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Liver function tests in HIV-1 infected asymptomatic patients and HIV-1 AIDS patients without hepatomegaly in Lagos, Nigeria

PS Ogunro, DP Oparinde, AB Okesina

 

Abstract

Hepatic functions were assessed by serum assays of albumin (ALB), total protein (TP), total bilirubin (TB), conjugated bilirubin (CB), serum activities of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP) and gamma – glutamyl transferase (GGT) in 51 HIV-1AIDS patients, 38 HIV-1 infected asymptomatic patients and 56 age and sex matched healthy HIV negative controls. The mean ± SEM serum ALB concentration of 23.5 ± 1.2 g/L in AIDS patients was significantly lower (p < 0.001) than those of HIV-1 infected asymptomatic patients and healthy controls; 38.9 ± 3.1g/L and 39.4 ± 2.8g/L respectively. The mean ± SEM TB concentration of 17.8 ± 1.3 μmol/L in AIDS patients was significantly higher (p < 0.01) than 11.7 ± 1.1μmol/L observed in HIV-1 infected asymptomatic patients and 10.8 ± 2.1μmol/L in the controls. Similarly, there was a significant elevation (p < 0.05) in serum CB concentration of 6.5 ± 0.9µmol/L in AIDS patients compared to HIV-I infected patients of 3.8 ± 1.0 μmol/L and controls of 3.1 ± 0.8 μmol/L. The mean ± SEM ALT, AST, ALP and GGT activities (iu/L) of 48.7 ± 3.1, 54.3 ± 3.3, 84.8 ± 4.3 and 47.5 ± 4.1 respectively in AIDS patients were significantly higher (p < 0.001) than 21.3 ± 2.9, 25.6 ± 1.3, 56.4 ± 3.2 and 25.1 ± 1.7 respectively observed for the same enzymes in HIV-1 infected patients and 20.1 ± 3.1, 24.5 ± 2.6, 54.6 ± 4.3 and 24.2 ± 2.1 respectively in the controls. These results provide evidence to suggest that hepatic damage is greater in AIDS patients than in HIV-1 infected asymptomatic patients even in the absence of hepatomegaly. We conclude that this may be due to opportunistic infections that set in at the later part of HIV-1 infection (i.e. at AIDS stage) or increase severity of HIV-1 infection or both.

Key Words: HIV-1 infected asymptomatic patient, AIDS, Hepatic functions

Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 40-45

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Health workers’ attitude and perception toward routine pre-marital HIV screening

OI Musa

 

Abstract

More than half of all new HIV infections occur among young adults, however, the rate of new infections among women surpasses men’s especially in Sub-Saharan Africa. This rising infection rates, particularly among women, exposes children to increased HIV risk even before they are born. This descriptive cross-sectional study was conducted to determine the attitude and perception of health workers to routine pre-marital HIV screening that is currently practice by some religious institutions as part of initiative directed towards controlling the spread of the infection. Three hundred (300) self-administered questionnaires distributed to the health workers in their respective units were analyzed. Majority of the respondents 270 (90%) agreed that pre-marital HIV screening is necessary and advantageous to couples intending to get married. Although more than half of the respondents (56.7%) believed that the screening exercise is associated with some disadvantages, as many as 205 (68.3%) were in support of its enforcement for all couple. Majority 260 (86.7%) agreed that religious leaders/institutions have important role to play in HIV control and most of them 265 (88.3%) would prefer that Government health facilities be used as screening centres; and medical doctors should be the person to reveal the test results to the couples 275 (91.7%). About two-third of the respondents felt that the couples should initiates request for HIV screening, and on the issue of whether or not the marriage should be contracted following a positive result in one or both partners, 180(60%) respondents felt that the decision should be made by the couple. Counseling of couples before and after HIV screening, adequate training of health workers on HIV counseling skill and making HIV screening free to couple were suggested by the respondents as incentive that would enhance voluntary pre-marital HIV testing.

Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 46-52

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Sero-prevalence of hepatitis C virus amoung patients attending STD clinic in Ibadan, Nigeria

AA Oni, GN Odaibo, OD Olaleye, RA Bakare, SO Ola

 

Abstract

In the tropics, hepatitis C virus (HCV) seroprevalence ranges from < 0.2% in whole Africa. A strong association between HCV and hepatitis B surface antigen (HBsAg)-negative chronic liver disease and hepatocellular carcinoma has been described. Hepatocellular carcinoma (HCC) is one of the most common cancers among Africans, and in Nigeria by 1970 the estimated rate was 6.6 per 100,000 populations per annum. Sexual transmission was regarded as a minor cause of HCV, the degree of which has not been properly evaluated in most environments. Since it has been established that sexual transmission is an important mode of acquisition of the infection, we therefore set out to find the seroprevalence of HCV among 95 patients attending sexually transmitted diseases (STD) clinic in University College Hospital, Ibadan, Nigeria with a view to recommending preventive and control measures of HCV in our community. The sera collected from these respondents were used for screening for syphilis using the VDRL test, and for HCV antibodies using the MONOLISA anti-HCV (Sanofi, Pasteur France). Mid-stream urine was collected from all participants, and urethral swabs from all male participants while endocervical and high vaginal swabs were collected from female participants. Ulcer swabs were collected from those with genital ulcers. The prevalence of HCV infection was found to be 37.9% in patients presenting with STDs. This comprised 38.9% of males and 61.1% females. This prevalence rate is very high compared with the rate in the general population and other “high-risk” groups in previous studies in the same environment. Factors associated with HCV infection in this environment include high heterosexuality, high level of education, and previous instrumentations such as in scarifications and termination of pregnancy. Prevention and control of STDs will definitely reduce HCV infection and hence the attendant consequences, particularly hepatocellular carcinoma, in our environment.

Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 53-59

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Prevalence of measles neutralizing antibody in children under 15 years in Southwestern Nigeria

OO Opaleye, MO Adewumi, E Donbraye, AS Bakarey, GN Odaibo, OD Olaleye

 

Abstract

The immune status of children under 15 years in the Southwestern region of Nigeria against measles virus was determined using the neutralization test with a view to assessing the herd immunity to the virus in these communities. A total of 256 serum samples collected from children were tested by the beta method of neutralization. Forty (15.6%) of these samples were found to be positive at a titre of 1:256, 35 (13.7%) at 1:128, 36(14.1%) at 1:64, 37(14.5%) at 1:32, 38 (14.8%) at 1:16, 27 (10.5%) at 1:8 and 16 (6.3%) at 1:4. Twenty-seven (10.5%) of the 256 samples had no detectable antibody to the measles virus. There was no significant relationship between the antibody titre to measles virus and the gender of the children (p > 0.05). Also, there was no significant difference using Chi square analysis between the neutralizing antibody titres and the age of the children (p > 0.05). All the children whose samples were tested were vaccinated against measles as attested to by their parents. However, the vaccination does not seem to protect all the children, for some of them had no detectable neutralizing antibody while some had low neutralizing antibody titre. In Nigeria, where only a single dose of measles vaccine is given at 9 month, measles may remain a serious threat to the children population with its attendant high morbidity and mortality.

Key Words: Prevalence, Neutralizing antibodies, Children < 15years

Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 60-63

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Sexually transmitted infections in Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria: A decade of clinic experience

AO Oyelese, AO Onipede, AO Aboderin, AN Adedosu, O Onayemi

 

Abstract

Sexually transmitted infections (STIs) remain cosmopolitan in all societies of the world and in some cases assume epidemic proportions. These infections are common infectious diseases nowadays, with an annual incidence of more than 200 million cases a year. Venereal pathogens continue to increase in number and the spectrum of pathogens has limitless elasticity. While genital discharge and ulceration are common presenting symptoms, unusual findings on examination and investigation are not uncommon. We assessed our clinic experiences during the first ten years in an STI clinic. Salient findings are that 85% of all patients seen have an STI. The breakdown of infections revealed that Candida albicans was the most common venereal pathogen accounting for 24% while Neisseria gonorrhoeae accounted for about 18.0%. Sarcoptes scabiei and Phthirus pubis causing scabies and pediculosis accounted for 1.8% and 0.3% respectively. As commonly established, the age bracket 19 to 39 years was clearly the age group in which sexually transmitted infections were mostly diagnosed. In a control programme, this age group should be targeted, while there is the need to continue to stimulate awareness of both the general public and health workers at all levels on the problems of sexually transmitted infections, the scourge of all ages.

Key Words: Sexually transmitted infections, venereal pathogens, clinic experience, control awareness

Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 64-68

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The role of clinical pathologists in the management of male infertility

EK Oghagbon, SS Taiwo, MO Buhari, DP Oparinde

 

Abstract

Male infertility is receiving increasing attention in Africa as up to 50% of cases of infertility are ascribed to it. In the management of this condition, the clinical laboratory plays a crucial role especially in the proper identification of causes of infertility. The role of the pathologists in this respect stems from the choice of laboratory equipment, reagents, type of samples needed, proper sample collection and its preparation. Added to these functions, the pathologist should help in the proper selection of required tests so as to ensure optimum diagnosis and treatment efficiency. Semen analysis is the first test required in the laboratory assessment of the infertile male. The obtained spermogram serves as the pivot for further tests which include hormonal assays, tissue studies and karyotyping. There is a disturbing high prevalence of azoospermia among Nigerians. The expected laboratory evaluation and treatment of such patients and others with abnormal spermogram are discussed in this review.

Key Words: Male infertility, review.

Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 69-76

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Materno-Fetal Haematological Relationship In Malaria At Mongomo, Guinea Equatoria

AAG Jimoh

 

Abstract

This study is aimed to determine the effects of maternal and fetal parasitaemia on maternal and fetal haemoglobin. A nine-month (January – September 1997) prospective study was carried out at the labour unit of the Regional Hospital in Mongomo, Guinea Equatoria. One hundred and twenty-four patients with singleton deliveries were studied. The prevalence rate of maternal and fetal parasitaemia were 102 (82.25%) and 33 (26.61%) respectively. The mean maternal haemoglobin was 10.11 + 1.35 gm/dl, those with parasitaemia 9.26+0.85 gm/dl and those without parasitaemia 11.45+1.20 gm/dl (p<0.005). There is a close correlation between maternal parasitaemia, worsening maternal haemoglobin level and fatal parasitaemia (p<0.005 df=3 95% CI). Fetal parasitaemia is significantly commoner in fetuses with severe anaemia compared to those with negative fatal parasitaemia (p<0.005). The author emphasized curative treatment of all pregnant women at the first antenatal care visit to be supplemented by adequate prophylaxis throughout pregnancy. Choice of drugs for treatment and prophylaxis must be guided by the local sensitivity patterns and safety profiles of the drugs to the mothers and the developing fetuses.

Afr. J. Clin. Exper. Microbiol. 2004; 5 (3): 217-220

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Prevalence And Distribution Of Ruminant Trypanosomosis In Bokkos Local Government Area Of Plateau State, Nigeria

JO Kalajaiye, SO Omotainse, GA Omoogun

 

Abstract

The seasonal prevalence of typanosomosis was investigated in Bokkos LGA of Plateau State, Nigeria. A total of 740 animals (684 cattle and 56 sheep) were bled during the dry and wet seasons. The standard methods used were simple random and jugular venipucture. Standard parasitological methods were used to determine the infection rate. In cattle, the findings showed an infection rate of 11.7% while in sheep it was 17.9%. Peak infection in animals was during the end of the rainy season and beginning of dry season (September-December). Complementary mice inoculation tests revealed 83 sub patent cases and are recommended as a confirmatory diagnostic technique.

Afr. J. Clin. Exper. Microbiol. 2004; 5 (3): 221-224

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Changes In Peripheral Leukocyte And Body Fluids Of Onchocerciasis Patients Treated With Ivermectin

OU Manafa, MA Mafe, ET Idowu, MB Ajayi

 

Abstract

This study evaluated the peripheral leukocyte count and the presence of microfilariae in the body fluids of onchocerciasis patients treated with ivermectin. Fifty-three patients over the age 10 years were selected from Ipogun, an onchocerciasis endemic area in Ondo State, Nigeria. Before and after treatment, all patients received a parasitologic and clinical examination that included physical examination, palpation of onchocercal nodules, assessment of microfilarial densities in iliac crest skin snips, diagnosis of concomitant parasitic infections in stool specimens and total leukocytes differential counts. Results indicated that ivermectin did not induce a decrease in the total number of peripheral leukocytes but there was a decrease in the number of eosinophils. Microfilariae were not found in increase frequency in the urine, blood and sputum, while the number of microfilariae per mg of skin snip decreased.

Afr. J. Clin. Exper. Microbiol. 2004; 5 (3): 225-230

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Epidemiological Mapping Of Lymphatic Filariasis In Southern Nigeria Preliminary Survey Of Akinyele Local Government Area

TS Awolola, OU Manafa, ET Idowu, JA Adedoyin, AK Adeneye

 

Abstract

Lymphatic filariasis caused by Wuchereria bancrofti is major public health problem in tropical and subtropical countries including Nigeria. The real burden of the disease in most endemic regions remains unknown. The nocturnal periodicity of the parasites requires parasitological examination to be done at night and this is quite cumbersome. The World Health Organization recently recommended two rapid methods for the assessment of lymphatic filariasis (RAGFIL). These RAGFILS methods i.e. using community health workers and key informants were used to rapidly map lymphatic filariasis in Akinyele Local Government area of Oyo State Nigeria. The prevalence of hydrocele and elephantiasis was highly sensitive in identifying this community as endemic for filariasis. The degree of association between finding by health workers and information obtained form the community key informants was high for the two major clinical manifestation of the disease used. Community key informants and health workers did provide useful information on the prevalence of clinical filariasis. These observations suggest that the mean number of cases obtained in the village through key informants and the examination of health workers for the clinical signs of the disease may be considered at an initial level to identify endemic areas. The need to extend this method to rapidly map lymphatic filariasis in Nigeria is discussed.

Key words: Lymphatic, Filariasis, Rapid, Mapping, Assessment and Health workers.

Afr. J. Clin. Exper. Microbiol. 2004; 5 (3): 231-234