Public Health in Practice

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.

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.

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.

BackgroundChronic lymphocytic leukemia (CLL) is a common adult blood cancer. There is no cure, but a third of people never require treatment and new targeted drugs have improved outcome. Understanding the experience of living with CLL is important for clinicians, health care providers and researchers. MethodsThis was an open internet-based survey of people with CLL, conducted by people with CLL. It was advertised via email and social media. Findings1,009 people completed the survey. Respondents were more likely to be women (526, 52% female; 482, 48% male) and were younger at diagnosis (574, 57% <71 years) than the general CLL population. For one third of respondents diagnosis was in the last five years. For 617 (61%) diagnosis was at a GP visit for another heath condition. 40% (406) reported no other health conditions. 558 (55%) respondents were currently on active monitoring, 261 (26%) were receiving treatment, and 190 (19%) in remission. Satisfaction with the speed of diagnosis, explanation of their CLL diagnosis and of the next steps in treatment was high. A quarter of respondents reported no current signs and symptoms of CLL, or side effects of treatment. Fatigue was reported by 578 (57%), three quarters of whom experienced this daily. Fatigue was reported to have a high impact on day-to-day life. Other common problems were bleeding and bruising more than normal (263, 26%) and getting infections often (228, 23%). From an emotional and a physical perspective, respondents reported their CLL had a higher impact on quality of life now than before the COVID-19 pandemic. Most respondents (829, 82%) received their treatment or monitoring at a hospital, for 253 (31%) contact was mostly/all remote. ConclusionsFatigue is a key problem for people with CLL. CLL impacts on the physical and emotional aspects of quality of life.

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.

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.

iii.Background and ObjectivesThe "Pan-European Transfusion Research InfrAstructure" (PETRA) project was established to advance the use of donor, blood product, and patient datasets in Europe, aiming to benefit both patient and donor health. Here, the initial PETRA objective was to describe the landscape of existing donor and blood establishment (BE) databases. Materials and MethodsAn online survey was circulated to the European Blood Alliances BE members. The survey collected information on the feasibility of accessing donor data, and challenges and possibilities for linking these datasets with information on the associated blood products and transfusion recipients, and donors own health records. ResultsSeventeen BEs across 16 countries completed the survey. The majority could, in principle, link their donor data to product data (13 BEs (76%)) and recipient data (10 BEs (59%)), for research purposes. However, capabilities were limited and in only 29% of the BEs was the donor to recipients linkage an automated process. BEs reported significant challenges to achieve full vein-to-vein linkage, including legal constraints and lack of consent (11 BEs) and resources (10-14 BEs). IT and data issues as well as lack of knowledge and training were cited as obstacles by a minority of BEs. ConclusionWhilst the survey results suggest considerable interest in developing linkages between blood donors, their products, and recipients, many challenges remain due to a variety of obstacles. First steps in working towards a PETRA may be assistance to navigate legal frameworks as well as investing in resources and quality and harmonisation of data collections. iv. HighlightsO_LI17 blood establishments (BEs) in 16 countries responded to a survey on obstacles and opportunities for achieving vein-to-vein datasets. C_LIO_LIIn 59% of the BEs donor-to-recipient links can be established for research improving transfusion outcomes, but only in 29% this is an automated process. C_LIO_LIIn order to work towards a "Pan-European Transfusion Research InfrAstructure" (PETRA), legal frameworks, adequate donor consent and (financial and human) resources are the most common obstacles that require addressing. C_LI

BackgroundSickle cell disease (SCD) is a genetic blood disorder characterized by abnormal hemoglobin S, leading to various complications. This study aimed to assess the spectrum of SCD-related complications and outcomes among pediatric patients at Mbeya Zonal Referral Hospital in Tanzania. MethodsA retrospective cross-sectional study was conducted, reviewing medical records of pediatric SCD patients admitted between June 2019 and June 2023. ResultsThe study found an inpatient prevalence of 7.7% for SCD. Vaso-occlusive pain events (68%), infections (55.3%), and severe anaemia (27.7%) were the leading causes of admission. Low rates of hydroxyurea (11.4%) and penicillin V (28.3%) use was observed. The median haemoglobin level was 6.5 g/dL, indicating significant anaemia. Newly diagnosed patients (50%) had an average age of 5.12 years at diagnosis, suggesting delayed identification. The mortality rate was 3%. ConclusionThese findings highlight the need of improved early diagnosis, management strategies, and access to essential medications for pediatric SCD patients in Tanzania. Implementation of newborn screening programs and increased awareness about SCD management could significantly improve patient outcomes.

Background: Sickle cell anaemia (SCA) is characterised by chronic haemolysis, inflammation, platelet activation, and recurrent vaso-occlusive complications. Mean platelet volume (MPV) is a readily available platelet index, but evidence regarding its relationship with disease severity in paediatric SCA remains limited and inconsistent, particularly in African populations. Objective: To evaluate the relationship between MPV and disease severity among children with SCA in Kwara State, North-Central Nigeria. Methods: This hospital-based cross-sectional study included 51 clinically stable children with confirmed SCA consecutively recruited from the paediatric haematology clinic of Children Emergency Specialist Hospital, Ilorin. Complete blood count, including MPV, was performed using a Rayto RT-7600 automated haematology analyser. Disease severity was assessed using a composite clinical and laboratory scoring system based on a previously described method. Pearson's correlation, Spearman's rank correlation, simple linear regression, and the Kruskal-Wallis test were used as appropriate. Statistical significance was set at p < 0.05. Results: Of 51 participants, 14 (27.5%) had mild, 33 (64.7%) moderate, and 4 (7.8%) severe disease. Mean MPV was 9.34 +/- 0.76 fL (range, 8.0-11.2). Pearson's correlation showed a weak positive, non-significant linear relationship with severity score (r = 0.231, p = 0.103), whereas Spearman's analysis showed a weak positive monotonic association (rho = 0.286, p = 0.042). Regression explained 5.3% of severity-score variation (R2 = 0.053, p = 0.103). MPV did not differ significantly across severity categories (H = 2.163, p = 0.339). MPV correlated inversely with haemoglobin (r = -0.556, p < 0.001) and positively with platelet count (r = 0.307, p = 0.029). Conclusion: MPV showed a weak relationship with disease severity but inconsistent statistical evidence across analyses. The limited explained variance and absence of significant differences between severity categories do not support MPV as a standalone severity marker. Larger longitudinal studies are warranted. Keywords: Sickle cell anaemia; Mean platelet volume; Disease severity; Platelet indices; Paediatric haematology; Cross-sectional study; Nigeria.

Background A persistent gap between motivation and action threatens voluntary blood supply. This study examined the publics knowledge, attitudes, and practices (KAP) regarding blood donation, with a particular focus on identifying the different determinants of past blood donation behavior and future willingness to donate. Methods Convenience sampling was used to conduct a cross-sectional survey among 1,058 eligible people in Qingdao, China, between July and November 2025. Data were collected via a self-designed KAP questionnaire. To find independent characteristics linked to previous behavior and future intention, respectively, multivariable binary logistic regression was used. Results Overall, 37.0% of participants (n=391) had a lifetime donation history, while 39.2% (n=415) intended to donate in the next 12 months. Past behavior was positively associated with older age (36-45 years: OR=6.84; 95% CI: 3.21-14.58), higher education (OR=2.06; 95% CI: 1.33-3.17), and interpersonal interaction channels (OR=1.45; 95% CI: 1.01-2.09) but hindered by safety concerns (OR=0.23; 95% CI: 0.16-0.34). Conversely, future intention was positively correlated with male sex (OR=1.69; 95% CI: 1.24-2.29), prior donation history (OR=2.69; 95% CI: 1.87-3.86), having family members or friends in need of blood (OR=2.75; 95% CI: 1.96-3.85), and traditional media exposure (OR=3.33; 95% CI: 2.18-5.10). Higher education was adversely correlated with future intention (OR=0.55; 95% CI: 0.38-0.79). Conclusion There is a substantial disparity between donation motivation and action. The determinants of past behavior and future intention are asymmetric, suggesting that stage-specific interventions are required, using social mobilization for initiating first-time donations, while employing family reciprocity and authoritative communication to sustain long-term engagement.

ObjectiveThis study aimed to evaluate the impact of combined use of chemiluminescent immunoassay (CLIA) and nucleic acid amplification testing (NAAT) to improve transfusion transmitted Hepatitis B Virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency Virus-1 (HIV-1) among blood donors in Pakistan. DesignRetrospective, single center observational. SettingRegional blood center at tertiary care hospital in urban Pakistan. ParticipantsAll adults of 18 years or above who were eligible to donate blood after meeting the pre-donation screening criteria during the study period (n = 26,778). Outcome MeasuresPrimary outcome measure was to estimate the incremental yield of HBV, HCV, and HIV-1 infections using combined CLIA+NAAT compared to CLIA-alone per 100,000 donations. Secondary outcome was to calculate inter-test agreement and discordance between CLIA and NAAT methods. ResultsAmong 26,778 donors, the combined CLIA+NAAT testing detected a total of 2,423.6 viral infections per 100,000 donations, NAAT alone contributed 739.7/100,000 of these. For HBV, NAAT uniquely detected 489/100,000 additional cases missed by CLIA; the combined detection rate was 1,561/100,000. For HCV, NAAT-only yield was lower (247/100,000), with total detection of 825.3/100,000. HIV-1 was rare in the donor pool; incremental NAAT yield was 3.7/100,000, with a combined detection rate of 37.3/100,000. Agreement between tests was substantial for HBV ({kappa} = 0.63) and moderate to fair for HCV ({kappa} = 0.47) and HIV-1 ({kappa} = 0.40). The discordant cases detected by NAAT alone for HBV, HCV and HIV-1 were 183, 431 and 37 respectively. McNemars test showed statistically significant differences (p < 0.001) across all markers, with large effect sizes for HIV-1 (0.92, 95% CI: 0.80-1.00) and HCV (0.69, 95% CI: 0.65-0.73). ConclusionIntegrating CLIA with NAAT enhanced the detection of HBV, including occult and window period infections, and refined estimates of active HCV and HIV-1 infections which significantly improved blood transfusion safety. STRENGTHS AND LIMITATIONS OF THIS STUDYO_LIThe selection bias was reduced by including all consecutive eligible blood donors during study period. C_LIO_LIThe information bias was minimized through uniform, fully automated, and validated protocols for combined CLIA and NAAT testing of blood donors. C_LIO_LIThe single center retrospective study design restricts generalizability and causal inference. C_LIO_LIThe false positives/negatives and genetic variability were not confirmed. C_LI

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.

This study examines the effects of rural out-migration and remittance inflows on food consumption outcomes among rural households in the Tigray region of Ethiopia. Utilizing household survey data collected from 521 rural households across three distinct Weredas (districts) (Tahtay Maichew, Kola Tembien, and Kilte-awlaelo). A Binary Probit model was employed to identify factors influencing migration decisions, while an Endogenous Switching Regression (ESR) model was used to estimate the impact of migration on food consumption outcomes while controlling for selection bias and unobserved heterogeneity. Food security was measured using the Food Consumption Score (FCS) and dietary diversity indicators. The empirical results reveal that severe food insecurity is widespread, with over 60% of all surveyed households falling into the "Poor" food consumption category. Descriptive baseline comparisons show that migration and remittance transfers marginally shift the raw average FCS upward from 23.86 to 25.48. However, this impact is profoundly nuanced: remittances serve as an immediate consumption-smoothing safety net but run parallel to a "labor-lost" constraint that reduces own-production capacities, forcing households to rely increasingly on market purchases for staple foods. The findings reveal that migration creates short-term labor shortages in agricultural production; however, remittance inflows substantially improve household food consumption frequencies, particularly for pulses, vegetables, and other nutrient-rich foods. After accounting for self-selection bias and unobserved traits, the rigorous ESR estimates indicate that migration increases the Food Consumption Score of participating households by an average Treatment Effect on the Treated (ATT) of 10.75 points, shifting them into more secure dietary tiers. Moreover, remittances help households mitigate the adverse effects of drought and other shocks by relaxing liquidity constraints and supporting both food purchases and agricultural investments. The study recommends establishing target food security safety nets for non-remittance households, promoting scale-appropriate labor-saving agricultural technologies, expanding traditional communal labor-sharing innovations, and boosting irrigation and agricultural input support programs to enhance rural food security and livelihood resilience.

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.

IntroductionThe ABO blood group system was the first human blood group system discovered by Austrian scientist Karl Landsteiner in 1901. The ABO blood group system is divided into four blood types on the basis of presence or absence of A and B surface antigens A and B antibodies presence in the plasma. Positive and Negative of the blood group determines by presence or absence of the D antigen.. ObjectivesThis study was carried out to determine the distribution pattern of blood groups among blood donors at a tertiary care hospital of Puducherry Materials and MethodsIt is a retrospective study done a period of 5 years from May 2017 to May 2022 that includes the 9062 blood donors. Blood group done as per the standard operative procedure. Data on the ABO and Rh blood group type of all blood donors was collected and analysed. ResultThe most common ABO blood group type was Group O (38%) followed by group B (33.5%), group A (21.6%) and group AB (6.9%) and one Bombay blood group. The distribution of Rh(D) blood group type revealed 92.5% as Rh-positive and 7.5% as Rh-negative. ConclusionThe most common ABO blood group type in our region (Puducherry) is Group O followed by B and A while, AB and Bombay groups are the least common type. Knowledge of the blood group distribution pattern is essential for the effective delivery of blood banking services.

BackgroundExtreme leukocytosis (EL), defined as an abnormally high white blood cell (WBC) count, is a critical clinical indicator associated with various underlying conditions, such as infections and malignancies. This study investigated the etiological factors and clinical profiles of patients presenting with EL at Mbeya Zonal Referral Hospital (MZRH). MethodsA retrospective cohort study was conducted among patients with WBC counts [&ge;]50x109/L who attended MZRH between January 2021 and December 2022. Data were retrieved from electronic health records and analyzed using Stata Version 16. ResultsA total of 178 patients with EL were included in the study. Malignant conditions accounted for 47.2% of cases, with haematological malignancies comprising 89.3%, predominantly chronic myeloid leukaemia (CML). Infections were the second most frequent cause (43.2%). Patients with malignancies had significantly higher median WBC counts (221 vs. 56 x 109/L, p<0.0001) and were more likely to present with symptoms such as bleeding, bone pain, B symptoms, splenomegaly, hepatomegaly, and lymphadenopathy. Severe thrombocytopenia (platelet count <50 x 109/L) was more common in the malignant group (p=0.0008). ConclusionMalignant etiologies, particularly haematological malignancies, are a leading cause of EL in patients with WBC counts [&ge;]50 x 109/L. Clinicians should maintain a high suspicion of malignancies in such patients and conduct thorough diagnostic evaluations to ensure optimal management.

COVID-19 Disease has strained our healthcare system. Convalescent plasma has been used to treat emerging infectious diseases -Influenza A/B, SARS-CoV, Ebola virus and now SARS-CoV 2. OBJECTIVEThis study aims to determine the outcome and clinical course of COVID-19 patients who received convalescent plasma transfusion at Cardinal Santos Medical Center. METHODSThis is a retrospective cohort analytical study of 75 patients who received convalescent plasma. RESULTSMedian time from admission to CP transfusion was 3 days. Majority of patients received additional therapies including dexamethasone (100%); Remdesivir (95%); antibiotics (100%), tocilizumab (65%); hemoperfusion (88%) or combination of these. Among the survivors, the median LOS was 15 days while non-survivors have a median LOS of 6 days. One patient (1.33%) had mild transfusion reaction. Four patients (5.33%) developed DVT despite anti-coagulation. There was improvement in the inflammatory markers (LDH pvalue 0.04, CRP pvalue 0.00, Ferritin pvalue 0.0001). There was improvement in the pulmonary parameters -increase in mean PaO2, mean SaO2, and mean PFR; and decrease in mean FiO2 and mean RR post-treatment. Median LOS is 14 days for the CP group vs 11 days for the non-CP group. Mortality rate among the CP group is 25.33% while the non-CP group was 26.67%. LOS and mortality rate did not reach statistical significance. CONCLUSIONSThere was no significant difference in mortality and length of hospital stay in patients given CP vs controls. CP might have a role in the improvement of inflammatory markers and pulmonary status.

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.

BackgroundMalnutrition remains the most common cause of morbidity and mortality in children under the age of 5 years. In Zimbabwe nearly 1 in every 3 children is malnourished. Child nutrition in the country is affected by inadequate knowledge among mothers and caregivers on appropriate diets especially in the first 1000 days of life. Weak coordination and inadequate resources for high impact nutrition interventions also affect nutrition in children. MethodsA descriptive cross sectional study was conducted on records from January 2013 to December 2018. All malnourished patients admitted into Community based management of acute malnutrition (CMAM) at health facilities in, with a diagnosis of Severe Acute Malnutrition (SAM) from January 2013 December 2018 as reported in the DHIS2 were included in the study. We retrieved the dataset from the DHIS2 to the excel sheet and analysed the data to come up with graphs demonstrating trends in management of acute malnutrition. ResultsThe 6-59 months age-group constitute the group with the highest cases of admission into the CMAM program. The 0-5 months age-group showed the least number of cases admitted and had the lowest HIV positivity over the period under review. The highest treatment outcome for HIV positive patients was death rate. Highest number of cases of malnutrition were admitted in 2016.The District failed to meet sphere standard default and cure rate throughout the period under review. ConclusionThe treatment outcomes of this study showed that HIV negative had better treatment outcomes than HIV positive. The age group 6 to 59 months had the highest number of cases admitted into CMAM program.The implementation of an effective public health approach for addressing malnutrition require a holistic approach that incorporates preventive measures such as poverty reduction, hygiene promotion, clean water, prevention of prenatal macronutrient and micronutrient deficiencies, and the promotion of age appropriate foods and feeding practices for infants and young children.

Background: In malaria-endemic tropical regions, the overlapping coagulopathy in COVID-19 and malaria poses diagnostic and prognostic challenges, particularly with potential sex differences. This study evaluated sex-specific variations in platelet indices and fibrinolytic markers and assessed the utility of Platelet Distribution Width (PDW) and D-dimer in mild/asymptomatic cases. Methods: A case-control study was conducted with 220 participants (55 each in healthy controls, malaria-positive, COVID-19-positive, and COVID-19+malaria co-infected groups), aged 20-65 years, in Port Harcourt, Nigeria. Platelet indices were analysed using Sysmex XP-300 haematology analyser, while D-dimer and fibrinogen were measured by ELISA. Data were analysed using SAS 9.4 with ANOVA, Tukey's HSD, Pearson correlation, and sex-stratified comparisons. Results: PDW was significantly elevated in all infected groups compared to controls (malaria: 15.21 +/- 0.22 fL; COVID-19: 15.21 +/- 0.22 fL; co-infection: 15.61 +/- 0.21 fL vs. control: 13.26 +/- 0.17 fL; F=25.850, p < 0.001). D-dimer levels were highest in the co-infected group (553.42 +/- 59.74 ng/ml, F=2.816, p = 0.040). No significant changes were observed in other platelet indices or fibrinogen across groups. No significant correlation existed between platelet indices and the fibrinolytic markers. Males exhibited significantly higher D-dimer levels across all infected groups (p < 0.05) and higher fibrinogen in COVID-19 subjects (p = 0.036). Sex exerted a stronger influence on parameters than age. Conclusion: Males show heightened fibrinolytic activation in COVID-19 and malaria co-infection. PDW and D-dimer are promising, cost-effective biomarkers for screening mild infections in resource-limited tropical settings.