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Tetanus toxoid immunization coverage among mothers of below one year of age in difficult-to-reach area of Lagos Metropolis

A Adeiga, SA Omilabu, RA Audu, F Sanni, GP Lakehinde, O Balogun, O Olagbaju

 

Abstract

A retrospective survey of tetanus toxoid immunization coverage was conducted among 196 mothers of children less than one year of age in a difficult-to-reach area of Lagos metropolis. This was to ascertain the status of coverage among the women presumed to have been immunized with minimum of two doses of tetanus toxoid during pregnancy, estimate drop out rates, and investigate reasons for failure to be immunized and determine missed opportunities to get immunized. An interview was conducted by administering questionnaires using WHO cluster form for tetanus toxoid immunization. Recall history and immunization card review were taken as response. The results showed that with card/history criterion, 109 (55.6%) women received first dose of tetanus toxoid (TT), 80 (40.8%) received second dose and 22 (11.2%) received third dose while 87 (44.4%) were not immunized. Using the card criterion that only established valid immunization, 20 (10.2%) women received first dose and 14 (7.2%) received the second dose. With the card criterion analysis, 14 (7.2%) mothers were protected against tetanus and only 4 (2%) babies born of these mothers were protected against tetanus. A decline was observed in compliance with the regimen of vaccination. Thirty three (16.8%) of women studied missed the opportunity of getting vaccinated and 87 (79.8%) of 109 who started vaccination dropped out. Reasons advanced for failure to be immunized included lack of information accounting for 65.85%, lack of motivation was 20.4% and 13.8% as environmental factors. Poverty and lack of health facilities also contributed to the low level of immunization coverage. For TT immunization to improve in the area studied, factors impeding immunization must be addressed.

Keywords: tetanus, immunization, coverage

African Journal of Clinical and Experimental Microbiology Vol. 6 (3) 2005: 233-237

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Opportunistic infections and clinico-epidemiological factors in HIV/AIDS casesseen in a tertiary care hospital in Nepal

RN Das, HS Joshi, R Biswas, HS Joshi

 

Abstract

Opportunistic infections are the leading cause of morbidity and mortality among HIV/AIDS patients. The spectrum of opportunistic pathogens involved in such infections in Nepal is not well documented. A cross sectional (hospital-based) study was carried out at the AIDS clinic of Manipal Teaching Hospital, Pokhara, Nepal. A total of 404 clinically suspected cases of HIV/AIDS seen at the clinic between July 2001 and December 2002, were screened for HIV. Seventy four (18.3%) were sero-positive for HIV. Fever was the commonest presenting symptoms 48.6% followed by cough and dyspnoea 36.5%, weight loss 36.5% and pulmonary tuberculosis 21.6%. Fifty five of the 74 (74.3%) HIV positive cases were in the age group 20-39 years. Heterosexual mode of acquisition/transmission was seen in 60.8% and 21.6% were intravenous drug abusers (IVDA). A total of 45 opportunistic pathogenic isolates were recovered from the 74 patients. Mycobacterium tuberculosis was the commonest pathogen 60%, followed by Cryptosporidium spp 13.3% and Candida spp 11.1%. Four patients died during the period of study giving a mortality rate of 5.4%. This study shows that HIV/AIDS is rapidly becoming a grave concern in the Pokhara valley of Nepal. Intensive and effective health education programmes among the target population may be a cost effective method to curb the rising prevalence of HIV/AIDS in a developing country like Nepal. Also, further regional studies are required to establish more detailed epidemiological database of opportunistic infections in HIV/AIDS patients in Nepal.

Keywords: HIV/AIDS, opportunistic infections, Nepal

African Journal of Clinical and Experimental Microbiology Vol. 6 (3) 2005: 239-245

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AIDS knowledge, attitude and behavioural patterns among high school students in southwestern Nigeria

OO Opaleye, OA Olowe, SS Taiwo, O Ojurongbe, OG Ayelagbe

 

Abstract

An evaluation of knowledge, attitude and behavioural patterns of high school students in Oyo and Osun States, Southwestern Nigeria, towards HIV/AIDS was undertaken. A structured questionnaire was administered to respondents from six secondary schools that were selected by systematic random sampling method from the two States. The questionnaire focused on specific aspects of knowledge, attitude and behavioural patterns related to HIV/AIDS, its mode of transmission and preventive measures. Results from the study showed that 362 (73%) of the 496 respondents had correct knowledge of the causative agent of AIDS, 69% had correct knowledge of the mode of transmission, 83.2% had correct knowledge of the people at risk and 80.2% had good knowledge of methods of prevention. Attitude toward AIDS victims was however relatively poor with 21% believing that AIDS patients should be isolated and avoided and additional 7% believing that people should not eat or share utensils with AIDS patients. Only 57.7% believed that people should relate freely with AIDS patients. This study showed an improvement in the knowledge and attitude towards HIV/AIDS over a previous one carried out over a decade ago in the same locality, highlighting the importance of mass media campaign programme embarked upon by the States over the years. However, there is need to further increase the awareness campaign especially as it relates to attitude towards AIDS patients and also on information dissemination, which should be more detailed and formal. Incorporating sex education into the curriculum of secondary schools will be a welcome development in stemming the tide of this dreaded disease.

Keywords: knowledge, attitude, sexual behaviour, HIV, AIDS

African Journal of Clinical and Experimental Microbiology Vol. 6 (3) 2005: 247-252

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Leishmaniasis presenting as severe anaemia in an adult female Nigerian

OD Kazeem, AA Oyekunle, LL Salawu, IA Adediran, NO Akinola, KB Badmos, OS Ojo, MA Durosinmi

 

Abstract

Visceral leishmaniasis is a rare cause of anaemia. We report a case of visceral leishmaniasis presenting as severe anaemia and pyrexia of unknown origin in an adult female Nigerian. The objective was to highlight the importance of exhaustive investigations in the diagnosis of anaemia and pyrexia of unknown origin in our environment.

Keywords: visceral leishmaniasis, chronic anaemia, pyrexia of unknown origin, Nigeria

African Journal of Clinical and Experimental Microbiology Vol. 6 (3) 2005: 253-255

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Cryptococcal meningitis in patients with human immunodeficiency virus infection: report of three cases

JO Ashiru, K Aleong

 

Abstract

Although cryptococcus is an infrequent pathogen in patients without AIDS, it is known to be a major cause of meningitis in those with the disease. In recent times, the incidence of cryptococcal meningitis in patients infected with HIV has increased worldwide mainly because of the increased awareness by both the physicians and clinical microbiologists. We report here three cases of cryptococcal meningitis in HIV patients treated at the Port-of Spain General Hospital in one year. The clinical manifestations in these patients included prolonged and severe headache, neck stiffness and blurring of vision. The patients were treated with amphotericin B. Two patients died a few days after receiving the drug while one patient survived. We suggest that any HIV patient with prolonged headache should be promptly investigated for cryptococcal meningitis.

African Journal of Clinical and Experimental Microbiology Vol. 6 (3) 2005: 257-260

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Leucocyte Phagocytosis In Children With Urinary Schistosomiasis And Asymptomatic Malaria Parasitemia

OG Arinola

 

Abstract

In the participants considered for this study, leucocyte migration, neutrophil candidacidal activity and ability to generate reactive oxygen were determined as percentage migration index (%M. I), candidacidal phagocytic index (%C.I) and bacterial stimulated nitroblue tetrazolium (NBT) dye reduction index (%NBT) respectively. Also, malaria density was counted from thick blood film of glass slide stained with Giemsa stain. The participants were 54 school children having urinary schistosomiasis without malaria parasites (USS-M), 18 children with both urinary schistosomiasis and malaria parasites (USS+M), 46 children with malaria parasites without urinary schistosomiasis (M-USS) and 29 controls. The mean % M.I was least while %NBT index was highest in USS+M subjects but M-USS subjects had least %C.I. Malaria density was higher in M-USS subjects than USS+M subjects. The results of this study showed that low prevalence and reduced severity of malaria parasites in children with urinary schistosomiasis may be due to adequate production of leucocyte migration inhibitory factor (LMIF) and reactive oxygen species.
Key words: Leucocyte phagocytosis, malaria, schistosomiasis, Nigeria

Afr. J. Clin. Exper. Microbiol. 2005; 6(2): 81-86

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The Pattern Of Packed Cell Volume, Plasma Electrolytes And Glucose Levels In Patients Infected With Plasmodium falciparum

MF Olaniyan

 

Abstract

Fifty-two patients (27 males, 25 females aged 25 &plusmn: 18.4 years) with Plasmodium falciparum infection and 53 healthy control subjects (27 males, 26 females aged 28.3 ± 19.2 years) were recruited for the study. Plasma electrolytes (Na+, K+, Cl–), glucose and HCO3– were respectively analyzed colorimetrically and biochemically. There was an observed lower significant mean value of packed cell volume, Na+, HCO3–and glucose in Plasmodium falciparum infected subjects than the values obtained from the normal control subjects with p < 0.05. Higher significant mean value of Cl– and K+ was observed in the test than the control subjects (p < 0.05). Significantly lower packed cell volume, Na+, Cl–, glucose and higher significant K+ levels were observed in the test subjects aged 1-10 years than test subjects aged 11-72 years with p < 0.05. This study further affirms the effects of Plasmodium falciparum infection on the pattern of packed cell volume, plasma electrolytes and glucose concentrations.
Key words: Electrolytes, Plasmodium falciparum, Glucose, Packed Cell Volume

Afr. J. Clin. Exper. Microbiol. 2005; 6(2): 87-90

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Prevalence Of Malaria Parasitaemia In Pregnant Women Attending Antenatal Clinic At Jos University Teaching Hospital, Nigeria

EI Ikeh, SN Akudo, VE Uguru

 

Abstract

The prevalence of malaria parasitaemia in 200 pregnant women attending the antenatal clinic (ANC) of Jos University Teaching Hospital (JUTH) between April and June 2003 was determined. Geimsa-stained thick and thin blood films were examined microscopically for malaria parasites; the parasite densities were determined on the thick films. Eighteen (9%) of the women were positive for malaria parasites and only Plasmodium falciparum was encountered in the study. Pregnant women in the 15-20 year age group recorded the highest prevalence of 16%, closely followed by the age group 21-25 years with 15.2%. The 26-30, 31-35, 36-40 and 41-50 year age groups recorded 6.7%, 4.5%, 4.1% and 0% prevalence rates respectively. Women in their first trimester recorded 13.3% as against 10.2% and 3.8% for the second and third trimester respectively. The primigravidae had a prevalence of 12.9% as against 7.2% for multigravidae. Most of the women with malaria parasitaemia (89%) had parasite densities of less than 1000/µL of blood. The low prevalence of malaria parasitaemia in the ANC women is attributed to the regular prophylactic malaria therapy and the impacts of the health talks normally given to pregnant women during routine antenatal visits
Key words: Malaria, pregnancy, prevalence, prophylaxisAfr. J. Clin. Exper. Microbiol. 2005; 6(2): 91-94

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Spleen Weight, Liver Weight And Levels Of Circulating Immune Complexes In Vitamin Deficient Mice Infected With Plasmodium berghei

OG Arinola, DI Onubogu, LS Salimonu

 

Abstract

Three groups of mice viz: well fed mice, vitamin deficient mice and vitamin deficient Plasmodium berghei infected mice were studied. In these groups of mice, the weights of the liver and spleen were determined using a weighing balance and the levels of circulating immune complexes (CICS) measured spectrophotometrically using polyethylene glycol precipitation method. The mean spleen weight, liver weight and CICs of vitamin deficient mice or vitamin deficient P. berghei infected mice were reduced compared with those of well-fed mice. However, the reduction in spleen weight was significant in vitamin deficient mice from day 15-post vitamin deficiency compared with well-fed mice. Also, the reduction in liver weight was significant in vitamin deficient mice at day 5- and day 10-post vitamin deficiency compared with well-fed mice while the reduction in liver weight was significant in vitamin deficient P. berghei infected mice at day 5-, day 10-, day 15- and day 20- post P. berghei infection compared with well-fed mice. The reductions in the levels of CICs were significant in both vitamin deficient mice and vitamin deficient P. bergheiinfected mice compared with well-fed mice from day 5-post P. berghei infection or day 5-post vitamin deficiency. The observed decreased CICs in vitamin deficient mice accompanied by reduction in liver and spleen weights showed that vitamin is essential in mounting effective immune response against malaria.

Afr. J. Clin. Exper. Microbiol. 2005; 6(2): 95-99

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Use Of Injectable Anti-Malarials Among Patients In Selected Health Facilities In Ilorin, Nigeria

TM Akande, SO Kolawole, GF Medubi

 

Abstract

Irrational use of injectable antimalarial is commonplace in developing countries. This descriptive survey was conducted to determine the prevalence of injectable antimalarials use and factors related to this practice in selected health facilities in Ilorin, Nigeria. A total of 356 outpatients were interviewed in the selected health facilities and available clinical records checked. Awareness of both oral and injectable antimalarials is fairly high among the respondents. Injectable antimalarial was the most preferred form by the patients. Request for injectable antimalarial was significantly more among educated patients and those attending private clinics and health centers. Among respondents 90.3% had ever used injectable antimalarial. Use of injectable antimalarial irrespective of clinical indications is common practice. Rational practices in the prescription of antimalarial and promotion of oral therapy need to be widely encouraged among health workers in developing countries. This will reduce the hazards associated with unnecessary injections and also reduce cost.
Key words: Injectable antimalarial, use, health facilities.

Afr. J. Clin. Exper. Microbiol. 2005; 6(2): 101-105