1
|
Erasmus R, Ondoa P. Taking the train of digital health and artificial intelligence to improve medical laboratory service in Africa: Key considerations. Afr J Lab Med 2023; 12:2329. [PMID: 38058852 PMCID: PMC10696532 DOI: 10.4102/ajlm.v12i1.2329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
No abstract available.
Collapse
Affiliation(s)
- Rajiv Erasmus
- Department of Chemical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Pathology, Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Department of Biomedical Sciences, Faculty of Health Sciences and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Pascale Ondoa
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia
- Department of Global Health, Institute of Global Health and Development, University of Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
2
|
Bawua SA, Ichihara K, Keatley R, Arko-Mensah J, Ayeh-Kumi PF, Erasmus R, Fobil J. Derivation of sex and age-specific reference intervals for clinical chemistry analytes in healthy Ghanaian adults. Clin Chem Lab Med 2022; 60:1426-1439. [PMID: 35786502 DOI: 10.1515/cclm-2022-0293] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/13/2022] [Indexed: 11/15/2022]
Abstract
OBJECTVIES This study is aimed at establishing reference intervals (RIs) of 40 chemistry and immunochemistry analytes for Ghanaian adults based on internationally harmonized protocol by IFCC Committee on Reference Intervals and Decision Limits (C-RIDL). METHODS A total of 501 healthy volunteers aged ≥18 years were recruited from the northern and southern regions of Ghana. Blood samples were analyzed with Beckman-Coulter AU480 and Centaur-XP/Siemen auto-analyzers. Sources of variations of reference values (RVs) were evaluated by multiple regression analysis (MRA). The need for partitioning RVs by sex and age was guided by the SD ratio (SDR). The RI for each analyte was derived using parametric method with application of the latent abnormal values exclusion (LAVE) method. RESULTS Using SDR≥0.4 as threshold, RVs were partitioned by sex for most enzymes, creatinine, uric acid (UA), bilirubin, immunoglobulin-M. MRA revealed age and body mass index (BMI) as major source of variations of many analytes. LAVE lowered the upper limits of RIs for alanine/aspartate aminotransferase, γ-glutamyl transaminase and lipids. Exclusion of individuals with BMI≥30 further lowered the RIs for lipids and CRP. After standardization based on value-assigned serum panel provided by C-RIDL, Ghanaian RIs were found higher for creatine kinase, amylase, and lower for albumin and urea compared to other collaborating countries. CONCLUSIONS The LAVE effect on many clinical chemistry RIs supports the need for the secondary exclusion for reliable derivation of RIs. The differences in Ghanaian RIs compared to other countries underscore the importance of country specific-RIs for improved clinical decision making.
Collapse
Key Words
- AG, anion gap
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- AMY, amylase
- AST, aspartate aminotransferase
- Alb, albumin
- BD, Becton Dickinson
- BMI, body mass index
- BR, bias ratio
- C-RIDL, Committee on Reference Intervals and Decision Limits
- C3, complement component 3
- C4, complement component 4
- CDL, clinical decision limit
- CI, confidence interval
- CK, creatine kinase
- CRP, C-reactive protein
- CV(b), CV of the regression slope b
- Ca, calcium
- Cl, chloride
- Cre, creatinine
- DBil, direct bilirubin
- F, female
- GGT, gamma-glutamyl transferase
- Glb, globulin
- Glu, glucose
- HDL-CHDL-C, high-density lipoprotein cholesterol
- HbA1c, hemoglobin A1c
- IFCC, International Federation of Clinical Chemistry and Laboratory Medicine
- IP, inorganic phosphate
- IgA, immunoglobulin A
- IgG, immunoglobulin G
- IgM, immunoglobulin M
- K, potassium
- LAVE, latent abnormal values exclusion
- LDH, lactate dehydrogenase
- LDL-C, low-density lipoprotein cholesterol
- LL, lower limit
- M, male
- MF, male + female
- MRA, multiple regression analysis
- Mg, magnesium
- NP, non-parametric
- Na, sodium
- P, parametric
- RI, reference interval
- RV, reference values
- SDR, standard deviation ratio
- SV, sources of variation
- TBil, total bilirubin
- TC, total cholesterol
- TCO2, total carbon dioxide
- TG, triglycerides
- TP, total protein
- UA, uric acid
- UL, upper limit
- between-country differences
- bias ratio
- eGFR, estimated glomerular filtration rate
- ethnicity
- latent abnormal values exclusion method
- multiple regression analysis
- nonparametric method
- parametric method
- rp, standardized partial correlation coefficient
- standard deviation ratio
- standardization
Collapse
Affiliation(s)
- Serwaa Akoto Bawua
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Accra, Ghana
| | - Kiyoshi Ichihara
- Faculty of Health Sciences, Department of Clinical Laboratory Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | | | - John Arko-Mensah
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Accra, Ghana
| | - Patrick F Ayeh-Kumi
- Department of Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Ghana
| | - Rajiv Erasmus
- University of Stellenbosch, Division of Chemical Pathology, Tygerberg, Cape Town, South Africa
| | - Julius Fobil
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Accra, Ghana
| |
Collapse
|
3
|
Allwood BW, Koegelenberg CF, Ngah VD, Sigwadhi LN, Irusen EM, Lalla U, Yalew A, Tamuzi JL, McAllister M, Zemlin AE, Jalavu TP, Erasmus R, Chapanduka ZC, Matsha TE, Fwemba I, Zumla A, Nyasulu PS. Predicting COVID-19 outcomes from clinical and laboratory parameters in an intensive care facility during the second wave of the pandemic in South Africa. IJID Reg 2022; 3:242-247. [PMID: 35720137 PMCID: PMC8971059 DOI: 10.1016/j.ijregi.2022.03.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023]
Abstract
Background The second wave of coronavirus disease 2019 (COVID-19) in South Africa was caused by the Beta variant of severe acute respiratory syndrome coronavirurus-2. This study aimed to explore clinical and biochemical parameters that could predict outcome in patients with COVID-19. Methods A prospective study was conducted between 5 November 2020 and 30 April 2021 among patients with confirmed COVID-19 admitted to the intensive care unit (ICU) of a tertiary hospital. The Cox proportional hazards model in Stata 16 was used to assess risk factors associated with survival or death. Factors with P<0.05 were considered significant. Results Patients who died were found to have significantly lower median pH (P<0.001), higher median arterial partial pressure of carbon dioxide (P<0.001), higher D-dimer levels (P=0.001), higher troponin T levels (P=0.001), higher N-terminal-prohormone B-type natriuretic peptide levels (P=0.007) and higher C-reactive protein levels (P=0.010) compared with patients who survived. Increased standard bicarbonate (HCO3std) was associated with lower risk of death (hazard ratio 0.96, 95% confidence interval 0.93-0.99). Conclusions The mortality of patients with COVID-19 admitted to the ICU was associated with elevated D-dimer and a low HCO3std level. Large studies are warranted to increase the identification of patients at risk of poor prognosis, and to improve the clinical approach.
Collapse
Affiliation(s)
- Brian W. Allwood
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Coenraad F. Koegelenberg
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Veranyuy D. Ngah
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lovemore N. Sigwadhi
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Elvis M. Irusen
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Usha Lalla
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Anteneh Yalew
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Statistics, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- National Data Management Centre for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Jacques L. Tamuzi
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marli McAllister
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Annalise E. Zemlin
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa
| | - Thumeka P. Jalavu
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa
| | - Rajiv Erasmus
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa
| | - Zivanai C. Chapanduka
- Division of Haematological Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa
| | - Tandi E. Matsha
- Faculty of Health and Wellness Sciences, Peninsula University of Technology, Bellville Campus, Cape Town
| | - Isaac Fwemba
- School of Public Health, University of Zambia, Lusaka, Zambia
| | - Alimuddin Zumla
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London Royal Free Campus, London, UK
- NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - Peter S. Nyasulu
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - COVID-19 Research Response Collaboration
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Statistics, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- National Data Management Centre for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa
- Division of Haematological Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa
- Faculty of Health and Wellness Sciences, Peninsula University of Technology, Bellville Campus, Cape Town
- School of Public Health, University of Zambia, Lusaka, Zambia
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London Royal Free Campus, London, UK
- NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
4
|
Matsha T, Hon G, Davids S, Erasmus R. W196 Weight management and perceived body weight and shape in an urban South African population. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
5
|
Motshwari DD, Matshazi DM, Erasmus R, Kengne AP, Matsha TE, George C. MicroRNAs associated with chronic kidney disease in the general population and high-risk subgroups: protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e057500. [PMID: 35173010 PMCID: PMC8852766 DOI: 10.1136/bmjopen-2021-057500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) is a significant health and economic burden, owing to its ever-increasing global prevalence. Due to the limitations in the current diagnostic methods, CKD is frequently diagnosed at advanced stages, where there is an increased risk of cardiovascular complications and end-stage kidney disease. As such, there has been considerable interest in microRNAs (miRNAs) as potential markers for CKD detection. This review seeks to identify all miRNAs associated with CKD and/or markers of kidney function or kidney damage in the general population and high-risk subgroups, and explore their expression profiles in these populations. METHODS AND ANALYSIS A systematic search of published literature will be conducted for observational studies that report on miRNAs associated with CKD or kidney function or kidney damage markers (serum creatinine and cystatin C, estimated glomerular filtration rate and urinary albumin excretion) in adult humans. The electronic database search will be restricted to English and French publications up to 31 October 2021. Two investigators will independently screen and identify studies for inclusion, as well as extract data from eligible studies. Risk-of-bias and methodological quality will be assessed by the Newcastle-Ottawa Quality Assessment Scale for observational studies and Grading of Recommendations Assessment, Development and Evaluation tools. Appropriate meta-analytic techniques will be used to pool estimates from studies with similar miRNAs, overall and by major characteristics, including by country or region, sample size, gender and risk-of-bias score. Heterogeneity of the estimates across studies will be quantified and publication bias investigated. This protocol is reported according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 guidelines. ETHICS AND DISSEMINATION This study design does not require formal ethical clearance and findings will be published in a peer-reviewed journal. CONCLUSION This review will provide the expression pattern of miRNAs associated with CKD. This will allow for further research into the identified miRNAs, which could later be used as biomarkers for prediction and early detection of CKD, monitoring of disease progression to advanced stages and as potential therapeutic targets. PROSPERO REGISTRATION NUMBER CRD42021270028.
Collapse
Affiliation(s)
- Dipuo Dephney Motshwari
- Department of Biomedical Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Don Makwakiwe Matshazi
- Department of Biomedical Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Rajiv Erasmus
- Department of Chemical Pathology, Stellenbosch University, Stellenbosch, South Africa
| | - A P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Department of Medicine, University of Cape Town, Rondebosch, South Africa
| | - Tandi E Matsha
- Department of Biomedical Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Cindy George
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
| |
Collapse
|
6
|
Erasmus R, Fourie P, Janse van Rensburg C, Jacobs H. An audit on the accuracy of freehand acetabular cup positioning in total hip arthroplasty with the direct lateral approach at a tertiary institution over seven years. SA orthop j 2022. [DOI: 10.17159/2309-8309/2022/v21n4a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND: The direct lateral approach for total hip replacement has been traditionally reserved and described for neck of femur fractures. Advantages of this approach include technically easy access to the acetabulum and femur and low incidence of hip dislocation. Imperfect positioning of the acetabular component leads to increased risk for dislocations, accelerated wear, reduced range of motion and increased revision rate. Freehand technique has been the gold standard for many decades, but newer technologies like computer navigation and robotic-assisted surgery have shown to improve the accuracy of cup placement. This study reports on the accuracy of freehand cup positioning via the direct lateral approach with mention of the dislocation rate METHODS: We retrospectively reviewed 253 patients who had total hip replacements done via the direct lateral approach. The patients' files were evaluated for patient parameters, demographic details, aetiology of hip pathology, confirmation of approach used, comorbidities and history of previous relevant surgery. The postoperative radiographs were analysed for acetabular component position inclination and anteversion. Dislocation rates were calculated as a secondary objective RESULTS: The radiographic analysis was performed using the Liaw method based on trigonometry of the eclipse generated. This showed a mean cup inclination of 42.3° (95% CI: 41.3-43.3°) and anteversion of 12.7° (95% CI: 12.0-13.7°). A total of 57% of the acetabular cups were within the safe zones described by Lewinnek. Of them, 78% were in the 30-50° range for inclination and 73% in the 5-25° range for anteversion. There were ten dislocations within one year from the index procedure: a dislocation rate of 4.0% (95% CI: 2.8-8.5% CONCLUSION: The freehand technique using the direct lateral approach for acetabular cup placement produces a poor overall accuracy of only 57%. Although our study only commented on ten dislocations, the rate (4%) is significantly worse compared to the 0.43% reported in literature for the direct lateral approach. The radiographic results for inclination and anteversion are comparable to other freehand techniques, regardless of the approach used, but significantly worse than results achieved with navigation and robotics Level of evidence: Level 4
Collapse
|
7
|
Bohn MK, Lippi G, Horvath AR, Erasmus R, Grimmler M, Gramegna M, Mancini N, Mueller R, Rawlinson WD, Menezes ME, Patru MM, Rota F, Sethi S, Singh K, Yuen KY, Wang CB, Adeli K. IFCC interim guidelines on rapid point-of-care antigen testing for SARS-CoV-2 detection in asymptomatic and symptomatic individuals. Clin Chem Lab Med 2021; 59:1507-1515. [PMID: 33908222 DOI: 10.1515/cclm-2021-0455] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 12/16/2022]
Abstract
With an almost unremittent progression of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections all around the world, there is a compelling need to introduce rapid, reliable, and high-throughput testing to allow appropriate clinical management and/or timely isolation of infected individuals. Although nucleic acid amplification testing (NAAT) remains the gold standard for detecting and theoretically quantifying SARS-CoV-2 mRNA in various specimen types, antigen assays may be considered a suitable alternative, under specific circumstances. Rapid antigen tests are meant to detect viral antigen proteins in biological specimens (e.g. nasal, nasopharyngeal, saliva), to indicate current SARS-CoV-2 infection. The available assay methodology includes rapid chromatographic immunoassays, used at the point-of-care, which carries some advantages and drawbacks compared to more conventional, instrumentation-based, laboratory immunoassays. Therefore, this document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Taskforce on COVID-19 aims to summarize available data on the performance of currently available SARS-CoV-2 antigen rapid detection tests (Ag-RDTs), providing interim guidance on clinical indications and target populations, assay selection, and evaluation, test interpretation and limitations, as well as on pre-analytical considerations. This document is hence mainly aimed to assist laboratory and regulated health professionals in selecting, validating, and implementing regulatory approved Ag-RDTs.
Collapse
Affiliation(s)
- Mary Kathryn Bohn
- Department of Paediatric Laboratory Medicine, CALIPER Program, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Andrea R Horvath
- Department of Clinical Chemistry, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Rajiv Erasmus
- Stellenbosch University, Cape Town, Western Cape, Republic of South Africa
| | | | | | | | | | - William D Rawlinson
- Department of Virology, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | | | | | | | - Sunil Sethi
- National University Hospital, Singapore, Singapore
| | | | | | | | - Khosrow Adeli
- Department of Paediatric Laboratory Medicine, CALIPER Program, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | |
Collapse
|
8
|
Smit F, Davison GM, Hoffman M, Erasmus R, Davids S, Matsha T. Response to IJLH-07-20-0590. Full blood count reference intervals in the healthy population residing in the CapeTown region, South Africa. Int J Lab Hematol 2020; 43:e97-e98. [PMID: 33340394 DOI: 10.1111/ijlh.13429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 11/20/2020] [Accepted: 11/28/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Francois Smit
- PathCare Laboratories, Cape Town, South Africa.,SAMRC/CPUT/ Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa
| | - Glenda M Davison
- SAMRC/CPUT/ Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa
| | | | - Rajiv Erasmus
- Division of Chemical Pathology, University of Stellenbosch and National Health Laboratory Services, Tygerberg, South Africa
| | - Saarah Davids
- SAMRC/CPUT/ Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa
| | - Tandi Matsha
- SAMRC/CPUT/ Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa
| |
Collapse
|
9
|
Bohn MK, Mancini N, Loh TP, Wang CB, Grimmler M, Gramegna M, Yuen KY, Mueller R, Koch D, Sethi S, Rawlinson WD, Clementi M, Erasmus R, Leportier M, Kwon GC, Menezes ME, Patru MM, Singh K, Ferrari M, Najjar O, Horvath AR, Adeli K, Lippi G. IFCC Interim Guidelines on Molecular Testing of SARS-CoV-2 Infection. Clin Chem Lab Med 2020; 58:1993-2000. [PMID: 33027042 DOI: 10.1515/cclm-2020-1412] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 12/12/2022]
Abstract
The diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection globally has relied extensively on molecular testing, contributing vitally to case identification, isolation, contact tracing, and rationalization of infection control measures during the coronavirus disease 2019 (COVID-19) pandemic. Clinical laboratories have thus needed to verify newly developed molecular tests and increase testing capacity at an unprecedented rate. As the COVID-19 pandemic continues to pose a global health threat, laboratories continue to encounter challenges in the selection, verification, and interpretation of these tests. This document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 provides interim guidance on: (A) clinical indications and target populations, (B) assay selection, (C) assay verification, and (D) test interpretation and limitations for molecular testing of SARS-CoV-2 infection. These evidence-based recommendations will provide practical guidance to clinical laboratories worldwide and highlight the continued importance of laboratory medicine in our collective pandemic response.
Collapse
Affiliation(s)
- Mary Kathryn Bohn
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Tze Ping Loh
- National University Health System, Singapore, Singapore
| | | | | | | | | | | | - David Koch
- Emory University School of Medicine, Atlanta, GA, USA
| | - Sunil Sethi
- National University Health System, Singapore, Singapore
| | - William D Rawlinson
- Virology Division, SEALS Microbiology, Prince of Wales Hospital, NSW, Randwick, Australia
| | | | - Rajiv Erasmus
- University of Stellenbosch, Cape Town, Western Cape, Republic of South Africa
| | | | - Gye Cheol Kwon
- Chungnam National University Hospital, Daejeon, Republic of South Korea
| | | | | | | | | | - Osama Najjar
- Allied Health Professions Ministry of Health, Palestine, Palestine
| | - Andrea R Horvath
- Department of Clinical Chemistry, New South Wales Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Khosrow Adeli
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Giuseppe Lippi
- University Hospital of Verona, Verona, Italy.,Taskforce on COVID-19, International Federation of Clinical Chemistry (IFCC), Milan, Italy
| |
Collapse
|
10
|
Thompson S, Bohn MK, Mancini N, Loh TP, Wang CB, Grimmler M, Yuen KY, Mueller R, Koch D, Sethi S, Rawlinson WD, Clementi M, Erasmus R, Leportier M, Kwon GC, Menezes ME, Patru MM, Gramegna M, Singh K, Najjar O, Ferrari M, Lippi G, Adeli K, Horvath AR. IFCC Interim Guidelines on Biochemical/Hematological Monitoring of COVID-19 Patients. Clin Chem Lab Med 2020; 58:2009-2016. [PMID: 33027044 DOI: 10.1515/cclm-2020-1414] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 02/06/2023]
Abstract
Routine biochemical and hematological tests have been reported to be useful in the stratification and prognostication of pediatric and adult patients with diagnosed coronavirus disease (COVID-19), correlating with poor outcomes such as the need for mechanical ventilation or intensive care, progression to multisystem organ failure, and/or death. While these tests are already well established in most clinical laboratories, there is still debate regarding their clinical value in the management of COVID-19, particularly in pediatrics, as well as the value of composite clinical risk scores in COVID-19 prognostication. This document by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 provides interim guidance on: (A) clinical indications for testing, (B) recommendations for test selection and interpretation, (C) considerations in test interpretation, and (D) current limitations of biochemical/hematological monitoring of COVID-19 patients. These evidence-based recommendations will provide practical guidance to clinical laboratories worldwide, underscoring the contribution of biochemical and hematological testing to our collective pandemic response.
Collapse
Affiliation(s)
- Simon Thompson
- Department of Clinical Chemistry, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Mary Kathryn Bohn
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Tze Ping Loh
- National University Health System, Singapore, Singapore
| | | | | | | | | | - David Koch
- Emory University School of Medicine, Atlanta, GA, USA
| | - Sunil Sethi
- National University Health System, Singapore, Singapore
| | - William D Rawlinson
- Department of Virology, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | | | - Rajiv Erasmus
- University of Stellenbosch, Cape Town, Western Cape, Republic of Australia
| | | | - Gye Cheol Kwon
- Chungnam National University Hospital, Daejeon, Republic of South Korea
| | | | | | | | | | - Osama Najjar
- Allied Health Professions Ministry of Health, Palestine, Palestine
| | | | | | - Khosrow Adeli
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Andrea R Horvath
- Taskforce on COVID-19, International Federation of Clinical Chemistry (IFCC), Milan, Italy.,Department of Clinical Chemistry, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | -
- Taskforce on COVID-19, International Federation of Clinical Chemistry (IFCC), Milan, Italy
| |
Collapse
|
11
|
Bohn MK, Loh TP, Wang CB, Mueller R, Koch D, Sethi S, Rawlinson WD, Clementi M, Erasmus R, Leportier M, Grimmler M, Yuen KY, Mancini N, Kwon GC, Menezes ME, Patru MM, Gramegna M, Singh K, Najjar O, Ferrari M, Horvath AR, Lippi G, Adeli K. IFCC Interim Guidelines on Serological Testing of Antibodies against SARS-CoV-2. Clin Chem Lab Med 2020; 58:2001-2008. [PMID: 33027043 DOI: 10.1515/cclm-2020-1413] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 12/16/2022]
Abstract
Serological testing for the detection of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is emerging as an important component of the clinical management of patients with coronavirus disease 2019 (COVID-19) as well as the epidemiological assessment of SARS-CoV-2 exposure worldwide. In addition to molecular testing for the detection of SARS-CoV-2 infection, clinical laboratories have also needed to increase testing capacity to include serological evaluation of patients with suspected or known COVID-19. While regulatory approved serological immunoassays are now widely available from diagnostic manufacturers globally, there is significant debate regarding the clinical utility of these tests, as well as their clinical and analytical performance requirements prior to application. This document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Taskforce on COVID-19 provides interim guidance on: (A) clinical indications and target populations, (B) assay selection, (C) assay evaluation, and (D) test interpretation and limitations for serological testing of antibodies against SARS-CoV-2 infection. These evidence-based recommendations will provide practical guidance to clinical laboratories in the selection, verification, and implementation of serological assays and are of the utmost importance as we expand our pandemic response from initial case tracing and containment to mitigation strategies to minimize resurgence and further morbidity and mortality.
Collapse
Affiliation(s)
- Mary Kathryn Bohn
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Tze Ping Loh
- National University Health System, Singapore, Singapore
| | | | | | - David Koch
- Emory University School of Medicine, Atlanta, GA, USA
| | - Sunil Sethi
- National University Health System, Singapore, Singapore
| | - William D Rawlinson
- Virology Division, SEALS Microbiology, Prince of Wales Hospital, NSW, Randwick, Australia
| | | | - Rajiv Erasmus
- University of Stellenbosch, Cape Town, Western Cape, Republic of South Africa
| | | | | | - K Y Yuen
- University of Hong Kong, Hong Kong, PR China
| | | | - Gye Cheol Kwon
- Chungnam National University Hospital, Daejeon, Republic of South Africa
| | | | | | | | | | - Osama Najjar
- Allied Health Professions Ministry of Health, Palestine, Palestine
| | | | - Andrea R Horvath
- Department of Clinical Chemistry, New South Wales Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | | | - Khosrow Adeli
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | |
Collapse
|
12
|
Bawua ASA, Ichihara K, Keatley R, Arko-Mensah J, Dei-Adomakoh Y, Ayeh-Kumi PF, Erasmus R, Fobil J. Establishing Ghanaian adult reference intervals for hematological parameters controlling for latent anemia and inflammation. Int J Lab Hematol 2020; 42:705-717. [PMID: 32881316 PMCID: PMC7754426 DOI: 10.1111/ijlh.13296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/12/2020] [Accepted: 06/30/2020] [Indexed: 12/18/2022]
Abstract
Background In Ghana, diagnostic laboratories rely on reference intervals (RIs) provided by manufacturers of laboratory analyzers which may not be appropriate. This study aimed to establish RIs for hematological parameters in adult Ghanaian population. Methods This cross‐sectional study recruited 501 apparently healthy adults from two major urban areas in Ghana based on the protocol by IFCC Committee for Reference Intervals and Decision Limits. Whole blood was tested for complete blood count (CBC) by Sysmex XN‐1000 analyzer, sera were tested for iron and ferritin by Beckman‐Coulter/AU480, for transferrin, vitamin‐B12, and folate was measured by Centaur‐XP/Siemen. Partitioning of reference values by sex and age was guided by “effect size” of between‐subgroup differences defined as standard deviation ratio (SDR) based on ANOVA. RIs were derived using parametric method with application of latent abnormal values exclusion method (LAVE), a multifaceted method of detecting subjects with abnormal results in related parameters. Results Using SDR ≥ 0.4 as a threshold, RIs were partitioned by sex for platelet, erythrocyte parameters except mean corpuscular constants, and iron markers. Application of LAVE had prominent effect on RIs for majority of erythrocyte and iron parameters. Global comparison of Ghanaian RIs revealed lower‐side shift of RIs for leukocyte and neutrophil counts, female hemoglobin and male platelet count, especially compared to non‐African countries. Conclusion The LAVE effect on many hematological RIs indicates the need for deliberate secondary exclusion for proper derivation of RIs. Obvious differences in Ghanaian RIs compared to other countries underscore the importance of country‐specific RIs for improved clinical decision‐making.
Collapse
Affiliation(s)
- Abigail S A Bawua
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Legon, Ghana
| | - Kiyoshi Ichihara
- Department of Clinical Laboratory Sciences, Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | | | - John Arko-Mensah
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Legon, Ghana
| | - Yvonne Dei-Adomakoh
- Medlab Ghana Ltd. (A Member of Synlab), Accra, Ghana.,Department of Hematology, University of Ghana Medical School, College of Health Sciences, Korle-Bu, University of Ghana, Legon, Ghana
| | - Patrick F Ayeh-Kumi
- Department of Microbiology, University of Ghana Medical School, College of Health Sciences, Korle-Bu, University of Ghana, Legon, Ghana
| | - Rajiv Erasmus
- Division of Chemical Pathology, University of Stellenbosch, Cape Town, South Africa
| | - Julius Fobil
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Legon, Ghana
| |
Collapse
|
13
|
Jalavu TP, Rensburg M, Erasmus R. Clinical staff knowledge and awareness of point-of-care-testing best practices at Tygerberg Hospital, South Africa. Afr J Lab Med 2020; 9:853. [PMID: 32832405 PMCID: PMC7433312 DOI: 10.4102/ajlm.v9i1.853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 03/24/2020] [Indexed: 11/01/2022] Open
Abstract
Background Point-of-care testing (POCT) is defined as testing done near or at the site of patient care with the goal of providing rapid information and improving patient outcomes. Point-of-care testing has many advantages and some limitations which affect its use and implementation. Objective The aim of the audit was to determine the current practices, staff attitudes and training provided to hospital clinical staff. Methods The audit was conducted with the use of a questionnaire containing 30 questions. One hundred and sixty questionnaires were delivered to 55 sites at Tygerberg Academic Hospital in Cape Town, South Africa, from 21 June 2016 to 15 July 2016. A total of 68 questionnaires were completed and returned (42.5% response rate). Results Most participants were nursing staff (62/68, 91%), and the rest were medical doctors (6/68, 9%). Most participants (66/68, 97%) performed glucose testing, 16/68 (24%) performed blood gas testing and 17/68 (25%) performed urine dipstick testing. Many participants (35/68, 51%) reported having had some formal training in one or more of the tests and 25/68 (37%) reported having never had any formal training in the respective tests. Many participants (46/68, 68%) reported that they never had formal assessment of competency in performing the respective tests. Conclusion Participants indicated a lack of adequate training in POCT and, thus, limited knowledge of quality control measures. This audit gives an indication of the current state of the POCT programme at a tertiary hospital and highlights areas where intervention is needed to improve patient care and management.
Collapse
Affiliation(s)
- Thumeka P Jalavu
- National Health Laboratory Service, Department of Chemical Pathology, Faculty Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Megan Rensburg
- National Health Laboratory Service, Department of Chemical Pathology, Faculty Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Rajiv Erasmus
- National Health Laboratory Service, Department of Chemical Pathology, Faculty Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| |
Collapse
|
14
|
Omuse G, Ichihara K, Maina D, Hoffman M, Kagotho E, Kanyua A, Mwangi J, Wambua C, Amayo A, Ojwang P, Premji Z, Erasmus R. Determination of reference intervals for common chemistry and immunoassay tests for Kenyan adults based on an internationally harmonized protocol and up-to-date statistical methods. PLoS One 2020; 15:e0235234. [PMID: 32645006 PMCID: PMC7347104 DOI: 10.1371/journal.pone.0235234] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 06/10/2020] [Indexed: 12/18/2022] Open
Abstract
Background Due to a lack of reliable reference intervals (RIs) for Kenya, we set out to determine RIs for 40 common chemistry and immunoassay tests as part of the IFCC global RI project. Methods Apparently healthy adults aged 18–65 years were recruited according to a harmonized protocol and samples analyzed using Beckman-Coulter analyzers. Value assigned serum panels were measured to standardize chemistry results. The need for partitioning reference values by sex and age was based on between-subgroup differences expressed as standard deviation ratio (SDR) or bias in lower or upper limits (LLs and ULs) of the RI. RIs were derived using a parametric method with/without latent abnormal value exclusion (LAVE). Results Sex-specific RIs were required for uric acid, creatinine, total bilirubin (TBil), total cholesterol (TC), ALT, AST, CK, GGT, transferrin, transferrin saturation (TfSat) and immunoglobulin-M. Age-specific RIs were required for glucose and triglyceride for both sexes, and for urea, magnesium, TC, HDL-cholesterol ratio, ALP, and ferritin for females. LAVE was effective in optimizing RIs for AST, ALT, GGT iron-markers and CRP by reducing influence of latent anemia and metabolic diseases. Thyroid profile RIs were derived after excluding volunteers with anti-thyroid antibodies. Kenyan RIs were comparable to those of other countries participating in the global study with a few exceptions such as higher ULs for TBil and CRP. Conclusions Kenyan RIs for major analytes were established using harmonized protocol from well-defined reference individuals. Standardized RIs for chemistry analytes can be shared across sub-Saharan African laboratories with similar ethnic and life-style profile.
Collapse
Affiliation(s)
- Geoffrey Omuse
- Department of Pathology, Aga Khan University, Nairobi, Kenya.,Division of Chemical Pathology, Department of Pathology, Stellenbosch University, Cape Town, South Africa
| | - Kiyoshi Ichihara
- Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Daniel Maina
- Department of Pathology, Aga Khan University, Nairobi, Kenya
| | | | | | | | | | | | - Angela Amayo
- Department of Pathology, University of Nairobi, Nairobi, Kenya
| | - Peter Ojwang
- Department of Pathology, Maseno University, Maseno, Kenya
| | - Zul Premji
- Formerly of Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Rajiv Erasmus
- Division of Chemical Pathology, Department of Pathology, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
15
|
Chiliza B, Asmal L, Oosthuizen P, van Niekerk E, Erasmus R, Kidd M, Malhotra A, Emsley R. Changes in Body Mass and Metabolic Profiles in Patients with First-Episode Schizophrenia Treated for 12 Months with A First-Generation Antipsychotic. Eur Psychiatry 2020; 30:277-83. [DOI: 10.1016/j.eurpsy.2014.11.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 11/26/2014] [Accepted: 11/27/2014] [Indexed: 12/11/2022] Open
Abstract
AbstractObjectives:To assess changes in body mass and metabolic profiles in patients with first-episode schizophrenia receiving standardised, assured treatment and to identify predictors and moderators of the effects.Methods:We investigated the changes in body mass, fasting blood glucose and lipids in 107 largely antipsychotic naïve, first-episode schizophrenia patients who were treated according to a standard algorithm with long-acting injectable flupenthixol decanoate over 12 months.Results:Eighty-three (78%) participants completed the 12 months of treatment, and 104 (97%) received 100% of the prescribed injections during their participation. There were significant increases in BMI (P < .0001), waist circumference (P = 0.0006) and triglycerides (P = 0.03) and decrease in HDL (P = 0.005), while systolic (P = 0.7) and diastolic blood pressure (P = 0.8), LDL (P = 0.1), cholesterol (P = 0.3), and glucose (P = 0.9) values did not change over time. The triglyceride: HDL ratio increased by 91%. Change in BMI was only correlated with change in triglycerides (P = .008). The only significant predictor of BMI increase was non-substance abuse (P = .002).Conclusions:The risks of weight gain and metabolic syndrome associated with antipsychotic treatment in first-episode schizophrenia are not restricted to second generation antipsychotics. This is a global problem, and developing communities may be particularly susceptible.
Collapse
|
16
|
Chikte U, Pontes CC, Karangwa I, Kimmie-Dhansay F, Erasmus R, Kengne AP, Matsha TE. Dental caries in a South African adult population: findings from the Cape Town Vascular and Metabolic Health Study. Int Dent J 2019; 70:176-182. [PMID: 31808148 DOI: 10.1111/idj.12538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/19/2019] [Accepted: 10/04/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES Caries is a ubiquitous non-communicable disease worldwide. There is a paucity of literature on adult caries in Africa, with the last epidemiological caries study in South Africa conducted in 1988/1989. This article reports on the decayed, missing and filled teeth (DMFT) scores in relation to demographic characteristics for a mixed-ancestry South African population. METHODS This cross-sectional epidemiological study was part of the ongoing Cape Town Bellville South Vascular and Metabolic Health Study. Each participant signed an informed consent form prior to enrolling in the study. During a clinical examination, DMFT score and components were recorded for each participant. Data analysis was performed with the statistical Package STATA 15. RESULTS A sample of 1,885 participants was included in the study. Sixty-eight percent of the population experienced high DMFT scores. Mean DMFT score increased with age from 5 (≤ 24-year-old group) to 32 (≥ 75-year-old group, P < 0.001). It was higher in women than in men (28.5 vs. 18, respectively, P < 0.001). The missing component contributed 83% to DMFT score, followed by decayed (14%) and filled (3%) scores. Males had a higher average number of teeth present than females (18 vs. 6.5, P < 0.001). CONCLUSIONS Dental caries experience was very high, with high levels of tooth loss in this community. These findings highlight limited access to preventive oral healthcare and a high rate of tooth extraction. Females presented higher levels of oral disease than males, indicating the need for preventive oral healthcare programmes in Cape Town, South Africa.
Collapse
Affiliation(s)
- Usuf Chikte
- Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Carla Cruvinel Pontes
- Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Innocent Karangwa
- Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Faheema Kimmie-Dhansay
- Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Rajiv Erasmus
- Division of Clinical Pathology, Stellenbosch University, Cape Town, South Africa
| | - Andre Pascal Kengne
- Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa.,Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Tandi E Matsha
- Department of Biomedical Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
| |
Collapse
|
17
|
Erasmus R. Clinical utility of point of care testing in Africa. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
18
|
Omuse G, Maina D, Mwangi J, Wambua C, Radia K, Kanyua A, Kagotho E, Hoffman M, Ojwang P, Premji Z, Ichihara K, Erasmus R. Complete blood count reference intervals from a healthy adult urban population in Kenya. PLoS One 2018; 13:e0198444. [PMID: 29879171 PMCID: PMC5991659 DOI: 10.1371/journal.pone.0198444] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/18/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There are racial, ethnic and geographical differences in complete blood count (CBC) reference intervals (RIs) and therefore it is necessary to establish RIs that are population specific. Several studies have been carried out in Africa to derive CBC RIs but many were not conducted with the rigor recommended for RI studies hence limiting the adoption and generalizability of the results. METHOD By use of a Beckman Coulter ACT 5 DIFF CP analyser, we measured CBC parameters in samples collected from 528 healthy black African volunteers in a largely urban population. The latent abnormal values exclusion (LAVE) method was used for secondary exclusion of individuals who may have had sub-clinical diseases. The RIs were derived by both parametric and non-parametric methods with and without LAVE for comparative purposes. RESULTS Haemoglobin (Hb) levels were lower while platelet counts were higher in females across the 4 age stratifications. The lower limits for Hb and red blood cell parameters significantly increased after applying the LAVE method which eliminated individuals with latent anemia and inflammation. We adopted RIs by parametric method because 90% confidence intervals of the RI limits were invariably narrower than those by the non-parametric method. The male and female RIs for Hb after applying the LAVE method were 14.5-18.7 g/dL and 12.0-16.5 g/dL respectively while the platelet count RIs were 133-356 and 152-443 x10(3) per μL respectively. CONCLUSION Consistent with other studies from Sub-Saharan Africa, Hb and neutrophil counts were lower than Caucasian values. Our finding of higher Hb and lower eosinophil counts compared to other studies conducted in rural Kenya most likely reflects the strict recruitment criteria and healthier reference population after secondary exclusion of individuals with possible sub-clinical diseases.
Collapse
Affiliation(s)
- Geoffrey Omuse
- Department of Pathology, Aga Khan University Hospital Nairobi, Nairobi, Kenya
- Division of Chemical Pathology, Department of Pathology, Stellenbosch University, Cape Town, South Africa
| | - Daniel Maina
- Department of Pathology, Aga Khan University Hospital Nairobi, Nairobi, Kenya
| | | | | | | | | | - Elizabeth Kagotho
- Department of Pathology, Aga Khan University Hospital Nairobi, Nairobi, Kenya
| | - Mariza Hoffman
- Division of Chemical Pathology, Department of Pathology, Stellenbosch University, Cape Town, South Africa
| | - Peter Ojwang
- Department of Pathology, Maseno University, Maseno, Kenya
| | - Zul Premji
- Formerly of Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Kiyoshi Ichihara
- Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Rajiv Erasmus
- Division of Chemical Pathology, Department of Pathology, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
19
|
Weale C, Davison G, Erasmus R, Kenge A, Matsha T. 5.10-P21Investigating the association between leucocyte telomere length and glucose intolerance in South Africa. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Weale
- Cape Peninsula University of Technology, South Africa
| | - G Davison
- Cape Peninsula University of Technology, South Africa
| | - R Erasmus
- Department of Pathology, Faculty of Medicine and Health Sciences, National Health Laboratory Service (NHLS) and Stellenbosch University, South Africa
| | - A Kenge
- NonCommunicable Diseases Research Unit, South African Medical Research Council, South Africa
- Department of Medicine, University of Cape Town, South Africa
| | - T Matsha
- Cape Peninsula University of Technology, South Africa
| |
Collapse
|
20
|
Motshwari D, Erasmus R, Zemlin A, Matsha T. 5.10-P2The effect of metabolic syndrome on the glycation gap in diabetic mixed ancestry population from South Africa. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Motshwari
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, National Health Laboratory Service (NHLS) and Stellenbosch University, South Africa
| | - R Erasmus
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, National Health Laboratory Service (NHLS) and Stellenbosch University, South Africa
| | - A Zemlin
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, National Health Laboratory Service (NHLS) and Stellenbosch University, South Africa
| | - T Matsha
- Department of Biomedical sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa
| |
Collapse
|
21
|
Mbu D, Hecotr S, Kengne A, Erasmus R, Matsha T. 5.10-P4Expression of circulating microRNA’s (miRNAs) in blood of mixed ancestry subjects in South Africa with glucose intolerance. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Mbu
- Cape Peninsula University Of Technology, South Africa
| | - S Hecotr
- Cape Peninsula University Of Technology, South Africa
| | - A Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, South Africa
| | - R Erasmus
- Department of Pathology, Faculty of Medicine and Health Sciences, National Health Laboratory Service (NHLS) and Stellenbosch University, South Africa
| | - T Matsha
- Cape Peninsula University Of Technology, South Africa
| |
Collapse
|
22
|
Davids S, Matsha T, Peer N, Erasmus R, Kengne A. 5.10-P3Time trend in absolute BP levels, prevalent hypertension and determinants in Mixed Ancestry South Africans. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Davids
- University of Cape Town, South Africa
- Department of Biomedical Sciences, Cape Peninsula University of Technology, South Africa
| | - T Matsha
- Department of Biomedical Sciences, Cape Peninsula University of Technology, South Africa
| | - N Peer
- University of Cape Town, South Africa
- Non Communicable Diseases Research Unit, South African Medical Research Council, South Africa
| | - R Erasmus
- Department of Chemical Pathology, National Health Laboratory Service (NHLS) and Stellenbosch University, South Africa
| | - A Kengne
- University of Cape Town, South Africa
- Non Communicable Diseases Research Unit, South African Medical Research Council, South Africa
| |
Collapse
|
23
|
Beebeejaun-Boodoo BMP, Erasmus R, Rademeyer M. Tetrahalometallate salts of N-(4-picolinium)-1,8-naphthalimide: structures and solid-state fluorescence. CrystEngComm 2018. [DOI: 10.1039/c8ce00292d] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The fluorescence behaviour and non-covalent aromatic- and hydrogen bonding interactions in a family of N-(4-picolinium)-1,8-naphthalimide tetrahalometallates are reported.
Collapse
Affiliation(s)
| | - R. Erasmus
- School of Physics
- University of the Witwatersrand
- Johannesburg
- South Africa
| | - M. Rademeyer
- Department of Chemistry
- University of Pretoria
- Pretoria
- South Africa
| |
Collapse
|
24
|
Omuse G, Maina D, Mwangi J, Wambua C, Kanyua A, Kagotho E, Amayo A, Ojwang P, Erasmus R. Comparison of equations for estimating glomerular filtration rate in screening for chronic kidney disease in asymptomatic black Africans: a cross sectional study. BMC Nephrol 2017; 18:369. [PMID: 29262800 PMCID: PMC5738877 DOI: 10.1186/s12882-017-0788-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 12/11/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Several equations have been developed to estimate glomerular filtration rate (eGFR). The common equations used were derived from populations predominantly comprised of Caucasians with chronic kidney disease (CKD). Some of the equations provide a correction factor for African-Americans due to their relatively increased muscle mass and this has been extrapolated to black Africans. Studies carried out in Africa in patients with CKD suggest that using this correction factor for the black African race may not be appropriate. However, these studies were not carried out in healthy individuals and as such the extrapolation of the findings to an asymptomatic black African population is questionable. We sought to compare the proportion of asymptomatic black Africans reported as having reduced eGFR using various eGFR equations. We further compared the association between known risk factors for CKD with eGFR determined using the different equations. METHODS We used participant and laboratory data collected as part of a global reference interval study conducted by the Committee of Reference Intervals and Decision Limits (C-RIDL) under the International Federation of Clinical Chemistry (IFCC). Serum creatinine values were used to calculate eGFR using the Cockcroft-Gault (CG), re-expressed 4 variable modified diet in renal disease (4v-MDRD), full age spectrum (FAS) and chronic kidney disease epidemiology collaboration equations (CKD-EPI). CKD classification based on eGFR was determined for every participant. RESULTS A total of 533 participants were included comprising 273 (51.2%) females. The 4v-MDRD equation without correction for race classified the least number of participants (61.7%) as having an eGFR equivalent to CKD stage G1 compared to 93.6% for CKD-EPI with correction for race. Only age had a statistically significant linear association with eGFR across all equations after performing multiple regression analysis. The multiple correlation coefficients for CKD risk factors were higher for CKD-EPI determined eGFRs. CONCLUSIONS This study found that eGFR determined using CKD-EPI equations better correlated with a prediction model that included risk factors for CKD and classified fewer asymptomatic black Africans as having a reduced eGFR compared to 4v-MDRD, FAS and CG corrected for body surface area.
Collapse
Affiliation(s)
- Geoffrey Omuse
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya
| | - Daniel Maina
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya
| | - Jane Mwangi
- PathCare Kenya Ltd., P.O. Box 12560-00606, Nairobi, Kenya
| | | | - Alice Kanyua
- Department of Pathology, Aga Khan Hospital, P.O. Box 2289, Dar es Salaam, Tanzania
| | - Elizabeth Kagotho
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya
| | - Angela Amayo
- Department of Human Pathology, University of Nairobi, P.O. Box 19676-00200, Nairobi, Kenya
| | - Peter Ojwang
- Department of Pathology, Maseno University, P.O. Box Private Bag, Maseno, Kenya
| | - Rajiv Erasmus
- Division of Chemical Pathology, Department of Pathology, Stellenbosch University, P.O. Box 19113, Tygerberg Hospital, Cape Town, South Africa
| |
Collapse
|
25
|
Omuse G, Maina D, Hoffman M, Mwangi J, Wambua C, Kagotho E, Amayo A, Ojwang P, Premji Z, Ichihara K, Erasmus R. Erratum to: Metabolic syndrome and its predictors in an urban population in Kenya: a cross sectional study. BMC Endocr Disord 2017; 17:43. [PMID: 28709425 PMCID: PMC5513051 DOI: 10.1186/s12902-017-0195-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 07/10/2017] [Indexed: 12/03/2022] Open
Affiliation(s)
- Geoffrey Omuse
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya.
| | - Daniel Maina
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya
| | - Mariza Hoffman
- Division of Chemical Pathology, Department of Pathology, Stellenbosch University, Tygerberg Hospital, P.O. Box 19113, Cape Town, South Africa
| | - Jane Mwangi
- PathCare Kenya Ltd, P.O. Box 12560-00606, Nairobi, Kenya
| | | | - Elizabeth Kagotho
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya
| | - Angela Amayo
- Department of Human Pathology, University of Nairobi, P.O. Box 19676-00200, Nairobi, Kenya
| | - Peter Ojwang
- Department of Pathology, Maseno University, P.O. Box Private Bag, Maseno, Kenya
| | - Zulfiqarali Premji
- Formerly of Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Kiyoshi Ichihara
- Graduate School of Medicine, Faculty of Health Sciences, Yamaguchi University, Minami-Kogushi 1-1-1, Ube, 755-8505, Japan
| | - Rajiv Erasmus
- Division of Chemical Pathology, Department of Pathology, Stellenbosch University, Tygerberg Hospital, P.O. Box 19113, Cape Town, South Africa
| |
Collapse
|
26
|
Omuse G, Maina D, Hoffman M, Mwangi J, Wambua C, Kagotho E, Amayo A, Ojwang P, Premji Z, Ichihara K, Erasmus R. Metabolic syndrome and its predictors in an urban population in Kenya: A cross sectional study. BMC Endocr Disord 2017; 17:37. [PMID: 28676116 PMCID: PMC5496352 DOI: 10.1186/s12902-017-0188-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 06/27/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The metabolic syndrome (MetS) is a clustering of interrelated risk factors which doubles the risk of cardio-vascular disease (CVD) in 5-10 years and increases the risk of type 2 diabetes 5 fold. The identification of modifiable CVD risk factors and predictors of MetS in an otherwise healthy population is necessary in order to identify individuals who may benefit from early interventions. We sought to determine the prevalence of MetS as defined by the harmonized criteria and its predictors in subjectively healthy black Africans from various urban centres in Kenya. METHOD We used data collected from healthy black Africans in Kenya as part of a global study on establishing reference intervals for common laboratory tests. We determined the prevalence of MetS and its components using the 2009 harmonized criterion. Receiver operator characteristic (ROC) curve analysis was used to determine the area under the curves (AUC) for various predictors of MetS. Youden index was used to determine optimum cut-offs for quantitative measurements such as waist circumference (WC). RESULTS A total of 528 participants were included in the analysis. The prevalence of MetS was 25.6% (95% CI: 22.0%-29.5%). Among the surrogate markers of visceral adiposity, lipid accumulation product was the best predictor of MetS with an AUC of 0.880 while triglyceride was the best predictor among the lipid parameters with an AUC of 0.816 for all participants. The optimal WC cut-off for diagnosing MetS was 94 cm and 86 cm respectively for males and females. CONCLUSIONS The prevalence of MetS was high for a healthy population highlighting the fact that one can be physically healthy but have metabolic derangements indicative of an increased CVD risk. This is likely to result in an increase in the cases of CVD and type 2 diabetes in Kenya if interventions are not put in place to reverse this trend. We have also demonstrated the inappropriateness of the WC cut-off of 80 cm for black African women in Kenya when defining MetS and recommend adoption of 86 cm.
Collapse
Affiliation(s)
- Geoffrey Omuse
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya
| | - Daniel Maina
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya
| | - Mariza Hoffman
- Division of Chemical Pathology, Department of Pathology, Stellenbosch University, P.O. Box 19113, Tygerberg Hospital, Cape Town, South Africa
| | - Jane Mwangi
- PathCare Kenya Ltd., P.O. Box 12560-00606, Nairobi, Kenya
| | | | - Elizabeth Kagotho
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya
| | - Angela Amayo
- Department of Human Pathology, University of Nairobi, P.O. Box 19676-00200, Nairobi, Kenya
| | - Peter Ojwang
- Department of Pathology, Maseno University, P.O. Box Private Bag, Maseno, Kenya
| | - Zulfiqarali Premji
- Formerly of Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Kiyoshi Ichihara
- Graduate School of Medicine, Faculty of Health Sciences, Yamaguchi University, Minami-Kogushi 1-1-1, Ube, 755-8505 Japan
| | - Rajiv Erasmus
- Division of Chemical Pathology, Department of Pathology, Stellenbosch University, P.O. Box 19113, Tygerberg Hospital, Cape Town, South Africa
| |
Collapse
|
27
|
Kengne A, Masconi K, Matsha T, Erasmus R. Recalibration in Validation Studies of Diabetes Risk Prediction Models: A Systematic Review. ACTA ACUST UNITED AC 2015. [DOI: 10.6000/1929-6029.2015.04.04.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
|
28
|
Essack Y, Hoffman M, Rensburg M, Van Wyk J, Meyer CS, Erasmus R. A comparison of five glucometers in South Africa. Journal of Endocrinology, Metabolism and Diabetes of South Africa 2014. [DOI: 10.1080/22201009.2009.10872202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
29
|
Tirimacco R, Koumantakis G, Erasmus R, Mosca A, Sandberg S, Watson ID, Goldsmith B, Gillery P. Glucose meters - fit for clinical purpose. Clin Chem Lab Med 2014; 51:943-52. [PMID: 23399591 DOI: 10.1515/cclm-2013-0011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 12/13/2012] [Indexed: 11/15/2022]
Abstract
Glucose meters have improved considerably since they were first introduced in 1960, but many questions are being asked about their accuracy and reliability in certain clinical situations. These questions have arisen because of the widespread use of these meters into clinical areas they have not been designed for such as critical care. The lack of understanding by some health professionals on factors that affect glucose results, such as sample type, glucose test strip methodologic limitations, calibration to recognized reference methods, and interferences, leads to misleading results that may affect patient care. Much debate continues on the quality specifications for glucose meters. Because there is an extensive use of these meters in different clinical scenarios, the setting of quality specifications will remain a challenge for regulatory and professional organizations. In this article, we have attempted to collect and provide relevant information addressing the limitations above. Pivotal to obtaining the best quality of results is education, particularly for diabetic patients monitoring their glucose. The International Federation of Clinical Chemistry and Laboratory Medicine through its Point-of-Care Testing Task Force and its Working Group on Glucose Point-of-Care Testing is actively working toward improving the quality of glucose results by improving education and working with the industry to improve strip performance and work toward the better standardization of strips.
Collapse
|
30
|
Billing DG, Black RS, Erasmus R. Structure and optical properties of natural low-dimensional semiconductors. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311090878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
31
|
Matsha T, Brink L, van Rensburg S, Hon D, Lombard C, Erasmus R. Traditional home-brewed beer consumption and iron status in patients with esophageal cancer and healthy control subjects from Transkei, South Africa. Nutr Cancer 2007; 56:67-73. [PMID: 17176219 DOI: 10.1207/s15327914nc5601_9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Consumption of home-brewed beer is associated with dietary iron excess and a high incidence of esophageal cancer in Transkei, South Africa. We examined the relationship between home-brewed beer consumption and body iron status in 234 patients with esophageal squamous cell carcinoma and 595 control subjects residing in Transkei. Subjects were screened for iron overload using transferrin saturation >45%, and/or serum ferritin >200 microg/l for women and >300 microg/l for men. A questionnaire was administered to all subjects, and iron content of randomly selected home-brewed beer samples was determined. The iron content of home-brewed beer was 258-fold higher than the commercial Castle Lager beer produced by South African Breweries. The prevalence of home-brewed beer consumption was 30.1% in esophageal cancer patients and 15.5% in control subjects and was found not to be a risk factor for esophageal cancer after adjustment for age, sex, and tobacco consumption (male subjects, odds ratio= 1.6 (95% confidence interval [CI]: 0.7-4.5); female subjects, odds ratio=1.7 (95% CI: 0.7-4.5). Iron overload as determined by transferrin saturation and elevated serum ferritin was observed in 4.3% of patients with esophageal cancer and 0.7% of control subjects and was not associated with the consumption of home-brewed beer. Consumption of home-brewed beer is not a risk factor for esophageal cancer and is not linked with iron overload in either cancer patients or control subjects; however, iron overload is likely to result from a combination of dietary intake and a genetic component.
Collapse
Affiliation(s)
- Tandi Matsha
- Department of Chemical Pathology, University of Stellenbosch Medical School, Tygerberg 7505, South Africa
| | | | | | | | | | | |
Collapse
|
32
|
van Rensburg SJ, van Zyl J, Hon D, Daniels W, Hendricks J, Potocnik F, Erasmus R. Biochemical model for inflammation of the brain: the effect of iron and transferrin on monocytes and lipid peroxidation. Metab Brain Dis 2004; 19:97-112. [PMID: 15214510 DOI: 10.1023/b:mebr.0000027421.33085.8b] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Cerebral inflammation plays a role in diseases such as multiple sclerosis (MS), Alzheimer's disease (AD), and depression. Iron is involved in infection and inflammation through free radical production. Theoretically transferrin should prohibit iron from participating in oxidative reactions, but transferrin has also been found to promote free radical damage. We reported previously that isolation of transferrin from plasma by ion exchange column chromatography produced a broad pink protein band that subsequently separated on a gel filtration column into three proteins containing many metals. In this study some properties of the three proteins were studied in 20 volunteers. Protein 3 (identified as transferrin by nephelometry) contained the most iron while Protein 1 (called "toxiferrin") contained significantly less iron (p < 0.00001). Plasma from volunteers obtained under conditions of infection/inflammation with fever (n = 5) had a significantly increased toxiferrin to transferrin ratio compared to healthy volunteers (n = 15; p < 0.001). In vitro, Protein 2 and transferrin inhibited lipid peroxidation, while toxiferrin (possibly a protease degradation product of transferrin), enhanced lipid peroxidation. Also, toxiferrin (1 mg/mL) caused a significant increase in viability of monocytes as measured by the 3-(4,5-dimethyl-thiazol-2-yl) 2,5-diphenyl tetrazolium bromide (MTT) reduction test, as well as the morphological transformation of monocytes to macrophages.
Collapse
Affiliation(s)
- Susan J van Rensburg
- Department of Chemical Pathology (National Health Laboratory Service), Tygerberg Hospital and Stellenbosch University, South Africa.
| | | | | | | | | | | | | |
Collapse
|
33
|
Abstract
AIM To study the prevalence and the different types of human papillomavirus (HPV) in patients with oesophageal cancer from a high risk area of South Africa (Transkei). METHODS DNA samples from 50 paraffin wax embedded tissue sections were analysed by nested polymerase chain reaction (PCR) using the degenerate HPV L1 consensus primer pairs MY09/MY11 and GP5+/GP6+. Positive PCR samples were subjected to DNA sequence analysis. RESULTS HPV DNA was detected in 23 of the 50 samples. Sequence analysis revealed that most patients (11) harboured DNA to HPV type 11, whereas other types included DNA HPV type 39 (seven patients), type 16 (two patients), and type 52 (one patient). HPV type 39 has not previously been shown to be associated with oesophageal cancer. In contrast to earlier studies that have found HPV type 16 to be more frequently associated with oesophageal cancer, HPV type 11 was the predominant subtype in this study. CONCLUSIONS The high frequency of occurrence of HPV in oesophageal tumours (23 of 50 patients; 46%) implicates HPV as one of the possible aetiological factors in this disease. The finding that the low risk HPV subtypes predominate indicates that transformation may be effected via the E6 and E7 proteins.
Collapse
Affiliation(s)
- T Matsha
- Department of Medical Biochemistry, Faculty of Health Sciences, University of Cape Town, Observatory, 7925 South Africa
| | | | | | | | | | | |
Collapse
|
34
|
Osotimehin B, Ojengbede O, Otolorin EO, Erasmus R, Ugbode C. Plasma renin activity and plasma aldosterone concentrations in normotensive pregnant Nigerians. Afr J Med Med Sci 1985; 14:193-8. [PMID: 3004180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Plasma renin activity (PRA) and plasma aldosterone concentrations were determined in thirty-four normotensive pregnant subjects, sixteen subjects who were examined 6 weeks post-partum and sixteen non-pregnant controls. Plasma renin activity and plasma aldosterone concentrations increased sequentially in pregnancy i.e. there were progressive significant increases when the values of the first, second and third trimesters were compared. The values for the post-partum subjects and the non-pregnant controls were not significantly different. There was no significant correlation between any pair of the following indices: mean arterial pressure (MAP), PRA and plasma aldosterone. The results are discussed in the light of the present state of knowledge of the pathogenesis of pregnancy-induced hypertension (PIH).
Collapse
|