Advances in Hematology

Gebrerufael, Gebru Gebremeskel;Hagos, Bsrat Tesfay

doi: 10.1155/2023/2900483pmid: 38178972

<i>Background</i>. In Sub-Saharan African (SSA) nations, including Ethiopia, anemia is a significant public health issue. Ethiopia has continued to bear the enormous burden of anemia infections. Over time, the prevalence of anemia has significantly increased in Ethiopia. In addition, there is a paucity of literature and regional variations in the pace of increment expansion. Therefore, the primary goal of this study was to evaluate the prevalence of anemia and risk factors among women in Ethiopia’s two most anemic regions. <i>Methods</i>. 2,519 women participated in a community-based cross-sectional study from January 18 to June 27, 2016. In order to determine the causes of anemia in women in two of Ethiopia’s most anemic regions, an ordinal logistic regression model was taken into consideration. The applicability of the proportional odds test was evaluated using the chi-square test of the parallelism assumption. A <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-3.42943pt" id="M1" height="10.2124pt" version="1.1" viewBox="-0.0498162 -6.78297 7.83752 10.2124" width="7.83752pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z"/></g></svg> value of 0.05 or below was used to define crucial and statistically significant predictor variables. <i>Results</i>. The overall prevalence rate of anemia was 56.8% (95% CI (54.8%–58.7%)). The chi-square test of the parallelism assumption indicated that the odds ratios were constant across all cut-off points of women’s anemia levels at a 5% significance level (<svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-3.42943pt" id="M2" height="10.2124pt" version="1.1" viewBox="-0.0498162 -6.78297 7.83752 10.2124" width="7.83752pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-113"/></g></svg> value = 0.122). Of the severity of anemia levels among women, 48.2, 46.1, and 5.7% had mild, moderate, and severe anemia levels, respectively. In multivariable ordinal logistic regression analyses, being born (lived) in the Somali region (AOR = 1.6, 95% CI: 1.37, 1.90), having a parity of 4–5 (AOR = 1.3, 95% CI: 1.05, 1.66), and having ≥6 children (AOR = 1.4, 95% CI: 1.1, 1.7), being a contraceptive user (AOR = 3, 95% CI: 2.5, 3.6), being currently pregnant (AOR = 2.8, 95% CI: 2.3, 3.4), having no ANC follow-up (AOR = 1.9, 95% CI: 1.6, 2.3), being married women (AOR = 1.4, 95% CI: 1.1, 1.9), and user of unimproved toilet facility (AOR = 1.3, 95% CI: 1.1, 1.6) were significantly positively associated with anemia. <i>Conclusions</i>. Finally, the anemia burden was dangerously greater than the national average. The region, usage of contraceptives, being pregnant at the time, ANC follow-up, toilet facilities, parity, and marital status all had a substantial impact on anemia. Therefore, to lessen the prevalence of anemia in certain parts of Ethiopia, public health initiatives that improve maternal health service utilization are required, such as ANC follow-up to minimize parity.

Sakamoto, Takamitsu;Mizuta, Hiroyuki;Niiro, Naohisa;Amagai, Teruyoshi

doi: 10.1155/2023/5549655pmid: 38116392

<i>Background</i>. Tokunoshima is a remote island in the Amami Islands, 470&#x2009;km southwest of the Kagoshima mainland. It has a population of 23,000 and consists of three towns: Tokunoshima, Isen, and Amagi. Three medical institutions on the island are responsible for blood transfusion medicine, but there is no blood stockpiling station on the island, and blood is stockpiled in each of the hospitals. Although Tokunoshima Tokushukai Hospital is responsible for 70&#x0025; of transfusion medicine on Tokunoshima, it is difficult to maintain a sufficient amount of blood in stock considering disposal. <i>Aim</i>. To determine whether changing the distribution of blood types in a hospital&#x2019;s stockpile would reduce the transfusion disposal rate. <i>Methods</i>. This was a retrospective survey. By changing the in-house stock of blood products for transfusions delivered to our hospital over 10&#x2009;years from January 2013 to December 2017 (preintervention) and from January 2018 to December 2022 (postintervention), we compared the cost-saving effects of these two intervention strategies on disposal rates and blood inventories, as well as the survival rates of case profiles requiring transfusion interventions in hospital-donated transfusion and ABO-incompatible transfusion between two periods. The hospital's stock of RBC had changes that storage of type (A, B, O, AB) RBC from (4, 4, 4, 2) units in the pre-interventon to (2, 2, 6, 0) units in the postintervention. <i>Results</i>. The annual blood product waste rate decreased from 23.4&#x0025; in the preintervention period to 17.9&#x0025; in the post-intervention period. <i>Conclusion</i>. By changing the blood products stockpiled for transfusion medicine in Tokunoshima, the transfusion disposal rate can be reduced.

Kovalenko, Iuliia;Saleem, Tabinda;Shah, Mitali;Seyedroudbari, Sara;Golubykh, Konstantin;Ali, Rimsha;Mirza, Taaha;Laek, Babray;Wahab, Ahsan;Chattaraj, Asmi;Proskuriakova, Ekaterina;Garg, Chandi;Khan, Rafiullah

doi: 10.1155/2023/9949961pmid: 38094101

<i>Background</i>. Graft-versus-host disease (GVHD) is a potentially fatal complication of allogeneic hematopoietic stem cell transplant. The mainstay of treatment is corticosteroids, which are ineffective in 30&#x2013;50&#x0025; of cases. Steroid-refractory GVHD (SR-GVHD) confers a poor prognosis, with high mortality rates despite appropriate therapy. While there is no reliable treatment for SR-GVHD, a variety of novel therapeutic options are slowly emerging and have yet to be examined simultaneously. <i>Objectives</i>. This review evaluates the potential of novel therapeutic options, as well as their efficacy and safety, for the treatment of SR-GVHD. <i>Study Design</i>. The literature search was conducted in PubMed, Cochrane, and Embase, employing MeSH terms and keywords. The studies had to be prospective phases 1, 2, or 3. We excluded retrospective and nonoriginal studies. <i>Results</i>. While the only approved drug for acute GVHD is ruxolitinib with an impressive overall response rate of 73.2&#x0025; and a complete response of 56.3&#x0025;, several monoclonal antibodies and other agents are currently under investigation, offering promising results. These include anti-CD2, anti-CD147, IL-2 antagonist, a mixture of anti-CD3 and anti-CD7 antibodies, anti-CD25, monoclonal antibody to a4b7 on T-cells, anti-CD26, pentostatin, sirolimus, denileukin diftitox, infliximab, itacitinib, and alpha-1 antitripsin. However, the toxicities associated with these novel drugs need further investigation. For chronic GVHD, approved options include ruxolitinib with an ORR of up to 62&#x0025;, ibrutinib with an ORR of up to 77&#x0025;, and belumosudil with an ORR of up to 77&#x0025;. Meanwhile, emerging treatments include tyrosine kinase inhibitors such as nilotinib, rituximab, and low-dose IL-2, as well as axatilimab and pomalidomide. <i>Conclusion</i>. While their efficacy needs to be better evaluated through large-scale, multicenter, randomized clinical trials, these novel agents show potential and could provide a better alternative for SR-GVHD treatment in the future.