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Prevalence and distribution of intestinal parasite infections in HIV seropositive individuals on antiretroviral therapy in Vom, Plateau State Nigeria

PM Lar, VK Pam, Julius Ayegba, Hosea Zumbes

 

Abstract

Background: The immunologic status of an individual can determine outcomes of treatment and their capacity to combat opportunistic infections. Co-infection with other parasites will confound the situation; however there is inadequate information on the interaction of HIV and helminth infections. We wanted to establish the relationship of the immunologic status and the prevalence of intestinal parasites in HIV/AIDS patients enrolled for antiretroviral therapy at the Vom Christian health centre.

Materials & Methods: With their consent, stool samples of 205 subjects were collected and examined parasitologically by direct microscopy and concentration techniques. Their most resent CD4+ cell counts were obtained at the centre. The demographic characteristics of the subjects were determined from their response to a questionaire.

Results: Out of the 205 subjects examined 61.9% of them had various parasites with helminthes occurring in 51.9% of the cases. The age group of 31-40 years was the most significantly infected (P< 0.05). Hookworms and Schistosoma mansonii were most frequent with prevalence rates of 18.1% and 16.5% respectively. The highest prevalence of parasites occurred in HIV/AIDS people with CD4+ cells between 101-200 cells/μ and those with counts below 100 cells/al.Occupation was highly associated with parasitic infections (p< 0.05).

Conclusion: Parasitic infection remained highly prevalent among the subjects examined in spite of ART treatment and in the case of intense infection in the immunocompromised, treatment outcome may be compromised.

Keywords: HIV/AIDS, Parasites, ART, Coinfection

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Prevalence and distribution of intestinal parasite infections in HIV seropositive individuals on antiretroviral therapy in Vom, Plateau State Nigeria

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Hematological derangement patterns in Nigerian dogs infected with Trypanosoma brucei: A simple prototype for assessing tolerance to trypanosome infections in animals

JN Abenga, SA Ode, G Agishi

 

Abstract

The haematology of Nigerian local puppies experimentally infected with the Federe strain of Trypanosoma brucei was studied in a total of six 9-weeks old puppies born to two local bitches. Four were randomly selected and inoculated with about 0.8 x 106 of T .brucei subcutaneously and the remaining two served as the uninfected control. The parasitaemia was monitored daily using wet mount microscopy. The packed cell volume (PCV), red blood cell (RBC) counts, total and differential white blood cell (WBC) counts and rates of both red blood cell and white blood cell loss per day and per parasitaemia log equivalent value(LEV) were monitored twice in a week . Parasitaemia was detected in the infected group four days after infection which was followed by an acute disease course, though with low fatality rate in the dogs. The anemia was characterized by a fluctuating PCV decrease from the pre-infection value of 29.5±4.5% and 15.3±3.3% at two weeks after infection when one of the dogs died. There was a mild decrease in the overall erythrocyte values which was attributable to trypanotolerance in the local breed of dogs. The post infection hematological derangement pattern was characterized by an overall post-infection RBC count drop of 1.92+0.23(x 1012/μ) (39.0%), mean daily drop of 0.07+0.05 (x 1012/μ) and an overall drop per LEV of 0.69(x 1012/μ). The overall mean postinfection total WBC count drop was 0.61±0.15(x109/μ)(43.6%) with a mean daily drop of 0.02±0.14(x109/μ), and an overall drop per LEV of 0.22±0.44(x109/μ). There was an overall higher post infection leukocyte drop compared to erythrocyte. The result poses fundamental research questions on the likelihood of differential surface sialic acid contents of erythrocytes and leukocytes and the possible roles of trypanosome sialidase in creating this difference as well as enhancing pathogenesis of leucopenia in the dogs . It was concluded that the patterns of hematological derangements demonstrated as erythrocyte and leukocyte drop (loss) rates and drop per parasitaemia Log Equivalent Values could serve as a prototype for comparing susceptibility to animal and human T. brucei infections and, other trypanosome species.

Keywords: Federe, Trypanosoma brucei, haematology, derangement, patterns

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Hematological derangement patterns in Nigerian dogs infected with Trypanosoma brucei A simple prototype for assessing tolerance to trypanosome infections

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Spectrum of aspergillosis: Pathogenesis, risk factors and management

C Iyalla

 

Abstract

This article reviews comprehensively the spectrum of diseases (aspergillosis) caused by Aspergillus spp, the commonest pathogenic form being the A.fumigatus. Aspergilus spp are ubiguitous in the environment and the respiratory tract is the portal of entry in most cases. Aspergillosis is associated with significant mortality and morbidity, the prevalence appears to be on the increase. About 10million people are at risk of aspergillosis, and 50% would die even with treatment. Immunodeficiency, especially neutropenia is central to the pathogenesis of aspergillosis. Diseases caused by A. fumigatus include;1) Invasive aspergillosis seen mostly in stem cell and organ transplant recipients, patients with haematological malignancies, cancer patients on chemotherapy and patients with AIDS. Invasive aspergillosis is life threatening, it affects the lungs and sinuses but could disseminate to affect the CNS, eye, skin and kidney. 2) Chronic pulmonary Aspergillosis occurs in the setting of previous cavitatry lung disease, most commonly tuberculous infections. 3) Allergic bronchopulmonary aspergillosis (ABPA) affects people with asthma and cystic fibrosis. A. fumigatus is also implicated in the exacerbation of asthma. The clinical symptoms of aspergillosis depend on the type and the systems affected; respiratory symptoms are more common as the respiratory tract is disproportionately affected in aspergillosis. Diagnostic features and treatment also depends on the type of aspergillosis. Diagnostic testing for aspergillosis includes radiologic tests, culture tests, galactomannan testing in body fluids, immunologic tests to detectAspergilus -specific immunoglobulins. Treatment modalities include surgery, use of antifungals and immunomodulatory therapy with cytokines.
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Pulmonary candidiasis and CD4 count in HIV positive patients seen in Jos, north central Nigeria

YJ Peter, AH Isa, AS Anzaku, MI Builders

 

Abstract

Background: Accurate and reliable diagnosis of HIV opportunistic infections plays a central role in effective HIV intervention programmes. Pulmonary infections are the leading cause of  morbidity and mortality in HIV infected individuals.

Objectives: We set out to determine the prevalence of Pulmonary candidiasis by isolating Candida species from the sputum of HIV sero-positive patient’s presenting to hospital with complaint of cough for more than two weeks and related the level of CD4 count to Pulmonary candidiasis.

Methods: Using sterile wire loop, each sputum sample was inoculated into duplicate SDA (Thermo Scientific, UK); one tube without antibiotics, another tube supplemented with Chloramphenicol (0.05%) and Cycloheximide (0.5%) antibiotics. The patient’s CD4 count was determined using a Cyflow machine (PARTECR, Germany).

Result: Fifty two (54.2%) female and 44(45.8%) male HIV positive subjects were compared with a control group made up of, 52(54.2%) female and 44(45.8%) male HIV negative subjects. Twenty one (21.9%) HIV positive subjects had Candida species in their sputum samples compared to 12(12.5%) in the HIV negative subjects. Among HIV positive subjects, 17(17.7%) had Candida albicans isolated from their sputum, 11(11.5%) of whom had a CD4 count of <200 cells/ul.

Conclusion: We concluded that, there is a risk of pulmonary candidiasis occurring in HIV infected patients with CD4 count <200cells/ul and that, Candida species contributes to chronic cough experienced by HIV infected patients. We recommend that HIV positive patients who have chronic cough and whose CD4 count is <200cells/ul be placed on systemic antifungal medication.

Keywords: Candida, Cough, Nigeria, Sputum

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Pulmonary candidiasis and CD4 count in HIV positive patients seen in Jos north central Nigeria

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Histological and biochemical markers of the liver of male Wistar rats on oral administration of nevirapine suspension

EK Oladipo, AY Afolabi, IO Omomowo, JK Oloke, EH Awoyelu

 

Abstract

Background: Mechanism of action of nevirapine in the prophylaxis treatment and treatment of HIV-1 may involve elevations in levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and other biomarkers of liver function. This study presents the hepatotoxic effect of nevirapine suspension using animal model.

Methods: A total number of 15 male Wister rats were fed normal chow and antiretroviral drug (Nevirapine) for a period of six weeks. The liver organ of the rats were obtained and subjected to histological procedures and biochemical analysis using enzyme assay obtained from Randox Laboratories Limited, Antrim United Kingdom (BT294QY).

Results: The wistar rats showed no significant mean body weight difference when compared with the control group. However there was significant difference in the mean values of AST (77.77±3.03) and ALT (89.37±3.19) of the treated rats. Nevirapine treated rats showed significant difference in AST, ALT, and ALP in the single (77.77± 3.03, 31.80±1.73, 43.81 ±1.54) and double (89.37±3.19, 33.38±2.01, 34.64 ±1.02) doses when compared with the controls (75.14 ±2.00, 29.16±0.17, 45.44 ±1.85) respectively. Mild vascular congestion, infiltration of sinusoids by inflammatory cells, and haemorrhage were induced by nevirapine as compared with the control group showing normal vessels without congestion, normal sinusoids appearing normal without infiltration.

Conclusion: The liver histology of the rats fed with Nevirapine suspension showed diffused hepatocellular necrosis. Routine check of the drug effect is important as it provides effective life management of HIV infected individuals.

Keywords: Nevirapine, Wister rat, Hepatotoxicity, Liver, Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP)

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Histological and biochemical markers of the liver of male Wistar rats on oral administration of nevirapine suspension

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Hepatitis C virus-associated porphyria cutanea tarda: A case report

AH Isa, M Mary Tapgun, OC Isichei

 

Abstract

Porhyria cutanea tarda (PCT) is a rare, inherited or acquired disorder due to decreased activity or deficiency of uroporphyrinogen decarboxylase (UROD), one of the enzymes in the haem synthetic pathway. It is characterized by cutaneous manifestations such as erosions, blisters and bulae in the dorsum of the hand, forearm, elbows and knees; and painful indolent sores that heal with dyspigmented and scarring lesions. A 25 year old sales man presented with a 7 month history of recurrent blistering of the skin of the extremities- hands, elbows, knees and feet which occurred spontaneously or following trivial trauma. There was no family history of similar skin symptoms. Examination showed broken and fresh blisters of varying sizes with some healed lesions on the dorsum of the hands, over the elbow and knee joints, and toes. Serum ferritin was 360μ/L (40- 340 μ/L), urine uroporphyrinogen was positive (+++) and Hepatitis C antibodies screening was positive. Some improvement of the cutaneous lesion was noticed following commencement of therapeutic phlebotomy.

Keywords: Porhyria, blisters, Hepatitis C virus, uroporphyrinogen

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Hepatitis C virus-associated porphyria cutanea tarda A case report

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Sero-epidemiological survey and risk factors for Hepatitis B Virus (HBV) infection among pregnant women in Logo LGA, Benue State, Nigeria

EPT Aluor, HOA Oluma, RAI Ega, N Owolcho

 

Abstract

Hepatitis B virus (HBV) infection is associated with chronic liver diseases, cirrhosis and hepatocellular carcinoma, liver failure and death. The prevalence of Hepatitis B virus carrier and infectivity status and social characteristics among three hundred and ten pregnant women in Logo LGA, Benue State, Nigeria, was determined through random anonymous testing of volunteers attending antenatal clinics of different hospitals within the community. Thirty of three hundred and ten blood samples tested positive for HBV infection. 11.9% were in the 3rd trimester of their pregnancy and 58.1% were within the age bracket of 21-30 years. Illiterates women constituted 14.4% of those sampled while civil servants were 6.7%. HBV carrier status was determined by the presence of Hepatitis B surface antigen (HBsAg). Repeated reactive samples were confirmed by Enzyme linked immounosorbent assay (ELISA) Kit (Diagnostic Automation, Inc., USA). Maternal HBV infectivity status was determined by testing all HBsAg positive samples for the presence of hepatitis B e antigen (HBeAg). A total of thirty (9.7%) pregnant women identified as carriers of HBV and eleven of the thirty tested positive for HBeAg. Hence, 3.6% (11/310) of the entire study population was found to have high viral replication as well as high risk of transmitting HBV to their neonates. The frequency of HBV carrier did not vary with age, however, it varies significantly with the previous use of contraceptives and the anaemic status of the subjects (P< 0.05) .This study demonstrates the endemicity of HBV infection in Logo and high infectivity rate, suggest that HBV is likely to be acquired by both vertical and horizontal means of transmission. Testing for HBsAg is recommended for all pregnant women at first prenatal visit so that positive mothers receive prompt intervention.

Keywords: Hepatitis B e antigen, Hepatitis B surface antigen, seropositivity, pregnant women, neonates

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Sero-epidemiological survey and risk factors for Hepatitis B Virus (HBV) infection among pregnant women in Logo LGA, Benue State, Nigeria

 

 

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Association of cytomegalo virus with type I diabetes mellitus among children in Minia Governorate

BaA Alia, WKM Mahdi

 

Abstract

Background: Type I diabetes (T1D) is the most common form of diabetes in most parts of the world.

Aim: The association between cytomegalovirus (CMV)and T1D mellitus was studied, with comparison to healthy subjects and to correlate its level with different clinical and laboratory parameters.
Materials & Methods: This study included 68 children and adolescents who were classified into two groups. GroupI comprised 53 patients diagnosed with T1D and having regular follow up in the pediatric endocrinology out-patient clinic, Minia University children’s hospital. Group II comprised 15 apparently healthy subjects, age and sex matched to the diseased group. According to the onset of diabetes, we divided the diabetic group into two sub-groups. Group Ia (newly diagnosed) comprised 20 patients, with ages ranging between 7 and 18 years; 10 were males (50 %), and 10 were females (50 %). Whilst group Ib (duration of disease >1 year) comprised 33 patients, with ages ranging between 6 and 17 years; 17 were males (49%) and 18 were females (51%). The studied groups were subjected to the following: thorough history taking, clinical examination and laboratory investigations (random blood glucose levels) and HbA1c%. DNA was extracted using QIAamp Min elute kit protocol for detection of cytomegalo virus by RTRCR.
Results:The frequency of cytomegalovirus was significantly higher in T1D children than the control and in group Ia than group Ib.
Conclusion: T1D children had significantly higher serum cytomegalovirus than the control group, as did those newly diagnosed compared to those with longer duration of illness.

Keywords:T1D, Cytomegalo-virus, Haemoglobin A1C, Polymerase chain reaction Key Messages: Dose of insulin, significant +ve correlations, RT-PCR

 

ASSOCIATION DU CYTOMEGALOVIRUS AVEC DIABETE SUCRE DE TYPE 1 CHEZ LES ENFANTS DANS LE GOUVERNORAT DE MINIA.

 

Contexte : Diabète de type 1(DT1) est la forme la plus courante du diabète dans la plupart des régions du monde.
But : L’association entre le cytomégalovirus et DT1 sucre a été étudiée avec une comparaison aux sujets sains et pour corréler son niveau avec les divers paramètres cliniques et laboratoires.
Matériaux et Méthodes : Cette étude a inclus 68 enfants et adolescents qui ont été classés en deux groupes. Le Groupe I a compris 53 patients diagnostiqués avec DT1 et ayant suivi régulier dans la clinique endocrinologie pédiatrique ambulatoire, l’Université hôpital d’enfants de Minia. Le Groupe II a compris 15 sujets apparemment sains, l’age et le sexe adapté au groupe malade. Selon l’attaque du diabète, nous avons divisé le groupe diabétique en deux sous – groupes. Le Groupe Ia (nouvellement diagnostiqué), a compris 20 patients, dont l’âge est compris entre 7 et 18 ans ; 10 étaient males (50%), et 10 étaient femelles (50%). Alors que le Groupe Ib (la durée de malade >1 ans) comprenait 33 patients ; 17 étaient males (49%), et 18 étaient femelles (51%). Les groupes étudiés ont été soumis a la suivante : grâce a la
prise de l’histoire, examen clinique et examen de laboratoire (nouveau de glycémie aléatoire) et HbA1c%. L’ADN a été extrait en utilisant QIAamp Min elute protocole du kit pour le dépistage du cytomégalovirus par RT – RCR.
Résultats : La fréquence du cytomégalovirus était considérablement plus élevée dans les enfants DT1 que le contrôlé et dans le Groupe Ia que le Groupe Ib.
Conclusion : Les enfants DT1 ont eu sérum cytomégalovirus plus élevé que le groupe contrôlé, comme ceux nouvellement diagnostiqués par rapport a ceux qui ont une plus longue durée de la malade.

Mots Clés : DT1, Cytomégalovirus, Hémoglobine A1C, la réaction en chaine de la Polymérase.
Messages Clés : Dose d’insuline, Significative +ve corrélations, RT – PCR.

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Association of cytomegalo virus with type I diabetes mellitus among children in Minia Governorate

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Epidemiology of Hepatitis B and Hepatitis C Virus infections among HIV counseling and testing clients in Jos, North central Nigeria

YJ Peter, AT Olayinka, OO Agbaji, FT Ogunsola

 

Abstract

Hepatitis B and hepatitis C virus infection are common in Nigeria; where they are a major cause of both acute and chronic liver disease, as well as hepatocellular cancer. Persons at risk of acquisition of Human Immunodeficiency Virus (HIV) infection are also at risk of acquisition of infection with Hepatitis B virus (HBV) and Hepatitis C virus (HCV). We set out to determine the epidemiology of HBV and HCV infection among HIV Counseling and Testing (HCT) clients at the Jos University Teaching Hospital (JUTH), Nigeria.
This was a cross-sectional study conducted at the HCT unit of the AIDS Prevention Initiative in Nigeria (APIN) Jos University Teaching Hospital (JUTH), Jos, Nigeria between November, 2012 and April 2013.
Subjects were recruited consecutively at the HCT unit of APIN JUTH. Included were subjects 18 years of age and above, antiretroviral (ARV) drug naive, who accepted and signed the consent form.Clients who declined to sign the consent form were excluded. The study involved collecting demographic data, exposure to risk factors and laboratory determination of HBV and HCV sero-prevalence in the subjects using Enzyme Linked Immunoassay (ELISA) and Polymerase chain reaction (PCR) assay methods.
Chi-squared test was used to determine significance of association between categorical variables.
One hundred and thirty two (56.9%) were females, 100 (43.1%) were males. Thirty six (15.5%) tested positive for HBsAg by ELISA, 31 (13.4%) were confirmed positive by DNA PCR. Nine (3.9%) tested positive by ELISA to HCV antibody, 7 (3.0%) were confirmed positive by RNA PCR. Co-infection rate of HIV / HBV was 5.2%. Infection was more common among those younger than 36 years in the case of HBV and those older than 36 years in the case of HCV.We concluded the prevalence of HBV infection was high. Study was limited by the cross sectional design.
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Burden of intestinal parasites amongst HIV/AIDS patients attending Bamenda Regional Hospital in Cameroon

MEA Bissong, NF Nguemain, TEN Ng’awono, FHL Kamga

 

Abstract

Background: Intestinal parasitic infections cause severe diarrhea especially in debilitated subjects with clinical complications of dehydration, malabsorption and severe weight loss, complicating treatment schemes.
Materials and Methods: This was a cross-sectional, hospital based study during which data were collected by the use of questionnaires and laboratory tests of stool and blood samples respectively.
Results: A total of 200 volunteer patients participated in this study of which 132 (66.0%) were females and 68 (34.0%) males. Eight different intestinal parasites were identified in 69 (34.5%) participants. The most prevalent parasite was Entamoeba histolytica with 8.0% of infected cases. Opportunistic parasites were identified in 15.5% of the study population. Seven percent of patients were infected with  Cryptosporidium parvum, 6.5% with Isospora belli, and 2% with Microsporidium species. Diarrhea was found in 38.5% of the study participants 62.3% of whom had at least a single intestinal parasite. Opportunistic parasites were significantly more prevalent in patients with diarrhea and participants with CD4+ T cell counts less than 200 cells/al (P < 0.05). Diarrhea was significantly more prevalent in
participants who were on antiretroviral drugs than in those who were not (66.5% vs. 33.5%, P<0.05).
Conclusion: Though opportunistic parasites were found in the majority of HIV/AIDS patients attending the Bamenda Regional Hospital, Entamoeba histolytica and other intestinal parasites represented a common burden. It was therefore recommended appropriate diagnosis before initiating the routine treatment which is usually practiced in our health settings.

Key words: Intestinal parasites, HIV/AIDS patients, Bamenda Regional Hospital

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Burden of intestinal parasites amongst HIVAIDS patients attending Bamenda Regional Hospital in Cameroon