ARTICLES

The prevalence of trypanosome infection in trade cattle, goats and sheep was investigated in slaughtered animals at the Kaduna Abattoir. Wet, thin, thick films, animal inoculation, haematocrit centrifugation technique and buffy coat methods were used to detect rypanosomes in the jugular blood of the animals. The packed cell volume (PCV) was also determined. A total of 300 cattle, 300 goats and 300 sheep were examined within five months (September, 1998 – January, 1999) and the prevalence rates in cattle, goats and sheep were found to be 5.00%, 4.67% and 3.33% respectively.
Mean PCV of infected cattle was 20.33% against uninfected cattle 35.08%. In goats, the PCV was 20.29%, uninfected goats 31.56%; while that of sheep was 19.40% and uninfected 32.85%. Trypanosoma vivax infection accounted for 60%, T. brucei 26.67% and T. congolense 13.33% in cattle. In goats, T. vivax infection accounted for 71.43%, T. brucei 21.43% and T. congolense 7.14%. Also T. vivax infection accounted for 70%, T. brucei 30% and T. congolense 0% in sheep. Sex did not significantly (P>0.05) affect infection rates. Although the prevalence rate of trypanosomiasis in cattle, goats and sheep appeared low compared with the previous works, natural trypanosomiasis remains economically importance in cattle, goats and sheep in Nigeria.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 15-25

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The Prevalence Of Trypanosome Infection In Trade Cattle, Goats And Sheep Slaughtered At The Kaduna Abattoir

Serum antibodies to Onchocerca volvulus native sodium duodecylsulphate slat extracted antigens and epitopes recognized by three monoclonal antibodies designated Cam8, Cam22, and Cam28 were measured using indirect (sandwich) and competitive enzyme-linked immunosorbent assay (ELISA). Paired serum samples (n=32) were obtained before and two months post-ivermectin treatment. Those with increases of ten percent and above (≥10%) were 16 (50%) for IgG, 13 (40.7%) for both IgG1 and IgG4. Nine (28.2%) for IgM, eight (25%) for IgG3, IgA with four (12.5%) was the least, while IgG2 was not assayed due to cross-reaction. The higher increases in IgG, IgG1 and IgG4 antibodies in
females (n=16) than males (n=16) were significant by T-test of unpaired data (P<0.05). Those without onchocercal skin disease, OSD (n=18) had a significant increase of 20.5±29.6%, with pre- and posttreatment values of 0.59±0.15 versus 0.68±0.13 for IgG antibody (P<0.05). Both IgG1 and IgG4 antibodies for those with OSD (n=14) increased by 16.0±24.8%. Only IgG4 antibody increased with the presence of palpable nodule and higher skin microfilarial density. Trend exhibited by Cam 22 and Cam 8 were similar to that of IgG and IgG4, respectively. In conclusion, while IgG1 and IgG4 were both associated with skin diseases, IgG4 assay proved more suitable for onchocerciasis drug screening.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 26-37

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Quantitative Changes In Antibodies Against Onchocercal Native Antigens Two Months Postivermectin Treatment Of Onchocerciasis Patients

With depressing nature of economy in many countries such as Nigeria where per capita income is low, there is need for utmost consideration for cost containment measures.
Objective: The objective of this study is to conduct pharmacoeconomic evaluation of two antichlamydial indicated non-gonococcal urethritis therapeutic options and to make
recommendations for inclusion of economic evaluation of drug therapies in health policy formulations and decision making. Methods: Cost effectiveness analysis was carried out retrospectively for prescribed/dispensed antibacterials to out-patients with chlamydial implicated non-gonococcal urethritis among other infectious diseases, by examining out-patient case notes between 2005 and 2007 in Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Results : The result shows that doxycycline costs N1.33/unit of effectiveness while tetracycline costs N2.77/unit of effectiveness in the treatment of chlamydial implicated non-gonococcal urethritis. Doxycycline is therefore more cost effective than tetracycline capsules. Subjecting the costs and effectiveness to sensitivity analysis did not change this conclusion. There is statistically significant difference in the effectiveness (outcome) of doxycycline (78.8%) and tetracycline (58.7%) ( x2 =9.4; p<0.05) There is therefore association between effectiveness and therapeutic option chosen with doxycycline being a more cost-effective option. The result is significant because doxycycline is not currently included in the Essential Drug list of Nigeria. However, the result is in agreement with Zimbabwean Essential Drug list which recommended that tetracycline be replaced by doxycycline in all indications and should be used only when
doxycycline is not available2. Also doxycycline is a drug of choice for other disease like
gonorrhorea and syphilis in non-pregnant women2. It was concluded that Doxycycline 100mg bd x 1/52 is more cost effective than Tetracycline 500mg qid x 1/52
in the treatment of chlamydial implicated non-gonococcal urethritis. Adoption of economic evaluation of drug therapies in Nigeria Health policy formulation and decisions is likely to enhance overall Health System cost effectiveness.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 35-46

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Pharmacoeconomic Evaluation Of Doxycycline And Tetracycline In The Treatment Of Chlamydial Implicated Non-Gonococcal Urethritis In A Tertiary Healthcare Institution

Healthcare organizations, governments and individuals have been forced by prevailing circumstances of economic crisis to be increasingly oriented towards cost containment due to escalating nature of health expenditure.
Objective:
The objective of this study is to determine the comparative cost effectiveness of various antituberculous therapeutic options and to make recommendation for the adoption of costeffectiveness evaluations in National Health Policy formulation and decision-making.
Method
Retrospective cost effectiveness analysis was carried out for prescribed/dispended antibiotic to outpatients with tuberculosis among other infectious diseases in outpatients case notes between 2005 and 2007 in Ahmadu Bello University Teaching Hospital, Zaria Nigeria.
Results
The result shows that ethambutol tablet cost N8.40/unit of effectiveness while streptomycin
injection cost N81.50/unit of effectiveness in the treatment of tuberculosis. Ethambutol tablet therefore appears to be more cost effective than streptomycin injection. Subjecting the cost and effectiveness to sensitivity analysis did not change this conclusion. Statistical analysis shows that there is a statistically significant difference in the effectiveness (outcome) of ethambutol (95%) and streptomycin injection (76.73%) (X2 =13.75; p<0.5). Therefore there is association between effectiveness and therapeutic option chosen with ethambutol tablet being a more cost effective option. The result of this study is significant because ethambutol is usually traded off for less cost-effective streptomycin in many cases even when there is no contraindication to the use of ethambutol.
CONCLUSION
Ethambutol tablet is more cost effective than streptomycin injection at their usual therapeutic doses in combination with isoniazed, rifampicin and pyrazinamide in the treatment of tuberculos at the intensive phase.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 47-55

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Comparative Cost-Effectiveness Analysis Of Streptomycin And Ethambutol In The Treatment Of Tuberculosis In A University Teaching Hospital In Nigeria

A case-control study was done using a convenience sample of 100 pairs of mothers and children (less than five years old) divided into two groups; the first group made of children with diarrhoea and their mothers (case group) and the second group made up of mothers and children who did not have diarrhoea (control).
A structured interview schedule and review of routine data were used to collect data.
Only 12.5% of children less than six months in the case group were exclusively being breastfed compared with 75% of the control group. 56% of the cases used water from unprotected wells for domestic activity while 70% of the control group used pipe- borne water. Also 24% of the case group did not cover stored water while 76% of the control group covered stored water. This demonstrated poor food and water safety.
Only 10% of cases had access to flushing water closets for human excreta disposal while the remaining 90% either used pit latrines or disposal into surrounding bushes.
It was recommended that good amenities for the disposal of refuse in the communities be
provided by the government and the delivery of pipe-borne water be made more regular to the inhabitants Further, appropriate education in simple language is to be offered by health
personnel especially at Ante-Natal Clinic and on radio stations and mothers are to be
encouraged to put into practice what they learn about the treatment and prevention of
diarrhoea.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 56-63

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The Influence Of Environmental Sanitation Practices And Hygiene On The Incidence Of Diarrhoea – The Case Of Koforidua Municipality, Ghana

To ascertain the sensitivity of Diazo (chemical) test in comparison to the Widal (serological) test in the diagnosis of enteric fevers, blood specimens from101 patients suspected of having enteric fevers were collected. 54.5% (55) of the patients were significantly seropositive. Fifteen urine specimens from these 55 seropositive patients were positive for Diazo tests, giving a sensitivity of about 27%. Salmonella typhi was the predominant serotype causing typhoid/paratyphoid fevers, followed by S. paratypi A; S. paratyphi C and S. paratyphi B respectively. Although Diazo test does not appear to be reliable, it could still be useful alongside with Widal agglutination test in endemic rural or urban areas where electricity and facilities are absent or inadequate for routine laboratory investigations.

African Journal of Clinical and Experimental Microbiology Vol. 9 (3) 2008: pp. 115-118

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The Sensitivity Of Diazo Test In The Diagnosis Of Enteric Fevers

Fifty adult patients in Adikpo, Benue State, Nigeria having an average of 50 microfilaria/skin snip (mflss) and 2 microfilaria/milliliter (mflml) in skin and urine respectively were given a single treatment of Ivermectin at a dose rate between 150 – 200mg/kg. Five of the patients also had microfilariae in their blood. Seven days after this treatment, there was a decrease of the microfilaria from pretreatment level to 17.8% and 10% in the skin and urine respectively (i.e.82% and 90% clearance). There was 100% clearance in the blood. Trace proteinuria shown in 30 (60%) patients before treatment was increased to 45 (90%) patients after treatment. This study has revealed that Ivermectin has a great efficacy in clearing microfilaria of Onchocerca volvulus in the skin, urine and blood of individuals. The increase in the number of patients with mild proteinuria after treatment and its implication require further investigation. It may not mean that the increase in protein content after treatment is due to Ivermectin.

African Journal of Clinical and Experimental Microbiology Vol. 9 (3) 2008: pp. 119-121

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Proteinuria And Occurrence Of Onchocerca Volvulus Microfilariae In Skin, Urine And Blood Of Onchocerciasis Patients After Ivermectin Treatment In Adikpo, Benue State,

Locally manufactured antimicrobial susceptibility discs are becoming increasingly used in both private and government hospital laboratories in Nigeria. Data on the quality of these locally manufactured antimicrobial discs are not available. In order to provide some data, we evaluated the quality of three brands of locally manufactured antimicrobial susceptibility discs in common use in southeastern Nigeria. The three brands are Brodisk, Jirehdisk and Optudisc. The performances of these brands in agar disc diffusion assay against clinical isolates of Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli were compared with that of Abtek, the imported brand. Un-interpretable zones of inhibition defined as large zones of inhibition that merged together or complete wiping out of bacterial growth at the time of reading of the plate, were common with Optudisc and Jiredisk brands. The imported brand, Abtek, did not produce any such results. While Gentamycin on Abtek produced a mean diameter of zone of inhibition of 15mm, 19mm and 16mm against S. aureus, P. aeruginosa and E. coli respectively, the same antibiotic disc with the same stated potency on Brodisk an Jiredisk produced no zone of inhibition against the test bacteria. Amoxylin and Augmentin discs on Abtek produced zones of inhibition of 13mm
and 21mm against S. aureus respectively. Amoxylin disc on Brodisk did not produce any zone of inhibition against the bacterial strain while Augmentin disc on Jirehdisk produced un-interpretable result. Of the three locally made brands, Brodisk is the only one that conformed to the international standard of not having more than eight discs per
90mm plate. In our opinion, Brodisk can be recommended for clinical use in Nigeria with further improvement. The outcome of this study indicates the need for improved standardization in the production of these locally manufactured susceptibility discs.

African Journal of Clinical and Experimental Microbiology Vol. 9 (3) 2008: pp. 122-128

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Evaluation Of The Quality Of Locally Manufactured Antimicrobial Susceptibility Testing Discs Used In South Eastern Nigeria