Public Health in Practice

BackgroundBlood donation and transfusion practices are very crucial for a health care system. This study aims to check the perceptions of Public about blood donation and transfusion practices in Allied Hospital, Faisalabad (Pakistan). Study Design and MethodsThe study used a qualitative exploratory design, conducting 20 semi-structured interviews with patients and attendees of the surgical and gynaecology unit at Allied Hospital, Faisalabad, from April to June 2023. Using Random sampling technique, data was collected from both donors and non-donors. Then, data was analysed using inductive thematic analysis, which involved identifying patterns and themes within the data. ResultsInitial analysis revealed various codes which were ultimately reduced to five main themes with their subthemes namely 1. Personal Factors with sub-themes (1a) Blood donation priorities, (1b) Family influence and Physical Attributes of donor, (1c) Socio economic status, (1d) Gender roles, 2. Consequences of transfusion and Donation; sub-themes (2a) Allergic reaction, (2b) Weight changes after Blood Donation, 3. Motivating Factors for Blood Donation; sub-themes (3a) Health Benefits, (3b) Humanitarian Factors, 4. Restriction Factors for Blood Donation; sub-themes (4a) Selling of Donated Blood, (4b) Substandard Blood Bank, (4c) Wasting of Donated Blood and 5. Awareness regarding blood donation. ConclusionThis study shows that religion, personal beliefs, family and friends, and socioeconomic status influence willingness of a person to donate. However, low understanding of benefits and risks is prevalent among Pakistanis, highlighting the need for counselling and health education activities.

The study aimed to assess the impact of the COVID-19 pandemic on Quality of Life (QoL) in persons living with Sickle Cell Disorder (SCD) in Lagos, Nigeria and to determine how they coped during the pandemic, particularly during the period of total lockdown with the additional "SHIELDING" measures to which they had to adhere. Data was collected using a standardized protocol PedsQL, Sickle Cell Disease Module version.3.0 designed for youth within the ages of (13-18) years, (19-35) years and their parents/Guardian if underage. The survey captured data on patients pain impact, hurts, management, treatments, communication with their caregivers and their Guardians perception. The survey was performed online, or Face-to-Face/telephone interview if online was not possible. Contacts of patients and parents were obtained from the database of Sickle Cell Foundation Nigeria. A total of 105 (80 patients and 25 parents) participants responded to the survey. The age distribution of respondents was highest at 56 % in the age bracket of 13 - 18 years old. Pain crisis were very common amongst patients. The survey revealed that the type of treatment or care received at these times determined whether or not the patients visited the hospital when they had pain crises. In addition, as patients reports an increase in ill-treatment they experienced in the hands of health care givers, so did the fear of accessing treatment during the COVID pandemic. It was observed that the frequency of pain crises experienced by SCD patients was proportional to the patients quality of life (the higher the frequency of pains, the worse the QoL). As a follow-up, a more detailed study would be required, as this study was limited in the capturing of the demographics, sex and number of participants; Considering the number of persons living with SCD that visit the Sickle Cell Foundation Nigeria, (about 3,000 patients), the number of responses in this study was low (105). It is believed that a higher number of responses would have given more information about the Sickle Cell burden and the QoL of persons living with SCD in Lagos during the COVID-19 pandemic. Lagos was the epicentre of the COVID-19 pandemic in Nigeria.

ObjectivesThis study will identify blood donor characteristics in Jordan. The study aims to investigate the extent of awareness and knowledge regarding blood donation among blood donors and to explore their attitudes towards blood donation in general. It also highlights various motivational factors and obstacles which impact the decision to donate blood among Jordanian donors. BackgroundRecruitment of low risk blood donors can be challenging. Efforts should be made to increase the level of awareness and positive attitude toward blood donation. An essential step to achieve this is obtaining comprehensive data about the current situation of awareness, knowledge, and attitudes of the population towards blood donation. Methods/MaterialsThe present study was conducted at two blood donation centers in Amman, Jordan, during 2021. A total of 535 whole blood donors were included. Data regarding their demographic characteristics, blood donation history as well as their knowledge and attitudes regarding blood donation was collected by a questionnaire. ResultsFour hundred ninety participants (91.6%) were males while 45 only (8.4%) were females. One hundred forty subjects (19.4%) were first time donors while 431 subjects (80.6%) had previous donations. The participants median score in the knowledge section was 19.0 points (range 5-25 points). There was no significant correlation between participants overall attitude score and their corresponding demographic characteristics or their overall knowledge score. ConclusionMeasures to improve knowledge and attitude toward blood donation should be implemented in order to meet the increasing demand for blood and blood components. Targeted campaigns, correction of some misconceptions, and using different motivations are suggested.

ObjectivesTo know and explore from convalescent plasma donators voices the experience in the blood donation process at a Peruvian social security hospital. MethodsQualitative study with a phenomenological design. The investigation was carried out in 01 hospitals of the social security of Peru. Semi-structured interviews were carried out. ResultsEleven donors of convalescent plasma were interviewed. The main motivations for donating were being able to contribute to national research and supporting patients affected by COVID-19. Fears focus on the possible risk of contagion within the hospital. Donors emphasised the attention and support of health personnel alongside the donation procedure. The main expectations and suggestions point towards greater dissemination of donation campaigns with special emphasis on safety. Likewise, an improvement in the time of the donation procedure (from enrolment to the extraction of convalescent plasma), and the implementation of friendly spaces to encourage future blood donation campaigns were highlighted. ConclusionsThe experience of the convalescent plasma donors was positive. However, improvements must be made in terms of processes and infrastructure to ensure future successful blood donation campaigns.

BackgroundOn 26th, February 2020, first cases of COVID 19 were confirmed in Pakistan. Since then, surgeries were halted in a bid to prevent transmission. However, since such a long halt is infeasible, a general protocol of screening the carriers, especially asymptomatic carries, is a dire need of time. The objective of our study is to propose an economically feasible protocol of COVID 19 screening. Simple but effective screening strategies can help to restore the workings of hospital surgical departments. MethodsWe analyzed the clinical data of patients turning up for elective surgeries at the Rawal General Hospital (RGH), Islamabad from the 24th of March to the 15th of May, 2020. Asymptomatic patients with negative COVID 19 contact and travel histories were screened with COVID 19 Immunochromatography (ICT) IgM / IgG Ab Test. Complete blood count (CBC) was done and interpreted in conjunction with the ICT results. Results39 patients with a mean age of 49 years were studied. The result of ICT for COVID-19 was positive in 9 cases (23%). The entire positive ICT patients population expressed significantly lower lymphocyte count (p<0.01); 8 patients had high monocyte count (p<0.05) whereas only 4 patients had a combined high neutrophil and monocyte count (P<0.05). All of these four patients with high neutrophil count were females. The combined interpretation of CBC and ICT IgM / IgG Ab Test had a high accuracy in diagnosing asymptomatic COVID-19 carriers that were later confirmed by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). ConclusionWe propose that joint CBC-ICT interpretation should be adopted on a large scale to help in the diagnoses of asymptomatic carriers as both tests are simple and inexpensive and thus suit the developing countries limited health budget. Future research projects should be adopted in order to assess the accuracy of the proposed protocol on a large scale.

BackgroundThalassemia is the most common congenital single-gene condition. It is marked by a lack of or reduced synthesis of either the alpha- or beta-globin chains and passed down from parents to offspring. This study aimed to determine how healthy students in Bangladeshi public universities were aware of thalassemia and how they felt about it. MethodsA cross-sectional descriptive online survey was conducted on public university students in Bangladesh using a structured questionnaire between June and November 2020. Students completed structured questionnaires consisting of three sections: demographic information, ten multiple-choice knowledge questions rated on a scale of 0 to 10, and ten attitude questions. The data were analyzed using Python. Descriptive statistics methods such as frequencies and percentages were used to present data. ResultsA total of 681 students participated in the online survey. The average age of the respondents in this study was 21.97 years, with a standard deviation of 2.9. Most of the students, 611(89.72%), had heard about thalassemia. Only 248 (36.42%) of the students had a fair understanding of thalassemia, with 138 (22.62%) being male and 110 (18.03%) being female (P-value = 0.0819). Students knowledge level did not differ significantly by gender (P-value = 0.0819), marital status (P-value = 0.2281), or academic year (P-value = 0.4619), but there was a substantial variation by field of study (0.0042). However, 478 (78.36%) participants showed a positive attitude toward "Premarital Screening" to prevent thalassemia. ConclusionsIn Bangladesh, where the rate of family marriage is high, it is recommended that university students and the general public engage in long-term, goal-oriented prevention measures. These initiatives would provide crucial information and increase peoples awareness of thalassemia when married and after becoming parents, reducing the impacts of illnesses.

Transfusion transmitted infections (TTIs) have remained a major deterrent to public health, particularly among the patients with transfusion-dependent Beta thalassemia in developing countries. Although proper donor selection through adoption of WHO-advised infection panel has lowered the rate of infections, the multi-transfused patients are not free of risk. The present study screened 148 transfusion-dependent Beta thalassemia patients to determine the frequency of HCV, HBV and HIV using ELISA method. Among these patients, infected cases with HCV, HBV and HIV were 13.51%, 3.37% and 0%, respectively. Moreover, 2% of the patients had co-infections with both HBV and HCV. The percentage of infections in the patients with frequent transfusion interval ([&le;]30 days) was significantly higher (P<0.0005) than that in the patients with less frequent transfusion intervals (>30 days). Immunochromatography (ICT)-based rapid test kits are usually used to screen and confirm these infections in the blood of the patients. However, ICT-based tests are not sensitive enough to detect the infections. So, a combination of both Nucleic Acid testing (NAT) and serological testing are suggested to significantly reduce the risk of viral infections during blood transfusion.

IntroductionAnaemia is a major cause of morbidity and mortality among children in sub-Saharan Africa. Anaemia has many aetiologies best addressed by different treatments, so regional studies of the aetiology of anaemia may be required. MethodsWe analysed data from Nigerias 2018 Demographic and Health Survey (DHS) to study predictors of anaemia among children ages 6-59m. We computed the fraction of anaemia at different degrees of severity attributable to malaria and sickle cell disease (SCD) using a regression model adjusting for demographic and socioeconomic risk factors. We also estimated the contribution of the risk factors to haemoglobin concentration. ResultsWe found that 63.7% (95% CI: 58.3-69.4) of semi-severe anaemia (<80 g/L) was attributable to malaria compared to 12.4% (95% CI: 11.1-13.7) of mild-to-severe (adjusted haemoglobin concentration <110 g/L) and 29.6% (95% CI: 29.6-31.8) of moderate-to-severe (<100 g/L) anaemia and that SCD contributed 0.6% (95%CI: 0.4-0.9), 1.3% (95% CI: 1.0-1.7), and 7.3% (95%CI: 5.3-9.4) mild-to-severe, moderate-to-severe, and semi-severe anaemia, respectively. Sickle trait was protective against anaemia and was associated with higher haemoglobin concentration compared to children with normal haemoglobin (HbAA) among malaria-positive but not malaria-negative children. ConclusionThis approach used offers a new tool to estimate the contribution of malaria to anaemia in many settings using widely available DHS data. The fraction of anaemia among young children in Nigeria attributable to malaria and SCD is higher at more severe levels of anaemia. Prevention of malaria and SCD and timely treatment of affected individuals would reduce cases of severe anaemia.

Thalassemia is a hereditary blood disorder with different severity spectrums. This study aimed to assess thalassemia screening rates between children of Bangladesh and selected camps of Forcibly Displaced Myanmar Nationals (FDMN) in Coxs Bazar in Bangladesh and compare the hematological parameters among the screening groups. Complete blood count (CBC) analysis and hemoglobin electrophoresis for each participant were performed by collecting venous blood. Statistical analysis was employed for the comparison of parameters in blood. The thalassemia carrier and other hemoglobin variant rate in Bangladeshi children in selected areas have been found to be 20.7% and in FDMN children, the rate is 8.2%. Hematological differences are visualized among children of two nations. Intra-and interpopulation variances are highlighted in principal component analysis where higher variance (94.87%) in Bangladeshi children than FDMN children (80.68%). Receiver operating characteristics (ROC) and area under the curve (AUC) analyses revealed, RBC (0.761, 0.902, and 0.791) and RDW-CV are better model (0.819, 0.925, and 0.858) among the classifier of blood parameters. Pearson correlation shows distinguished covariation or association among the parameters. The outcome of the study highlights the discrepancies in levels of carriers in regions in Bangladesh and suggests further screening as well as population based molecular research to ensure better treatment strategies.

BackgroundGlobally, thrombocytopenia is one of the most common hematologic conditions seen in ill neonates. In countries with limited resources, like Ethiopia, it is a serious concern. Because the burden of thrombocytopenia is so great, generating updates evidence on predictors of mortality and survival status is vital to fight it. However, the problem is not well investigated in Addis Ababa. Therefore, this study aimed to assess survival and predictor of thrombocytopenic neonatal death in Public Hospitals, Addis Ababa, Ethiopia, 2024/2025. Methods and MaterialsA prospective follow-up study was done among a total of 350 neonates from March 20, 2025, to April 30, 2025, in Addis Ababa public hospitals. All thrombocytopenic neonates that meet the inclusion criteria were chosen as study participants. Data were collected using the Kobo Tool through direct observation and review of maternal and neonatal charts. After export to an Excel spreadsheet, data cleaning and recoding were performed using SPSS version 26, followed by statistical analysis using STATA version 17. The Kaplan-Meier failure curve was used to demonstrate the pattern of death, estimate the chance of death, and compare failure curves. Collinearity, Schoenfeld residual, and log-rank tests were performed. The Cox proportional hazards model was fitted with global test result of 0.7882. Finally, the findings were presented both descriptively and analytically. ResultsIn this study, the overall magnitude of thrombocytopenic neonatal death was 14.1% (95% CI: 10.4-18.1), with an incidence rate of 13.04/1000 (95% CI: 0.009-0.017) neonate-days. The restricted mean time to death in this study was 23.36 days (95% CI: 22.23-24.50). Being born to a mother with severe preeclampsia (AHR = 3.84; 95% CI: 1.78-8.26), very low birth weight (<1499g) (AHR = 3.67; 95% CI: 1.14-11.80), perinatal asphyxia (AHR = 2.76; 95% CI: 1.32-5.79), necrotizing enterocolitis (AHR = 2.45; 95% CI: 1.14-5.31), and delayed initiation of feeding (AHR = 3.37; 95% CI: 1.10-10.29) were the identified predictors of mortality. Conclusion and recommendationIn this study, a high burden of thrombocytopenic neonatal death. Early detection and treatment of high-risk conditions like severe preeclampsia, very low birth weight, perinatal asphyxia, and necrotizing enterocolitis should be the main goal of efforts to lower thrombocytopenic neonatal mortality. Furthermore, prompt neonatal feeding initiation ought to be given top priority.

BackgroundVenous thromboembolism (VTE) is common and preventable disease among non-surgical hospitalized patients. Its incidence is high and alarming. Acute medical patients have VTE risk during and after hospitalization. Padua prediction score is a risk model created to identify high VTE risk patients among non-surgical hospitalized patients. MethodsWe performed a cross-sectional survey of 107 patients admitted in Internal Medicine wards that were assessed as acute ill patients at Emergency Department, in a period of 4 weeks. The demographic and clinical data were collected using a designed questionnaire. VTE risk was defined as having a Padua Prediction score of [&ge;]4 points. Statistical analysis was done to determine prevalence. The patients at high VTE risk received thromboprophylaxis. ResultsOf one hundred and seven eligible patients included. 84% were found with high VTE risk. Among physiologically unstable patients, 60% of the patients were classified in red color during the time of triage, this means, they were severely sick and needing resuscitation. Among leading diagnosis, severe pneumonia was predominant (29%). Severe pneumonia and uncontrolled DM showed significant association with high VTE risk. 11.1% of high VTE risk patients were taking anticoagulant thromboprophylaxis prior to the recruitment. ConclusionThis study demonstrated a high prevalence of VTE risk among acute ill medical patients and underuse of anticoagulants thromboprophylaxis in potential patients at Kigali University Teaching Hospital, CHUK. Padua prediction score should be implemented for early detection of patients at-risk of VTE in severely ill patients and start anticoagulant thromboprophylaxis on time for reducing mortality and morbidity.

BackgroundCryoprecipitate is used without knowing the concentration of coagulation factors it contains which poses danger of circulatory overload with no any improvement if several bags with low factor levels are transfused when the levels changes or drastically reduce. ObjectiveThe objective was to evaluate gender influence on changes of Coagulation factors in cryoprecipitate plasma at Kisii Teaching and Referral Hospital. MethodsThe study involved time series analysis design involving analysis of cryoprecipitate during storage at -18{degrees}C for 5 weeks. Blood collected from the Kisii satellite blood transfusion center was received at Hematology laboratory where factor assays were performed on Erba Mannheim ECL 105 semi-automated coagulation analyzer. Thawing for subsequent coagulation factor analysis and serial testing was done using Stericox Plasma Thawing Bath at 37{degrees}C, for 45 mins. Data were entered into Excel and analyzed by SPSS version 25. ResultsThe mean rank for cryoprecipitate from week one to week five was in a decreasing trend with 3.00, 1.99 and 1.01 respectively. This confirms a steady statistical significant difference in mean ranks for the time period. The coagulation factors in cryoprecipitate plasma in the donated blood were not affected by the gender of the blood donor. ConclusionThe gender of the donor has no effect on the coagulation factors in cryoprecipitate plasma

ObjectiveHepatitis C virus (HCV) infection is the most commonly reported bloodborne infection in Pakistan. Frequent blood transfusions in {beta}-thalassemia patients expose them to a high risk of HCV infection. The purpose of this paper is to summarize the current data on the prevalence of HCV infection among {beta}-thalassemia patients in Pakistan by using a systematic review and meta-analysis. DesignSystematic review and meta-analysis. Participants{beta}-thalassemia patients in Pakistan. Data sourcesFollowing PRISMA guidelines, a comprehensive literature search in PubMed/MEDLINE and EMBASE was performed to identify published articles reporting on the prevalence of HCV among {beta}-thalassemia patients in Pakistan. Only English language articles were considered. Two independent authors selected studies. The methodological quality of the included studies was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. ResultsThe search conceded a total of 138 studies, of which 27 studies were finally considered for meta-analysis. The pooled prevalence of HCV in {beta}-thalassemia patients in Pakistan was 36.21% (95% CI: 28.98- 43.75%) based on 5,789 {beta}-thalassemia patients, but there was considerable heterogeneity. Meta-analysis estimated the HCV prevalence among the {beta}-thalassemia patients at 45.98 % (95% CI: 38.15-53.90%) in Punjab, 31.81% (95% CI: 20.27-44.59%) in Sindh, and 28.04% (95% CI: 13.58-45.26%) in Khyber Pakhtunkhwa. Meta-regression analysis showed that geographical location was a key source of heterogeneity. ConclusionsThe pooled prevalence of hepatitis C virus among {beta}-thalassemia patients in Pakistan was 36.21%, but varies regionally within the country. The prevalence is higher than in neighboring countries. With the use of standard prevention procedures during blood transfusion, the risk of HCV transmission among {beta}-thalassemia patients could be controlled hence prevalence of HCV in {beta}-thalassemia patients could be reduced. Strengths and limitations of this study[tpltrtarr] This is the first systematic review and meta-analysis to estimate the pooled prevalence of HCV infection among the {beta}-thalassemia patients in Pakistan [tpltrtarr]We used of an extensive search strategy and adherence to predetermined inclusion and exclusion criteria. [tpltrtarr]Strong and reliable methodological and statistical methods were used. [tpltrtarr]Our analyses possessed a considerable amount of quantifiable heterogeneity. [tpltrtarr]Not all regions in Pakistan were represented and most of the included studies were hospital-based, making it difficult to generalize the findings of this review.

Background and objectivesIn an effort to improve donor health, we set out to investigate determinants other than blood donation that increase risk of ID in a healthy population and if they should be implemented into current blood donor selection processes. MethodsWe systematically searched the PubMed, Ovid Medline and Scopus for articles related to ID. ResultsCurrent evidence suggests that several determinants, including biological, environmental, lifestyle and socioeconomic factors increase the risk for ID. ConclusionsHeavy menstruation, use of some medications and dietary factors could potentially be implemented in donor selection, however further study is needed.

Anaemia is a condition in which either the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs, which vary by age, sex, altitude, smoking and pregnancy status. The global estimate of childhood anaemia indicates that 293.1 million children are anaemic, and 28.5% of these children reside in sub-Sahara Africa. Also, anaemia is a significant public health problem with a high age-standardised death rate of 11.18 per 100,000 in Zambia. We conducted a cross-sectional study involving 392 anaemic children aged one year to 14 years. The study was conducted at the Children Hospital, University Teaching Hospitals, which is a third-level referral Hospital in Lusaka, Zambia. The aim was to determine the most common type of anaemia, its severity, and the most affected age groups among children aged 1-14 years. Out of 392 participants, 219 (56%) were female. Maximum haemoglobin recorded was 10.9g/dl, a minimum of 2.0 g/dl, a mean of 7.8g/dl and a standard deviation of 1.86g/dl. 200 (51%) participants had severe anaemia, and 192 (49%) had moderate anaemia with none having mild anaemia. Microcytic hypochromic anaemia was the commonest (60%), followed by normochromic normocytic anaemia (26%) and the least was macrocytic anaemia in 14% of the participants. An analysis of variance (ANOVA) showed that the difference in mean haemoglobin concentration between age groups was not significant, F (7.94) = 0.83, p > 0.57. A Chi-squared test was used to determine the relationship between anaemia types (microcytic, hypochromic) and age groups. The interaction was not significant (Chi-Square (1) = 1.28, p-value = 0.73. Microcytic hypochromic anaemia was the most prevalent and all age groups were equally affected. We recommend the countrys National Food and Nutrition Commission to revisit the Zambian National Strategy and Plan of Action for the Prevention and Control of Vitamin A Deficiency and Anaemia of 1999 to 2004 and implement the measures stated in the strategic plan.

Background and ObjectivesMicrocytic hypochromic anemia is the most common feature of alpha-thalassemia and depends on the number of alpha genes deleted. Therefore, in this study, we aim to determine the most common deletion mutations among microcytic anemia cases of West Bengal and correlate them with different biochemical parameters and endophenotypes. MethodsTwo hundred and sixty patients with microcytic anemia were recruited. The GAP-PCR technique was adopted to identify the 3.7 kb and 4.2 kb deletion mutation in the HBA gene. ResultsForty patients were found to have either 3.7 kb or 4.2 kb deletion mutations which represents ~15.38% of the microcytic anemia patient population. A statistically significant lowering of MCH values (P = 0.02) and elevated levels of Total Bilirubin (P = 0.0001), direct bilirubin (P = 0.0004), unconjugated bilirubin (P = 0.0001), SGPT (P = 0.005), SGOT (P = 0.005), ALP (P = 0.008), RBC count (P = 0.01) and Hemoglobin level (P = 0.02) were observed among the alpha-thalassemia mutation carriers than non-mutant. The study failed to show any correlation between mutation status disease severity and gender bias. ConclusionThe two common deletion mutations (-3.7 kb or -4.2 kb) in the HBA gene are most commonly found in microcytic anemia cases of West Bengal and can be correlated with several biochemical parameters.

IntroductionThe rates of request and use of blood concentrates are still poorly reported in the literature. This study aimed to analyze the rates of requests for blood concentrates and their use in patients undergoing emergency surgery in a teaching hospital. MethodsA retrospective, quantitative and descriptive study was conducted in 359 medical records of patients in urgent surgery scheduled with a request for a reserve of blood concentrate. The ratios between crossmatched and transfused units (C/T), transfusion index (TI), and probability (TP) were calculated, and the times between request and delivery at the transfusion agency (TA) and patient admission to the surgical center (SC). ResultsThe mean age was 58.5 {+/-} 22.2 years, with the majority being male (53.1%). There was an average of 27.5 monthly requests (min 12, max 44). Ninety-seven units of blood concentrates were transfused into 44 patients (C/T ratio 7.59; TI 0.27; TP 12.3%). Only seven patients had their requests made after admission to the OR. The median time between the request and arrival at the TA was 1h15min, while that between the request and the patients arrival at the SC was 5h23min. There was greater transfusion in major surgery (major 37, 14.8% vs. medium 7, 6.5%; p = 0.027) and non-orthopedic surgery (orthopedic 9, 4.0% vs. non-orthopedic 35, 26.9%; p < 0.001). Conclusionthere was a significant discrepancy between the number of requests for blood reservation and its real use and an increased time between reservation requests and their arrival at the TA.

BackgroundAnaemia during childhood adversely affects mental, physical and social development of the children, therefore morphological patterns of anaemia in under-five children are considered essential for classification, diagnosis and management. AimThis study aimed at assessing morphological patterns, the prevalence and associated factors of anaemia among under-five children on Prevention of Mother-To-Child Transmission (PMTCT) programmes in Masogo sub-county hospital, Kisumu County, Kenya. MethodA cross-sectional health facility-based study was conducted among 175 children aged 6 to 59 months who attended clinic for the PMTCT programme for the period of January 2020 to December 2020. Pretested and structured questionnaires were used to collect socioeconomic and demographic characteristics of the family and child. Capillary blood sample was collected from each child for malaria parasite and Peripheral Blood Film (PBF) examination. ResultComplete blood counts indicate that microcytic pattern was the most common, representing 30 (42.3%) followed by microcytic hypochromic pattern 20 (28.2%), normocytic normochromic pattern with 11 (15.5%) and lastly dimorphic pattern with 10 (14.0%). High prevalence of anaemia was observed in children who were urban dwellers (50.0%), in children whose mothers aged 18-27 years (44.0%) and had no formal education (48.1%). Besides, the high prevalence rate of anaemia was found among children with a family monthly income of less than 500 Ksh. (46.9%), early (<6 months) introduction of complementary foods (71.4%) ConclusionThis study has revealed that the prevalence of anaemia in children less than five years is high and is a severe public health problem in the study area. Therefore, the policymakers should make a strategy that can reduce poverty and increase the awareness to women on breastfeeding, nutrition, and other associated factors to reduce anaemia.

Food insecurity, defined as the lack of physical or economic access to safe, nutritious and sufficient food, remains one of the main challenges included in the 2030 Agenda for Sustainable Development. Near real-time data on the food insecurity situation collected by international organizations such as the World Food Programme can be crucial to monitor and forecast time trends of insufficient food consumption levels in countries at risk. Here, using food consumption observations in combination with secondary data on conflict, extreme weather events and economic shocks, we build a forecasting model based on gradient boosted regression trees to create predictions on the evolution of insufficient food consumption trends up to 30 days in to the future in 6 countries (Burkina Faso, Cameroon, Mali, Nigeria, Syria and Yemen). Results show that the number of available historical observations is a key element for the forecasting model performance. Among the 6 countries studied in this work, for those with the longest food insecurity time series, that is Syria and Yemen, the proposed forecasting model allows to forecast the prevalence of people with insufficient food consumption up to 30 days into the future with higher accuracy than a naive approach based on the last measured prevalence only. The framework developed in this work could provide decision makers with a tool to assess how the food insecurity situation will evolve in the near future in countries at risk. Results clearly point to the added value of continuous near real-time data collection at sub-national level.

Background and aimsAlpha-thalassaemia is a group of disorders characterised by wide phenotypic variation caused by mutations in the -globin genes (1 and 2) of chromosome 16. The aim of this study was to investigate the molecular profile of -thalassemia variants and to compare and characterise the chromatographic behaviour and haematological properties of -thalassemia minor (-/-, --/) and -silent carriers (-/) on HPLC. Materials & MethodsA dataset of 200 individuals consisting of 42 alpha thalassemia minor (-/-, -- /), 103 alpha silent carriers (-/) and 55 normal participants from the Human Genetics Unit (HGU) of the Faculty of Medicine, Colombo, Srilanka was included. Blood samples from each patient were analysed by PCR for genotyping, haemogram and high performance liquid chromatography (HPLC) for characterisation. These data were then comparatively analysed using standard descriptive statistics. ResultsIt was analysed in three sections as haematological, biochemical and molecular. Haematologically, alpha thalassaemia silent carrier was completely normal; alpha thalassaemia minor: decreased haemoglobin level; decreased MCV and MCH, normal RBC count. Alpha Thalassaemia Minor patients show a statistically significant difference from alpha silent carriers and normal population in terms of MCV, MCH, HGB, PCV, RDW. Biochemically, alpha thalassaemia silent carriers were found to have normal alpha-globin chain production, alpha thalassaemia minor: low HBA2 as determined by HPLC. In terms of HPLC tests, similar results were observed between alpha thalassaemia minor patients and alpha silent carriers and between alpha thalassaemia minor patients and the normal group, with no statistical significance for all parameters except HBA2. Molecularly, the most common mutations in both variants are _3.7 and _4.2 mutations. ConclusionIn summary, despite the haematological and biochemical differences between -thalassaemia minor and normal individuals, both variants of alpha thalassaemia present a diagnostic conundrum, as CBC and HPLC results for individuals are comparable to normal humans. Although MCV, MCH, HGB, PCV and HBA2 levels differ between alpha thalassaemia minor carriers, alpha silent carriers and the normal group, conventional haemoglobin electrophoresis and haemogram alone have been found insufficient for the diagnosis of alpha thalassaemia. Therefore, although HPLC does not seem to be sufficient to distinguish between normal individuals and the two variants, the decrease in HBA2 levels is an important finding. Identifying a mutated alpha globin gene requires newer molecular diagnostic tests such as next generation sequencing (NGS) and quantitative PCR (qPCR). It should be noted that a given genotype can greatly alter the clinical manifestation by the presence of additional mutations, making the relationship between genotype and phenotype highly variable.