Frequency of hemophilia and hemostatic evaluation in persons with bleeding symptoms in Southeast, Nigeria

Abstract

Background: A significant number of people living with hemophilia and other bleeding disorders are reported to be either underdiagnosed or untreated in most developing countries. Objectives: To evaluate the frequency of hemophilia and some hemostatic parameters in persons with bleeding symptoms in Southeast Nigeria. Materials and Methods: This was a cross-sectional, hospital-based pilot study of 50 persons consecutively recruited with bleeding symptoms from four tertiary hospitals in Southeast Nigeria. Full blood count was carried out using Mythic 22 semiautomated analyzer, (Orphee, Geneva, Switzerland). Prothrombin time (PT) and activated partial thromboplastin time (APTT) mixing studies and one-stage factor assays were carried out using tube tilt technique. Bleeding score was assessed using the International Society on Thrombosis and Haemostasis bleeding assessment tool. Data were analyzed using the Graphpad Prisim, version 6.0, San Diego. Results: Only 2% of the subjects had hemophilia A, whereas 68% of the subjects had thrombocytopenic bleeding. Most (32.4%) had bleeding score of four. Analysis of variance of these variables showed a significant relationship with P < 0.0001. Post hoc analysis showed significant P values for platelet count versus bleeding score (P = 0.000, 95% confidence interval [CI]: 95.74–126.4) and APTT versus bleeding score (P = 0.000, 95% CI: 44.34–74.98). Conclusion: Bleeding assessment tools are important in evaluating persons with bleeding symptoms and it may be necessary to screen for hemophilia in these cases. Larger multicenter epidemiological studies are needed to determine the prevalence of hemophilia and other bleeding disorders in our environment.