Infection In Nigeria Research Articles

Mothers Education and Respiratory Infection in Under-Five Children in Nigeria

Respiratory infection is one of the major causes of child ill health and mortality not only in Nigeria, but in most developing countries of the world. This study therefore, investigated the causal relationship between mothers’ level of education and under-five age respiratory infection in Nigeria. Probit regression is used to analyse data from Nigeria Multiple indicator cluster survey 2017. Results from the bivariate regression indicated a significant negative relationship between mothers’ educational level and respiratory infection in under-five age children in Nigeria. Mothers’ educational level became insignificant after controlling for other important covariates which signifies an indirect relationship with child respiratory infection. This implies that mothers’ education influences child respiratory disorder through other variables like place of residence and immunization. Other variables found to influence child respiratory infection includes region of residence, age of child, immunization and ethnicity. On the other hand, sex of child and wealth index were not found to be significant determinants of child respiratory infection. Nigerian government should encourage girl child education through the provision of free quality education at least to secondary school level. Programs to target free diagnosis, treatment and prevention of respiratory infection especially among under-five children should be prioritized by the ministry of health. Health care providers should also intensify awareness to mothers on preventive measures of child respiratory infection especially during antenatal care programs.

Vulnerability to HIV infection among adolescent girls and young women in Nigeria

ABSTRACT Adolescent girls and young women (AGYW) account for a disproportionate number of new HIV infections among young people living with HIV. This study identified factors associated with the vulnerability of AGYW to HIV infection in Nigeria. We conducted a cross-sectional survey of AGYW aged 15–24 years in three states (Akwa-Ibom, Kaduna, and Oyo) and the Federal Capital Territory (FCT) Abuja in Nigeria. We collected information on sociodemographic characteristics, risky sexual behaviors, practices, attitudes, perceptions of HIV, and related socio-cultural experiences from 4320 respondents. We identified twelve vulnerability factors and used a modified Delphi technique to assign relative weights to each. Composite vulnerability score was calculated by adding the weighted scores on all factors for each respondent and dichotomized using k-median analysis. Higher scores corresponded to higher vulnerability to acquiring HIV. More than 43% had a high vulnerability to HIV infection. Being older, of lower educational status, married, in a lower wealth quintile, and having low self-esteem were statistically significantly associated with being more vulnerable to acquiring HIV. Being knowledgeable about HIV prevention was protective but not statistically significant. We conclude that sociodemographic characteristics and self-esteem are important determinants of vulnerability to acquiring HIV among young women in Nigeria. Interventions targeted to reduce vulnerability to HIV among young women must address social-demographic and psychological risk factors.

Sero-epidemiology of human T-cell lymphotropic viruses-1 and -2 infection among pregnant women attending Abuja Teaching Hospital, Nigeria.

There is the paucity of HTLV-1/-2 studies on Nigerian pregnant women despite the medical and public health significance of maternal-to-child transmission of HTLV-1/-2. This study aims to determine the seroprevalence and risk factors of HTLV-1/-2 infections among pregnant women attending the University of Abuja Teaching Hospital (UATH), Abuja, Nigeria. Blood samples were collected from consented pregnant women and analysed for ant-HTLV-1/-2 total antibodies using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit. Pretested structured questionnaires were used to collate participants' socio-demographic variables and risk factors of HTLV infection. Out of the 156 pregnant women tested for HTLV-1/-2 antibodies, 16 (10.3%) were seropositive. There was no significant association between the socio-demographic variables collated and seroprevalence of HTLV-1/-2 infection among pregnant women (p> 0.05). Pregnant women with HIV infection had a lower prevalence of HLTV-1/-2 infection than those without HIV infections (7.5% versus 11.7%). Pregnant women with multiple sexual partners had a higher risk of HTLV-1/-2 infection than those who had single (OR = 2.08, 95% CI: 0.53-8.18). Women with a history of needles injury had a higher risk of HTLV-1/-2 infection than those who do not (OR = 1.24, 95% CI: 0.38-4.08). The history of blood transfusion was significantly associated with HTLV-1/-2 infection (p= 0.027). However, no significant association existed between other risk factors of HTLV-1/-2 infection among pregnant women (p> 0.05). Considering the 3% pooled national prevalence of HTLV-1/-2 infection in Nigeria, the seroprevalence reported in this study is relatively high. Thus, there is a need for more large cohort studies and routine screening of population at increased risk of infection.

Serological and Molecular Epidemiology of Leptospirosis and the Role of Dogs as Sentinel for Human Infection in Nigeria

Objective: Prospective cross-sectional study of dogs in Nigeria to study leptospirosis, inferred to be endemic in all regions of the country by researchers. Aim is to generate empirical updated evidence of leptospiral infection and delineate serovars involved. Methods: Study determined the sero-prevalence and infection rate in 342 dogs of various demographics using sero-assays, culture isolation and novel qPCR. In-house designed primers targeting conserved regions were used to amplify genes in quantitative Real-Time PCR (qRT-PCR) assays for leptospiral detection to serogroups. Molecular analysis of the leptospiral 16S rRNA and LipL 32 genes, reported earlier as novel diagnostic targets, were used for identification of pathogenic Leptospira species. Primers targeting the O-antigen ( rfb ) region of the Leptospira lipopolysaccharide (LPS) were used for differentiating serovars based on comparative melting temperature (Tm) analysis of PCR product against reference serogroups. Results: Overall serological and bacteriological prevalence of 56(16.4%) and 40(11.7%) respectively was recorded. German shepherds were the most highly represented group, with a sero-prevalence of 17(22.4%). Vaccination, ages and season(s) were the strongest determinants of infection and the presence of circulating antibodies to leptospires after seroconversion. Unvaccinated animals, stray dogs as well as symptomatic dogs presented statistically significant (P<0.05) higher risk of infection: OR 25.531(6.108, 106.712; 95% CI). Discussion: The evidence suggests 1 of every 10 dogs is infected and could be symptomatic for the disease or a carrier of leptospires in the studied region in Nigeria. Given the proximity of dogs to humans, quantifying the burdens of leptospirosis in dogs is a priority from a public health perspective. Funding Information: The Vinetz Laboratory and the Fulbright Grant #15150575 jointly funded this work. Declaration of Interests: None to declare. Ethics Approval Statement: Animal Approval was obtained from Usmanu Danfodiyo University with number 2014/RO-11.

Hepatitis B virus infection among Nigerian pediatric population

ABSTRACT Hepatitis B infection has continued to be a growing global health concern in spite of the discovery and administration of hepatitis B vaccines over the years. The focus of this study was to evaluate the burden of this infection among asymptomatic pediatric population. Children, who visited the hospital between March and August 2018, were recruited into this study. Blood samples were collected after obtaining informed consent. The samples were processed and screened for HBsAg. Data were analyzed using chi-square statistic. Six (2.9%) of the 206 children in the study were positive for HBsAg. A hundred (48.5%) of the children were males and 106 (51.5%) were females in the ratio 1:1.1 (male to female). More male tested positive (4%) (4/96) than their female counterparts (1.9%) (2/104)(x2 = 0.813; p = .367). Age group 13–18 years had the highest infection rate 6.6% (4/57), followed by age group 5–12 years with 3.8% (2/50). No HBV detection was recorded among those below the age of 5 years. Patients with no vaccination history had a higher HBV infection rate (4.2%) compared with those who had been vaccinated (1.1%) (x2 = 1.164; p = .281). The study showed that HBV infection is of intermediate endemicity among the study population, a reflection of the endemic status of the infection in Nigeria. Vaccination effort among children should be sustained and intensified. We advocate for a more intensive public enlightenment on the infection especially among women of marriageable age.

Seroprevalence and associated risk factors of hepatitis E virus infection among pregnant women attending Maiduguri teaching hospital, Nigeria

Background: Hepatitis E Virus (HEV) is a major public health problem in developing countries and often fatal among pregnant women in the third trimester. Objectives: The study investigated the sero-prevalence and risk factors of HEV infection among pregnant women attendee of University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Methods: The cross-sectional study was carried out between 4th January 2016 to 30th May, 2016. One hundred and eighty blood samples from pregnant women who consented and enrolled for the study were analyzed for anti – HEV IgM using a quality assured commercial Enzyme Linked Immunosorbent Assay (ELISA) kit. Structured questionnaires were used to collate the sociodemographic characteristics and risk factor of study subjects. Results: Out of the 180 pregnant women sampled, the anti-HEV IgM seroprevalence of 13.3% was recorded. The seroprevalence was significantly higher in the age range of 31 – 35 years (26.5%) and least in age range ≤ 20 years (4.9%) (p=0.009). The highest seroprevalence was recorded in the third trimester 14.1% followed by second (p>0.05). After logistic regression, nature of toilet system, and source of water consumption were significant risk factors for active HEV infection (p˂0.05). Conclusion: Based on the 10.8 % pooled national prevalence of HEV infection in Nigeria, this study recorded a significantly high level of anti – HEV IgM seropositivity, an indication of recent and active HEV infection among pregnant women at the study area. Also, these infections are most among the pregnant women in their third trimester. HEV infection was related to personal, water and environmental hygiene.

Epidemiological Analysis and Time Prediction Models of Coronavirus (COVID-19/SARS-CoV-2) Spread in Selected Epicentres around the World: Nigeria as a Case Study

The spread of coronavirus disease (COVID-19/SARS-CoV-2) in Nigeria from index to community cases is becoming alarming that what the future holds should be brought to bear. An analytical study and time prediction model have been conducted on the epidemiological spread of coronavirus (COVID-19/SARS-CoV-2) with data collected from records of selected epicentres in Nigeria. The data was collected between March 1 and May 31, 2020. It can be shown that the highest daily infection in March was recorded on the 28th with 32 infections while the highest fatality rate was recorded on 24th with a rate of 2.3% and recorded daily infection of 10. As at the 31st, a total number of 139 confirmed cases were recorded in Nigeria with a fatality and discharge rates of 1.4 and 6.5% respectively. It can be deduced that the highest daily infection in Nigeria in April was recorded on 30th, with daily infection of 204 confirmed cases. The highest discharge rate of 34.4% was recorded on 16th, with a fatality rate of 2.9% while the highest fatality rate of April was 3.5% recorded on 18th, which has a discharge rate of 30.6% and a daily infection record of 49. As of April 30, 2020, Nigeria had recorded a total of 1932 confirmed cases with 58 deaths. It can also be deduced that the highest daily infection in Nigeria in May was recorded on 30th, with daily infection of 553 confirmed cases. It can also be observed that the highest discharge and fatality rates for May 2020 are 29.6% and 3.6% recorded on 31st and 2nd respectively. As of May 31, 2020, the total infection stood at 10162 confirmed cases and there seems to be a continuing upward trajectory for the situation under investigation. It can also be observed that the rate of discharged cases continued to surpass those of the fatality for the months of investigation. No doubts that the COVID-19/SARS-CoV-2 was first recorded in the Ogun State of Nigeria, but Lagos state has surpassed both the daily infections and the cumulative infections for the country. With collected data, MLR simple linear regression extension was used to estimate an outcome or target variable based on two or more independent variables. The variables which are the three months data collected from daily infections, totally confirmed case, total deaths and total discharged cases between March 1, 2020, and May 31, 2020, were used to propose regression equations for the prediction of the cases under study for anytime period.

Forensic mental health service implications of COVID-19 infection in Nigeria

Forensic mental health services are fledgling in most African countries including Nigeria. The current formulation of such services in Nigeria is correctional psychiatry in addition to some hospital-based services. The COVID-19 pandemic presents significant challenges to the already fragile state of forensic mental health services within the country. Its impact includes limitation of access to and continuity of mental healthcare in prison as well as reduction in referrals from other services within the criminal justice system such as the police and the courts. Further tapering of previously less prominent aspects of forensic mental health service in the country such as the preparation of psychiatric court reports has also been observed. Forensic psychiatry training and research have equally been hampered by the pandemic. The lessons learnt from these challenges should offer practitioners and policy makers insight into strategic developmental objectives for the post-COVID era within services and training programmes.

Genetic Diversity of Plasmodium falciparum Isolated from Symptomatic and Asymptomatic Individuals in Parts of Kaduna Metropolis, Kaduna State, Nigeria

Malaria due to Plasmodium falciparum is still a major public health problem and cause of high morbidity and mortality in Nigeria despite many efforts and interventions programmes put in place to control malaria, with transmission occurring throughout the year. Characterization of P. falciparum isolates from different geographical locations of Nigeria could provide the much needed information on the genetic composition of P. falciparum natural populations with regard to three polymorphic genes: Merozoite Surface Protein 1 (MSP 1), Merozoite Surface Protein (MSP 2) and Glutamate-Rich Protein (GLURP) genes, the findings of this study will assist in adopting more strategies and intervention programmes aim at controlling P. falciparum infection in Nigeria. This study was conducted to determine the genetic diversity and elucidate possible genomic variation between isolates of P. falciparum from symptomatic and asymptomatic malaria cases in Kaduna metropolis. Plasmodium falciparum genomic DNA was extracted from 42 positive blood samples collected onto whatmani¯s filter paper using the phenol-chloroform DNA extraction method. Genotyping of P. falciparum was based on the amplification of MSP 1, MSP 2 and glurp genes. Analysis of PCR products of P. falciparum isolates shows the presence of 33 alleles spread across MSP 1, MSP 2 and glurp genes at a frequency of 5, 24 and 4 respectively. Detection of the three genes; (MSP1); MAD20 and KI, (MSP2); FC27 and 3D7/ICI and (glurp) gene and the occurrence of single and multiple genotypic infection recorded showed the diverse genetic composition of P. falciparum population, an indication of the endemicity of malaria. This information is essential for effective malaria control programme.

Human Immunodeficiency Virus Infection among Exposed Infants in Selected Primary Health-Care Facilities in Nigeria: A Retrospective Cohort Study

BACKGROUND: Nigeria is the second largest country with paediatric HIV infections. Mother to Child transmission of HIV remains a major source of paediatric infection in Nigeria. This study was conducted to determine the outcomes of HIV exposed infants in selected Primary Health Care Centres.METHODS: A retrospective cohort study on HIV exposed infants between January 2015 to July 2016. A proforma was used to abstract information from clinic records on socio-demographics characteristics, ARV prophylaxis, mode of delivery, birth weight, infant prophylaxis, early infant diagnosis (EID), referral to ART. Descriptive and multivariate analysis was done to determine predictors of HIV infection among exposed infants.RESULTS: 170 exposed infants were recruited, and more than two-third of the infants were males (74.1%) with median age 4±3months ranging from (0 -11months). One hundred and fifty (88.2%) received infant prophylaxis and 116 (68.2%) had EID done at 6weeks. Of the 170 exposed infants 19(11.1%) were positive at 18months. Predictors of HIV infection were age of mothers ≥30years (Adjusted Odd’s Ratio = 2.5,95%CI 1.9 – 16.93), Vaginal tear (Adjusted OR= 2.7,95%CI 2.1- 19.21), infants whose maternal CD4 count &lt; 500(Adjusted OR= 3.5,95%CI 1.7 -15.02) and infant received prophylaxis other than daily Nevirapine for 6weeks (Adjusted OR=3.0,95%CI 2.4-12.74).CONCLUSION: The positivity rate among studied exposed infants was high. Continuous placement of younger HIV positive mothers and exposed infants on recommended prophylaxis and timely early infant diagnosis will go a long way in reducing the burden of paediatric HIV.

Phyloevolutionary analysis of SARS-CoV-2 in Nigeria.

Phyloepidemiological approaches have provided specific insight into understanding the emergence and evolution of infection. Knowledge on the outbreak and spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Nigeria would assist in provision of preventive measures to reduce transmission among populations at risk. This study aimed to investigate the evolution of SARS-CoV-2 in Nigeria. A total of 39 complete genomes of SARS-CoV-2 were retrieved from the GISAID EpiFlu™ database on 29 March 2020 to investigate its evolution in Nigeria. Sequences were selected based on the travel history of the individual and the collection date. Other sequences were not selected because they were short, contained artefacts, were not from an original source or had insufficient information. Evolutionary history was inferred using the maximum likelihood method based on the general time reversible model. A phylogenetic tree was constructed to determine the common ancestor of each strain. The phylogenetic analysis showed that the strain in Nigeria clustered in a monophyletic clade with a Wuhan sublineage. Nucleotide alignment also showed a 100% similarity indicating a common origin of evolution. Comparative analysis showed 27 972 (93.6%) identical sites and 97.6% pairwise identity with the consensus. The study evidently showed the entire outbreak of SARS-CoV-2 infection in Nigeria stemmed from a single introduction sharing consensus similarity with the reference SARS-CoV-2 human genome from Wuhan. Preventive measures that can limit the spread of the infection among populations at risk should be implemented.

Covid-19 and Challenges of Management of Infectious Medical Waste in Nigeria: A Case of Taraba State

The outbreak and spread of covid-19 pandemic has triggered awareness in people about how vital the hospital waste management process in every single country can be. The increasing number of covid-19 infection in Nigeria is already putting increasing pressure on the healthcare systems in the country. The highly infectious nature of the coronavirus would require a complex and special protocol of handling and managing the infectious medical waste generated such as confinement (bins, bags etc.) and availability of proper storage and disposal facilities. In Nigeria, all efforts towards containing the outbreak and spread of the corona virus is directed towards establishing testing, isolation and treatment centres/facilities. Little or nothing is said about the handling and safe disposal of infectious waste generated from the management of the disease. This study has examined covid-19 and the challenges of management of infectious medical waste in Nigeria using the case of Taraba state. The study used interview and secondary materials online to generate data used in the study. The study findings reveal that the medical waste is spread out beyond hospitals. Findings from the study reveals that Jalingo the state capital has no any officially approved dumpsite in the metropolis. Also the tertiary healthcare facilities in the State has no proper safe disposal facilities of infectious medical waste at the moment. Other challenges include the various myths surrounding the reality of the covid-19 pandemic, poor enforcement of infectious medical waste guidelines and lack of political will on the part of the government. Based on the findings, the study recommends effective enforcement of the guidelines on the safe disposal of infectious, use of PPEs by all waste collection workers and creation of environmental department in every hospital to handle all infectious medical waste.

Human Toxoplasma gondii infection in Nigeria: a systematic review and meta-analysis of data published between 1960 and 2019

BackgroundOver 70% of the worlds’ population is infected by Toxoplasma gondii; a pathogen capable of causing cerebral toxoplasmosis in HIV patients and neonatal complications like miscarriage, chorioretinitis, hydrocephalus, cerebral calcification and foetal death in the third trimester of pregnancy. In spite of this, the burden of this zoonotic pathogen is poorly understood in Nigeria. The aim of the present study therefore, is to determine the burden of T. gondii among normal individuals, HIV patients and pregnant women as well as the distribution of the infection across Nigeria.MethodsUsing the PRISMA guidelines, we conducted a systematic review and meta-analysis of data retrieved from six electronic databases (AJOL, Google Scholar, PubMed, Scopus, Science Direct and Web of Science). Pooled prevalence (PP) and heterogeneity were determined by the random-effects model and the Cochran’s Q-test respectively. The quality of each study and publication bias were assessed by the 9 point Joanna Briggs Institute Critical Appraisal Instrument and the Egger’s regression asymmetry test respectively, while the robustness of a pooled estimate was tested by the single study omission analysis.ResultsExactly 5834 of the 16,230 individuals examined for T. gondii infection by 50 studies across 17 Nigerian States were positive for the infection. Overall PP was 32.92% (95% CI: 27.89, 38.37), with a range of 14.41% (95% CI: 5.32, 33.54) to 86.82% (95% CI: 66.13, 95.69) across sub-groups. Pooled prevalence was significantly higher (p < 0.001) among pregnant women (40.25%; 95% CI: 33.19, 47.73) and HIV patients (31.68, 95% CI: 20.53, 45.41) than normal individuals (23.32, 95% CI: 17.25, 30.75). T. gondii prevalence declined by over 58% during the 59 years reviewed.ConclusionToxoplasma gondii infection is moderately prevalent in Nigeria. Highest prevalence estimates were observed among pregnant women and in the south-south region. For effective control of the disease in Nigeria, a holistic approach involving on-farm, environmental, public health and animal components are suggested.

Prevalence of rotavirus A infection and the detection of type G3P[11] strain in ruminants in Yobe state, Nigeria.

Rotaviruses have a worldwide distribution and the infection is associated with diarrhea in young of ruminants as well as children. However, limited data exist on its prevalence and types in Yobe state, Nigeria. Detection of rotavirus A and types in ruminant population in Yobe state was the aim of the study. A total of 470 diarrheic fecal samples were collected and tested for rotavirus and types using serology and molecular techniques respectively. A prevalence rate of 2.98% (14/470) was found in the three species with specific rates of 2.9% (6/202), 3.8% (6/158), and 1.8% (2/110) in goat, sheep, and cattle respectively. The prevalence rates of 3.6% (12/331), 1.2% (1/84), and 1.8% (1/55) were for those aged < 1-3, 4-6, and 7-9months old, respectively, while 4.9% (9/185) and 1.7% (5/285) were in males and females respectively. Rotavirus genes VP7 and VP4 were detected in 2 (14.3%) out of the 14 ELISA-positive samples while deduced amino acid sequences of the major variable regions revealed the genes to belong to types G3P[11] strain. Significant association was found between the infection and sex (P < 0.05) unlike in the species and age groups of the ruminants. The circulation of rotavirus virus in ruminants and type G3P[11] in cattle has been confirmed in the study. Hence, there is a need for continuous surveillance, awareness campaign, and assessment of the economic losses and public health implications of rotavirus infection in Nigeria.

Acute Toxicity Studies and Anti-plasmodial Potentials of Newbouldia laevis and Crateva adansonii in Plasmodium Berghei-infected Mice

Background: Newbouldia laevis and Crateva adansonii are popular plants used traditionally in the management of patients with malaria infection in Nigeria. In this study, the acute toxicity and anti-plasmodial effects of the leaf extracts of Newbouldia laevis and Crateva adansonii were investigated in mice. Methods: The Anti-plasmodial activities of both extracts were investigated individually and combined in mice infected with the chloroquine sensitive ANKA-65 Plasmodium berghei strain. Five groups of four mice each were used in our experiments. The LD50 was determined, using the line equation of the mortality against dose levels plot. Results: The extracts of N. laevis and C. adansonii had a safety level of 200 mg/kg (LD50= 471.43 mg/kg) and 600 mg/kg (LD50=3,500 mg/kg), respectively. Each experimental group was infected with P. berghei strain. The percent inhibition of parasitemia induced by the extracts of N. laevis and C. adansonii were 30.14±2.88% and 61.35±1.41%, respectively, compared to the 78.89% achieved for the standard drug (chloroquine). Mice treated with the combined extracts had a parasite inhibition of 24.23±0.86%. Upon the analysis of the extracts, there were tannins, steroids, flavonoids, saponins and alkaloids in both. The quantitative analyses revealed that tannins were the most abundant (261.85±4.76 mg/100 g &amp; 92.71±6.58 mg/100 g) while saponins were the least abundant (15.09±1.13 mg/100 g &amp; 14.08±1.28 mg/100 g) phytochemicals in both extracts. Conclusion: The findings support the notion that the traditional use of either plant in the management of malaria in Nigeria appears to be logical.

“Infodemic” in a pandemic: COVID-19 conspiracy theories in an african country

Introduction: Coronavirus disease 2019 (COVID-19), being the first pandemic to occur in the digital communications era, is rife with “infodemic” of misinformation and conspiracy theories. This article explored popular conspiracy theories about COVID-19 in Nigeria and highlighted the sources of COVID-19 information among Nigerians and perceived trustworthiness of the information sources. It also identified various inaccurate information and conspiracy claims reported by traditional media in Nigeria. Methods: This cross-sectional study was carried out among a sample of 736 undergraduate students of a public tertiary institution in Nigeria. A purposive sampling technique was used to recruit participants through social media platforms. Google Forms was used to host an anonymous questionnaire and the link sent to the Facebook and WhatsApp groups of students' associations. Participation was voluntary and anonymous. The data collection was initiated on May 27 and closed on June 5, 2020. Descriptive statistical analyses were conducted on participants' responses. Results: COVID-19 infection in Nigeria is seen as “an exaggeration by the government and media,” and as a “Chinese biological weapon.” Traditional media is the most popular source of information about COVID-19. Nigeria Centre of Diseases Control is the most trusted source of COVID-19 information, while information from political leaders and social media was perceived as untrustworthy. Conclusion: COVID-19 conspiracy theories were driven majorly on social media, by a dearth of trust in political leadership and “breaking” of inaccurate coronavirus news by traditional media. Stakeholders need to collaborate to debunk conspiracy theories.

Hepatitis C viral load and genotypes among Nigerian subjects with chronic infection and implication for patient management: a retrospective review of data.

IntroductionHepatitis C Virus (HCV) is highly infectious with no currently available vaccine. Prior to treatment, it is recommended to confirm HCV infection with either quantitative or qualitative nucleic acid test. Access to these assays in Nigeria is limited but for effective management of patients, HCV viral load (VL) prior to therapy is required and genotype may be needed in some instances. This study aimed at reviewing the pattern of HCV viral load and genotype in the country, and its implication in patient management.Methodsthis was a retrospective study that involved data abstraction from an electronic database of an accredited laboratory between June 2013 and May 2017. De-linked data were abstracted from records of adult subjects with HCV VL and genotype results, these were analysed using Microsoft Excel 2010 and SPSS v20.Resultswithin the study period, 346 subjects had baseline VL and 134 (38.7%) had genotype results available. Of these, 202/346 (58.4%) had detectable VL results with higher prevalence in males (64.7%) and ≥51years (42.5%) age group. The median VL among 202 subjects was 407,430 (IQR: 96,388 - 1,357,012) IU/mL. Distribution of genotypes showed that genotypes 1 and 4 had prevalence of 63.2% and 16.8% respectively.Conclusiongenotypes 1 and 4 have the highest prevalence. A greater proportion of subjects had VL values ≤800,000 IU/mL, an indication that they are more likely to respond well to available antiviral therapy hence, access to these antivirals will greatly improve management of HCV infection in Nigeria.

Helicobacter pylori antibiotic sensitivity pattern in dyspeptic patients in Kano, Nigeria.

BackgroundDespite the high prevalence of Helicobacter pylori infection in Nigeria, in the North-West there are no studies on the antibiotic sensitivity pattern of this organism. This study aims to determine the antibiotic sensitivity pattern of this bacterium as well as bridge the gap in knowledge.MethodsThe study was cross-sectional in design. Questionnaires were administered in dyspeptic patients to obtain the relevant data. Two sets of gastric biopsy specimens were taken during upper gastrointestinal (GI) endoscopy. One set was sent to the histopathology laboratory for assessment and H. pylori identification, while the other set for culture was minced and plated on Columbia blood agar media (Oxoid Ltd, England) incubated at 37°C in an anaerobic jar containing CampyGen (Oxoid Ltd) to provide the required micro-aerobic environment. The disc diffusion method was used in determining the sensitivity pattern of isolates. Pre-treatment and post-treatment stool samples were collected from each patient for a H. pylori faecal antigen test to assess eradication rate.ResultsThe sensitivity of H. pylori to amoxicillin was 9.2%, and 100% for both clarithromycin and levofloxacin. Tetracycline, metronidazole, cefuroxime, tinidazole and ciprofloxacin were 100% resitant. The prevalence of H. pylori at histology was 81.7%. Only 101 subjects had a positive H. pylori stool antigen test.ConclusionThis study showed a high amoxicillin resistance; however, there is high sensitivity (100%) to clarithromycin and levofloxacin. We recommended that levofloxacin be adopted in preference to amoxicillin as part of triple therapy in Nigeria.

Prevalence of multi-drug-resistant tuberculosis among human immunodeficiency virus and nonhuman immunodeficiency virus-positive pulmonary tuberculosis patients of two referral hospitals in Southeast Nigeria

Introduction: Multidrug-resistant tuberculosis (MDR-TB) is a type of TB that is resistant to the two most effective first-line drugs: rifampicin and isoniazid and it remains a major public health threat, particularly in developing countries. Objectives: To assess the MDR-TB prevalence among human immunodeficiency virus (HIV) and nonHIV positive pulmonary TB patients of two referral hospitals in southeast Nigeria. Materials and Methods: Sputum specimens of individuals presenting with a cough of &gt;2 weeks duration were screened by Ziehl–Neelsen technique for the presence of acid-fast bacilli (AFB). Results: A total of 103 subjects with AFB-positive sputum samples were recruited from the two referral hospitals and HIV-1/2 antibodies were screened using serial algorithm method. The positive sputum samples were subjected to Xpert MTB/RIF assay (GeneXpert®, Cepheid, USA) and cultured on the Lowenstein–Jensen medium for 42 days at 37°C. Drug susceptibility testing was done on the isolates using the nitrate reduction assay. Eighty-three (80.6%) of the isolates were obtained from culture after suspected colonies were subjected to morphological, biochemical, and immunological tests and of the 83 (80.6%) samples analyzed using Xpert MTB/RIF assay 45 (67.2%) were rifampicin-resistant. The prevalence of culture-positive TB was higher in the HIV-negative sub-population (82.02%) when compared with the HIV-positive participants (71.40%). The rate of MDR-TB was high among HIV-positive patients though not statistically significant. HIV positive patients showed prevalence of (66.70%), whereas HIV-negative patients had (42.60%). Conclusions: The World Health Organization estimated that 26% of patients with TB infection in Nigeria are HIV-positive and the alarming evidence of MDR-TB prevalence in this study calls for close monitoring of the prevalence of drug resistance, especially in HIV-infected population.

Hepatitis E Infection in Nigeria: A Systematic Review.

BACKGROUND:Research done globally on hepatitis E virus (HEV) infection is far fewer compared with other types of hepatitis virus infection. Little is known on the prevalence of HEV in Nigeria.AIM:The present study presents the prevalence of HEV infection in Nigeria from a few available research papers on HEV. The detailed statistical analysis was used to analyse the prevalence of HEV in humans and animals.MATERIAL AND METHODS:A literature search in Web of Science, Scopus and PubMed databases was done, and a final 7 articles were selected. Minitab 17.0 was used to perform the correlational and binary logistic analyses.RESULTS:Serum and faecal analysis of blood and stool samples of 1178 humans and 210 pigs (animals) were done, and the presence of anti-HEV IgG or HEV RNA in the study samples were 127 and 138 respectively. Further analysis showed the prevalence of HEV are 10.8% and 65.7% in humans and animals, respectively. Weak positive non-significant association (r = 0.327, p-value = 0.474) was obtained between the target (humans and animal) and the HEV infection (positive) groups. The application of binary logistic regression yielded an equation that can be used to predict the target group from the HEV positive humans or animals. Generally, the logistic model was not statistically significant (p-value = 0.376), and the model was able to explain 9.3% of the deviation or variability of the model. The odds ratio is OR = 1.0344 with 0.9550, 1.204 95% Confidence Interval (CI). Thus, in Nigeria, the odds of prevalence of HEV in animals are 1.0344 higher than humans.CONCLUSION:The risk factors obtained from the few available articles are consistent with the global epidemiology of HEV infection. Food and animal handlers and those that consume unsafe water are the key people at risk of HEV infection in Nigeria.