Abstract
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Pregnancy is a physiologically immunocompromised state, during which alterations in T-lymphocyte subsets may occur. Reference values for CD4 counts in pregnancy have not been established particularly in sub-Saharan populations. This study aimed at describing expected (‘normal’) values of CD4 counts in healthy HIV-negative pregnant women so these could serve as reference for assessing the progress of HIV disease in HIV-infected pregnant women. The study was conducted in antenatal clinics in the Buea Health District, Cameroon. All eligible women were interviewed using a standardized questionnaire. Whole blood samples collected were tested for HIV using Determine 1/2 and SD Bioline HIV-1/2 3.0 rapid tests. The CD4+ absolute counts were assessed using the Partec Cyflow Counter and the CD4 easy count kit. A total of 279 women were analysed. Their ages ranged from 15 to 47 years. A vast majority (95%) of participants were in the second or third trimester of gestation. Slightly less than half (43%) were primiparous. The CD4 cell count ranged from 321 to 1808 cells/μl . This distribution was approximately normal with a mean of 851cells/μl, a median of 831cells/μl , and a standard deviation of 254cells/μl . The expected (‘normal’) range, covering 95% of the sample was 438-1532 cells/μl. Participants with malaria parasitaemia tended to have a lower CD4 count (lower on average by 115 cells/μl, P<0.001). CD4 cell counts in HIV-negative pregnant women appear similar to those of the general population of HIV-negatives. These values can thus be used as references when assessing HIV-seropositive pregnant women.
Keywords: CD4 counts, HIV-negative, pregnancy
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Reference Values of CD4-Lymphocyte Counts in HIV Seronegative Pregnant Women in Buea, Cameroon
Cytomegalovirus (CMV) is a recognized cause of morbidity and mortality among immunocompromised individuals. This review will concentrate on understanding the pathogenesis, clinical manifestations and laboratory diagnostic options for CMV infection.
Keywords: Review, Cytomegalovirus, Immunosuppressed
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Cytomegalovirus in Immunosuppressed Patients A Silent and Potential Killer
This study detected and subtyped strains of influenza virus from pigs in Lagos, South-western Nigeria. A total of 116 (58 nasal and 58 throat) samples from healthy pigs were analysed from two different sites in Ayedoto farm at Ojo Local Government between June and September, 2010 using reverse transcription polymerase chain reaction (RT-PCR). Influenza virus type A 31(26.7%) was detected. Subtyping was done using RT-PCR with H1, H3 and H5 primers and only subtypes H1 [5(16.1%)] and H5 [5(16.1%)] were detected. No positive detection was made for subtype H3. This research work is the first documented detection of influenza A virus in pigs in Lagos, Nigeria and demonstrates the need for a sustainable surveillance mechanism of swine and other influenza viruses to be able to prevent influenza epidemic in the environment.
Keywords: Subtype, Influenza A, Pig, Lagos
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Otitis media, an inflammation of the middle ear, is a common illness in childhood, and also one of the most frequent reasons for outpatient antimicrobial therapy. This study was undertaken to determine the bacterial etiology of otitis media in our environment and their pattern of antibiotic susceptibility. Between November 2009 and March 2011, ear swabs collected from 132 patients with clinical diagnosis of acute otitis media and chronic suppurative otitis media were subjected to bacteriological analysis. The bacterial pathogens isolated were tested against ten antibiotics using standard bacteriologic techniques.
A total of 142 isolates were recovered from the 132 patients involved in this study. The most frequently isolated organism in acute otitis media and chronic suppurative otitis media was Pseudomonas aeruginosa, (43.7%), followed by Klebsiella species (31.0%), Proteus species (14.1%), Escherichia coli (7%), H.influenzae (2.8%) and Staphylococcus aureus (1.4%). Generally, high resistance rates were recorded against many of the antibiotics tested. However, ciprofloxacin demonstrated the highest susceptibility rates for P.aeruginosa (77.4%) and Klebsiella species (59.1%).All the pathogens demonstrated nil susceptibility towards cefixime except E.coli where the susceptibility rate was 40%.In conclusion, determination of the susceptibility pattern of bacterial pathogens of otitis media is of utmost importance to its effective management.
Key words: Otitis media, bacterial pathogens, resistance pattern
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Trends in the Resistance Pattern of Bacterial Pathogens of Otitis Media in Ibadan, Nigeria.
Detection of AmpC-mediated resistance in Gram negative organisms poses a problem due to misleading results in phenotypic tests. There are no recommended guidelines for detection of this resistance mechanism and there is a need to address this issue as much as the detection of extended spectrum beta lactamases (ESBLs) since both may co-exist and mask each other. Several methods have been used to detect the presence of AmpC β-lactamase production in some isolates but most of these methods are not reliable. There is a need for a reliable method of evaluating the presence of AmpC β-lactamases in clinical isolates. A total of 81 consecutive non repetitive clinical isolates of Escherichia coli(n=40) and Klebsiella spp. (n=41) were screened for AmpC production by disc diffusion method using cefoxitin (30 Zg) disc and confirmed by inhibitor based test using boronic acid as inhibitor. A total of 16 E.coli isolates (40%) and 16 Klebsiella isolates (39.02%) screened harbored AmpC enzymes, of which 43.75% of E.coli and 56.25% of Klebsiella isolates coproduced ESBL enzymes. Pure AmpC production was observed in 56.25% of E.coli and 43.75% of Klebsiella isolates. The inhibitor based test was useful in identifying cefoxitin susceptible AmpC producers and could also effectively differentiate ESBL from AmpC producing isolates.
Keywords: ESBL, antibiotic susceptibility, clinical samples, β-lactam disks.
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Detection of Amp C Beta Lactamases in Clinical Isolates of Escherichia coli and Klebsiella
The Clinotech TB Screen test, a 3rd generation multi-antigen rapid chromatographic immunoassay for detection of IgG antibodies in serum against recombinant protein antigens 38kDa, 16kDa and 6kDa, was assessed for its diagnostic potential for diagnosis of active pulmonary TB in routine TB control programme in Abia State, Nigeria. The overall sensitivity and specificity of Clinotech TB Screen test were 24.1% and 87.8% (95% Confidence intervals [CI]: 14.7-33.5% and 80.6-95.0%) respectively. The positive and Negative Predictive Values (PPV and NPV) were 79.2% and 37.5% respectively. The performance of the test was inferior to that of the sputum smear microscopy which had a sensitivity of 50.0% (95% CI, 39.0%-61.0%) and specificity of 92.3(95% CI: 86.4-98.2%). In 37 culture positive smear positive PTB cases, Clinotech TB Screen test was positive in 18(48.65%). The rapid test showed a very low degree of sensitivity in smear –negative culture positive PTB cases; detecting just one (2.38%) out of 42 cases. These results indicate that the diagnostic value of Clinotech TB Screen test for routine diagnosis of PTB in this setting is limited.
Key words: Tuberculosis, serological tests, immunochromatographic tests, rapid TB tests
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