Tuesday, December 13, 2011

Dr. Tundun Williams - Weeks 2 and 3 in Ogbomoso, Nigeria

The literature states that the prevalence of G6PD deficiency in Africa is anywhere between 15-30%.



Risk factors for hemolysis include use of mentholated products in the first six months of life, illness, certain drugs (e.g., Primaquine, sulfa drugs, Quinine) and fava beans (the jury is still out with regards to whether Nigerians eat fava beans).



We screened children at schools, churches and small villages. The screen included asking simple screening questions and collecting blood samples from children under the age of 16 years old. Samples were processed back at the hospital lab.



By the end of the third week, we had exceeded our goal of screening 1,000 children.



Initial analysis of our data shows a prevalence of 10-19%; differences in prevalence appeared to be related to ethnic group.



Parents of deficient children will soon be sent notification letters telling them what to avoid and how to recognize symptoms of hemolysis. Lab personnel have been taught how to do the simple G6PD screening test. We hope they will continue to screen children long after we leave.



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The Baptist seminary elementary school, one of the first sites we visited to perform G6PD screens.



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Ajinapa village; more children to screen for G6PD



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Adodo village. These boys were insistent on striking fighting poses.



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Ilota village school



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Our host, Dr. Daniel Gbadero, speaks to children at Ayegun Baptist Church.



TundunWithSamuelAtBaptistMedicalCenterStaffSchool.jpg

At Baptist Medical Center Staff School. This is Samuel, looking very sharp in his school uniform (the bowtie is optional, and as you can see, is worn by only those young men with discerning taste). You wouldn't know it from this picture, but Samuel is a giggler. He was particularly amused when I asked him if he had ever had tea-colored urine.



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When the generator was not running, the power supply was unpredictable. Here, Troy Lund and I are running hematocrits on a battery-operated Hemocue machine by lantern light.



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We used the fluorescent screening method for G6PD deficiency. Patients who have adequate G6PD activity produce NADPH, which fluoresces under long wave UV light. The spots that do not fluoresce represent patients that are G6PD deficient.



Ogbomoso, a town of just over 1 million inhabitants, is located in Oyo State (in Yoruba-land), about 150 miles north of Lagos.



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Photo courtesy Google Maps and Wiki Commons



Like all other Yoruba towns, there is a story behind the origins of Ogbomoso. It is said that a mighty warrior named Elemoso once habitually terrorized the inhabitants of present day Ogbomoso.



The people got fed up with being pillaged and decided to send a warrior of their own to defend their city.



This warrior fought with and beheaded Elemoso.



The alaafin (king) of Oyo heard of this feat and was impressed. He dubbed the warrior "Ogbori Elemoso" (he who beheaded Elemoso) and crowned him soun (regional king) of his hometown.



Over the years, the name of the town, originally Ilu Ogbori Elemoso (the place of origin of Ogbori Elemoso), has contracted to just Ogbomoso.



We chose Ogbomoso as the site for the G6PD deficiency study because of Tina (Slusher)'s long-standing ties with the Baptist Medical Centre, where we have guaranteed access to a lab.




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