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Glycated haemoglobin levels in patients with multidrug-resistant tuberculosis infection during 6 months of treatment

KS Akinlade, SK Rahamon, VF Edem, OM Ige, OG Arinola

 

Abstract

Background: There is little information on the possible impact of drugs used in the treatment of  multi-drug resistant tuberculosis (MDR-TB) on glycaemic levels. This study therefore assessed changes in glycated haemoglobin levels in patients with MDR-TB.
Materials and Methods: This longitudinal study involved 21 MDR-TB patients who were followed up for 6 months. Glycated haemoglobin (HbA1c) level of each patient was determined before the  commencement of MDR-TB drug regimen and at 2, 4 and 6 months post treatment as part of a study which investigated them every 2 months. Differences in means were assessed using the paired Student’s t-test and statistical significance was set at P<0.05.
Results: A patient had undiagnosed diabetes mellitus (DM) with an HbA1c value of 6.5% and died before the second month sample collection; another patient became critically ill; therefore, 19 patients completed the study. Before the commencement of MDR-TB therapy, two patients had pre-diabetes with HbA1c values of 6.0% and 5.8% while the HbA1c values of the remaining patients were less than 5.7%. There was a significant reduction in the mean HbA1c level at 2 months post therapy compared with the baseline. However, the HbA1c levels increased slightly after the 2nd month of therapy but no significant change was observed in the HbA1c levels at 4 and 6 months of MDR-TB therapy compared with baseline.
Conclusion: Diabetes mellitus is not common among Nigerians with MDR-TB and MDR-TB drug  regimen might have an acute effect on glycaemic changes in patients with MDR-TB.

Keywords: Diabetes mellitus, Glycaemic change, Glycated haemoglobin, Multidrug resistant tuberculosis therapy

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Glycated haemoglobin levels in patients with multidrug-resistant tuberculosis infection during 6 months of treatment

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T lymphocyte subsets in prostate cancer subjects in south eastern Nigeria

AO Oluboyo, BO Oluboyo

 

Abstract

Humoral and cellular mechanisms play roles in immune response to foreign antigens. The present study  was designed to determine the T lymphocyte subsets (CD4 + T cells, CD8 + T cells and CD4/CD8 ratio) in the prostate cancer subjects and control subjects. CD4 + T cells (`l/count) and CD8 + T cells (`l/count) were estimated using flow cytometric method by Partec while CD4/CD8 ratio was calculated from the results obtained from the CD4 + T cells and CD8 + T cells. CD4 + T cells and CD8 + T cells decreased  significantly while the CD4/CD8 ratio increased significantly in the prostate cancer subjects compared to the
control subjects. The suppressed CD4 + and CD8 + T cell counts in prostate cancer subjects may indicate  immune instability in the prostate cancer subjects.

Key words: T lymphocyte subsets, prostate cancer, tumour

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T lymphocyte subsets in prostate cancer subjects in south eastern Nigeria

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Species distribution and antifungal susceptibility pattern of candida isolates from pregnant women in a tertiary hospital in Nigeria

AM Efunshile, O Oduyebo, CS Osuagwu, B Koenig

 

Abstract

Introduction: Information regarding the resistance pattern of Candida species in developing countries  is limited. Most sensitivity studies were performed on few isolates and/or few antifungal agents using  the disc diffusion method because of limited resources.
Methods and Material: We evaluated six antifungal agents against Candida isolates recovered from  the vagina of apparently healthy pregnant women using the E-test method.
Results: One hundred and seventy Candida isolates recovered from 500 participants were identified and subjected to an antifungal susceptibility test. Candida albicans(53.5%) was the most common specie  identified, followed by Candida glabrata(14.1%). C. albicans was mostly resistant to itraconazole (31.9%), with MIC 50 and 90 of 0.038 mg/L and 6 mg/L, respectively. Resistance to 5-fluorocytosine, fluconazole, and voriconazole was not observed for C. albicans. Caspofungin resistance was observed in 3 C.  albicansand 1 C. glabrata isolates. Resistance to amphotericin B (50%) and itraconazole (100%) were the highest for C. glabrata. Flucytosine and voriconazole resistance was not observed in this study.
Conclusion: The observed species diversity and the presence of C. albicans resistance to 3 of the 6  antifungal agents tested justify the need for a regular surveillance of the sensitivity pattern to antifungal  drugs in Nigeria.
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CD4 cells profile of HAART naive HIV seropositive clients in Kogi State University Teaching Hospital, Anyigba, Kogi State. Nigeria

OJ Alabi, SPO Akogu, M Akpa, V Ukeje, PO Okpanachi, OG Agama, S Gideon, B Adegboro

 

Abstract

CD4 lymphocyte cells are the primary targets of Human immune-deficiency virus (HIV). Enumeration of CD4 T lymphocytes in the peripheral blood is used in the assessment of disease clinical stage, risk of  opportunistic infections, evaluation of prognosis and guide decision on the commencement of  antiretroviral therapy. The objective was to determine CD4 cells profile of HIV sero-positive naïve  patients in Kogi State University Teaching Hospital( KSUTH) Anyigba. A total of 404 HIV sero-positive Highly Active Anti Retro Viral Treatment ( HAART) naïve patients comprising 147(36.4%) males and  257 (63.6%) females were examined. Approval was obtained from ethical committee of Kogi State University Teaching Hospital (KSUTH), Anyigba. Written and verbal informed consent was taken from all patients. The overall mean age of patients was 33.0 ± 12.7 years and female-male ratio was  1.7:1. Majority of patients were in the clinical stage two 121(30.5%) and three 200(50.4%). Patients had overall mean CD4 cells count of 381.8 ± 240.8 cells /mm3. Patients CD4 cells count varied statistically with the HIV clinical staging (F =4.512 & P value=0.004) and statistically insignificant with gender (P value = 0.7562 & t Test= 0.3106) and tuberculosis status (P value=0.223 & F=  1.505).Conclusion: This study showed HIV sero-positive HAART naive patients presented in KSUTH with mean age of 33 years. Majority of patients presented in disease clinical stage two and three with a mean CD4 cells counts of 381.8 cells/mm3 . This study recommend the need to reduce stigmatization, discrimination and promote early access to treatment , care and support services.

Keywords: HIV/AIDS, CD4, Patient/clients, KSUTH, Nigeria.

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CD4 cells profile of HAART naive HIV seropositive clients in Kogi State University Teaching Hospital, Anyigba, Kogi State. Nigeria

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Selenium as adjunct to HAART in the management of HIV/Hepatitis B Virus coinfection: A Randomized open label study

NN Odunukwe, JO Okwuzu, AP Okwuraiwe, TA Gbajabiamila, ZA Musa, PM Ezeobi, EO Somefun, OO Kalejaiye, DI Onwujekwe, OB Salu, CK Onwuamah, RA Audu, OC Ezechi

 

Abstract

Objective: Management of viral hepatitis in patients with HIV disease is quite challenging and  complex. With effective HIV treatment, people with HIV/HBV co-infection are living longer. HBV  epidemiologic surveys showed an inverse association between selenium (Se) level and regional cancer incidence, as well as viral infection. This study assessed effect of selenium as adjunct to HAART in management of HIV/HBV co-infection.

Methods: A randomized open label study with participants allocated into three treatment groups: – HAART-only, Se-only and HAART-plus-Se. HIV viral load, HBV viral load, CD4 cell count, and alanine aminotransaminase (ALT), were analyzed at baseline and 18th month, analyzed using SPSS 5 v11. Ethical approval was obtained from Institute’s Ethical Review Board.

Results: Sample size was 149 HIV/HBV patients. Rate of HBV clearance was higher among those on HAART-plus-Se at 18th month when compared with rate of clearance among those on HAART-only (p=0.046). CD4 count increment among HAARTplus- Se group compared with HAART-only group was higher (p=0.133), though not statistically significant. On comparison of baseline and 18th month ALT, there was significant decline for HAART-plus-Se (p=0.002) compared with HAART-only group.

Conclusion: Selenium seems to have protective effect on liver cells; may be beneficial as adjunct to HAART in HIV/HBV management.

Key words: HIV/HBV co-infection, Selenium adjunct, HAART

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Selenium as adjunct to HAART in the management of HIVHepatitis B Virus coinfection A Randomized open label study

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Performance characteristics of enzyme linked immunosorbent assay and rapid immunochromatographic test for routine screening of human norovirus

HE Sharaf, SS Morsi, MA Gerges

 

Abstract

Noroviruses (NoV) are identified as the major cause of epidemic and sporadic acute gastroenteritis. Controlling the spread of the disease needs early recognition of NoV. This study investigated the  contribution of norovirus to sporadic cases of pediatric gastroenteritis in Zagazig University Hospitals and studied the performance characteristics of enzyme linked immunosorbent assay(EIA) and  immunochromatographic (ICT) assay for their ability to detect NoV. Two hundred stool specimens were
collected from pediatric patients with acute gastroenteritis. Samples were tested for Norovirus presence by reverse transcription PCR (RT-PCR), ICT kit and EIA. 27% of the samples showed the 338-bp portion of the RNA-dependent RNA polymerase (RdRp) gene of both Norovirus genogroups I and II by RT-PCR. The ICT assay showed high specificity (97.94%) and high sensitivity (85.18%). The EIA  showed high specificity (93.8%) but low sensitivity (64.8%). In conclusion, the high detection rate of NoV as the cause of diarrhea in children reported in this study supports their addition in screenings to  identify sporadic cases of acute gastroenteritis. The ICT and RIA Norovirus kits may be useful for rapid screening of stool samples from patients with acute gastroenteritis. However, RT-PCR should be  considered for negative samples to be confirmed.

Key words: Norovirus, pediatric gastroenteritis, RNA-dependent RNA polymerase (RdRp) gene,  enzyme linked immunosorbent assay, immunochromatographic assay, Sensitivity, Specificity.

Abbreviations: NoV , Noroviruses; EIA, enzyme linked immunosorbent assay; ICT,  immunochromatographic; RT-PCR, reverse transcription PCR; RdRp, RNA-dependent RNA polymerase; ORFs, open reading frames.

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Performance characteristics of enzyme linked immunosorbent assay and rapid immunochromatographic test for routine screening of human norovirus

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Recent rubella infection among childbearing women in a tertiary hospital in Nigeria: A seroepidemiological indication for vaccination need

ST Suleiman, R Bakare, AA Akanbi, A Fowotade, SA Billiaminu, KA Durowade

 

Abstract

Background: Congenital Rubella Infection can be prevented and future generation saved from  disability by protecting women of reproductive age through vaccination. The study is aimed at  determining serological evidence of recent rubella infection among women of childbearing age.
Method: A cross sectional study was carried out among 285 women aged between 15 and 49 years. Enzyme immunoassay method was used to detect and quantify human IgM and IgG antibodies with avidity for Rubella virus in sera of participants. Socio-demographic characteristics of the subjects, along with recent history of fever, rash and adverse pregnancy outcome among others were obtained using a questionnaire. Statistical analysis was carried out using the program statistical package for social sciences (SPSS) version 16. Majority (78.3%) of the women recruited for the study were within 15-34 years age range. Of the 285 sera assayed for Rubella IgM antibodies, 23 (8.1%; 95% CI: 4.9%-11.3 %.) was IgM seropositive, while the remaining 262 (91.9%) were seronegative. A total of 7 (2.5%) of reproductive age women in Ilorin had a recent primary infection while 16 (5.6%) had a persistent Rubella infection or recent re-infection.
In conclusion, there is need for vaccination of susceptible women of reproductive age in Ilorin as a large number of women have Rubella in their reproductive age.

Keywords: Rubella, Immunoglobulin M, avidity, reproductive age, Ilorin, Nigeria

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Recent rubella infection among childbearing women in a tertiary hospital in Nigeria A seroepidemiological indication for vaccination need

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Seroprevalence of Hepatitis C Virus (HCV) antibodies in pregnant women in Anyigba, Kogi State, North Central Nigeria

EO Nwankwo, AM Lawal, M Abba

 

Abstract

Background: Hepatitis C virus (HCV) infection is a major public health concern. The aim of this study was  to ascertain the seroprevalence and risk factors of HCV antibodies among pregnant women in  Anyigba, Kogi State North Central Nigeria.

Materials and methods:Blood samples (5mls) were collected from one hundred and thirty consenting pregnant women attending antenatal clinic in Grimad hospital and eighty non-pregnant women from the out-patient clinic were screened for the presence of HCV antibodies. This was done by Skytech diagnostic  laboratory rapid strip (USA) and confirmed by ELISA method.

Results: Out of 130 pregnant women 9(6.9%) were confirmed to be positive to HCV antibodies. Also out of 80 non-pregnant women of the same age group, used as control, 4(5.0%) were positive.

Conclusion: A prevalence rate of 6.9% calls for urgent attention by policy makers and healthcare providers to begin massive enlightenment of this problem. All pregnant women should be screened for early detection.

Keywords: Hepatitis C Virus, Pregnancy, Screening, Transmission.

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Seroprevalence of Hepatitis C Virus (HCV) antibodies in pregnant women in Anyigba, Kogi State, North Central Nigeria

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Perception of the efficacy of artemisinin-based combination therapy (ACT) and chloroquine prescription pattern and among nurses in South-West Nigeria

AM Efunshile, RO Oduyemi, DN Igwe, CN Igwenyi, V Adenugba

 

Abstract

Background-Malaria remains a threat to millions of children despite the recent advances recorded in the fight against the disease which remain the 3rd largest killer of children below the age of 5 years in endemic regions. Drug resistant plasmodium species continues to limit the fight against malaria, while the spread of fake and substandard antimalarial drugs has been recognized as a major problem across Africa because of its association with drug resistant parasite. We aim to find out the prescription pattern of chloroquine among nurses in South-West Nigeria and perception of artemisinin-based combination therapy (ACT).

Design and methods-About 180 pre-tested questionnaires were administered to randomly selected nurses out of which 155 were sufficiently completed and suitable for analysis. Results-Majority (56.1%) still have confidence in the efficacy of CQ which was still being prescribed by 45.2% of the respondents. CQ was mostly prescribed by those who had previous ACT treatment failure experience (54.3%) with their patients, P=0.03; as well as those who believe that ACT resistance malaria is now in circulation (44.3%). Fifty (32.3%) of our respondents claimed that they had come across fake and substandard ACT, from which 40.0% now prescribe CQ.

Discussion-The high rate of CQ prescription in this study showed that many of the health workers were still resistant to the change in antimalarial treatment policy, which is related to unsatisfactory experience with ACT. Additional measures are urgently required to verify this experience so as to win the confidence of healthcare workers away from chloroquine.

Keywords: Artemisinin-based combination therapy (ACT), chloroquine, substandard antimalarial

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Perception of the efficacy of artemisinin-based combination therapy (ACT) and chloroquine prescription pattern and among nurses in South-West Nigeria

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Prevalence of Entamoeba histolytica in stool specimens at Muhondo Health Center, Rwanda

Noel Gahamanyi, Jean de Dieu Mugabo, Claude Bayingana

 

Abstract

Entamoeba histolytica is a protozoan parasite causing amebiasis. It occurs usually in the large intestine and causes internal inflammation as its name means (histo = tissue, lytic = destroying). Between 40 and 50 million people are infected worldwide, mostly in tropical countries, in areas of poor sanitation. The infection occurs by ingestion of mature cyst in fecally contaminated food, water or hands. The disease shows different symptoms including vomiting, abdominal pain, nausea, watery and bloody diarrhea. While the infection becomes extra intestinal, it may cause abscess in other organs such as liver, kidney, brain and lungs.

The present study was carried out to determine the prevalence of E. histolytica in stool specimens at Muhondo Health Center. A total of 103 fecal specimens were collected over a period of three months. Out of 103 specimens, only 26 (25.2%) were positive for E. histolytica. Out of the 26 specimens positive for E. histolytica, 17 (16.5%) and 9 (8.7%) were from males and females respectively. Furthermore, of the 26 Specimens positive for E. histolytica, 15 (14.6%) and 11 (10.7%) were from people ≤ 15 and >15 years of age respectively. Entamoeba histolytica was more prevalent 26 (25.2%) than other parasites including Giardia with 15 (14.6%), Ascaris sp with 5 (4.9%), Trichomonas intestinalis with 16 (15.5%) and Entamoeba coli with 1 (1%). In order to reduce Entamoeba histolytica contamination and infections, the following recommendations were pointed out: (i) improving personal hygiene (washing hand before eating and after using latrines) ; (ii) avoiding fecal contamination of food, water, and utensils ; and (iii) boiling drinking water before consumption.

Keywords: Parasites, Prevalence, Entamoeba histolytica, amebiasis, Stool specimens, Muhondo Health Center

Prevalence of Entamoeba histolytica in stool specimens at Muhondo Health Center, Rwanda