Screening for Occult Factor VIII Deficiency in Prospective Blood Donors in South-South Nigeria

Background and Objective: Factor VIII and IX play pivotal roles in the coagulation cascade, essential for blood clotting. In health, these clotting factors act in concert to ensure effective haemostasis. The aim was to investigate the activity levels of factor VIII and IX of Prospective blood donors attending the Blood Donor Bay, University of Calabar Teaching Hospital, Calabar, Nigeria. Materials and Methods: This was a cohort study design of 50 subjects, adult males and females, aged 15 to 45 years. Micro-haematocrit method for Hct was tested for recruitment, and Quick’s One Stage Method using Helena Biosciences Europe Factor Deficient Plasmas in APTT-based Factor Assay Testing was used for APTT, FVIII, and FIX. Results were expressed as Mean±S.D, and analyzed using Student’s t-test, one-way ANOVA, and Pearson correlation, with significance set at p<0.05. Results: The majority of donors were male (88%) and students (76%), with most aged 26-35 years (46%) and the fewest aged 36-45 years (10%); non-alcohol consumers made up 66% and alcohol consumers 34%, while first-, second-, and third-time donors accounted for 66, 20, and 14% respectively, with no statistically significant influence (p>0.05) of age, gender, donation frequency, or alcohol use on factor VIII and IX activity. The Mean±SD of Hct, APTT, FVIII, and FIX of prospective Blood Donors was 0.418L/L, 30 sec, 80.0 and 90.7%. The factor VIII and IX activity levels were 92% and 100%, respectively in the normal (Non-Haemophilia range) of 50-150% factor activity. Meanwhile, only factor VIII revealed 2% each in Near-Normal (Non-Haemophilia range) and Mild Haemophilia of >40%-<50% and >5%-<40%, respectively. The male donors have the highest factor VIII and IX activity levels 80.6 and 90.9% to the female 77.0% and 89.2%. For alcohol consumers, there was a statistical difference in APTT (<0.044) when compared with non-alcoholic. There was no correlation between FVIII and FIX activity levels vs. APTT (p<0.001). Conclusion: This study has shown Near-Normal (non-haemophilia range) and mild haemophilia of factor VIII among blood donors. However, an adequate activity level of factor IX was seen in all blood donors. Therefore, assessing factor VIII and FIX activity levels of blood donors should be used as a criterion to assess and know donors who have adequate and efficient replacement therapy for patient with medical issues.