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Evaluation of Usefulness of Polymerase Chain Reaction in the Diagnosis of Malaria in Nigeria

DO Ogbolu, OA Terry Alli, AS Nassar, OO Ajagbe

 

Abstract

Microscopy has been the most common technique for the diagnosis of malaria in south western Nigeria. This study was undertaken to determine the efficiency of PCR for malaria diagnosis in south western Nigeria. A total of 450 samples submitted for malaria diagnosis at Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife between the months of January and December, 2009 were used. Methods used included Giemsa staining procedure for estimation of parasite densities and polymerase chain reaction (PCR) to detect the presence of malaria parasite in the whole blood. Using microscopy as reference gold standard, patients comprising 120 males and 330 females with age ranging between less than 1 and 60 samples were used. In all, about 255 (56.7 %) of the samples were positive for microscopy, while 75 (16.7 %) with high parasitaemia on microscopy were positive for PCR analysis. The study concluded that PCR for diagnosis of malaria has sensitivity of 29.4% and specificity of 100% using crude method of DNA extraction while the use of DNA extraction kit has sensitivity of 90.2% and specificity of 100%, hence effort should be geared towards increasing the sensitivity and reduce the cost of doing the test in low resource country like Nigeria.

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Group B Streptococcus Carriage during Late Pregnancy in Ile-Ife, Nigeria

A Onipede, O Adefusi, A Adeyemi, E Adejuyigbe, A Oyelese, T Ogunniyi

 

Abstract

This study determined the prevalence of Group B Streptococcus (GBS) in late pregnancy and the antimicrobial susceptibility of isolated GBS as well as the impact of GBS infections on pregnancy related clinical outcome with a view of providing an epidemiological baseline data for policy formulation in the teaching hospital. It is an observational and cross-sectional hospital based study. One hundred and fifty pregnant women from 35-40 weeks of gestation were purposively selected and included in the study from May to December 2010. Vaginal swab samples were aseptically collected from the subjects after informed consent. The samples were assayed for presence of GBS. The susceptibility pattern of the isolated GBS to different antibiotics were assessed using disc diffusion and agar dilution techniques based on the Clinical and Laboratory Standards institute(CLSI) standards. The result showed prevalence of 11.3% GBS vaginal colonization which increased with age. There was no significant association between GBS colonization status and age (p >0.05)), gestational age (p >0.05)), gravidity (p >0.05) and obstetric risk factors (p >0.05)). There was no incidence of GBS infection observed. Although, all (17) the GBS isolates were 100% resistance to penicillin, ampicillin, cefoxitin and clindamycin. Resistance to cefotaxime (11.8%), erythromycin (64.7%) and vancomycin 70.6% were observed. Group B Streptococcus colonization in vagina in late pregnancy has been established in the antenatal clinic of the teaching hospital with the attendant risk to the fetus in the population of those affected. There were high and multiple resistance patterns of the GBS isolates to different antibiotics in this study. This calls for a review of the present hospital policy to include the routine screening of GBS during antenatal visits and surveillance.
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Epidemiological Significance of the Colonization of Streptococcus Agalactiae in the Anorectum and Endocervix of Non-Parturients in Jos, Nigeria

DS Nsagha, HLF Kamga, JCN Assob, AL Njunda, CSS Bello, YT Kandakai-Olukemi

 

Abstract

Knowledge of Group B Streptococcus (GBS) carriage and infections in Africa is very scanty but few cases have been reported in Nigeria in particular. Streptococcus agalactiae has been reported to cause infections and diseases in non-parturients and adults ranging from bacteremia, osteomylitis, arthritis, and endocarditis to breast abscess among others, hence the necessity for this study. Fifty six non-pregnant women of different age groups and social status were screened for GBS in Plateau State Specialist Hospital using the Christie, Atkins and Munch-Petersen (CAMP) and hippurate hydrolysis tests. Two (3.6 %) of the 56 women were positive for GBS. The 2 isolates were all from the anorectum. The endocervix yielded no culture. The antibiogram showed that ampicillin is the drug of choice with all isolates (100%) sensitive to the drug. No statistically significant relationship was observed between the clinical and epidemiological characteristics of the patients and GBS carriage (P>0.05). This survey shows a much lower carriage proportion than that reported in Ibadan, Nigeria from non-parturients.

Key words: Streptococcus agalactiae, epidemiology, anorectum, endocervix, non-parturients

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Epidemiological Significance of the Colonization of Streptococcus Agalactiae in the Anorectum and Endocervix of Non-Parturients in Jos, Nigeria

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The Aetiology of Enteric Fever in Abuja, North Central Nigeria

IC Peletiri, NKO Ibecheozor

 

Abstract

Enteric fever is caused by Salmonella enterica serotype typhi, Salmonella paratyphi A, B, C, and Salmonella typhimurium respectively. Of the 2818 blood cultures reviewed, only 90 (3.2%) had positive cultures for Salmonella species while the 10,007 faecal samples cultured, 159 (1.6%) were positive for Salmonella species. Identification of isolates was by usual bacteriological techniques including biochemical and serological methods. Percentage occurrence of Salmonella species in blood and faecal samples show Salmonella enterica serotype typhi (75.6% and 59.8%), Salmonella paratyphi A (4.4% and 9.4%), Salmonella paratyphi B (17.8% and 19.5%), Salmonella paratyphi C (2.2% and 6.3%) and Salmonella typhimurium (0.0% and 5.0%). The susceptibility pattern of all the isolates to the eleven drugs used as listed on table iii is highly revealing. For epidemiological status and proper management of patients, it is necessary that appropriate specimens (blood, bone marrow and faecal cultures) are examined and identification of isolates carried out as well as proper sensitivity testing performed prior to treatment for enteric fever.

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The Aetiology of Enteric Fever in Abuja, North Central Nigeria

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The Influence of Gestational Age on the Loss of Maternal Measles Antibodies in Newborn Infants in North-Eastern Nigeria: A Call for a Review of Measles Immunization Schedule

UA Baba, MA Bello, RT Akuhwa, AM Alhaji, JS Dawurung, S Pius, G Saidu

 

Abstract

Background: Maternal measles antibodies (MMA) are actively transferred in mother-infant pairs during third trimester of pregnancy. Gestational age (GA) affects the levels of MMA such that longer GA may result in infants starting out with high levels of MMA.
Objective: To determine the influence of GA on the loss of MMA in newborn infants in North-Eastern Nigeria.
Method: A prospective study was conducted on newborn infants at Maiduguri; sera were collected at birth and at six months of age. Enzyme linked immunosorbent assay (ELISA) was used to measure MMA while GA was determined using the last menstrual period, ultrasound scan reports and the Dubowitz criteria.
Results: Seventy eight newborn infants were enrolled. Seventeen (89.5 %) preterm, 43 (95.6 %) term and 14 (100 %) postterm had protective levels of MMA at birth. Two (10.5 %) preterm, nine (20.0%) term and two (14.3 %) postterm had protective MMA at six months of age. Comparison of mean MMA at birth and at six months of age was significant (p = 0.005), however, it was independent of GA of the newborn infants.
Conclusion: Significant decline of mean MMA levels was seen in these infants at six months of age, which was independent of their GA. These infants may be prone to measles at an earlier age (less than six months). Therefore, the current recommendation of measles immunization to infants at nine months of age may require reconsideration.
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Socio-Demographic Characteristics of Patients Diagnosed with HIV in Accra and Kumasi Metropolis

I Baidoo, RR Boatin, T Adom, D Datohe, T Voure, D Bansa, C Brown, A Diaba

 

Abstract

Human Immunodeficiency Virus (HIV) is RNA virus that causes Acquired Immune Deficiency Syndrome (AIDS). In Ghana the AIDS epidemic is spreading very fast in densely populated areas with higher numbers of cases occurring in the southern regions especially the densely populated capitals such as Kumasi, Koforidua and Accra as well as mining towns like Obuasi and Tarkwa, and in border towns. Data was collected from Accra and Kumasi on socio-economic backgrounds such as age, sex, education, marital status, household size, among others with a structured questionnaire and analysed using statistical Package for Social Sciences (SPSS) version 16.0. About 72% females and 28% males were interviewed with close to 74% lying between 22 to 40 age brackets. Also 63% of these completed JHS/Middle school, Seventeen (36.1%) are married people, 15 (31.9%) widowed. Majority of them are Akans who are also Christians with different denominations. Among these people, 20 (42.6%) of them are unemployed, and 3 (6.4%) claimed to be self-employed in various disciplines. Most of them said they use condoms as contraceptives in order to prevent the spread of the disease. Income level of the respondents predominantly lies between GH¢50.00- GH¢450.00 per annum. Some of the interventions for preventing the disease include promoting abstinence and faithfulness, promoting reductions in the number of sexual partners, encouraging delays in the onset of sexual activity among others.
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Pattern of Microbial Colonization of the Vagina of Diabetics in Ibadan, Nigeria

AA Oni, DO Ogbolu, OA Daini, N Abdulrahaman, BA Ugbe

 

Abstract

The pattern of microbial flora of the vagina of diabetics was studied, to advise on empirical regimen for the treatment of sepsis in diabetics with the lower genital tract as source. In 2003, microscopy, culture and sensitivity of high vaginal swabs from 60 consecutive non-insulin-dependent diabetics and 20 non-diabetics attending Oluyoro Catholic Hospital, Ibadan were done. The fasting plasma glucose was estimated. The prevalence of micro-organisms decreased with duration of diabetes. The isolates were Gardnerella vaginalis, Candida species, Staphylococcus epidermidis, Klebsiella species, Enterococcus faecalis, and viridans Streptococcus. Klebsiella species and Escherichia coli were incriminated in Gram negative bacilli (GNB) bacteraemia in diabetics in this environment. In addition to metronidazole, ceftazidime or ceftriazone should be used as first line drugs, while the quinolones should be reserved for the treatment of sepsis in diabetics where lower genital tract is the likely source of infection.
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Efficacy of Three Disinfectant Formulations against Multidrug Resistant Nosocomial Agents

OS Alabi, EA Sanusi

 

Abstract

The current increase in the prevalence of nosocomial infections within the hospital environment despite adequate cleaning and disinfection can be said to be due to the following: (i) ineffectiveness of the various disinfectant formulations used in infection control on the various hospital equipments and wards; (ii) development of resistance to the various chemical disinfectant formulations been used in the hospitals by the various microorganisms. Ten bacteria isolates from different clinical specimens of hospitalized patients identified using standard bacteriological methods and found after screening to be resistant to two or more classes of the antibiotics: cephalosporins, quinolones, Betalactams, nitrofuran, macrolide and an aminoglycoside using the Kirby-Bauer method of disc diffusion test were used in this study. These were subjected to susceptibility testing against three selected disinfectant formulations (Izal, Dettol and Jik) at the manufacturer’s dilutions and half the dilutions prescribed on their labels by using agar diffusion method. Out of these clinical isolates used in this study, 5 (50%) and 2 (20%) were resistant to manufacturer’s dilution and half the dilution of Dettol respectively, 9 (90%) and 6 (60%) to manufacturer’s dilution and half the dilution of Izal respectively while 1 (10%) and 0 (0%) were resistant to manufacturer’s dilution and half the dilution of Jik respectively. The resistance demonstrated by some of the nosocomial agents in this study against the selected disinfectant formulations at their manufacturer’s dilution and half the prescribed dilutions showed the probability of the nosocomial agents developing some mechanisms of resistance against the various disinfectant formulations rather than ineffectiveness of the disinfectant formulations. However, the effectiveness of Jik formulation at half the manufacturer’s prescribed dilution shows that Jik is still an important disinfectant formulation in the control of nosocomial agent most especially the resistant strains.
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Molecular Epidemiology of Hepatitis C Virus (HCV) in Kaduna State

Z Sheyin, BD Jatau, AI Mamman, AJ Randawa

 

Abstract

Objective: To determine the distribution of hepatitis C virus (HCV)  genotypes and subtypes among blood donors and outpatients attendees positive for antibody to HCV (anti-HCV).
Justification: Hepatitis C virus (HCV) continues to be a major disease burden on the world and Man is the only known natural host of Hepatitis C virus (Chivaliez and Pawlotsky, 2007). There is no published data on the prevalence of the genotypes and subtypes of HCV in Kaduna State.
Setting: Three hospitals one in each of the 3 senatorial zones in Kaduna State.
Patients: Blood donors who reported for blood donation and outpatient department attendees.
Method: Antibody detection by a third generation HCV ELISA (Biotech Laboratories, UK); HCV RNA and genotyping by Reverse Transcriptase polymerase chain reaction with genotype-specific primers. (Sacace Biotechnologies, UK).
Results: of the 259 plasma specimens screened for Hepatitis C virus in this study, 20(7.7%) were positive for anti-HCV antibodies by ELISA and 16(6.2%) of the antibodies positive specimen were positive for HCV RNA. Of the 139 blood donors tested, 8 (5.8%) were HCV RNA positive. Similarly, 120 were tested from the outpatient Department attendees and 8 (6.7%) were HCV RNA positive. Hepatitis C virus genotype 1b was found in the entire HCV RNA positive sample.
Conclusions: The findings of 6.2% prevalence of HCV infection based on HCV RNA test confirmed that there is Hepatitis C virus in Kaduna State with genotype 1b as the predominant genotype found in all the three senatorial zones.
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A Critical Review on HIV/AIDS and Wound Care

EP Weledji, HLF Kamga, JC Assob, DS Nsagha

 

Abstract

Wound infections in AIDS patients increase discomfort, prolong hospital stay, render an additional burden upon an already debilitated patient and weaken the immune system further. Treatment must relate to the aetiology of the wound and take into account the patients underlying health problems. The treatment of wounds in HIV-AIDS patients is not different from the standard treatment. There are wound -related criteria for selecting the appropriate types of dressing. The best dressing for postoperative wound healing by secondary intention is unknown. Continuing wound evaluation and the appraisal of what dressing is useful for the type of wound and stage of healing is the basis of optimum wound care Optimum wound care, emotional support; health education will enhance both the emotional and physical wellbeing of the HIV-AIDS patient.

Key words: Human immunodeficiency virus (HIV), Acquired immune deficiency syndrome (AIDS), wound infection, delayed wound healing, optimum wound care, dressing types, nutrition, and pain control

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A Critical Review on HIVAIDS and Wound Care