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Automated hematology analyzers deliver accurate and reliable hemoglobin measurement but they are expensive to afford for most of the developing countries like Ethiopia. Point of care hemoglobin analyzer like HemoCue301+ has potential to alleviate such problems. The main aim of this study was to compare the hemoglobin concentration measured by HemoCue301+ with the Sysmex KX-21N method at University of Gondar Com-prehensive Specialized Hospital, Gondar, Ethiopia, 2020.A hospital based cross-sectional study with convenient sampling technique was employed from November to December 2020. Institutional ethics approval was obtained prior to sample utilization. A total of 147 specimens were analyzed by HemoCue301+ and Sysmex KX-21N hematology analyzer to compare the hemoglobin concentration measured by the two methods. Paired sample t-test and Bland-Altman plot were used to arrive at conclusions. SPSS version 20 and MedCalc software were used for analysis of the data.The paired sample t-test indicated the mean difference of the two measurements was 0.08299 with a standard deviation of 0.82332 and t-test: 1.222 at 146 degrees of freedom. There was no significant difference between the two measurements with a p-value of 0.224. The concordance correlation coefficient of the two methods was 0.956 (95% CI: 0.940 - 0.968, p0.0001). From the Bland-Altman plot, the limit of agreement was -1.50 - 1.70 g/dL with the mean difference of 0.08299 (95% CI: -0.05121 - 0.2172).There was no significant difference in the hemoglobin measurement by the HemoCue and Sysmex KX-21N (coef = -0.127, 95% CI: -0.379 - 0.634). The HemoCue301+ may be used interchangeably with Sysmex-KX-21N automated hematology analyzers.

Mekuanint Geta,1 Endalew Yizengaw,2 Zegeye Getaneh,3 Tamyalew Getahun4 1Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Departments of Microbiology, Immunology and Parasitology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 4Laboratory Department, Addis Alem Hospital, Bahir Dar, EthiopiaCorrespondence: Mekuanint GetaDepartment of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, PO Box 196, Gondar, EthiopiaEmail yageta23@gmail.comBackground: Hepatitis B virus (HBV) causes severe liver disease, such as hepatocellular carcinoma (HCC) and life-threatening liver disease. Hepatitis B virus infection is one of the most dominant public health problems these days. Therefore, this study aimed to determine the seroprevalence of HBV infection among patients attending Addis Alem Hospital, Bahir Dar, Northwest Ethiopia.Methods: A retrospective study was conducted from January to February 2019 on HBV registered from January 2016 to December 2018 for three years period. The presence of HBsAg in serum was detected using the One Step Cassette Style HBsAg test kit. Data were analyzed using SPSS version 20. Descriptive statistics were used to describe the characteristics of participants with HBV infection. Statistical association of the determinants with HBV infection was determined by the X2 test.Results: In this study, a total of 2010 participants of HBsAg rapid test records in the laboratory logbook were included. The median age of women was 25 years. The overall seroprevalence of HBsAg was 78 (3.9%). There was a general increment of HBV infection from 2016 to 2018, X2 =7.52; P=0.023. Age (X2 =8.19; P= 0.042) and sex (X2 =37.77; P < 0.001) were associated with HBsAg positivity.Conclusion and Recommendations: An intermediate seroprevalence of HBV infection was detected among participants in our study area. This figure raises significant public health concerns. Therefore, implementing strategies for routine screening of women for HBV and hospital attendants would be critical.Keywords: HBV, HBsAg, Addis Alem, Bahir Dar

Hussen Ebrahim,1 Fikir Asrie,2 Zegeye Getaneh2 1Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 2Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Hussen EbrahimDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie 1145, EthiopiaTel +251921332772Email husshosam@gmail.comBackground: Diabetes is a heterogeneous group of metabolic disorders characterized by hyperglycemia. The disease is highly associated with micro-vascularand macro-vascular complications. Thus, the main aim of this study was to compare basic coagulation profiles and platelet parameters among type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and healthy controls.Methods: A comparative cross-sectional study was conducted at Dessie Referral Hospital from February to April 2019. A total of 180 study participants consisting of (60 T1DM, 60 T2DM, and 60 healthy controls) were enrolled using a systematic random sampling technique. Basic coagulation profiles and platelet parameters were determined using the HUMACLOT JUNIOR coagulometer and DIRUI BF 6500 automated hematology analyzerrespectively. Non-parametric Kruskal–Wallis test supplemented with Dunn-Bonferroni correction and Spearman rank-order correlation test were used to compare basic coagulation profiles and platelet parameters among the groups. The test result was expressed in median and interquartile range and presented in texts and tables. P-value < 0.05 was considered to be statistically significant.Results: Prothrombin time (PT) and international normalization ratio (INR) were significantly reduced in T2DM as compared to T1DM and healthy controls (p < 0.05). Platelet distribution width (PDW) and mean platelet volume (MPV)were significantly increased in both T1DM and T2DM as compared to healthy controls (p < 0.05). Moreover, PT and INR were negatively correlated with fasting blood glucose (FBG) among T1DM and PT, INR and activated partial thromboplastin time (APTT) were negatively correlated with FBG among T2DM.Conclusion: Basic coagulation profiles and platelet parameters were significantly different between diabetes and controls where PT and INR in T2DM were significantly reduced as compared to T1DM and controls. However, PDW and MPV were significantly elevated in both T1DM and T2DM as compared to controls. Moreover,FBGwas significantly negatively correlated with PT and INR among T1DM and FBGwas significantly negatively correlated with PT, INR, and APTT among T2DM. Therefore, T2DM may be related to increased risk of thrombosis indicated by reduced PT and INR and high PDW and MPV than T1DM and controls. Basic coagulation profiles and platelet parameters should be regularly tested for early diagnosis and proper management of diabetes-related thrombosis.Keywords: diabetes mellitus, basic coagulation profiles, platelet parameters, Dessie, Ethiopia

Solomon Getawa, Zegeye Getaneh, Mulugeta Melku Department of Hematology and Immunohematology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaCorrespondence: Solomon GetawaDepartment of Hematology and Immunohematology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaTel +251-914-665-736Email solomon2525geta@gmail.comIntroduction: The hematopoietic system is one of the systems which can be affected by malnutrition, leading to impaired production of all blood cell lines. Undernourished children with hematological abnormalities like anemia are at higher risk of mortality. Therefore, this study aimed at determining the magnitude and associated factors of hematological abnormalities among undernourished under-five children attending at the University of Gondar Specialized Referral Hospital, Northwest Ethiopia.Methods and Materials: An institution-based cross-sectional study was conducted on a total of 251 undernourished under-five children at University of Gondar Specialized Referral Hospital from January to May 2020. A convenient sampling technique was employed to select study participants. Data were collected using a pretested structured questionnaire. Blood samples were collected for complete blood count which were determined by Sysmex KX-21N analyzer. Stool sample was processed via direct wet mount. Thin and thick blood films were examined to assess malaria parasite. The data were entered to EpiData version 4.6.0.0 and analyzed using SPSS version 23 software. Bi-variable and multi-variable binary logistic regression model were fitted to identify factors associated with hematological abnormalities. A p-value < 0.05 in the multivariable analysis was considered as statistically significant.Results: The overall magnitude of anemia, leukocytosis, thrombocytosis, thrombocytopenia, and leukopenia was 53.4%, 26.7%, 23.9%, 8%, and 2.8%, respectively. Being male, age 6– 23 months, high birth order, intestinal parasite infection, edema, not eating vegetables and fruits, and paternal occupation were found to be associated with anemia. Only the age of a child was associated with leukocytosis in undernourished children.Conclusion: The current study demonstrated the predominant existence of anemia, leukocytosis, and thrombocytosis among undernourished under-five children. Therefore, early diagnosis, monitoring and setting intervention strategies for anemia especially among children under two years old are required to prevent further complication.Keywords: anemia, leukocytosis, thrombocytosis, leukopenia, thrombocytopenia, children, undernutrition, Ethiopia

Background Diabetes mellitus (DM) patients show a significant derangement in various hematological parameters including changes affecting the red blood cells (RBCs). All these derangements have an imposing effect on any of the RBC indices. Thus, the main aim of this study was determining the RBCs parameters and their correlation with renal function, and also the magnitude of anemia in DM patients in comparison with healthy controls. Methods A comparative cross-sectional study was conducted at the chronic illness clinic of University of Gondar Hospital from January to April 2020. A total of 246 participants (164 DM and 82 controls) were selected using a simple random sampling technique. Data were collected using a pretested structured questionnaire. Five milliliters venous blood was collected by vacutainer blood collection technique. RBC parameters and renal function tests were determined by using Sysmex KX21N and BS-200E Mindray analyzers, respectively. The data were tested for normality using Shapiro-Wilk and Kolmogorov-Smirnov tests. Independent sample t-test and Pearson's and Spearman correlation statistics were used to analyze variables. A p-value ˂0.05 was considered as statistically significant. Results The mean hemoglobin (Hgb) concentration was 13.8±0.7 and 15±1.3 among DM and controls, respectively. RBC (p=0.014), Hgb (p ˂0.001), hematocrit (Hct) (p ˂0.001), and mean cell volume (MCV) (p ˂0.001) were significantly lower in DM patients as compared to controls. On the other hand, mean cell hemoglobin concentration (MCHC) was significantly increased in DM patients (p ˂0.001) than the controls. Besides, a significant negative correlation was found between Hgb and creatinine (Cr) in DM patients. Conclusion The mean values of RBC parameters (RBC, Hgb, Hct, and MCV) for DM patients were found significantly lower than the control groups. Besides a significant negative correlation was found between Cr and RBC indices (RBC, Hgb, Hct, and MCV) in DM patients. It is, therefore, suggested that RBC parameters abnormalities should be evaluated and treated periodically in DM patients for better prognosis and quality of life.

Thrombocytopenia is a common hematological disorder during pregnancy next to anemia. Pregnant women with thrombocytopenia have complications of excessive bleeding during or after childbirth, cesarean section incision site oozing, stillbirth and neonatal thrombocytopenia. Findings on the magnitude of thrombocytopenia among pregnant women were inconsistent. Therefore, this review aimed to estimate the pooled prevalence of thrombocytopenia among pregnant women in Africa. This systematic review and meta-analysis were performed based on PRISMA guidelines. The databases (PubMed, PubMed Central, Hinari, Science Direct, Pop line, Google Scholar, and African Journals Online) were searched to identify relevant studies. Data were analyzed using STATA 11 statistical software. A random-effect model was fitted to estimate the pooled prevalence of thrombocytopenia. I2test statistics were done to test the heterogeneity of included studies. Funnel plots analysis and Egger weighted regression tests were done to detect publication bias. Of the total 1,517 articles retrieved, 15 articles which involved 8,380 pregnant women were eligible for meta-analysis. The overall pooled prevalence of thrombocytopenia among pregnant women in Africa was 10.23% (95% confidence interval (CI): 7.44, 13.02%). Its level of severity showed that, 77.95% (I2=43.1%), 15.62% (I2=53.4%), and 5.60 (I2=0.0%) of pregnant women had mild, moderate and severe thrombocytopenia, respectively. The highest prevalence of thrombocytopenia was occurred in the third trimester of pregnancy (54.05% (95% CI: 29.48, 78.61)). This systematic review and meta-analysis showed that the pooled prevalence of thrombocytopenia among pregnant women in Africa was found to be relatively higher compared with the globe. Therefore, routine screening and follow-up programs are needed to identify pregnant women with thrombocytopenia and provide them with the necessary interventions.

Preeclampsia (PE) is a pregnancy-related illness characterized by high blood pressure (BP) and proteinuria after the 20th gestational week (GW). Platelet (PLT) parameter changes are the common hematological abnormalities observed in PE patients. The main aim of this study was to assess the role of PLT parameters for PE diagnosis among pregnant women.A comparative cross-sectional study was conducted at the University of Gondar Specialized Hospital. A total of 126 pregnant women (63 normotensive [NT] and 63 PE) were recruited using a convenient sampling method. Three milliliter blood was collected from each participant, and PLT parameters were determined using Sysmex XS-500i analyzer. An independent t-test supplemented with receiver-operating characteristics (ROC) were used for comparisons and diagnostic value of PLT parameters between the study groups.Platelet count (PC) was significantly lower in the PE group compared to that in the NT group, whereas mean platelet volume (MPV), platelet large cell ratio (P-LCR), and platelet distribution width (PDW) were significantly higher in PE. MPV had the largest area under the curve (AUC) [0.91: 95% CI; 0.85-0.96] followed by PC [0.79: 95% CI; 0.72-0.87]. MPV can differentiate PE patients from NT pregnant women at cut-off value ≥12.10 fl (84.1% sensitivity and 87.3% specificity) while PC can indicate PE at a cut-off value ≤176.5 × 10A decreased PC and an increased MPV, P-LCR, and PDW can be used as a simple, cost-effective, quick, and reliable method of PE screening. Of them, MPV is the best indicator of PE.

Lymphoma is one of the hematologic malignancies that occur at a higher rate in human immunodeficiency virus-infected individuals. It is one of the most frequent neoplastic causes of death in those individuals. Non-Hodgkin's lymphoma and Hodgkin's lymphomas are acquired immunodeficiency syndrome defining lymphoma and non-acquired immunodeficiency syndrome defining lymphoma, respectively. Non-Hodgkin's lymphoma is the most common type of lymphoma in human immunodeficiency virus-positive people. The lymphoma that develops in patients infected with the human immunodeficiency virus/acquired immunodeficiency syndrome is heterogeneous in terms of morphology, pathogenesis pathways, and cellular derivation. A narrative review was conducted on the basis of relevant literature on the current topic to summarize the current epidemiology, pathogenesis, laboratory diagnosis, and treatment of lymphoma in human immunodeficiency virus-infected patients. The finding showed that although the incidence of non-Hodgkin's lymphoma has decreased after the advent of highly active antiretroviral therapy, it has remained higher in human immunodeficiency virus-infected people than in the general population. On the other hand, the incidence of Hodgkin's lymphoma has increased after the introduction of highly active antiretroviral therapy. Therefore, it is recommended that people living with human immunodeficiency virus/ acquired immunodeficiency syndrome be screened for the development of lymphoma to increase their survival time and quality of life, and further research is required regarding the pathogenesis, treatment, and laboratory diagnosis of human immunodeficiency virus/ acquired immunodeficiency syndrome-associated lymphoma.

Background Preeclampsia (PE) is a pregnancy-specific disorder characterized by endothelial dysfunction, and activation of the coagulation system. Alteration of PLT parameters is the common hematological abnormality observed in women with PE. The main aim of this study was to systematically review previous studies from around the world to generate evidence about the relationship between platelet count (PC) and PE, as well as mean platelet volume (MPV) and PE, by calculating the pooled weighted mean difference (WMD) of PC and MPV between PE and normotensive (NT) groups. Methods Relevant articles which were published in the English language from January 10, 2011, to January 10, 2021, were systematically searched through PubMed, Web of Science, and African journals online. In addition, reference probing of published articles searching was employed through Google Scholar and Google for searching grey literature. The methodological qualities of articles were assessed using Joana Brigg’s institute critical appraisal checklist. A random-effects model was used to estimate pooled WMD of PLT parameters between the two groups with the respective 95% confidence intervals (CI) using Stata version 11.0. The I2 statistics and Egger’s regression test were used to assess heterogeneity and publication bias among included studies, respectively. Results A total of 25 articles were included in this systematic review and meta-analysis. Of which, 23 studies were used in each PC and MPV analysis. The overall pooled WMD of PC and MPV between PE and NT groups were -41.45 × 109/L [95% CI; -51.8, -31.0] and 0.98 fl [95% CI; 0.8, 1.1], respectively. The pooled WMD revealed that PC decreased significantly in the PE group compared to the NT group while MPV increased significantly in the PE group. Conclusions This systematic review and meta-analysis indicated that there is a significant decrease in PC and a significant increase in MPV during PE development among pregnant women. As a result, a change in these parameters among pregnant women may indicate the development of PE.

Background Currently, studies showed that eosinophil count had clinical significance in the diagnosis and prognosis of diseases. But, the clinical significance of eosinophil count in pregnancy specifically in preeclampsia (PE) is not well studied. The main objective of the present study was to assess the diagnosis value of eosinophils counts among pregnant women with PE. Methods A comparative cross-sectional study was conducted on a total of 126 pregnant women at the University of Gondar Comprehensive Specialized Hospital, using a convenient sampling technique. Socio-demographic and clinical data were collected by questionnaire and datasheet from patient’s charts, respectively. A total of six ml of blood was collected from each study participant; three ml for complete cell count analysis using Sysmex XS-500i hematology analyzer and three ml for liver function tests using Humastar 200 chemistry analyzer. The data were entered into Epi-data and exported to SPSS 20 for analysis. The independent t-test was used for normally distributed data and, the Mann–Whitney U test was used for non-normally distributed data. Binary logistic regression and receiver operative curve analyses were also done to assess the diagnosis value of eosinophils count. P-value Results The eosinophils count of PE pregnant women were significantly lower than the normotensive (NT) pregnant women (median (IQR): 50 (10—200) vs. 120 (60 – 270); (p = 0.002). The eosinophil count ≤ 55 cells/µL had an AUC of 0.66 (95% CI; 0.56—0.75) for diagnosis of PE with a sensitivity of 50.8%, specificity of 77.8%, and positive and negative predictive value of 69.6% and 61.3%, respectively. The abnormal AST and ALT results were significantly higher among PE pregnant women compared to NT pregnant women (AOR: 14.86; 95% CI: 4.97—44.4 and Fischer exact test p-value = 0.001, respectively). Conclusion The eosinophil count ≤ 55cells/µl had a reasonable/acceptable AUC which may use in the diagnosis of PE. AST and ALT were also significantly higher in PE pregnant women compared to NT pregnant women. Multicenter longitudinal studies with a large sample size are recommended to verify the role of eosinophil count in the diagnosis of PE.

Background Altered level of many hematological parameters such as white blood cells (WBC) and platelet function has been observed in diabetes mellitus (DM) patients. Therefore, this study aimed to determine the WBC and platelet profiles and their association with anthropometric measurement and blood pressure in DM patients and healthy controls. Method A comparative cross‐sectional study was conducted on a total of 246 participants at the University of Gondar Specialized Referral Hospital. Venous blood with K2 EDTA anticoagulant was drawn and analyzed by using Sysmex KX21N hematology analyzers for WBC and platelet parameters. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results were presented as frequency and mean ± standard deviation (SD). The independent sample t test was used to compare quantitative variables between DM and control groups. The bivariate (spearman's rank) correlation was used to analyze continuous variables. A p‐value ˂ 0.05 was considered as statistically significant. Results The mean platelet count was significantly higher among diabetics (252.77 ± 77.7) compared to non‐diabetic controls (208.22 ± 68), p, The mean platelet count was significantly higher among diabetics (252.77 ± 77.7) compared to non‐diabetic controls (208.22 ± 68), p

Background Tuberculosis is a major public health problem caused by Mycobacterium tuberculosis, occurring predominantly in population with low socioeconomic status. It is the second most common cause of death from infectious diseases. Tuberculosis becomes a double burden among anemic patients. Anemia increases an individual’s susceptibility to infectious diseases including tuberculosis by reducing the immunity level. Therefore, the purpose of this study was to determine whether anemia is a risk factor for tuberculosis. Method Relevant published articles were searched in electronic databases like PubMed, Google Scholar, EMBASE, and Cochrane Library using the following MeSH terms: risk factor, predictors, tuberculosis, TB, Anaemia, Anemia, hemoglobin, Hgb, and Hb. Articles written in the English, observational studies conducted on the incidence/prevalence of tuberculosis among anemic patients, or papers examined anemia as risk factors for tuberculosis were included. From those studies meeting eligibility criteria, the first author’s name, publication year, study area, sample size and age of participants, study design, and effect measure of anemia for tuberculosis were extracted. The data were entered using Microsoft Excel and exported to Stata version 11 for analysis. The random-effects model was applied to estimate the pooled OR and HR, and 95% CI. The sources of heterogeneity were tested by Cochrane I-squared statistics. The publication bias was assessed using Egger’s test statistics. Results A total of 17 articles with a 215,294 study participants were included in the analysis. The odd of tuberculosis among anemic patients was 3.56 (95% CI 2.53–5.01) times higher than non-anemic patients. The cohort studies showed that the HR of tuberculosis was 2.01 (95% CI 1.70–2.37) times higher among anemic patients than non-anemic patients. The hazard of tuberculosis also increased with anemia severity (HR 1.37 (95% CI 0.92–2.05), 2.08 (95% CI 1.14–3.79), and 2.66 (95% CI 1.71–4.13) for mild, moderate, and severe anemia, respectively). Conclusion According to the current systematic review and meta-analysis, we can conclude that anemia was a risk factor for tuberculosis. Therefore, anemia screening, early diagnose, and treatment should be provoked in the community to reduce the burden of tuberculosis.

Background Anemia is the most common hematologic abnormalities in AIDS patients usually associated with disease progression and poor clinical outcomes. Zidovudine (AZT), which is one of the nucleoside reverse transcriptase inhibitor drug families of the first line antiretroviral therapy regimen for HIV/AIDS patients, causes anemia due to early long-term of higher-dose therapy. This study was aimed to assess the magnitude and associated factors of anemia among AZT containing HAART experienced adult HIV/ADIS patients at University of Gondar Comprehensive Specialized Referral Hospital, northwest, Ethiopia, 2019. Methods A retrospective cohort study was conducted among a total of 320 adult AZT based HAART experienced HIV/AIDS patients from January 2016 to December 2018. Systematic random sampling technique was used to select the patients’ charts. All required data for this study were extracted from patients’ medical charts. Data were coded, cleared and entered into Epi Info version 3.5.3, and transformed to SPSS version 20 for analysis. Descriptive statistics, bivariable and multivariable logistic regression models were fitted to identify associated factors of anemia and P-value Results A total of 320 adult AZT based HAART experienced HIV/AIDS patients’ charts were assessed. Of the total patients, 198 (61.9%) were females and 133 (41.6%) were within the age range of 35–45 years. More than half, 237(76.9%) of the patients were from the urban area and 186 (58.1%) were on WHO clinical stage III at the baseline. The prevalence of anemia was 50% (95% CI 44.7–55.0%), 44.1% (95% CI 38.4–50.0%), 35.6% (95% CI 30.3–40.6%), 40% (95% CI 34.4–45.6%), 40.6% (95% CI 35.0–46.3) and 39.1% (95% CI 33.4–44.1%) at baseline, 6 months, 12 months, 18 months, 24 months and 30 months of follow-up period, respectively. The overall prevalence of anemia was 41.6%. Anemia had significant association with WHO clinical stage and base line Hgb values. Conclusions A significant number of participants were anemic in this study. WHO clinical stage and baseline Hgb value were the contributing factors for anemia among these patients. Therefore, anemia needs an immediate intervention on associated factor to improve the anemic status and living condition of HIV patient.

Background Anemia is one of the global public health problems that affect more than one third of the world population. It has been strongly associated with poor growth and development, limited psychomotor development, and poor long-term performance in cognitive, social, and emotional functioning in children. There is not a single national figure about childhood anemia in Ethiopia. There is also inconclusive evidence about factors associated with anemia. Moreover, the present meta-analysis will generate concrete evidence in which the result may urge policy makers and program managers to design appropriate intervention to control childhood anemia. Thus, the aim of this review is to estimate the pooled prevalence and to identify associated factors of anemia among children in Ethiopia. Method Published relevant cross-sectional studies will be searched using comprehensive search strings through PubMed/Medline, SCOPUS, HINARI, EMBASE, Web of Science databases. In addition, Google Scholar and Google will be searched for grey literature. Reference lists and communication with content experts will be used to get additional relevant studies. Two groups of review authors will independently appraise the studies for scientific quality and extract the data using the Joanna Briggs Institute (JBI) tools. The pooled estimate will be determined using random effect model. Heterogeneity between the studies will be assessed using the I2 statistics. Sensitivity and subgroup analysis will be employed in the case of heterogeneity. Publication bias will be assessed by visual inspection of the funnel plot, and using Egger’s and Begg’s statistical tests. Discussion Childhood anemia is known to have negative consequences on mental, physical and social development of children. The burden and its associated factors are greatly varied as to the social, economic, and geographical differences of the target population. Therefore, the proposed systematic review will generate evidence about the pooled prevalence of anemia and its associated factors among children in Ethiopia. Protocol registration The protocol was registered at PROSPERO International Prospective Register of Systematic Reviews. (Registration number: CRD42018088223).

Objective: The purpose of this study was comparing the erythrocyte sedimentation rate (ESR) results of trisodium citrate (TSC) and ethylene diamine tetra-acetic acid (EDTA) anticoagulants. A comparative cross-sectional study was conducted at the University of Gondar specialized referral hospital, northwest, Ethiopia. A total of 70 TB presumptive participants were recruited. From each of the 70 participants of the study, 3 and 1.6 ml of blood was collected in EDTA tubes and 0.4 ml of trisodium Citrate anticoagulant containing test tubes, respectively. Results: The mean ± SD values of ESR were 57.9 ± 41.45 mm/hr in EDTA and 50.99 ± 43.5 mm/hr in TSC anticoagulated blood. The mean difference of ESR values between EDTA and TSC blood (6.91 ± 13.66 mm/hr) was statistically significant. The Mean ± SD of ESR values using EDTA and TSC in males were 59.57 ± 42.31 and 53.57 ± 44.61 mm/hr while for females it was 54.71±40.44 and 46.04 ± 41.82 mm/hr, respectively. The study indicated that there was a significant difference between ESR values with EDTA and tri-sodium citrate anticoagulants. Keywords: Erythrocyte sedimentation rate, EDTA, Tri-sodium citrate, Westergren Method, Comparison

Background Hematological changes are the most common complications occurred in malaria pathology. Anemia, thrombocytopenia, and mild-to-moderate atypical lymphocytosis are the main hematological changes occurred in malaria infection. Therefore, this study aimed to compare hematological profiles of malaria-infected adult patients in the Raya Alamata Hospital, Northeast Ethiopia from February 1, 2019, to April 30, 2019. Methods The hospital-based comparative cross-sectional study was done to compare the hematological profiles of a total of 238 study participants, consisting of 119 malaria-infected patients as cases and 119 malaria negatives as controls. Malaria diagnosis was done by thick and thin blood film microscopy. We determined the hematological parameters using an automated DiRUi BCC/3000B hematology analyzer. Data for the different hematological parameters were expressed as mean (± SD). A binary logistic regression model was constructed for categorical dependent variables to see the associations with predictors. Results In this study, the mean values of red blood cell count, hemoglobin, mean corpuscular volume, platelet count, and eosinophil count were significantly lower in the cases than the controls. The prevalence of anemia and thrombocytopenia in malaria patients were 39.5% and 56.3%, respectively. Being female, and having high malaria parasitemia were found significantly associated with thrombocytopenia. The odds of developing thrombocytopenia was 8.4-fold higher in malaria patients with high malaria parasitemia. Conclusions Anemia and thrombocytopenia were the common hematological abnormalities observed in malaria patients. Therefore, malaria patients should be assessed for the presence of such hematological abnormalities and need to be managed timely.

Additional file 1: Table S1. Paired Samples t-test of the ESR values of the study participant using EDA and TSC whole blood.

Additional file 2: Figure S1. Comparison of the ESR values from the EDTA and TSC whole blood using manual Westergren method by regression analysis (r = 0.949, P = 0.001).

Objective: The purpose of this study was comparison of erythrocyte sedimentation rate results of sodium citrate and ethylene diamine tetra-acetic acid anticoagulant. A comparative cross-sectional study was conducted at University of Gondar Referral Hospital, Northwest, Ethiopia. A total of 70 TB suspected study participants were recruited. From each study participants, 3ml blood was collected in to EDTA tube and 1.6ml blood was collected in to a test tube containing 0.4ml Sodium Citrate anticoagulant. Results: The mean ± SD values for ESR were 57.9 ± 41.45 in EDTA and 50.99 ± 43.5 in citrate anticoagulated blood. The mean difference of ESR values between EDTA and citrated blood was 6.91 ± 13.66 mm/hr with a significant difference. The mean ± SD of ESR for EDTA and citrate blood was 59.57 ± 42.31 and 54.71 ± 40.44 mm/hr for males and 53.57 ± 44.61 and 46.04 ± 41.82 mm/hr for females, respectively. This study indicated that there was a significant difference between ESR values with EDTA and tri-sodium citrate anticoagulants.

Background: Hematological changes are the most common complications encountered in malaria and they play a major role in malaria pathology. Hematological changes like red blood cells, platelets and leukocytes have been observed in patients with malaria. Therefore, this study aimed to compare hematological parameters of malaria infected adult patients in Alamata Hospital, Northeast Ethiopia from February 01- April 30, 2019. Methods: Comparative cross sectional study was used to compare the hematological parameters on a total of 238 study participants, consisting of 119 malaria infected patients and 119 malaria negative controls at Raya Alamata Hospital. Malaria diagnosis was done based on thick and thin blood films microscopy. Hematological parameters were determined by using an automated, DiRUi BCC/3000B hematology analyzer. Malaria parasite density was determined by counting the asexual parasites against 200 WBCs, and then calculated by using the standard formula. Data for the different hematological parameters were expressed as mean (±SD). Independent t-test was used for comparison the hematological parameters between the two groups. Binary logistic regression model was constructed for categorical dependent variables to see associations between predictors and outcomes. Results: In current study parameters like red blood cells count, hemoglobin, mean corpuscular volume, platelets count, and eosinophil counts were significantly lowered in malaria-infected patients than the controls. The prevalence of anemia and thrombocytopenia in malaria patients was 39.5% and 56.3%, respectively. Being female and malaria parasitaemia were found significantly associated with thrombocytopenia. The odds of developing thrombocytopenia with high malaria parasitaemia were 8.4 times more likely develop thrombocytopenia.Conclusion: Anemia and thrombocytopenia were the two common hematological abnormalities seen in malaria patients. The platelet count during malaria infection was inversely correlated with the parasitaemia. Malaria patients should be checked for the presence of hematological abnormalities such as anemia and have to be managed for those abnormalities. Keywords: Malaria, Malaria parasitaemia, Hematological parameters, Ethiopia

Objective: The main aim of this study was comparison of erythrocyte sedimentation rate results of sodium citrate and ethylene diamine tetra-acetic acid anticoagulant. A comparative cross-sectional study was conducted at University of Gondar Referral Hospital, Northwest, Ethiopia. A total of 70 TB suspected study participants were recruited. From each study participants, 3ml blood was collected in to EDTA tube and 1.6ml blood was collected in to a test tube containing 0.4ml Sodium Citrate anticoagulant. Results: The mean ± SD values for ESR were 57.9 ± 41.45 in EDTA and 50.99 ± 43.5 in citrate anticoagulated blood. The mean difference of ESR values between EDTA and citrated blood was 6.91 ± 13.66 mm/hr with a significant difference. The mean ± SD of ESR for EDTA and citrate blood was 59.57 ± 42.31 and 54.71 ± 40.44 mm/hr for males and 53.57 ± 44.61 and 46.04 ± 41.82 mm/hr for females, respectively. This study indicated that there was a significant difference between ESR values with EDTA and tri-sodium citrate anticoagulants.

B-cell non-Hodgkin’s lymphomas are tumors of B-cells that arise following clonal expansion and consequent invasion of immune organs by B-cells blocked at a certain step of the differentiation process. Genetic abnormalities with altered gene expression are common in the transformed state of B-cells at any stage of B-cell development. These stages are regulated by a combination of transcription factors, epigenetic modifications, microRNAs, and extrinsic signals. MicroRNAs are a class of short non-coding single-stranded RNAs implicated in the regulation of mRNA function and translation. Each microRNA can regulate multiple transcripts; and a transcript is under potential control by multiple microRNAs. Their dysregulation can contribute to the pathogenesis of B-cell non-Hodgkin lymphomas, and they could be used as a potential target for diagnosis, evaluation of prognosis and therapy monitoring. The mechanisms of microRNA dysregulation range from dysregulation of the DNA sequences encoding the microRNAs to transcriptional regulation of microRNA loci. In this review, we summarized the microRNA profiles of the most common B-cell Non-Hodgkin Lymphomas for the pathogenesis, diagnosis and their potential therapeutic implications.

Questionnaire. (DOC 218 kb)

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Objective. We aimed at assessing the basic coagulation parameters of HIV-infected adults at the University of Gondar Hospital antiretroviral therapy clinic. Methods. A comparative cross-sectional study was conducted from February to May 2017. A total of 300 study participants, consisting of 100 HAART-naïve HIV-infected adults, 100 HIV-infected adults who were taking HAART, and 100 HIV-seronegative apparently healthy adults, were included. Basic coagulation functional assays such as PT, APTT, and INR were determined by coagulation analyzer. CD4 cells and platelet count were analyzed by FACS count and SYSMEX K-21N automated analyzer, respectively. The data were entered, cleaned, and edited using Epi Info version 7 and analyzed using SPSS version 20. Kruskal-Wallis H, Dunn-Bonferroni pairwise comparison test, and Spearman’s rank-order correlation analysis were used for inferential statistics. The results were expressed by a median and presented in tables. P value < 0.05 was considered as statistically significant. Results. PT, APTT, and INR were significantly higher, whereas platelet count was significantly lower in HIV-infected adults (both who were taking HAART and HAART-naïve) than HIV-seronegative adults (P<0.001). PT and INR were significantly higher, and platelet count was significantly lower in HAART-naïve HIV-infected adults than HIV-infected adults who were taking HAART. In Spearman’s rank-order correlation analysis, APTT has shown a significant negative correlation with a CD4 count in HAART-naïve HIV-infected adults. Conclusion. HIV-infected adults are more likely to develop coagulation abnormality than HIV-seronegative subjects. Coagulation parameters need to be checked regularly to monitor coagulation disorders in HIV-infected adults.

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Figure S2. Eggerâ s Plot. A Plot of Eggerâ s test of publication bias for pooled estimate of anemia among children in Ethiopia. Eggerâ s test is a statistical method to test the presence of small-study effect or publication bias on the pooled estimate. (DOC 26 kb)

Objective. This study is aimed at assessing the magnitude and its associated factors of anemia in geriatric population visiting outpatient department at the University of Gondar referral hospital, northwest Ethiopia.Method. A cross-sectional study was conducted among elder patients in Gondar town, North Gondar District, in May 2013. A total of 200 randomly selected geriatric population participated in the study. Summary statistics were computed and presented in tables and figure. Both bivariate and multivariable binary logistic regression were fitted to identify associated factors. APvalue < 0.05 was considered as statistically significant.Result. The median age of the study participants was 65 years (Interquartile range (IQR): 8 years). The prevalence of anemia in the geriatric patients was 54.5% (n=109), of which 61.5% (n=67) were males. Mild type anemia was predominant, 55.96% (n=61). Geriatric patients with an elevated erythrocyte sedimentation rate (AOR = 9.04, 95% CI: 4.2–19.7) and who are vegetarians (AOR = 2.2, 95% CI: 1.03–4.71) were at high risk of developing anemia.Conclusion. The magnitude of anemia was high in geriatrics. Mild anemia was the predominant type. Vegetarians and geriatrics with elevated erythrocyte sedimentation rate were more likely to develop anemia. Hence, early diagnosis and management of anemia have paramount importance to prevent adverse outcomes in geriatrics.

Figure S1. Funnel Plot. The Funnel plot showing the pooled estimate of anemia among children in Ethiopia. This is a visual method to see small-study effect or publication bias. (DOC 26 kb)

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Background Anemia is a global public health problem affecting 305 million school children (SC) worldwide. It has deleterious effects in SC, including lower school achievement due to impaired cognitive development and physical growth, fatigue and poor attention span, and increased morbidity because of reduced resistance to infection. Hence, the aim of this study was to assess the prevalence and associated factors of anemia among SC attending public primary schools in Gondar town, northwest Ethiopia. Methods A school-based cross sectional study was conducted on a total of 523 SC aged from 6–14 years old. Multi-stage sampling followed by systematic random sampling techniques were employed to select study participants. Data on socio-demographic and socio-economic characteristics, and dietary status of children were collected using pre-tested structured questionnaire through face-to-face interview of children’s caregivers. Anthropometric measurements were taken. Hemoglobin (Hb) concentration was determined by using HemoCue 301+analyser. Stool and blood samples were collected in the school premises, and examined for intestinal and hemoparasites, respectively. Data were entered into Epi Info version 3.5.3 and transferred to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression models were fitted to identify associated factors of anemia. P-value < 0.05 was considered as statistically significant. Result Of the total SC participated in the study, 269 (51.4%) were males. The median (inter quartile range (IQR)) age was 12 (10–13) years, and 332 (63.5%) of them were in the age group 11–14 years. About 81 (15.5%; 95%CI: 12.4%, 18.7%) of them were anemic: 56 (69.1%) and 25 (38.9%) of them were mildly and moderately anemic, respectively. Low maternal education (AOR = 2.30; 95%CI: 1.11, 4.78), stunting (AOR = 2.22; 95%CI: 1.30, 3.80), severe food insecurity (AOR = 5.11; 95%CI: 1.53, 17.13), and soil-transmitted helminthic (STH) infection (AOR = 7.13; 95%CI: 3.16, 16.86) were found significantly associated with anemia. Conclusion Anemia among SC was found to be a mild public health problem. It was strongly associated with low maternal education, food insecurity, stunting and intestinal helminthic infection. Focused policies and strategies towards the above factors should be designed to reduce anemia among SC.

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Fikir Asrie,Bamlaku Enawgaw,Zegeye Getaneh Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Introduction: Thrombocytopenia is a common hematologic abnormality during pregnancy. Pregnant women with thrombocytopenia have a higher risk of bleeding excessively during or after childbirth, particularly if they need to have a cesarean section or other surgical intervention during pregnancy, labor or in the puerperium. The main aim of this study was to determine the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Hospital, northwest Ethiopia.Materials and methods: A cross-sectional study was used to assess the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Hospital from January to April 2015. A total of 217 pregnant women were included in the study and a structured pretested questionnaire was used to obtain sociodemographic information, nutritional factors, obstetrics and gynecological factors, history and clinical condition. Blood samples were collected for platelet count and other platelet parameters, which were determined by using SysmexKX 21 automation. The data were entered to Epi info version 6 software and analyzed using SPSS version 20 software. Bivariable and multivariable statistical analyses were used to evaluate the effect of independent variable over the dependent variable. A p-value of