African Journal of Laboratory Medicine最新文献

{"title":"Alarming resistance to third-generation cephalosporins and carbapenems among <i>Enterobacterales</i> colonising pregnant women and neonates in eastern DRC.","authors":"Théophile Mitima Kashosi, Antonella Minutolo, Carlotta Fiorilla, Marialaura Fanelli, Daniella Ashuza Kagayo, Jean-Baptiste Kajiramugabi, Alfred Cubaka Kabagale, Sandro Grelli, Francesca Pica, Vittorio Colizzi","doi":"10.4102/ajlm.v15i1.2995","DOIUrl":"https://doi.org/10.4102/ajlm.v15i1.2995","url":null,"abstract":"<p><strong>Background: </strong>Extended-spectrum cephalosporin-resistant <i>Enterobacterales</i> (ESCR-E) and carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) pose a growing threat to maternal and neonatal health, particularly in low-resource settings. In eastern Democratic Republic of the Congo (DRC), data on antimicrobial resistance in these populations are scarce.</p><p><strong>Objective: </strong>To determine resistance profiles of ESCR-E and CRE among pregnant women, postpartum mothers, and their newborns in South Kivu, eastern DRC.</p><p><strong>Methods: </strong>A cross-sectional multicentre study was conducted from April 2023 to October 2024 in urban and rural health facilities. Rectal swabs or stool samples were collected. Bacterial identification was performed using conventional biochemical galleries, and antimicrobial susceptibility testing was performed by the standard disk diffusion (Kirby-Bauer) method.</p><p><strong>Results: </strong>High rates of ESCR-E and CRE colonisation were found across all groups. Over 90% of ESCR-E isolates were resistant to third-generation cephalosporins and showed multidrug resistance, including to aminoglycosides and fluoroquinolones. Carbapenem-resistant <i>Enterobacteriaceae</i> isolates were resistant to penicillin and cephalosporins but remained susceptible to ceftazidime-tazobactam. These resistance profiles severely limit treatment options in maternal and neonatal care.</p><p><strong>Conclusion: </strong>The high prevalence of multidrug-resistant ESCR-E and CRE in mothers and newborns highlights an urgent need for improved antimicrobial stewardship, resistance surveillance, and infection prevention strategies. The potential use of probiotics to restore gut microbiota and reduce colonisation should also be explored.</p><p><strong>What this study adds: </strong>This study provides the first comprehensive data on ESCR-E and CRE colonisation in mothers and newborns in eastern DRC, revealing alarming multidrug resistance patterns and highlighting the urgent need for targeted stewardship, surveillance, and Infection Prevention and Control strategies in maternal and neonatal care settings.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"2995"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired clinical, biological, and cytokine patterns in HIV-1 exposed uninfected newborns in Yaoundé: A comparative study of neonatal immune vulnerability.","authors":"Sabine A Touangnou-Chamda, Palmer M Netongo, Jacky Njiki Bikoï, Véronique S Mboua Batoum, Donatien S Mbaga, Carole S Sake, Marie-Christine M Nzuno, Chris M Nana Mbianda, Maurice Boda, Sara H Riwom Essama","doi":"10.4102/ajlm.v15i1.3035","DOIUrl":"10.4102/ajlm.v15i1.3035","url":null,"abstract":"<p><strong>Background: </strong>Immune dysregulation is hypothesised to underpin the heightened susceptibility of HIV-1-exposed uninfected (HEU) infants to morbidity and mortality, which occurs at a rate three times higher than that of HIV-1-unexposed uninfected (HUU) controls. However, robust evidence substantiating this hypothesis and advocating targeted interventions remains scarce in Cameroon.</p><p><strong>Objective: </strong>To examine how maternal HIV-1 infection influences the immune response of HEU neonates in Yaoundé.</p><p><strong>Methods: </strong>A comparative cross-sectional study was conducted in 280 mother-child pairs at birth in Yaoundé. Clinical parameters were assessed, while umbilical cord blood samples from both HEU and HUU newborns were analysed for comprehensive immunophenotyping and quantification of 12 pro-inflammatory and anti-inflammatory cytokines.</p><p><strong>Results: </strong>Significant differences were observed between HEU (representing 100% of exposed newborns tested) and HUU newborns. Notably, 1/54 (1.85%) of HEU newborns exhibited a lower Appearance, Pulse, Grimace, Activity, Respiration score at 1 min (<i>p</i> = 0.01); HEU expressed severe leucocytosis (<i>p</i> = 0.008) and neutropaenia (<i>p</i> = 0.01). As well, dysregulated cytokine production was observed, with significantly elevated levels of pro-inflammatory cytokines Interleukin-6 (IL-6) (<i>p</i> = 0.003) and Interleukin-1 beta (IL-1β) (<i>p</i> = 0.004), as well as decreased levels of anti-inflammatory cytokine Transforming Growth Factor beta 1 (<i>p</i> = 0.024). Strong negative correlations were further demonstrated between monocytes and pro-inflammatory cytokines IL-1β (<i>r</i> = -0.74), Interleukin-5 (<i>r</i> = -0.75), and IL-6 (<i>r</i> = -0.75), (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Maternal HIV-1 infection is associated with impaired outcomes in HEU newborns, highlighted by immune dysregulation in an early pro-inflammatory environment. These findings underscore the heightened vulnerability of HEU neonates and elucidates the underlying factors contributing to their subsequent health challenges.</p><p><strong>What this study adds: </strong>It provides initial information on pertinent but not yet described pro-inflammatory cytokines impairment in Cameroonian HEU newborns. Unlike previous research that has focused on their KIR-21 gene expression and responsiveness to measles vaccine, this study introduces their immunological responses through their umbilical cord blood analysis, a previously unexamined specimen.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3035"},"PeriodicalIF":1.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing laboratory quality management systems in Ghana: A quality audit of accreditation readiness in clinical and public health laboratories (2021-2023).","authors":"Emma E Kploanyi, David W Dowdy, Joseph Kenu, Benjamin Buade, Benedicta Owusu-Arthur, David A Opare, Franklin Asiedu-Bekoe, Alfred E Yawson, Ernest Kenu, Lee F Schroeder","doi":"10.4102/ajlm.v15i1.3049","DOIUrl":"10.4102/ajlm.v15i1.3049","url":null,"abstract":"<p><strong>Background: </strong>The Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA) checklist has demonstrated improvement in laboratory quality in Africa. In Ghana, however, implementation has targeted mainly higher-tier clinical laboratories. A balanced approach across the laboratory network is needed to strengthen national laboratory quality.</p><p><strong>Objective: </strong>To evaluate the quality management performance and accreditation readiness of clinical and public health laboratories (PHLs) in Ghana.</p><p><strong>Methods: </strong>Using a modified SLIPTA checklist, we audited randomly selected clinical and PHLs from districts in the three ecological zones from February 2021 to November 2023. Analyses employed Wilcoxon rank-sum tests, Kruskal-Wallis tests, and quantile regression to assess associations between laboratory characteristics and SLIPTA scores.</p><p><strong>Results: </strong>Forty-five health facilities and four PHLs were audited: 80% of facilities were in the public sector. Laboratories performed a median of 24 (Interquartile range [IQR]: 10-70) tests daily. The median SLIPTA score was 50% (IQR: 35% - 58%), with hospitals recording the highest scores [median, IQR: 58% (51% - 61%)]. Of the 12 SLIPTA quality systems essentials, laboratories performed highest in organisation and personnel. In multivariable regression, facility location in the Northern zone (adjusted coefficient = -23, 95%CI = -38 to -8; <i>p</i> < 0.001) was negatively associated with SLIPTA scores compared to the Southern zone.</p><p><strong>Conclusion: </strong>More hospitals and PHLs had achieved a minimum one-star rating towards International Organization for Standardization accreditation readiness during the quality audit. Persistent gaps in client management, internal audits, and corrective actions require targeted training and mentoring to support effective implementation of improvement initiatives.</p><p><strong>What this study adds: </strong>This study provides the first nationwide quality audit of a representative sample of clinical laboratories and PHLs in Ghana with a balanced representation of health facilities in the tiered laboratory network, underscoring the need for a more inclusive, sustainable approach to laboratory quality improvement across the tiered network of the country.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3049"},"PeriodicalIF":1.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Additional sex combs-like 1</i> variants in an acute myeloid leukaemia and a general elderly cohort in central South Africa.","authors":"Melissa V Bergman, Jean F Kloppers, Phillip A Bester, Anne-Cecilia van Marle","doi":"10.4102/ajlm.v15i1.3061","DOIUrl":"10.4102/ajlm.v15i1.3061","url":null,"abstract":"<p><strong>Background: </strong>In patients with acute myeloid leukaemia (AML), pathogenic variants in the <i>additional sex combs-like 1</i> (<i>ASXL1</i>) gene confer poor prognosis and are frequently involved in clonal haematopoiesis of indeterminate potential, with increasing prevalence with advancing age.</p><p><strong>Objective: </strong>We determined the prevalence of <i>ASXL1</i> variants in an AML cohort and general elderly population in central South Africa.</p><p><strong>Methods: </strong>The study included 40 participants with de novo AML and 100 elderly participants (≥ 65 years). Polymerase chain reactions and Oxford nanopore sequencing of <i>ASXL1</i> exon 12 were performed on all samples between 01 October 2023 and 30 September 2024.</p><p><strong>Results: </strong>Of the 40 AML participants, 25 (62.5%) were women, with a median age of 42 years. <i>ASXL1</i> mutations were detected in 5%. In total, 248 <i>ASXL1</i> variants were detected in 68 of the 100 elderly participants aged 65-88 years (mean 71 years). Variants in the coding regions included synonymous (58.4%) and missense (41.6%) variants. Benign variants were detected in 29% of the elderly participants, while variants of uncertain significance were present in 2%, each with a variant allele frequency of ≥ 20%. No pathogenic or likely pathogenic variants were identified.</p><p><strong>Conclusion: </strong>The prevalence of <i>ASXL1</i> exon 12 variants in our AML cohort was consistent with international data. Variants in the elderly population were very prevalent; however, with no actionable variants capable of driving clonal expansion, clonal haematopoiesis of indeterminate potential was not detected. The variants of uncertain significance at allele frequencies of ≥ 2% likely suggest a clonal haematopoietic process.</p><p><strong>What this study adds: </strong>Routine <i>ASXL1</i> testing in all AML patients is not recommended in our resource-limited setting. Testing should be individualised according to its potential clinical impact, using high-throughput sequencing with clinically relevant variant classification.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3061"},"PeriodicalIF":1.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review on genomic insights into antimicrobial resistance in ESKAPE pathogens.","authors":"Husna F Ibrahim, Nasiru Abdullahi, Ibrahim Yusuf, Bashir I Waziri, Ahmad Abdulhadi, Khadija Muhammad, Maryam M Ibrahim, Aisha A Abdullahi, Muhammad A Abbas, Hamisu M Salihu","doi":"10.4102/ajlm.v15i1.2893","DOIUrl":"10.4102/ajlm.v15i1.2893","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) is a major global public health threat. ESKAPE pathogens <i>(Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa</i>, and <i>Enterobacter</i> spp.) pose a major threat owing to resistance to last-line antibiotics. Genomic surveillance is crucial to understanding global and regional antimicrobial resistance genes (ARGs) in AMR transmission.</p><p><strong>Aim: </strong>This systematic review synthesised global genomic evidence to identify global and region-specific ARGs distribution among ESKAPE pathogens.</p><p><strong>Methods: </strong>Following PRISMA guidelines, studies published January 2019 to December 2024 were identified from PubMed, Google Scholar, and Web of Science. Eligible studies reported genomic characteristics and resistance patterns of one or more ESKAPE pathogens from any source.</p><p><strong>Results: </strong>Seventy-seven studies were included, with most originating from Asia, followed by Europe and Africa. Clinical isolates predominated <i>K. pneumoniae</i> was the most frequently investigated pathogen, followed by <i>S. aureus, P. aeruginosa</i>, and <i>A. baumannii</i>. The most reported resistance genes were <i>bla</i>CTX-M, <i>bla</i>NDM, and <i>bla</i>SHV. Distinct regional patterns of antimicrobial resistance gene (ARG) distribution were observed, with tetracycline and quinolone resistance genes prevailing in Africa and South America, and <i>bla</i>OXA variants dominating in Asia and Europe. Region-specific ARG patterns were identified through descriptive synthesis and comparative analysis of study-reported frequencies.</p><p><strong>Conclusion: </strong>This review provides a synthesised global map of ARG distribution in ESKAPE pathogens, highlighting surveillance gaps in underrepresented regions and non-clinical settings. Addressing these gaps will support targeted genomic surveillance and stewardship programmes.</p><p><strong>What this study adds: </strong>This study contributes to the body of knowledge by mapping global and regional antimicrobial resistance gene patterns in ESKAPE pathogens, identifying key surveillance gaps and informing targeted AMR monitoring and stewardship strategies.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"2893"},"PeriodicalIF":1.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential expression of cyclin D1 in pituitary neuroendocrine tumours: Relation to aggressive potential.","authors":"Kasiemobi E Uchime, Nicholas A Awolola, Charles C Anunobi, Olufemi B Bankole, Adekunbiola A Banjo, Sung-Hye Park","doi":"10.4102/ajlm.v15i1.3077","DOIUrl":"10.4102/ajlm.v15i1.3077","url":null,"abstract":"<p><strong>Background: </strong>In Nigeria, patients with pituitary neuroendocrine tumours (PitNETs) commonly present late with complications. Early identification of aggressive PitNETs could improve outcomes.</p><p><strong>Objective: </strong>This study aimed to determine frequency and degree of cyclin D1 expression in PitNETs and compare levels in aggressive versus non-aggressive tumours and normal pituitary.</p><p><strong>Methods: </strong>Retrospective case-control study (2010-2019) using two tissue microarrays from mitotically active hotspots on paraffin blocks: 70 histologically diagnosed PitNETs and 29 normal pituitary controls. Immunohistochemistry was performed for Ki-67, cyclin D1, anterior pituitary transcription factors, CK MNF116, and hormones. Aggressive PitNETs were classified per 2022 WHO criteria (mitotic rate > 2/10 HPF, Ki-67 ≥ 3% or radiological invasion).</p><p><strong>Results: </strong>Fourteen (20%) PitNETs were classified as aggressive (8 invasive, 6 proliferative). Median age in the aggressive group was 36.5 years with equal gender distribution. The commonest aggressive subtype was PIT-1 lineage lactotroph PitNET (5/14, 35.7%). Moderate-strong nuclear cyclin D1 expression (IRS ≥ 5) occurred in 85.7% of aggressive PitNETs versus 67.9% of non-aggressive tumours and 0% of controls (<i>p</i> < 0.01). Positive predictive value of cyclin D1 for aggressiveness among PitNETs was 24% (12/50 positive cases).</p><p><strong>Conclusion: </strong>Cyclin D1 is significantly overexpressed in aggressive PitNETs compared with non-aggressive tumours and normal pituitary, suggesting its potential as a biomarker for early detection, risk stratification, and therapeutic targeting, especially in resource-limited settings.</p><p><strong>What the study adds: </strong>This study demonstrates marked cyclin D1 overexpression in aggressive PitNETs, supporting its use as a biomarker for early detection, more precise risk stratification, and as a potential therapeutic target in resource-limited environments.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3077"},"PeriodicalIF":1.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the utility of storage solutions to preserve nucleic acid integrity at ambient temperature in South Africa.","authors":"Timothy Moshoma, Maemu P Gededzha, Nakampe Mampeule, Elizabeth Mayne","doi":"10.4102/ajlm.v15i1.2915","DOIUrl":"10.4102/ajlm.v15i1.2915","url":null,"abstract":"<p><strong>Background: </strong>Maintaining nucleic acid integrity during transport and storage is important for downstream diagnostic and research applications. Innovative solutions are needed to reduce the requirement for costly cryopreservation in low- and middle-income countries.</p><p><strong>Objective: </strong>To assess the feasibility of nucleic acid storage at a range of temperatures using commercially available storage solutions and as dried blood spots (DBS).</p><p><strong>Methods: </strong>Total nucleic acids were extracted from 50 residual blood samples sourced from a routine haematology laboratory in Johannesburg, South Africa between 01 March 2021 and 15 December 2023. DNA and RNA aliquots were stored in commercial storage media and as DBS at a range of temperatures (-80 °C, 2 °C - 8 °C, room temperature [RT] and 40 °C - 50 °C) for 24 h, 96 h, 30 days and 90 days. Post-storage nucleic acid concentration and integrity were measured.</p><p><strong>Results: </strong>Four DNA and four RNA aliquots (stored complexed to beads and in commercial storage solution) and three DBS prepared from 50 whole blood samples were analysed. Nucleic acids stored at RT and at 2 °C - 8 °C maintained acceptable concentration and integrity tested using TapeStation Bioanalyser with a DNA integrity number median score of 7.5 (RT) and 7.4 (2 °C - 8 °C) for both beads and storage solutions, and DNA integrity number (acceptable range above 7). RNA integrity was moderate, with a median RNA integrity range of 3.1-3.9 (acceptable range above 5). Samples stored at 40 °C - 50 °C showed extensive degradation with no bands produced on gel electrophoresis. Dried blood spot yielded low RNA concentrations (median 1.33 ng/μL, range 0.08 - 4.63 ng/μL).</p><p><strong>Conclusion: </strong>Commercial storage solutions, beads and DBS offer a feasible alternative to cryopreservation for the storage of nucleic acids at ambient temperature.</p><p><strong>What this study adds: </strong>This study is a proof-of-concept study which investigates the feasibility of nucleic acid storage and transport at RT in Africa.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"2915"},"PeriodicalIF":1.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mutational landscape of classical myeloproliferative neoplasms in the Western Cape Province, South Africa.","authors":"Marthinus J Dicks, Erica-Mari Nell, Carmen Swanepoel, Ibtisam Abdullah, Zivanai C Chapanduka","doi":"10.4102/ajlm.v15i1.2965","DOIUrl":"10.4102/ajlm.v15i1.2965","url":null,"abstract":"<p><strong>Background: </strong>The classical myeloproliferative neoplasms (MPNs) are driven by somatic variants in <i>Janus kinase 2</i> (<i>JAK2</i>), <i>calreticulin</i> (<i>CALR</i>) and <i>thrombopoietin receptor</i> (<i>MPL</i>) genes. The heterogeneity in mutational frequency of <i>JAK2, CALR, MPL</i> and triple-negative MPNs between regions indicates that epidemiological studies in sub-Saharan Africa are required.</p><p><strong>Objective: </strong>The aim of this study was to describe the genetic variants seen in MPNs at a South African tertiary hospital.</p><p><strong>Methods: </strong>A retrospective study was conducted at Tygerberg Hospital, Western Cape Province, South Africa. Patients investigated for a classical MPN driver variant (polycythaemia vera [PV], primary myelofibrosis [PMF] and essential thrombocythaemia [ET]) from 2009 to 2020 were included in the study. The associated MPN diagnosis was sought from full blood count and bone marrow reports. <i>Janus kinase 2</i>-positive and -negative groups were compared for each MPN using a two-tailed independent samples <i>t</i>-test.</p><p><strong>Results: </strong>There were 128 patients diagnosed with an MPN over the 12-year study period. Polycythaemia vera was the most prevalent (38%), followed by PMF (33%), essential thrombocythaemia (20%), and MPN unclassifiable (9%). The most frequent variant was <i>JAK2</i> p.V617F (78%) followed by <i>CALR</i> variants (8%). No <i>MPL</i> variants were detected among the patients tested. In PMF, patients with <i>JAK2</i> p.V617F variants were older (mean age 65 years vs 58 years, <i>p</i> = 0.048) and had a higher haemoglobin (10.6 g/dL vs 8.1 g/dL, <i>p</i> = 0.013) at diagnosis when compared to patients without <i>JAK2</i> p.V617F.</p><p><strong>Conclusion: </strong>These data suggest that there are differences with regard to MPN epidemiology and variant frequency in South Africa, and further clinical studies are required to fully characterise MPNs in the South African context.</p><p><strong>What this study adds: </strong>This retrospective study expanded the profiling of MPNs and driver variants of MPNs in a South African population. Primary myelofibrosis made up a higher percentage of MPN cases than reported in international studies. In addition, in PMF and essential thrombocythaemia, <i>JAK2</i> p.V617F was more common and <i>CALR</i> variants were less common than reported internationally, while <i>MPL</i> variants were not detected.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"2965"},"PeriodicalIF":1.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of visual inspection with acetic acid and Pap smear tests in early cervical cancer screening among women in Meru County, Kenya.","authors":"Mary N Chege, Stanley Kang'ethe, Scolastica N Kimani","doi":"10.4102/ajlm.v15i1.3054","DOIUrl":"10.4102/ajlm.v15i1.3054","url":null,"abstract":"<p><strong>Background: </strong>Early cervical dysplasia screening can save women from death resulting from cervical cancer.</p><p><strong>Objective: </strong>To evaluate and compare the diagnostic performance of the Papanicolaou (Pap) smear and visual inspection with acetic acid (VIA) against histopathology as the reference test.</p><p><strong>Methods: </strong>We recruited 160 women aged 25-60 years who were undergoing early cervical screenings at the Meru teaching and referral hospital, from June to October 2024. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated by comparing VIA and Pap smear outcomes against histology (gold standard).</p><p><strong>Results: </strong>Mean age of the study sample was 44.96 years (s.d. = 9.49). Eighteen (11%) had inflammation, 3 (1.9%) had squamous cell carcinoma against 11 (6.9%) detected by histology, and 14 (8.8%) had precancerous lesions. There was no statistical significance between age or number of pregnancies and histology-confirmed cervical lesions. Pap smear had a sensitivity of 100% (95% confidence interval [CI]: 86-100), specificity of 94% (95%CI: 89-97), PPV of 76% (95%CI: 58-89), and NPV of 100% (95%CI: 97-100). In comparison, VIA showed diagnostic performance with sensitivity of 72% (95%CI: 51-88), specificity of 81% (95%CI: 74-88), PPV of 42% (95%CI: 27-58), and NPV of 94% (95%CI: 88-98).</p><p><strong>Conclusion: </strong>Pap smear showed higher overall diagnostic accuracy than VIA in diagnosing cervical lesions. While less specific, VIA showed a high NPV, suggesting its potential in ruling out disease in low-resource settings. Although age and pregnancy showed no statistical significance with cervical dysplasia, more studies including characteristics are required.</p><p><strong>What this study adds: </strong>Results provide updated evidence on the relative diagnostic performance of VIA and Pap smear, to guide cervical cancer screening strategies in settings with limited resources.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3054"},"PeriodicalIF":1.4,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should bilateral (versus unilateral) bone marrow biopsies be routine in paediatric classical Hodgkin Lymphoma where PET-CT is unavailable?","authors":"Stephanie J Kennedy, Mampoi T Jonas, Anne-Cecilia van Marle, Jan du Plessis","doi":"10.4102/ajlm.v15i1.3111","DOIUrl":"10.4102/ajlm.v15i1.3111","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric classical Hodgkin Lymphoma (cHL) can be treated successfully with modern therapeutic regimens. In the context of risk-adapted treatment strategies, accurate staging and risk stratification are crucial to improve outcomes. Although fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) detects bone marrow (BM) involvement accurately in cHL and is recommended over BM biopsies in the staging of paediatric cHL, this imaging modality is not widely available in most African countries, and BM biopsies continue to be performed.</p><p><strong>Case presentation: </strong>An 8-year-old HIV-negative boy from Lesotho was referred to the Universitas Academic Hospital Paediatric Oncology Unit, South Africa, in March 2024, with a 2-year history of a progressively enlarging neck mass, fever, loss of appetite, hepatosplenomegaly, and cytopenias. Bilateral BM aspirate and trephine biopsies revealed discrepant results: The right-sided biopsy showed only reactive features, whereas the left side confirmed a diagnosis of stage 4 cHL.</p><p><strong>Management and outcome: </strong>The child was initiated on the high-risk arm of the South African cHL treatment protocol. Owing to availability and cost constraints, a PET-CT could neither be done at diagnosis nor to evaluate his initial therapeutic response. Instead, repeat bilateral BM and CT investigations were performed to guide management as per the protocol. He completed all treatment and remains in complete remission 2 years later.</p><p><strong>Conclusion: </strong>Delayed referral and diagnosis of paediatric cancers remain a problem in Africa and may contribute to advanced disease at presentation. In this child, correct staging and risk stratification of cHL ensured optimal treatment selection and a favourable outcome.</p><p><strong>What this study adds: </strong>Bilateral, rather than unilateral BM biopsies should be considered for cHL staging where PET-CT is unavailable.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3111"},"PeriodicalIF":1.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}