Prevalence and Determinants of Pre-diabetes and Latent Tuberculosis Infection Among Apparently Healthy Adults in Three Communities in Southern Nigeria
Benson Olu Akinshipe,
Edirin Omorigho Yusuf,
Felix Oladapo Akinshipe,
Muyiwa Adeleye Moronkeji,
Anthony Chukwuka Nwaobi
Issue:
Volume 7, Issue 2, June 2019
Pages:
23-32
Received:
3 July 2019
Accepted:
26 July 2019
Published:
14 August 2019
Abstract: Type 2 diabetes mellitus (DM) is commonly associated with pulmonary tuberculosis (TB) and vice versa. Although most individuals with DM and TB pass through intermediate state of pre-diabetes mellitus (PDM) and latent tuberculosis infection (LTBI) respectively, however, data is scant on PDM and LTBI in co-endemic populations to inform recommendations on intervention in those settings. This study aimed to assess the prevalence of PDM and LTBI and determine the susceptibility factors among presumably low- risk adults in a high DM-and TB setting. A cross-sectional study of 352 able-bodied adults was conducted in three communities representative of the southern Nigeria population. Socio-demographic and anthropometric data of the participants were collected using a modified WHO STEPS Wise instrument. A single random blood sample was used to measure glycated hemoglobin (HbA1c) using Cobas c111 Auto-analyzer and interferon-gamma (INF-γ) production with the aid of Quantiferon TB-Gold-In Tube (QFT-GIT) kit. Pre-diabetes was defined as HbA1c between 5.7-6.4% and LTBI as INF- γ positivity (≥0.35 IU/ml). Overall, the prevalence of PDM was 29 (8.2%) (95% CI: 6.4-9.4%) and LTBI 83 (23.6%) (95% CI: 21.6-27.3%), while 9 (2.6%) had dual PDM-LTBI. The urbanites recorded higher PDM 15 (12.8%) (X2=6.340, p=0.022) whereas LTBI was higher among villagers 48 (43.6%) (X2=36.503, p=0.0001). Risk factors associated with PDM and LTBI were: residence status, aging, smoking, familial DM and non-BCG vaccination. Aging was the single most important predictor of PDM (X2=8.469, p=0.007), LTBI (X2=59.541, p=0.001); with aged 50-59 years having four-fold higher risk of PDM-LTBI (OR=4.72, 95% CI=3.25; p=0.0001). These findings indicate that one in twelve and one in four presumably healthy persons screened were found to harbor PDM and LTBI respectively. There is a twin epidemic of PDM and LTBI among southern Nigeria adults. Susceptibility pattern suggests environmental, familial and cumulative life-time risks. ‘Syndemic’ DM and TB in the area is imminent in the absence of timeous intervention.
Abstract: Type 2 diabetes mellitus (DM) is commonly associated with pulmonary tuberculosis (TB) and vice versa. Although most individuals with DM and TB pass through intermediate state of pre-diabetes mellitus (PDM) and latent tuberculosis infection (LTBI) respectively, however, data is scant on PDM and LTBI in co-endemic populations to inform recommendation...
Show More
Prevalence of Anti Erythocyte Alloimmunization to Sub-Saharan African Blood Donors
Sekongo Yassongui Mamadou,
Dasse Sery Romuald,
Altemeyer Anaïs,
Soraya Amar,
Tayou Claude,
Anani Ludovic,
Kassogue Kadidia,
Geisen Cristof,
Herbrich Anne,
Kouamenan Sisonie,
Konate Seidou
Issue:
Volume 7, Issue 2, June 2019
Pages:
33-36
Received:
4 May 2019
Accepted:
23 August 2019
Published:
6 September 2019
Abstract: A part from any incompatible blood transfusion, anti-erythrocyte alloimmunization is observed to pregnant women. It is the result of the passage of red blood cells carrying antigens different from those of the mother during pregnancy and delivery. The Rhesus D system is the most involved; but there are also other systems involved in this alloimmunization. Non-transfusion alloimmunization is an extremely rare event in the order of 1 of 4000 to women in Europe and in most cases concerns the Rhesus D. In sub-Saharan Africa, there are no statistics collected on foeto-maternal alloimmunization. As part of our postgraduate thesis on the sensitization status of red blood cells to acridine, we used the technique of looking for irregular agglutinins. The goal was to find anti-erythrocyte alloimmunization to blood donors in sub-Saharan Africa. We conducted a two-year multicenter prospective and descriptive study of 903 blood donors in Côte d'Ivoire, Benin and Cameroon. The samples were analyzed in the laboratories of the National Blood Transfusion Center of Côte D'Ivoire and Frankfurt according to the technique of the RAI gel card of the BIORAD company after centrifugation and incubation using test red cells treated with S-303. In the case of a positive reaction, identification is made by a panel of red blood cells in the different blood group systems. In our study population, there is a male predominance with a male/female ratio of 7.42. We found a very low prevalence of alloimmunization to non-transfused blood donors (0.9% or 8 cases out of 902). 4 anti-erythrocyte antibodies have been identified (1 Ac anti D and 3 AC anti S); 2 pan-agglutination, 2 unidentified Ac (insufficient serum) and suspicion of anti-glutathione. Anti-erythrocyte alloimmunization to sub-Saharan Africa blood donor is about 0.9% in our series. It remains high compared to European data. This alloimmunization is mainly observed to women with low frequency antigens to black peoples.
Abstract: A part from any incompatible blood transfusion, anti-erythrocyte alloimmunization is observed to pregnant women. It is the result of the passage of red blood cells carrying antigens different from those of the mother during pregnancy and delivery. The Rhesus D system is the most involved; but there are also other systems involved in this alloimmuni...
Show More