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Meningococcal carriage and cerebrospinal meningitis after MenAfriVac mass immunization in Burkina Faso

A Ky-Ba, J Tranchot, I Sanou, P Christiansen, AS Ouedraogo, K Ouattara, M Kienou, M Tamboura, D Kambiré, R Ouédraogo-Traoré, L Sangaré

 

Abstract

The aims of this study were to evaluate the impact of conjugate vaccine A, MenAfriVac, on Neisseria meningitidis (Nm) asymptomatic carriage and cerebrospinal meningitis in three health districts (Bogodogo, Kaya, and Dandé) of Burkina Faso. Asymptomatic carriage of Nm was assessed by performing cross-sectional studyrepeated (rounds 1 to 10) before and after introduction of the conjugate vaccine against serogroup A of N. meningitidis (NmA), MenAfriVac. In each round at least 1,500 people were enrolled in each district for a month. Data oncases of meningococcal meningitis in the three studied health districts were collected through meningitides epidemiological surveillance of Burkina Faso.Nm was identified in680 of 23,885 throat swabs before vaccination (2. 84%)withNmYasthe dominant serogroup(1.87%). During the same period (2009 and 2010), 891 cases of suspected meningitis were reported in the three health districts among whom 42 were due toNm (4.71%) withNmX (3.70%) asthe most frequently identified serogroup. After vaccination, Nm was identified in 1117 of 27,245 pharyngeal samples (6.42%); NmX (4.42%) wasthe dominantserogroup. From 2011 to 2013, 965 cases of suspected meningitis were reported in all health facilities in the three studied health districts located in the geographical study area; 91 was due toNm (9.43%) andNmWasthe most commonserogroup(52 cases= 5.38%).After introduction of conjugate vaccine A (MenAfriVac), the NmAserogroup almost disappeared both in asymptomatic carriers and in patients with cerebrospinal meningitis. However the presence of the NmW and NmXserogroups, which appear to have replaced serogroup A, is very worrying with regard to meningitis prevention and control in Burkina Faso. It appears necessary to strengthen surveillance and laboratory diagnosis of the different meningococcal serogroups circulating in Africa.

Keywords: meningococcal meningitis, serogroups W and X, meningococcal carriage, MenAfriVac.

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Meningococcal carriage and cerebrospinal meningitis after MenAfriVac mass immunization in Burkina Faso

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Dynamics of germs responsible for acute bacterial meningitis in Burkina Faso in the last ten years (2005-2014)

Absatou Ky-Ba, Mahamoudou Sanou, Juliette -Diallo Trancho, Paul A. Christiasen, Abdoul Salam Ouedraogo, Mamadou Tamboura, Dinanibé Kambiré, Kalifa Ouattara, Maxime Kienou, Idrissa Sanou, Isaïe Medah, Daouda Koussoubé, Rasmata Ouédraogo

 

Abstract

The aim of this study was to analyze ten (10) years of epidemiological surveillance data of meningitis in Burkina Faso for high risk germs patterns identification in order to contribute to the strengthening of prevention strategies.

A retrospective study of the past decade (2005- 2014) of cases of acute bacterial meningitis occurred in the thirteen health regions, collected through epidemiological surveillance data meningitis in Burkina Faso. From a total of 88 057 suspected cases of acute bacterial meningitis, we recorded 9134 deaths. From the laboratory confirmed cases, the identified germs were as follows: 56.79% of Neisseria meningitidis, 41.09% of Streptococcus pneumoniae and 2.13% of Haemophilus influenzae. Among the meningococcus isolated, we observed the following distribution: 23.11% of NmA, 58.84% of NmW and 18% of NmX.

Mortality associated with acute bacterial meningitis remains still high in Burkina Faso despite the complete disappearance of NmA since 2012, after the conjugate vaccine A (MenAfriVac) has been introduced in this country. However the emergence of NmX, the reemergence of NmW and the persistence of high prevalence of Streptococcus pneumoniae are a major concern in the fight against meningitis in Burkina Faso. So, it is necessary, in addition to the strengthening of surveillance, diagnosis and case management to develop and make available and accessible a conjugate trivalent vaccine against NmA the NmX and NmW serogroups.

Keywords: meningococcal meningitis, W and X serogroups, Streptococcus pneumoniae, MenAfriVac

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Dynamics of germs responsible for acute bacterial meningitis in Burkina Faso in the last ten years (2005-2014)

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Prevalence and distribution of intestinal parasite infections in HIV seropositive individuals on antiretroviral therapy in Vom, Plateau State Nigeria

PM Lar, VK Pam, Julius Ayegba, Hosea Zumbes

 

Abstract

Background: The immunologic status of an individual can determine outcomes of treatment and their capacity to combat opportunistic infections. Co-infection with other parasites will confound the situation; however there is inadequate information on the interaction of HIV and helminth infections. We wanted to establish the relationship of the immunologic status and the prevalence of intestinal parasites in HIV/AIDS patients enrolled for antiretroviral therapy at the Vom Christian health centre.

Materials & Methods: With their consent, stool samples of 205 subjects were collected and examined parasitologically by direct microscopy and concentration techniques. Their most resent CD4+ cell counts were obtained at the centre. The demographic characteristics of the subjects were determined from their response to a questionaire.

Results: Out of the 205 subjects examined 61.9% of them had various parasites with helminthes occurring in 51.9% of the cases. The age group of 31-40 years was the most significantly infected (P< 0.05). Hookworms and Schistosoma mansonii were most frequent with prevalence rates of 18.1% and 16.5% respectively. The highest prevalence of parasites occurred in HIV/AIDS people with CD4+ cells between 101-200 cells/μ and those with counts below 100 cells/al.Occupation was highly associated with parasitic infections (p< 0.05).

Conclusion: Parasitic infection remained highly prevalent among the subjects examined in spite of ART treatment and in the case of intense infection in the immunocompromised, treatment outcome may be compromised.

Keywords: HIV/AIDS, Parasites, ART, Coinfection

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Prevalence and distribution of intestinal parasite infections in HIV seropositive individuals on antiretroviral therapy in Vom, Plateau State Nigeria

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Hematological derangement patterns in Nigerian dogs infected with Trypanosoma brucei: A simple prototype for assessing tolerance to trypanosome infections in animals

JN Abenga, SA Ode, G Agishi

 

Abstract

The haematology of Nigerian local puppies experimentally infected with the Federe strain of Trypanosoma brucei was studied in a total of six 9-weeks old puppies born to two local bitches. Four were randomly selected and inoculated with about 0.8 x 106 of T .brucei subcutaneously and the remaining two served as the uninfected control. The parasitaemia was monitored daily using wet mount microscopy. The packed cell volume (PCV), red blood cell (RBC) counts, total and differential white blood cell (WBC) counts and rates of both red blood cell and white blood cell loss per day and per parasitaemia log equivalent value(LEV) were monitored twice in a week . Parasitaemia was detected in the infected group four days after infection which was followed by an acute disease course, though with low fatality rate in the dogs. The anemia was characterized by a fluctuating PCV decrease from the pre-infection value of 29.5±4.5% and 15.3±3.3% at two weeks after infection when one of the dogs died. There was a mild decrease in the overall erythrocyte values which was attributable to trypanotolerance in the local breed of dogs. The post infection hematological derangement pattern was characterized by an overall post-infection RBC count drop of 1.92+0.23(x 1012/μ) (39.0%), mean daily drop of 0.07+0.05 (x 1012/μ) and an overall drop per LEV of 0.69(x 1012/μ). The overall mean postinfection total WBC count drop was 0.61±0.15(x109/μ)(43.6%) with a mean daily drop of 0.02±0.14(x109/μ), and an overall drop per LEV of 0.22±0.44(x109/μ). There was an overall higher post infection leukocyte drop compared to erythrocyte. The result poses fundamental research questions on the likelihood of differential surface sialic acid contents of erythrocytes and leukocytes and the possible roles of trypanosome sialidase in creating this difference as well as enhancing pathogenesis of leucopenia in the dogs . It was concluded that the patterns of hematological derangements demonstrated as erythrocyte and leukocyte drop (loss) rates and drop per parasitaemia Log Equivalent Values could serve as a prototype for comparing susceptibility to animal and human T. brucei infections and, other trypanosome species.

Keywords: Federe, Trypanosoma brucei, haematology, derangement, patterns

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Hematological derangement patterns in Nigerian dogs infected with Trypanosoma brucei A simple prototype for assessing tolerance to trypanosome infections

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Spectrum of aspergillosis: Pathogenesis, risk factors and management

C Iyalla

 

Abstract

This article reviews comprehensively the spectrum of diseases (aspergillosis) caused by Aspergillus spp, the commonest pathogenic form being the A.fumigatus. Aspergilus spp are ubiguitous in the environment and the respiratory tract is the portal of entry in most cases. Aspergillosis is associated with significant mortality and morbidity, the prevalence appears to be on the increase. About 10million people are at risk of aspergillosis, and 50% would die even with treatment. Immunodeficiency, especially neutropenia is central to the pathogenesis of aspergillosis. Diseases caused by A. fumigatus include;1) Invasive aspergillosis seen mostly in stem cell and organ transplant recipients, patients with haematological malignancies, cancer patients on chemotherapy and patients with AIDS. Invasive aspergillosis is life threatening, it affects the lungs and sinuses but could disseminate to affect the CNS, eye, skin and kidney. 2) Chronic pulmonary Aspergillosis occurs in the setting of previous cavitatry lung disease, most commonly tuberculous infections. 3) Allergic bronchopulmonary aspergillosis (ABPA) affects people with asthma and cystic fibrosis. A. fumigatus is also implicated in the exacerbation of asthma. The clinical symptoms of aspergillosis depend on the type and the systems affected; respiratory symptoms are more common as the respiratory tract is disproportionately affected in aspergillosis. Diagnostic features and treatment also depends on the type of aspergillosis. Diagnostic testing for aspergillosis includes radiologic tests, culture tests, galactomannan testing in body fluids, immunologic tests to detectAspergilus -specific immunoglobulins. Treatment modalities include surgery, use of antifungals and immunomodulatory therapy with cytokines.
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Pulmonary candidiasis and CD4 count in HIV positive patients seen in Jos, north central Nigeria

YJ Peter, AH Isa, AS Anzaku, MI Builders

 

Abstract

Background: Accurate and reliable diagnosis of HIV opportunistic infections plays a central role in effective HIV intervention programmes. Pulmonary infections are the leading cause of  morbidity and mortality in HIV infected individuals.

Objectives: We set out to determine the prevalence of Pulmonary candidiasis by isolating Candida species from the sputum of HIV sero-positive patient’s presenting to hospital with complaint of cough for more than two weeks and related the level of CD4 count to Pulmonary candidiasis.

Methods: Using sterile wire loop, each sputum sample was inoculated into duplicate SDA (Thermo Scientific, UK); one tube without antibiotics, another tube supplemented with Chloramphenicol (0.05%) and Cycloheximide (0.5%) antibiotics. The patient’s CD4 count was determined using a Cyflow machine (PARTECR, Germany).

Result: Fifty two (54.2%) female and 44(45.8%) male HIV positive subjects were compared with a control group made up of, 52(54.2%) female and 44(45.8%) male HIV negative subjects. Twenty one (21.9%) HIV positive subjects had Candida species in their sputum samples compared to 12(12.5%) in the HIV negative subjects. Among HIV positive subjects, 17(17.7%) had Candida albicans isolated from their sputum, 11(11.5%) of whom had a CD4 count of <200 cells/ul.

Conclusion: We concluded that, there is a risk of pulmonary candidiasis occurring in HIV infected patients with CD4 count <200cells/ul and that, Candida species contributes to chronic cough experienced by HIV infected patients. We recommend that HIV positive patients who have chronic cough and whose CD4 count is <200cells/ul be placed on systemic antifungal medication.

Keywords: Candida, Cough, Nigeria, Sputum

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Pulmonary candidiasis and CD4 count in HIV positive patients seen in Jos north central Nigeria

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Histological and biochemical markers of the liver of male Wistar rats on oral administration of nevirapine suspension

EK Oladipo, AY Afolabi, IO Omomowo, JK Oloke, EH Awoyelu

 

Abstract

Background: Mechanism of action of nevirapine in the prophylaxis treatment and treatment of HIV-1 may involve elevations in levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and other biomarkers of liver function. This study presents the hepatotoxic effect of nevirapine suspension using animal model.

Methods: A total number of 15 male Wister rats were fed normal chow and antiretroviral drug (Nevirapine) for a period of six weeks. The liver organ of the rats were obtained and subjected to histological procedures and biochemical analysis using enzyme assay obtained from Randox Laboratories Limited, Antrim United Kingdom (BT294QY).

Results: The wistar rats showed no significant mean body weight difference when compared with the control group. However there was significant difference in the mean values of AST (77.77±3.03) and ALT (89.37±3.19) of the treated rats. Nevirapine treated rats showed significant difference in AST, ALT, and ALP in the single (77.77± 3.03, 31.80±1.73, 43.81 ±1.54) and double (89.37±3.19, 33.38±2.01, 34.64 ±1.02) doses when compared with the controls (75.14 ±2.00, 29.16±0.17, 45.44 ±1.85) respectively. Mild vascular congestion, infiltration of sinusoids by inflammatory cells, and haemorrhage were induced by nevirapine as compared with the control group showing normal vessels without congestion, normal sinusoids appearing normal without infiltration.

Conclusion: The liver histology of the rats fed with Nevirapine suspension showed diffused hepatocellular necrosis. Routine check of the drug effect is important as it provides effective life management of HIV infected individuals.

Keywords: Nevirapine, Wister rat, Hepatotoxicity, Liver, Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP)

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Histological and biochemical markers of the liver of male Wistar rats on oral administration of nevirapine suspension

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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