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Prevalence and immune status of HIV/HBV co-infected pregnant women

PM Lar, VK Pam, PB Christopher, L Gwamzhi, JD Mawak

 

Abstract

HIV/HBV co-infection places patients at high risk of liver-related morbidity and mortality and the interaction of the two viruses can further complicate treatment. Pregnant women are especially at high risk for increased morbidity and mortality due to infection, and information about HIV/HBV co-infection in pregnant women is scanty. This study examined the occurrence of HBV antibodies in HIV-1 positive pregnant women and the relationship to  Ante-retroviral therapy (ART) and other demographic characteristics. Blood samples were collected from 135 HIV pregnant positive women who were either on ART or Not, from May – June, 2008 at the Jos University Teaching Hospital (JUTH) and the Plateau State Specialist Hospital (PSSH). Presence of hepatitis B surface (HBsAg) antigen in serum was determined using Antec strips (Antec diagnostics UK) and their immunologic status were determined by measuring the CD4+ counts using SL_3 cyFlow counter (Partec, Germany) . Sixteen 16 (11.8%) of the women examined were seropositive for Hepatitis B virus. Occupation was significantly associated with the prevalence of the hepatitis co-infection in the population examined (8.8% of house wives and 5.5% of business women had  co-infection, p<0.05). The immunologic status (CD4+ of most of the HIV/HBV co-infected pregnant women (81.5%) was low (below 300 cells/mm3) although all were on Anti retroviral therapy. The 11.8% prevalence rate reported in this study confirms the endemicity of HBV /HIV co-infection in Nigeria, and this supports the calls for screening for Hepatitis B as a routine in antenatal care.

Keywords: HIV, Hepatitis, Co-infection, CD4, Pregnant women

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Prevalence and immune status of HIVHBV co-infected pregnant women

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Risk factors for Hepatitis C virus antibody seropositivity among children with sickle cell anaemia in Ilorin, Nigeria

CE Onuchukwu, A Ojuawo, SK Ernest

 

Abstract

Background: Hepatitis C is an infectious disease of the liver caused by the hepatitis C virus (HCV) resulting to a chronic hepatitis. Chronic HCV infection constitutes a serious public health challenge in Nigeria where donor blood is not routinely screened for HCV. Patients with sickle cell anaemia (SCA) are considered a subset of the population at higher
risk of acquiring the virus, due to their frequent needs for transfusion of blood and its products. Other risk factors like scarification markings, tattooing, and circumcision also predispose children to acquiring this infection. However, the magnitude of HCV infection has not been adequately measured in our general population and specific data on HCV in SCA patients are scanty, hence a prospective case controlled study to determine the risk factors that predispose to the acquisition of hepatitis C Virus infection.
Objective: To determine the risk factors for Hepatitis C Virus Antibody Seropositivity among transfused children with SCA in Ilorin.
Subjects and Method: Eighty two transfused SCA children aged 6 months to 14 years were recruited consecutively from February 2008 to January 2009 while eighty four non transfused SCA children of the same age range recruited over the same period served as controls. Hepatitis C virus Antibody screening was done using a second generation ELISA method. Information on the study population were collected by use of a pretested questionnaire by the investigator.
Results: There was a positive correlation between numbers of units of blood transfused and seropositivity. Those who had three or more units of blood had a prevalence rate of more than 50%. There was a strong correlation between seropositivity and scarification marks in both subjects and controls (p=0.001 and 0.02 respectively). Other plausible risk factors for hepatitis C infection tested in this study included circumcision and sharing of clippers which showed no statistically significant difference. No cases of tattooing, drug abuse, needle sharing or sexual activities were seen in this study.
Conclusion: Transfused SCA patients belong to a high risk group for hepatitis C virus infection compared to the non transfused population. The risk of acquisition increases with higher number of transfusions and scarifications marks.

Key words: Hepatitis C virus, Sickle cell anaemia, Risk factors, Blood transfusion.

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Risk factors for Hepatitis C virus antibody seropositivity among children with sickle cell anaemia in Ilorin, Nigeria

 

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Prevalence of Rubella virus-specific immunoglobulin-g and -m in pregnant women attending two tertiary hospitals in southwestern Nigeria

OT Obijimi, AB Ajetomobi, WP Sule, DO Oluwayelu

 

Abstract

Background: Rubella is a self-limiting disease that causes congenital rubella syndrome (CRS) when rubella virus (RV) infects women in the first trimester of pregnancy.
Objective: To assess a population of pregnant women attending antenatal clinics in two tertiary hospitals in southwestern Nigeria for anti-RV IgG and IgM in order to determine the proportions susceptible to the viral infection and infectious to their fetuses.
Method: Ninety consenting pregnant women were consecutively recruited and aseptically bled for the study. The sera were screened with commercial ELISA kits for anti-rubella virus IgG and IgM. Due to the controls and calibrators included in the tests, the IgG test was performed on 89 sera while all 90 samples were screened for IgM.
Results: Of the 89 pregnant women tested for anti-RV IgG, 86 (96.6%) were positive with protective serum concentrations of the antibody. Only six (6.7%, 95% CI: 1.5-11.8%, n = 90) women were positive for anti-RV IgM with 5 (5.6%, 95% CI: 0.8-10.3%) having both anti-RV IgG and IgM. Overall, three (3.4%) of the women were susceptible to RV infection, one (1.1%) of these in the first trimester of gestation was probably infectious.
Conclusion: Majority of the pregnant women had protective levels of anti-RV IgG antibody although susceptibility to rubella as well as level of infectiousness were low. Intensification of rubella immunization of all females of child-bearing age in Osun and Oyo States is advocated.

Keywords: Prevalence, Rubella, Antibodies, Pregnant women, Southwestern Nigeria.

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Prevalence of Rubella virus-specific immunoglobulin-g and -m in pregnant women attending two tertiary hospitals in southwestern Nigeria

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In-vitro antifungal effect of Garcinia kola and garlic (Alliums sativum) on vaginal isolates of candida

OY Adejare, OO Oduyebo, RO Oladele, FO Nwaokorie, FT Ogunsola

 

Abstract

Background/Objectives:Within the last decade there has been an emergence of antifungal drug resistance. Alliums sativum and Garcinia kola seeds were tested for their anticandidal properties in comparison with fluconazole and miconazole.
Methods: High Vaginal swab samples from patients with vulvovaginal candidiasis were processed and identified to the species level by germ tube method, morphology on corn meal agar and sugar fermentation reactions. Methanol and aqueous extracts of Garcinia kola and Alliums sativum, as well as fluconazole and miconazole were tested in-vitro using the agar dilution method.
Results: One hundred and twenty six women with symptoms of  vulvovaginal candidiasis were sampled and Candida species were isolated from 25 of them. Candida spp. identified were C. albicans (44%), C. tropicalis (28%), C. glabrata (16%) and C. parapsilosis (12%). All species except C. glabrata were inhibited by fluconazole and miconazole, all isolates of the same species having same minimum inhibitory  concentrations (MICs). The highest MICs (25 mg/ml) with the alcoholic extracts were shown by C. albicans and C. glabrata and the lowest MICs (12.5 mg/ml) were shown by C parapsilosis and C tropicalis. All the isolates tested with Garcinia kola aqueous extract had a uniform MIC of 50 mg/ml, those tested with garlic aqueous extract had an MIC of 200 mg/ml. C. albicans and C. glabrata had MIC of 200 mg/ml of the alcoholic extract but C. tropicalis was inhibited at 25 mg/ml.
Conclusion: We found that Garcinia kola and Alliums ativum have activity against the vaginal Candida species isolated thus showing promise as alternative therapy for vaginal candidiasis.

Keywords: Alliums ativum, Candida spp, Garcinia kola, Minimum inhibitory concentrations

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In-vitro antifungal effect of Garcinia kola and garlic (Alliums sativum) on vaginal isolates of candida

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Prevalence of methicillin-resistant Staphylococcus aureus in Saudi Arabia: Systemic review and meta-analysis

SA AL Yousef, SY Mahmoud, MT Eihab

 

Abstract

In recent years, methicillin-resistant Staphylococcucs aureus (MRSA) have become a truly global challenge. Systemic review and meta-analysis was performed to summarize the prevalence of MRSA in different regions of Kingdom of Saudi Arabia (KSA). A search of the PubMed, Google and Google Scholar databases for studies published during the period of 1 January 2002 through 31 December 2012 was conducted. We included studies that looked at the number and prevalence of MRSA among total S. aureus. Meta-analyst and comprehensive meta-analysis were used for statistical analysis. Twenty six studies were included in the review, representing five regions of KSA. Pooled estimation of 22,793 S. aureus strains showed 35.6% (95% Confidence interval (CI), 0.28 –0.42; P < 0.01) of the strains were MRSA with significant heterogeneity. Prevalence of MRSA ranged from 5.97% to 94% in Dahran and Riyadh cities, respectively. MRSA proportion among KSA regions is slightly high and varied from one city to the other.

Key words: Saudi – methicillin-resistant Staphylococcucs aureus -systemic review.

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Prevalence of methicillin-resistant Staphylococcus aureus in Saudi Arabia Systemic review and meta-analysis

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Aerobic bacterial isolates from infected wounds

NO Esebelahie, FO Newton-Esebelahie, R Omoregie

 

Abstract

Background: Wound infection causes great distress in terms of associated mortality and morbidity, increased length of hospital stay, profound discomfort and significant increased in healthcare cost. Infection in a wound delays healing and may cause wound break down, herniation of the wound and complete wound dehiscence.Therefore the knowledge of the causative agents of wound infection will be helpful in the control of wound infection and selection of empiric antimicrobial therapy as an
infection control measure.

Methods:A total of 207 wound specimens collected from patients attending the University of Benin Teaching Hospital were used for this study. All specimens were collected using sterile swabs sticks. Specimens were processed using standard microbiological methods.

Results:A total of 278 bacterial isolates were obtained from 207 wound specimens processed in this study. Positive growth were observed in 185 (89.4%) of the wound cultures and no bacterial isolates were obtained in 22 (21.1%) of the cultured materials. Staphylococcus aureus(26.9%) was the most predominant isolate followed by Klebsiellapneumoniae (17.6%), Pseudomonas aeruginosa (16.9%) and Escherichia coli(12.6%). All isolates were resistant to ampicillin, amoxyillin-clavulanate and tetracycline but show variable susceptibility to other antibacterial used. Majority of the
isolates produced beta lactamase.

Conclusion: A high proportion of the wounds were infected.The variety of microorganisms observed in this study support the need to obtain culture specimen from infected wounds for microbiological evaluation and antibiotic susceptibility determination, so that adapted chemotherapy can be prescribed.

Key words:wound infection, polymicrobial, immune status, host

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Aerobic bacterial isolates from infected wounds

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A profile of wound infections in National Hospital Abuja

KC Iregbu, NS Uwaezuoke, IP Nwajiobi-Princewill, SO Eze, N Medugu, S Shettima, Z Modibbo

 

Abstract

Background: Wound Infections cause prolonged hospital stay, increased costs and also can result in increased patient morbidity and mortality.
The current spread of multi -drug resistant bacteria has further heightened the need for regular bacteriological review of infected wounds and regular antibiotics surveillance studies so as to avoid the unguided empirical treatment of wound infections which is quite common in this environment
Aim: To determine the distribution of the isolates from wound specimens submitted to the medical microbiology laboratory of National Hospital Abuja for processing.
Method: A review and analysis of 380 woundspecimens results from various wards in the hospital over a period of 10 months (1st Marto Dec 31st 2010) was conducted.
Result: A total of 314 isolates were recovered from the 380 wound specimens giving a yield of 83%. 240(76%) yielded single isolates of various pathogens, while 74(24%) were poly-microbial. Gram negative bacilli constituted 66% of all the pathogens with Pseudomonas aeruginosa (19%) and Proteus species (18%) as the most frequent, while gram positive isolates made up 33% with S aureus (27%) as most predominant and most frequently isolated bacteria from all the wound specimens. Two candida species comprised about 1% of the isolates. Frequency of infection was highest in surgical wards (27%), gynaecology ward (14%) and accident and emergency unit (12%). The fluoroquinolones, aminoglycosides, and Beta-lactam antibiotics were the most effective drugs for most of the isolates. Staphylococcus aureus was most sensitive to amikacin (83%) and erythromycin (79%); Pseudomonas aeruginosa to imipenem (96%) and amikacin (83%) and Proteus species to amikacin (100%) and imipenem (78%).
Conclusion: S aureus, Pseudomonas aeruginosa and Proteus species were the predominant bacteria from wounds, with surgery and gynaecology wards having the highest prevalence. Resistance to commonly used antibiotics is high. There is need to institute antibiotic stewardship and effective and efficient infection control measures in the hospital

Keywords: Wound infections, National Hospital , Abuja

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A profile of wound infections in National Hospital Abuja

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Multiple Antibiotic Resistance (MAR) indices of Pseudomonas and Klebsiella species isolates in Lagos University Teaching Hospital

OO Osundiya, RO Oladele, OO Oduyebo

 

Abstract

Background/Objectives: Pseudomonas and Klebsiella infections are important nosocomial infections because of the attendant significant morbidity, mortality and socio-economic impact. These infections are difficult to treat due to the innate and acquired resistance mediated by the organisms’ genome and other transferable genetic elements. We determined the multiple antibiotic resistance indices of Pseudomonas spp and Klebsiella spp isolated from clinical specimens in Lagos University Teaching Hospital.
Methods: 110 clinical isolates were evaluated using MicrobactTM 24E (Oxoid, UK) and Pseudomonas and Klebsiella species isolates were 34 and 21 respectively. The antimicrobial susceptibility patterns of the  Pseudomonas and Klebsiella isolates were determined by Kirby-Bauer’s disc diffusion method and results interpreted by CLSI interpretative values. Multiple Antibiotic Resistance index (MAR) were calculated.
Results: MAR index of the Pseudomonas and Klebsiella samples was 0.4, as 31 (91.2%) and 14 (66.7%) of Pseudomonas spp and Klebsiella spp respectively were multi drug resistant. Isolates of Pseudomonas spp demonstrated the highest level of resistance to Ceftazidime (79.4%), Cefixime (76.5%), Cedipime (50%) and Piperacillin (44.1%); while that of Klebsiella spp were carbenicillin (76.4%), pipericillin (71.4%), cefixime (52.4%) and cefradoxil (42.9%) respectively. There was a low level
of resistance to quinolones and aminoglycosides.
Conclusion: The MAR index shows increase in the rates of resistance among these organisms thus making antimicrobial susceptibility surveillance and testing more crucial in selecting empiric regimen or definitive treatment.

KEY WORDS: Lagos, multiple antibiotic resistance (MAR), antimicrobial susceptibility, Pseudomonas and Klebsiella spp.

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Multiple Antibiotic Resistance (MAR) indices of Pseudomonas and Klebsiella species isolates in Lagos University Teaching Hospital

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Urinary tract infections in a Tertiary Hospital in Abuja, Nigeria

KC Iregbu, PI Nwajiobi-Princewill

 

Abstract

Background: Urinary tract infections (UTIs) are among the most common bacterial infections. In uncomplicated cases the infection is easily treated with a course of antibiotic, but there is increased resistance to many of these antibiotics.
Objective: To determine the profile of UTI among patients using National Hospital Abuja and the antibiotic susceptibility profile of isolated uropathogens.
Methods: This prospective study was carried out at the department of Medical Microbiology of National Hospital, Abuja over a period of three years (January 2010 – December 2012). A total of 6763 urine samples were analyzed for age, gender, distribution, yield and antibiotics sensitivity.
Results: Of 6763 urine samples, 885 (13.1%) yielded uropathogens, with the highest percentage yield in the below one year and above 57 years age groups. The mean age was 33.9 years and modal group was 25 -32 years. The most common isolates were Escherichia coli 323 (37%) and Klebsiella spp 202 (25%). Although more infections occurred in outpatients than inpatients, the rate was more with inpatients (36% vs 11%). 97% of Klebsiella spp, 89% of E coli and 83% of P.aeruginosa were sensitive to imipenem, while their respective sensitivities to amikacin were 65%, 98% and 96% Most isolates showed high levels of resistance to many other antibiotics tested.
Conclusion: High levels of resistance exist among uropathogens in our study area. This calls for regular surveillance and improved antibiotic stewardship.

Keywords : Urinary tract infection, National Hospital Abuja, antibiotic

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Urinary tract infections in a Tertiary Hospital in Abuja, Nigeria

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Knowledge, attitude and practice of blood culture: A cross sectional study among medical doctors in a Nigerian Tertiary Hospital

CK Ojide, AI Onwuezobe, EE Asuquo, CS Obiagwu

 

Abstract

Background: Blood culture is one of the most important investigations done in clinical microbiology laboratories. Not only has it been long recognized as the ggold standardh for diagnosis of Blood Stream Infections (BSIs), very important decisions regarding septicaemic patientsf management are based on it. Being a user-dependent diagnostic test, quality of results often depends on the performer.
Aim: To study the knowledge, attitude and practice of blood culture among doctors in a Nigerian tertiary hospital.
Materials and Methods: A pre-tested self-administered semi- structured questionnaire developed by the research team was used to access the biodata, knowledge, attitude and practice of blood culture among doctors in our institution.
Results: Forty-eight (54.5%) out of the 88 doctors studied had good knowledge regarding blood culture, 34 (38.6%) moderate knowledge and 6 (6.8%) poor knowledge. Majority of the senior registrars (75.0%),  registrars (64.3%) and house officers (65.9%) studied had good  knowledge while majority of the consultants (75.0%) had moderate knowledge. Doctors from paediatrics (62.5%) and internal medicine (60.0%) departments had higher proportions with good knowledge  compared to those from surgery (57.9%) and obstetrics and gynaecology (45.0%) (p = 0.240). Majority of the doctors with <10 years experience as doctors (57.0%) had good knowledge compared to 33.3% recorded among those .10 years. Attitude and practice was generally positive.
Conclusion: Through this study areas of unsatisfactory knowledge, attitude and practice of blood culture were identified.
This will help in designing an educational intervention programme for the purpose of addressing identified problems areas in blood culture.

KEYWORDS: Blood culture, Knowledge, Attitude, Practice, Doctors

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Knowledge, attitude and practice of blood culture A cross sectional study among medical doctors in a Nigerian Tertiary Hospital