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Hepatitis C virus-associated porphyria cutanea tarda: A case report

AH Isa, M Mary Tapgun, OC Isichei

 

Abstract

Porhyria cutanea tarda (PCT) is a rare, inherited or acquired disorder due to decreased activity or deficiency of uroporphyrinogen decarboxylase (UROD), one of the enzymes in the haem synthetic pathway. It is characterized by cutaneous manifestations such as erosions, blisters and bulae in the dorsum of the hand, forearm, elbows and knees; and painful indolent sores that heal with dyspigmented and scarring lesions. A 25 year old sales man presented with a 7 month history of recurrent blistering of the skin of the extremities- hands, elbows, knees and feet which occurred spontaneously or following trivial trauma. There was no family history of similar skin symptoms. Examination showed broken and fresh blisters of varying sizes with some healed lesions on the dorsum of the hands, over the elbow and knee joints, and toes. Serum ferritin was 360μ/L (40- 340 μ/L), urine uroporphyrinogen was positive (+++) and Hepatitis C antibodies screening was positive. Some improvement of the cutaneous lesion was noticed following commencement of therapeutic phlebotomy.

Keywords: Porhyria, blisters, Hepatitis C virus, uroporphyrinogen

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Hepatitis C virus-associated porphyria cutanea tarda A case report

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Sero-epidemiological survey and risk factors for Hepatitis B Virus (HBV) infection among pregnant women in Logo LGA, Benue State, Nigeria

EPT Aluor, HOA Oluma, RAI Ega, N Owolcho

 

Abstract

Hepatitis B virus (HBV) infection is associated with chronic liver diseases, cirrhosis and hepatocellular carcinoma, liver failure and death. The prevalence of Hepatitis B virus carrier and infectivity status and social characteristics among three hundred and ten pregnant women in Logo LGA, Benue State, Nigeria, was determined through random anonymous testing of volunteers attending antenatal clinics of different hospitals within the community. Thirty of three hundred and ten blood samples tested positive for HBV infection. 11.9% were in the 3rd trimester of their pregnancy and 58.1% were within the age bracket of 21-30 years. Illiterates women constituted 14.4% of those sampled while civil servants were 6.7%. HBV carrier status was determined by the presence of Hepatitis B surface antigen (HBsAg). Repeated reactive samples were confirmed by Enzyme linked immounosorbent assay (ELISA) Kit (Diagnostic Automation, Inc., USA). Maternal HBV infectivity status was determined by testing all HBsAg positive samples for the presence of hepatitis B e antigen (HBeAg). A total of thirty (9.7%) pregnant women identified as carriers of HBV and eleven of the thirty tested positive for HBeAg. Hence, 3.6% (11/310) of the entire study population was found to have high viral replication as well as high risk of transmitting HBV to their neonates. The frequency of HBV carrier did not vary with age, however, it varies significantly with the previous use of contraceptives and the anaemic status of the subjects (P< 0.05) .This study demonstrates the endemicity of HBV infection in Logo and high infectivity rate, suggest that HBV is likely to be acquired by both vertical and horizontal means of transmission. Testing for HBsAg is recommended for all pregnant women at first prenatal visit so that positive mothers receive prompt intervention.

Keywords: Hepatitis B e antigen, Hepatitis B surface antigen, seropositivity, pregnant women, neonates

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Sero-epidemiological survey and risk factors for Hepatitis B Virus (HBV) infection among pregnant women in Logo LGA, Benue State, Nigeria

 

 

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INCIDENCE OF DERMATOPHYTE INFECTIONS AMONGST SOME OCCUPATIONAL AND SELECT GROUPS IN JOS

P.O. Nwadiaro

 

Abstract

Fifty-nine Agro farm workers, 265 inmates from Jos main prison, 60 hair weavers and 40 car washers were examined in Jos for dermatophyte infections. Dermatophyte isolates included Trichophyton and Microsporum species. The highest infection rate of 75% was recorded among the farm workers with toeweb infections due to T. mentagrophytes and M. canis. 25% of the other infections were from the groin region due to T. tonsurans and T. mentagrophytes. Fifty-nine percent of infection by T. mentagrophytes in prison inmates was restricted to the groin region. Other species of fungi isolated from the inmates were Trichosporon cutaneum and Aspergillus niger. Among the car washers, tinea manum, ringworm of the hand, and interdigital infections due to T.mentagrophytes were observed. There was no visible infection among either the female hair weavers or the female prison inmates.

Keywords: Dermatophytosis, T. mentagrophytes, T. tonsurans, M. canis, Tinea pedis, Tinea cruris.

(Af J Clinical & Exp Microbiology: 2003 4(2): 11-17)

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INHIBITION OF SWARMING BY UREA AND ITS DIAGNOSTIC IMPLICATIONS AMONG UROPATHOGENIC PROTEUS SPECIES FROM LAGOS, NIGERIA

B.A. Iwalokun, K.A. Akinsinde, N. Nkiruika

 

Abstract

The anti-swarming property of urea and effects on antibiotic susceptibility among 52 uropathogenic Proteus strains from Lagos, Nigeria were investigated. Urea caused a reduction in swarming and number of swarmed cells at 0.5% (n = 42, DOCZ = 15.5mm), 0.75% (n= 24, DOCZ = 10.7mm), 1% (n = 17, DOCZ = 3.4mm) and 1.25% (n = 8, DOCZ = 1.7mm).  Compared to DOCZ obtained at 0.5% urea, the further reduction in DOCZ at other urea concentrations was found to be significant (p < 0.05).  Urea at less than 0.75% allowed identification of E. coli, K. pneumoniae and S. saprophyticus in mixed cultures containing Proteus spp, while colonies of Pseudomonas aeruginosa were distinctly identified at 1% urea with swarming restrained at 1.25% urea.  At 1.25% urea, antibiotic susceptibility testing by agar diffusion method revealed significant increase and decrease in the number of Proteus strains that showed resistance to amoxicillin and nitrofurantoin. Compared with the control, significant increases in the MICs of gentamicin or nitrofurantoin and streptomycin were found at $ 0.5% and $ 0.75% urea respectively (p<0.05). The identification of extended spectrum beta lactamases (ESBL) producing strains were unaffected by urea.  This study has demonstrated urea induced swarming inhibition of uropathogenic Proteus in vitro.  However, results suggest the use of urea with great caution in diagnostic practices for optimal clinical and public health benefits in Nigeria.

Keywords: Antibiotic susceptibility, anti-swarming, urea, uropathogenic proteus, Nigeria, DOCZ = Diameter of outermost colony zone mean value

(Af J Clinical & Exp Microbiology: 2003 4(2): 18-28)

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THE EFFECT OF SOME NIGERIAN LOCAL HERBS ON HELICOBACTER PYLORI

S. I. Smith, K.S. Oyedeji, B. Opere, B. A. Iwalokun, E. A. Omonigbehin

 

Abstract

Four Nigerian medicinal plants commonly used in the treatment of bacterial infections were tested for antimicrobial activity against twenty local strains of Helicobacter pylori recovered from patients with gastro-duodenal ulcers and gastritis. In vitro agar diffusion assay revealed anti-Helicobacter pylori activity of ethanolic extracts of C. papaya and M. lucida to 80% (16/20) of the isolates tested, while the ethanolic extracts of O. gratissimum and P. amarus inhibited the colonial growth of 35% (7/20) of these strains. The zones of inhibition ranged from 5 – 20 mm in diameter. Contrastingly, the aqueous extracts of these plants appeared to lack anti-Helicobacter pylori activity except in M. lucida and O. gratissimum where inhibition of a total of three isolates was observed. The present results suggest the presence of anti-Helicobacter pylori principles in ethanolic extracts of C. papaya and M. lucida and support their future use in the treatment of ulcers and gastritis in Nigeria.

(Af J Clinical & Exp Microbiology: 2003 4(2): 29-35)

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BACTERIOLOGICAL QUALITY OF SOBO DRINKS RETAILED WITHIN ILORIN METROPOLIS

A. O. Olowe, K.I.T. Eniola, A.O. Adeyeba, S. Awe

 

Abstract

Sobo drinks retailed within Ilorin metropolis were investigated for their bacteriological quality, in terms of the total bacterial count and types of bacterial species present. The sobo drinks were found to have an average pH of 3.2. The bacterial counts were generally high ranging from 5.0×104 to 24×104 CFU/ml. Six bacterial species; Bacillus subtilis, Staphylococcus aureus, Streptococcus faecalis, Klebsiella spp, Enterobacter spp, and Escherichia coli were isolated. Consideration of the distribution pattern showed that samples from Unilorin Main Campus and General Post Office contained all the isolates, while three of the isolates; Escherichia coli, Bacillus subtilis and Staphylococcus aureus were common to all samples. Possible sources of the contaminants and their public health implications are discussed and suggestions offered on ways of ensuring safety of the sobo drinks.

(Af J Clinical & Exp Microbiology: 2003 4(2): 36-40)

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BACTERIOLOGICAL EXAMINATION OF CHRONIC OSTEOMYELITIS CASES IN ILE-IFE, SOUTHWESTERN NIGERIA

A.K. Ako-Nai, I.C. Ikem, A. Aziba, A.A. Ajayi, O.A. Onipede

 

Abstract

The bacteriological examination of chronic osteomyelitis cases in Ile-Ife, revealed Proteus mirabilis as the predominant isolate encountered (23.1%). Staphylococci constituted 30.7% of the total bacterial isolates with Staphylococcus aureus accounting for only 10.2%. Other Gram-positive cocci cultured include, Staphylococcus spp (20.5%), coagulase negative staphylococci (CONS) (12.8%) and Streptococcus spp (1.2%). Gram-negative rods constituted 55.1% of the total isolates with Pseudomonas aeruginosa being 8.5%, Escherichia coli 5.1%, Citrobacter freundii and Salmonella spp 2.5% each. Antibiotic sensitivity test revealed all isolates to be multi-resistant to traditional antimicrobials, which is of epidemiologcal importance in treating cases of chronic osteomyelitis in this environment. The study suggests institution of aggressive therapeutic interventions to avert possible sequalae.

(Af J Clinical & Exp Microbiology: 2003 4(2): 41-51)

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STUDIES ON DIABETIC FOOT ULCERS IN PATIENTS AT JOS UNIVERSITY TEACHING HOSPITAL, NIGERIA

E.I. Ikeh, F. Peupet, C. Nwadiaro

 

Abstract

An epidemiologcal and microbiological studies of diabetic foot ulcers were carried out in our hospital, with a view to reducing the amputation and mortality rate associated with the disease. Wound swabs from 38 Diabetes Mellitus (DM) foot ulcer patients were investigated using culture methods for both strict aerobes and anaerobes. The bacterial isolates were subjected to antibiotic susceptibility tests using the disc diffusion method. Baseline biochemical and haematological analysis were also carried out. The prevalence of the disease was stratified in relation to some clinical and laboratory parameters, gender, age, educational and occupational status of the patients. The prevalence of the disease was 24.7%, with amputation and mortality rates of 18.4% and 15.8% respectively. Only 13% had DM for less than 1 year, while 53% for more than 10 years. 28.9% have regular shoe-wearing habits. Duration of healing ranged from 2 weeks to 24 weeks (mean = 2.7months). 31% of the patients with marked periosteal reaction had lower extremity amputation or died before amputation could be done. Staphylococus aureus (31%), Proteus spp (16%), Pseudomonas aeruginosa (10%), Klebsiella spp (6%), Peptococcus spp (6%), Bacteroides fragilis (3%), Streptococcus pyogenes (3%), Escherichia coli (3%), Candida albicans (3%), Streptococcus viridans (1%), Flavobacterium spp (1.5%) and Bacteroides melaninogenicus (1%) were isolated. Most of the bacteria isolates were sensitive to pefloxacin. Our results demonstrate a very high rate of diabetic foot ulcer with the corresponding high rate of amputation and mortality. A multi-disciplinary approach to the management of DM foot ulcers is advocated. Efforts should be made to carry out cultures of samples from refractory ulcers to rule out yeast colonization, which if not treated will delay wound healing.

Key words: Diabetic foot ulcers, Microbial and antimicrobial surveillance, Refractory ulcers.

(Af J Clinical & Exp Microbiology: 2003 4(2): 52-61)

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AETIOLOGIC AGENTS OF DIARRHOEA IN CHILDREN UNDER FIVE YEARS OF AGE IN OSOGBO, OSUN STATE

O.A. Olowe, A.B. Olayemi, K.I.T. Eniola, O.A. Adeyeba

 

Abstract

A survey of the aetiological agents of diarrhoea in children under 5 years of age was carried out in Osogbo, Osun State. A total of 135 patients visiting the outpatient and children emergency units of LAUTECH Teaching Hospital were examined. Strains of Shigella isolated were tested for antibiotic sensitivity. Consideration of the distribution showed that Escherichia coli was more prevalent in children aged between 3 to 5 years (57%) and was the most encountered of the organisms isolated (present in 77.8% of all samples) while Shigella spp was found in 16.3% of samples, Vibrio cholerae 0.7% and other coliforms 5.2%. Statistical analysis showed that E. coli was significantly associated with diarrhoea in the patients aged 3-5 years (P< 0.05). Shigella spp was shown to show some resistance to tetracycline and high sensitivity to ofloxacin.

(Af J Clinical & Exp Microbiology: 2003 4(2): 62-66)

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PHAGE AMPLIFICATION TECHNOLOGY AND ANTI-TUBERCULOUS DRUG SUSCEPTIBILITY TESTING IN NIGERIA

E.J. Otive-Igbuzor

 

Abstract

The emergence of multi-drug resistant tuberculosis (MDR-TB) defined as combined resistance to the two most effective anti-tuberculosis drugs, rifampicin and isoniazid, threatens to create a public health hazard of unprecedented proportion. The fact that MDR-TR is more difficult and expensive to cure creates the need for prompt diagnosis. Conventionally, the proportion method on Lowenstein Jensen (L J) medium is used in most developing countries as the ‘gold standard’ in the drug susceptibility testing of Mycobacterium tuberculosis (MTB) and it takes 3-4 weeks to give results from an MTB culture. The use of phage as a diagnostic is fast gaining ground today. It involves targeting viable MTB cells from culture with a specific mycobacteriophage. After a one-hour incubation, it is treated with an antivirus to destroy the phages that are not protected with the bacilli. Upon addition of cells of growing, non-pathogenic Mycobacterium smegmatis (sensor cells), progeny phage from the MTB cells infect the sensor cells, thus amplifying the effect of the phage. When plated in an agar medium overnight, plaques occur in the cell lawn indicating the presence of viable MTB in an original sample. A comparison is made between the number of plaques produced in a drug-free control and a sample incubated in the presence of the drug. While the presence of plaques beyond a cut-of point indicates drug resistance, the absence of plaques indicates that the drug destroyed MTB cells. Overall accuracy from several trials so far conducted is put at 97-98% compared with the ‘gold standard’. With the phage amplification method, antituberculosis drug susceptibility results are obtained from MTB culture within 48 hours as opposed to the L J proportion method, which gives resulted in 3 to 4 weeks. Also, phage, as a diagnostic, is much more applicable in Nigeria laboratories than newer, rapid methods which requires specially dedicated instrumentation and are therefore very expensive. Phage amplification technology requires no special equipment and the results can be read visually.

Key words: Tuberculosis, drug susceptibility, phage, treatment, FASTPlaque-TB, rifampicin

(Af J Clinical & Exp Microbiology: 2003 4(2): 67-78)