Browsing by Author "Ajayi, Seun"

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    Comparing HemoCue® and Quantitative Buffy Coat® and Coulter Counter‑measured haemoglobin concentrations in African children with acute uncomplicated malaria: a Bland–Altman analysis
    (BMC, 2025) Ayuen, S. Dhol; Olupot‑Olupot, Peter; Muhindo, Rita; Onyamboko, A. Marie; Ajayi, Seun; Chimjinda, Natenapa; Taya, Chiraporn; Uyoga, Sophie; Williams, N. Thomas; Maitland, Kathryn; Fanello, Caterina; Day, P. J. Nicholas; Taylor, R. Walter; Mukaka, Mavuto
    Background: Anaemia is a deleterious consequence of malaria, and its accurate diagnosis is crucial for effective management. However, laboratory methods for measuring haemoglobin (Hb) concentration, like the Coulter Counter and the Quantitative Buffy Coat® (QBC®), are costly and not widely accessible in resource-limited settings. The pointof-care HemoCue® test is a cheaper alternative and suitable in rural areas. The study aimed to determine the level of agreement between Coulter Counter/QBC® vs. HemoCue®-measured Hb concentrations by Bland–Altman analysis. Methods: As part of a randomized, placebo-controlled trial of single low-dose primaquine in Ugandan and Congolese children with acute uncomplicated Plasmodium falciparum malaria, Hb concentrations were measured on days 0, 3, 7, and 28 using Coulter Counter (Uganda, n=1880 paired values), QBC® (DR Congo, n=1984 paired values) and HemoCue® Hb-301™. The predefined clinically acceptable limits were set at±0.5 g/dL. Results: The Bland–Altman analysis showed that the HemoCue® minus Coulter Counter mean Hb difference was − 0.15 g/dL with lower and upper limits of agreement of − 3.68 g/dL and 3.39 g/dL, respectively. Corresponding HemoCue® minus QBC® values were − 0.23 g/dL, − 1.66 g/dL and 1.22 g/dL. Linear regression of Hb concentration differences vs. mean Hb concentrations showed negative correlations: r=− 0.43 and r=− 0.34 for HemoCue® vs. Coulter Counter and HemoCue® vs. QBC®, respectively. Conclusions: Compared to Coulter and QBC®, mean HemoCue® measured Hb concentrations were lower and, compared to the Coulter or QBC® methods, had an overall tendency to measure lower Hb concentrations with increasing Hb concentrations. Upper and lower limits of agreement were wider than the predefined clinically acceptable limits of±0.5 g/dL. HemoCue® should be used with caution in settings where decisions about blood transfusions are made. Keywords Bland–Altman analysis, Haemoglobin, Anaemia, Malaria, HemoCue, Coulter Counter, QBC®
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    Plasma folate dynamics in Plasmodium falciparum-infected African children treated with artemisinin combination therapy and single low-dose primaquine or placebo
    (BMC, 2025) Ajayi, Seun; Onyamboko, A. Marie; Olupot-Olupot, Peter; Ayuen, S Dhol; Chimjinda, Natenapa; Taya, Chiraporn; Williams, N Thomas; Uyoga, Sophie; Maitland, Kathryn; Fanello, Caterina; Day, P J Nicholas; Mukaka, Mavuto; Taylor, R J Walter
    Background: Adding single low-dose (0.25 mg/kg) primaquine (SLDPQ) to block Plasmodium falciparum transmission is now a WHO recommendation. Whether SLDPQ increases haemolysis in glucose-6-phosphate dehydrogenase deficient (G6PDd) patients, leading to increased folate demand and impaired haemoglobin (Hb) recovery is unknown. This study sought to answer this question. Methods: This randomized, placebo-controlled trial measured serial plasma folate concentrations [Day (D) 0, 3, 7 and 28] in falciparum-infected Ugandan and Congolese children (6 months to 11 years), treated with age-dosed SLDPQ/placebo and artemether-lumefantrine/dihydroartemisinin-piperaquine. Genotyping defined G6PD (G6PD c.202T allele) status. Multiple linear and non-linear, mixed effects, cubic spline regression were fitted to identify factors significantly associated with plasma folate at baseline and over time, respectively. Results: 408 children (3 had missing D0 values) had ≥ 1 plasma folate value. Of these, 66 (16.2%) were G6PD-deficient, 51 (12.5%) heterozygous females, 283 normal and 8 unknown. Mean baseline folate concentrations were 10.83 [standard deviation (SD) 3.58, SLDPQ] vs 10.92 (SD 4.54, placebo) ng/ml, associated independently with baseline Hb [estimate: 0.52 ng/ml (95% CI: 0.26 to 0.79, p = 0.0001)] and baseline parasitaemia [estimate: - 0.18 ng/ml (- 0.32 to - 0.05, p = 0.007)]. For all patients, mean plasma folate concentration paralleled mean haemoglobin concentration with an initial mean fall of 1.65 ng/ml (p < 0.0001 vs. baseline), followed by a sustained rise achieving a mean D28 concentration of 11.04 (SD 4.45) ng/ml. Over time, only age (p = 0.0001), male sex (p = 0.017) and baseline parasitaemia (p = 0.029) were significantly associated with a reduced plasma folate. Conclusion: SLDPQ and G6PD status did not compromise posttreatment plasma folate concentrations in young children with acute uncomplicated falciparum malaria, providing additional evidence of SLDPQ safety and supporting its use without G6PD testing. Trial registration: The trial is registered, reference number ISRCTN11594437. Keywords: Folate; Glucose-6-phosphate dehydrogenase; Malaria; Single low-dose primaquine