Browsing by Author "Hoffman, Mariza"
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- ItemComplete blood count reference intervals from a healthy adult urban population in Kenya(Public Library of Science, 2018) Omuse, Geoffrey; Maina, Daniel; Mwangi, Jane; Wambua, Caroline; Radia, Kiran; Kanyua, Alice; Kagotho, Elizabeth; Hoffman, Mariza; Ojwang, Peter; Premji, Zul; Ichihara, Kiyoshi; Erasmus, RajivBackground: There are racial, ethnic and geographical differences in complete blood count (CBC) reference intervals (RIs) and therefore it is necessary to establish RIs that are population specific. Several studies have been carried out in Africa to derive CBC RIs but many were not conducted with the rigor recommended for RI studies hence limiting the adoption and generalizability of the results. Method: By use of a Beckman Coulter ACT 5 DIFF CP analyser, we measured CBC parameters in samples collected from 528 healthy black African volunteers in a largely urban population. The latent abnormal values exclusion (LAVE) method was used for secondary exclusion of individuals who may have had sub-clinical diseases. The RIs were derived by both parametric and non-parametric methods with and without LAVE for comparative purposes. Results: Haemoglobin (Hb) levels were lower while platelet counts were higher in females across the 4 age stratifications. The lower limits for Hb and red blood cell parameters significantly increased after applying the LAVE method which eliminated individuals with latent anemia and inflammation. We adopted RIs by parametric method because 90% confidence intervals of the RI limits were invariably narrower than those by the non-parametric method. The male and female RIs for Hb after applying the LAVE method were 14.5±18.7 g/dL and 12.0± 16.5 g/dL respectively while the platelet count RIs were 133±356 and 152±443 x103 per μL respectively. Conclusion: Consistent with other studies from Sub-Saharan Africa, Hb and neutrophil counts were lower than Caucasian values. Our finding of higher Hb and lower eosinophil counts compared to other studies conducted in rural Kenya most likely reflects the strict recruitment criteria and healthier reference population after secondary exclusion of individuals with possible sub-clinical diseases.
- ItemDistribution and association of hs-CRP with cardiovascular risk variables of metabolic syndrome in adolescent learners(AOSIS Publishing, 2012-06) Rensburg, Megan A.; Matsha, Tandi; Hoffman, Mariza; Hassan, Mogamat S.; Erasmus, Rajiv T.Objective: Metabolic syndrome (MetS) and its associated cardiovascular risk are on the increase in children. High-sensitivity C-reactive protein (hs-CRP) has emerged as a useful marker for inflammation associated with atherosclerosis and cardiovascular disease. Our aim was to determine the distribution of hs-CRP in an effort to identify the MetS variable that is critical in modulating plasma CRP levels in a population of South African adolescents. Design: A cross-sectional analytical study design was used for this investigation, where the dependent and independent variables were measured simultaneously. Methods: Anthropometric variables, blood pressure, fasting blood glucose and lipids were performed on 324 consenting learners aged 15–18 years from three different ethnic groups (Black, White and Coloured). The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) for ages 15–18 year olds was used to define MetS. Results: The prevalence of MetS and obesity was 3.7% and 7.1%, respectively. The hs-CRP levels were significantly higher in subjects with a waist-circumference greater than the 90th percentile (p < 0.01) and in obese learners with MetS, but was lower in adolescents with normal weight and MetS. Median hs-CRP levels increased with an increasing number of metabolic abnormalities and exceeded 3 mg/L in 19% of adolescents. Gender and ethnic differences were observed. Conclusion: Our findings suggest that obesity and waist circumference appear to be major mediators of hs-CRP levels in South African adolescents.
- ItemMetabolic syndrome and its predictors in an urban population in Kenya : a cross sectional study(BioMed Central, 2017-07-04) Omuse, Geoffrey; Maina, Daniel; Hoffman, Mariza; Mwangi, Jane; Wambua, Caroline; Kagotho, Elizabeth; Amayo, Angela; Ojwang, Peter; Premji, Zulfiqarali; Ichihara, Kiyoshi; Erasmus, RajivAbstract Background The metabolic syndrome (MetS) is a clustering of interrelated risk factors which doubles the risk of cardio-vascular disease (CVD) in 5–10 years and increases the risk of type 2 diabetes 5 fold. The identification of modifiable CVD risk factors and predictors of MetS in an otherwise healthy population is necessary in order to identify individuals who may benefit from early interventions. We sought to determine the prevalence of MetS as defined by the harmonized criteria and its predictors in subjectively healthy black Africans from various urban centres in Kenya. Method We used data collected from healthy black Africans in Kenya as part of a global study on establishing reference intervals for common laboratory tests. We determined the prevalence of MetS and its components using the 2009 harmonized criterion. Receiver operator characteristic (ROC) curve analysis was used to determine the area under the curves (AUC) for various predictors of MetS. Youden index was used to determine optimum cut-offs for quantitative measurements such as waist circumference (WC). Results A total of 528 participants were included in the analysis. The prevalence of MetS was 25.6% (95% CI: 22.0%–29.5%). Among the surrogate markers of visceral adiposity, lipid accumulation product was the best predictor of MetS with an AUC of 0.880 while triglyceride was the best predictor among the lipid parameters with an AUC of 0.816 for all participants. The optimal WC cut-off for diagnosing MetS was 94 cm and 86 cm respectively for males and females. Conclusions The prevalence of MetS was high for a healthy population highlighting the fact that one can be physically healthy but have metabolic derangements indicative of an increased CVD risk. This is likely to result in an increase in the cases of CVD and type 2 diabetes in Kenya if interventions are not put in place to reverse this trend. We have also demonstrated the inappropriateness of the WC cut-off of 80 cm for black African women in Kenya when defining MetS and recommend adoption of 86 cm.