiological Appraisal Instrument for observational studies. Data will be pooled for meta-analysis if deemed appropriate. CONCLUSION This review seeks to clarify outcomes associated with perioperative anaemia at various time-points around hip fracture surgery. These findings will potentially inform evidence-based clinical practice on interventions in those with anaemia.

A Novel Approach for Iron Deficiency Anaemia with Liposomal Iron: Concept to Clinic

Iron deficiency anaemia is the most common nutritional deficiency disorder, contributing to 50 percent of all the anaemias in the world. Dietary changes alone are insufficient for the correction and management of iron deficiency anaemia. Hence, iron supplementation is necessary. Conventional oral iron therapy is limited in many patients because of dose dependent side effects, insufficient absorption, lack of compliance and limitation in various inflammatory conditions. Liposomal iron is a technologically designed, innovative form of iron which due to its differential delivery system ensures higher absorption and bioavailability, greater tolerability and least gastro-intestinal side effects unlike conventional oral iron preparations. This review provides a critical discussion and a comprehensive view based on the author’s review of the medical literature concerning the technology of liposomal iron preparation, mechanism of its absorption, its advantage over conventional iron preparations and clinical evidence on its usage in iron deficient states in pregnancy and certain inflammatory conditions.

Haematopoietic Effects of Amloki (<i>Emblica officinalis</i>) in Pregnancy with Iron Deficiency Anaemia

Due to poverty and ignorance more than half of the pregnant women in developing country are suffering from iron deficiency anaemia (IDA). Different gastrointestinal side effects cause low compliance to iron supplementation. Amloki (Emblica officinalis) is very popular among pregnant women for its taste and traditional belief of well-being. The aim of this study is to determine the effects of amloki on RBC, WBC and Platelet count. Prospective comparative study was carried out on patients of Outpatient Department of Obstetrics and Gynecology, Dhaka Medical College Hospital from July 2016 to June 2017. A total of 43 pregnant women between the 13th to the 20th weeks of gestation with IDA were selected aged 18 - 36 years in this study. Anemic pregnant women supplemented with oral iron and amloki were considered as study group (A) and control group (B) were with only iron supplementation for 45 days. Total count of RBC, WBC and platelet were done in the Department of Hematology & BMT Unit, Dhaka Medical College Hospital, Dhaka. For statistical analysis, Paired Student’s “t” test and Unpaired Student’s “t” test were considered using SPSS 22.0 version. A significant increase (p < 0.05) of blood RBC count was observed after intervention of iron in both groups. There was also significant increase in RBC count in iron + amloki supplemented group than that of only iron supplemented group. In this study, there was also increase of WBC count in iron + amloki supplemented group and decrease of platelet count in both groups, but these changes were not statistically significant. It can be concluded that oral amloki supplementation causes increased blood RBC count in IDA with pregnancy.

Hepatitis C virus antibodies among transfused children with sickle cell anaemia at University of Ilorin Teaching Hospital

Background: Hepatitis C is an infectious disease of the liver caused by the Hepatitis C virus (HCV) resulting to a chronic Hepatitis. Chronic HCV infection constitutes a serious health challenge in places where prevalence is substantial. In Nigeria, there is a high risk because donor blood is not routinely screened for HCV. Patients with sickle cell anaemia (SCA) are considered a subset of the population at higher risk of acquiring the virus, due to their frequent needs for transfusion of blood and its products. However, the magnitude of HCV infection has not been adequately measured in our general population and specific data on HCV in SCA patients are scanty, hence a prospective case controlled study to determine the prevalence of HCV antibodies in transfused SCA patients attending the sickle cell anaemia clinic in the University of Ilorin Teaching Hospital (UITH), Ilorin was taken. Objective: To determine the prevalence of Hepatitis C virus antibodies among transfused children with SCA in Ilorin. Subjects and Method: Eighty two transfused SCA children aged 6 months to 14 years were recruited consecutively from February 2008 to January 2009 while eighty four non transfused SCA children of the same age range recruited over the same period served as controls. Hepatitis C virus antibody screening was done using a second generation ELISA method. Results: The overall prevalence of HCV antibody was 3.0%, while it was 3.7% and 2.4% in the transfused and non transfused SCA patients respectively (χ2 = 0.23, p = 0.68). The patients were also comparable across the social class when subcategorized into high and low social class (χ2 = 0.37, p = 1.00 (subjects), χ2 = 0.42, p = 1.00 (controls). Conclusion: The prevalence of Hepatitis C virus anti- bodies in transfused SCA patients is low. The difference in prevalence between transfused and nontransfused SCA patient was not statistically significant. This was cautiously interpreted due to the hospital based premise of the work. Therefore, Hepatitis C virus antibody acquisition might be from sources other than transfusion of unscreened blood.

Erythropoiesis Stimulating Agents (ESAs) in the Treatment of Cardio-Renal Syndrome Anaemia

Coexistence of chronic kidney disease (CKD) and chronic heart failure (CHF) define a recently recognized clinical entity known as cardio-renal syndrome. Sufficient evidence suggests that the two pathological conditions share common pathogenic etiology which is not yet fully defined. Superimposed anaemia is a common finding among patients suffering from cardio-renal syndrome. The combination of CKD, CHF and anaemia increase the probability of death by 6 times compared to normal individuals. Early attempts to restore anaemia either by iron supplementation, erythropoiesis stimulating agents (ESAs) or combination of the two have reported to improve quality of life, morbidity and mortality especially among patients treated by cardiologists. Recent publications of well controlled epidemiological studies failed to prove convincing beneficial effect of the above mentioned therapy moreover skepticism has raised concerning the safety of restoring anaemia among patients with cardio-renal syndrome as well as used medications. There are still unresolved problems concerning the definition of anaemia, by means of hemoglobin level among these patients, the target hemoglobin level and the therapeutic regimen of ESAs administration and iron supplementation. We need much more evidence in order to define an effective and safe treatment strategy correcting anaemia among patients with cardio-renal syndrome.

The Impact of Malaria Control Interventions on Malaria and Anaemia in Children under Five after Ten Years of Implementation in the Hohoe Municipality of Ghana

Background: Malaria remains a dominant health issue among children in Ghana. We monitored the trend of long lasting insecticide net (LLIN) ownership and use and its impact on malaria and anaemia among children under five over the past decade in an area of intense, prolonged and seasonal malaria transmission. Methods: A total of 1717, 2155 and 1915 children were surveyed in June and 1717, 2155 and 1697 in November in 30 communities of the Hohoe Municipality in 2006, 2010 and 2015 respectively. The primary outcomes monitored were the trend of LLIN ownership, use and prevalence of malaria and anaemia through cross-sectional surveys. Findings: Results showed a significantly positive trend (p Interpretation: Ownership of LLIN and its use together with other indicators of malaria prevalence generally improved five years after the implementation of a malaria control programme. Ten years after programme implementation, consistent improvement was only in LLIN ownership and use. Also malaria prevalence indicators improved in the post as compared to the pre-rainy season in the study communities.

Cholelithiasis in Children with Sickle Cell Anaemia: A Cross-Sectional Analysis from Northeast Nigeria

Background: Nigeria contributes 30% to the global sickle cell anaemia burden. Cholelithiasis occurs commonly in children with sickle cell anaemia and may remain undiagnosed, mimic abdominal vaso-occlusive crises or become complicated by calculus cholecystitis. Early identification of children with sickle cell anaemia who have Cholelithiasis reduces the chances of misdiagnosis, mistreatment and improves outcomes. There is limited knowledge about the prevalence of Cholelithiasis among Nigerian children with sickle cell anaemia. The present study aimed to determine the prevalence of Cholelithiasis in children with sickle cell anaemia in Gombe, northeast Nigeria. Methodology: This was a cross-sectional analysis of children with sickle cell anaemia being followed-up at the sickle cell centre of the Federal Teaching Hospital, Gombe, northeast Nigeria. We consecutively recruited 294 children aged 2 - 17 years while in steady state from June to November 2017. Quantitative data were collected from parents/caregivers via a researcher administered questionnaire and cholecystosonography performed after a minimum of 8-hour fast. Predictors of Cholelithiasis were examined using binary logistic regression. Results: The mean age of children with sickle cell anaemia was 9.0 ± 4.5 years. The prevalence of Cholelithiasis in children with sickle cell anaemia in steady state was 4.8%. Children aged 15 - 17 years had 12 times higher odds of having Cholelithiasis [AOR = 12.268 (95% CI = 1.3 - 112.8)]. Conclusion: The prevalence of Cholelithiasis in children with sickle cell anaemia though generally low, increases progressively with age to peak during middle to late adolescence.

Pentazocine Abuse in Two Siblings with Sickle Cell Anaemia

Vaso-occlusive crisis is a common clinical manifestation in children with sickle cell anaemia, frequently warranting in-patient management with intravenous fluids, analgesics and occasionally anti-malaria and antibiotics. Pain is the principal symptom of vaso-occlusive crisis and it can affect any part of the body. Pentazocine is a well-known opioid analgesic, commonly used in the treatment of painful crisis in children affected by sickle cell anaemia. It was discovered in the 1950s and was initially thought to be addiction—proof, but this has been disproved over the years by reports of pentazocine dependence/addiction especially in patients living with chronic pain. There have been some case reports of pentazocine abuse/dependence among sickle cell disease patients in the literature, most of which are from Nigeria but none involved joint addiction by siblings. We therefore, report the case of two siblings, known sickle cell anaemia (HbSS) patients, referred to our emergency paediatric unit with history of recurrent painful crisis over a 10-month period leading to abuse of pentazocine. They were jointly managed successfully by the paediatric hematology and the pain and palliative units of the University of Ilorin Teaching Hospital and helped to overcome their abuse and addiction.

Anaemia in Pregnancy in an African Setting after Preventive Measures

Background: Anaemia in pregnancy is a public health issue in developing countries because of its high prevalence and its maternal and perinatal bad outcomes. It affects 24.8% of the world population and 67.6% of the population in sub-Saharan Africa. In Burkina Faso, anaemia prevalence is estimated at 68.3%. In Burkina, preventive measures for anaemia in pregnancy have been implemented by the ministry of health to reduce its burden. This study aimed to assess the epidemiological, clinical and the outcomes of anaemia in pregnant women at OUAHIGOUYA REGIONAL HOSPITAL. Findings will be used to strengthen the preventives measures for anaemia in pregnancy. Methods: A cross-sectional descriptive and analytical study was conducted during a four-month period from October, 28th, 2014 to February, 28th, 2015. pregnant women with haemoglobin level below 11 g/dL was considered anaemic according to WHO criteria, and who are willing to participate and who were admitted at the obstetrics and Gynecology department of the REGIONAL HOSPITAL of OUAHIGOUYA. Results: Four hundred eighty three pregnant women were anaemic out of eight hundred eighty three women hospitalized. The prevalence of maternal anaemia was 54.7% with significant monthly variations. The mean age was 24.7 ± 6.6 years. The women without non-salary occupation (housewives and pupils) represented 90.1%. A past medical history of haemoglobin defects (6.6%), twin pregnancies (6.0%), malaria (23.6%) bleeding during pregnancy (20.3%) were the most frequent. Monitoring the pregnancy was effective in 91.1% of women. The mean haemoglobin level was 8.8 ± 2.1 g/dL. The outcome was marked with 1.7% and 18.9% maternal and perinatal death respectively. The most common contributory factors were: Occupational status, number of prenatal visits, length of treatment with iron and folic acid, history of malaria, history of haemorrhage and brachial perimeter low (p 0.05). Conclusion: Maternal anaemia is a major health issue at the OUAHIGOUYA REGIONAL HOSPITAL in Northern Burkina Faso. Maternal and perinatal outcomes could be improved by reinforcing the preventive measures but also by improving the nutritional status and the living conditions of pregnant women.

Pre-Operative Anaemia Predicts Poor Outcomes in Patients Undergoing Infra-Inguinal Bypass Surgery

Objectives: Critical limb ischaemia (CLI) requiring infra-inguinal bypass is a common presentation to the vascular surgery service. A significant number of CLI patients also present with anaemia as a comorbidity, the impact of which is unknown. We reviewed the impact of anaemia on mortality and amputation in patients who underwent infra-inguinal bypass surgery. Methods: Demographic data from all patients who underwent infra-inguinal bypass surgery for CLI at the Flinders Medical Centre & Repatriation General Hospital, South Australia between January 2005 and January 2010 were recorded. Haemoglobin (Hb) level, serum creatinine (SCr) level, mortality and amputation events were also recorded for retrospective analysis. Results: 190 patients (141M, 49F) who underwent infra-inguinal bypass surgery over a 5 year period were analyzed. 100 (53%) of these patients had mild anaemia (mean Hb 113 g/L, mean for females 103 g/L, mean for males 116 g/L). Those who presented with anaemia were more likely to have diabetes and renal dysfunction as comorbidities. Anaemia had a significant negative impact on mortality with 30% deaths in those who were anaemic compared to 15.6% deaths in those without anaemia odds ratio (OR) 1.76, 95% CI: 0.90 - 3.48, p < 0.01. This relationship was similar when looking at amputation as an outcome;with the number of amputations in those who were anaemic preoperatively 14% vs 6.7% in those who were not anaemic, OR 2.56, 95% CI: 1.00 - 6.54, p = 0.05. The negative impact of anaemia on mortality 43.5% vs 18.8% was also noted in patients who did not have diabetes or impaired renal function as a comorbidity p < 0.05. Conclusions: Anaemia is a common comorbidity in patients presenting with CLI and it predicts poor outcomes after infra-inguinal bypass. The role of transfusion is debatable, but it is clear that this group of patients requires careful management during the perioperative period to ensure they are medically optimized.

Distortion product otoacoustic emissions in newborn babies with and without late-term maternal iron deficiency anaemia

Background:Studies on animals have demonstrated that maternal iron deficiency anaemia(IDA)could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions(DPOAEs)of young guinea pigs.Thus,it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA.The current study explores maternal IDA’s effect on DPOAEs in newborn babies.Method:A total of 110 newborn babies with gestational age≥34 weeks were considered and a‘betweensubjects’design was used.The participants were divided into 3 groups-“Normal”(61 babies without maternal IDA),“Mild”(28 babies with mild maternal IDA)and“Moderate”(21 babies with moderate maternal IDA).The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies(1 k 8 kHz)and a range of intensities(7040 dB SPL in 10 dB steps).Results:The analysis of both DP-gram and DP input-output(I/O)function showed that there was no significant difference(p>0.05)across the normal,mild,and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities(7040 dB SPL).Also,the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship.Conclusion:The current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.

Sickle Cell Anaemia: Errors in Haemoglobin Genotyping: Impact on Parents of Children Attending Two Hospitals in South East Nigeria

Objectives: The study is aimed at determining that errors in assigning genotypes to intending couples do exist;and the impact of these errors on parents. Methods: The study was conducted at the children clinics in Enugu and Abakiliki, south east Nigeria. It is a cross-sectional retrospective study in which a review of the records of all the children attending 2 private clinics in Enugu and Abakaliki of Enugu and Ebonyi states respectively, over a 3-year period was done. Results: A total of 6006 children attended the children clinics over the study period. Twenty three (23) of them had sickle cell anaemia. Out of the 23 cases 10 (43.5%) were males and 13 (56.5%) were females. Male to female ratio was 1:1.3. The commonest features were abdominal and leg pains, involving 20 (87%) and 21 (91.3 %) respectively. Among the 23 parents that had their genotypes repeated, 9 males had different genotypes from what they had during courtship or before marriage. The genotypes of all the females that could recall their genotypes before marriage or during courtship were the same after a repeat test. Conclusions: There exist errors in assigning genotypes to parents which at the end made them have children with sickle cell anemia, unwittingly, with serious consequences bordering on strained relationship between the parents with the children bearing the brunt.