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Risk factors associated with HIV prevalence in pregnant women in Burkina Faso, from 2006 to 2014

D Konaté, H Dahourou, W Traoré, C Ouedraogo, A Bambara-Kankouan, A Somda, A Guiré, M.J. Sanou, M Lingani, N Barro, A.S. Traoré, L Sangaré

 

Abstract

Purpose of the study: To determine the socio-demographic factors influencing the dynamics of HIV prevalence among pregnant women in Burkina Faso.

Material and methods: A total of 66,597 pregnant women from the 13 health regions of Burkina Faso were included in this study conducted between 2006 and 2014. Venous blood samples were collected and analyzed for the detection of HIV antibodies according to WHO / UNAIDS strategy II, using the mixed test Vironostika HIV Uniform II Plus O (Bio-Mérieux) and the test discriminating ImmunoCombII HIV-1 & 2 BiSpot (Orgenics). Samples with discordant results between the two tests, as well as those positive to HIV-2 or HIV-1 + 2, were retested with HIV BLOT 2.2 (MP Diagnostics). Sociodemographic data collected from the participants were correlated with their HIV status to determine key risk factors influencing HIV infection prevalence in Burkina Faso.

Results: Sociodemographic data showed that the study population consisted mainly of married women (91.2%) at their first pregnancy (27.1%) with a large majority of them being housewives (86.2%) who did not attend any form of schooling (69.4%). About 88.4% had stayed longer than a year in the health region where they initially participated in the study and 55.8% were between 20 and 29 years of age. Overall HIV prevalence significantly dropped from 2.7 % in 2006 to 1.3% in 2014. However HIV seroprevalence in this study has varied significantly according to socio-demographic characteristics including marital status, parity, occupation, education, age group and the length of stay in the women’s health community (p <0.0001). Factors sustaining HIV transmission included the status of being unmarried (OR=1.67 [1.42-1.97]), primigest (OR=1.64 [1.41-1.89]), having other occupations except being student (OR = 1.68 [1.20-2.33]), aged between 20-49 years (OR=3.14 [2.51-3.93]) and the duration of stay less than a year in their locality (OR=5.33 [4.61-10.16]) and these factors were identified as main risk factors associated with HIV prevalence.

Conclusion: Burkina Faso remains among the countries with concentrated epidemics despite a significant reduction in the prevalence observed in this study. The inclusion of identified risk factors in the national HIV program could improve the quality of the response to the epidemic.

Keywords:

D Konaté, H Dahourou, W Traoré, C Ouedraogo, A Bambara-Kankouan, A Somda, A Guiré, M.J. Sanou, M Lingani, N Barro, A.S. Traoré, L Sangaré

 

Abstract

Purpose of the study: To determine the socio-demographic factors influencing the dynamics of HIV prevalence among pregnant women in Burkina Faso.

Material and methods: A total of 66,597 pregnant women from the 13 health regions of Burkina Faso were included in this study conducted between 2006 and 2014. Venous blood samples were collected and analyzed for the detection of HIV antibodies according to WHO / UNAIDS strategy II, using the mixed test Vironostika HIV Uniform II Plus O (Bio-Mérieux) and the test discriminating ImmunoCombII HIV-1 & 2 BiSpot (Orgenics). Samples with discordant results between the two tests, as well as those positive to HIV-2 or HIV-1 + 2, were retested with HIV BLOT 2.2 (MP Diagnostics). Sociodemographic data collected from the participants were correlated with their HIV status to determine key risk factors influencing HIV infection prevalence in Burkina Faso.

Results: Sociodemographic data showed that the study population consisted mainly of married women (91.2%) at their first pregnancy (27.1%) with a large majority of them being housewives (86.2%) who did not attend any form of schooling (69.4%). About 88.4% had stayed longer than a year in the health region where they initially participated in the study and 55.8% were between 20 and 29 years of age. Overall HIV prevalence significantly dropped from 2.7 % in 2006 to 1.3% in 2014. However HIV seroprevalence in this study has varied significantly according to socio-demographic characteristics including marital status, parity, occupation, education, age group and the length of stay in the women’s health community (p <0.0001). Factors sustaining HIV transmission included the status of being unmarried (OR=1.67 [1.42-1.97]), primigest (OR=1.64 [1.41-1.89]), having other occupations except being student (OR = 1.68 [1.20-2.33]), aged between 20-49 years (OR=3.14 [2.51-3.93]) and the duration of stay less than a year in their locality (OR=5.33 [4.61-10.16]) and these factors were identified as main risk factors associated with HIV prevalence.

Conclusion: Burkina Faso remains among the countries with concentrated epidemics despite a significant reduction in the prevalence observed in this study. The inclusion of identified risk factors in the national HIV program could improve the quality of the response to the epidemic.

Keywords: HIV-Pregnant Women-Risk Factors-Burkina Faso

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Risk factors associated with HIV prevalence in pregnant women in Burkina Faso, from 2006 to 2014

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Residual mother-to-child transmission of HIV in Burkina Faso

A Ky Ba, M Sanou, L Toguyeni Tamini, I Diallo, A.S. Ouédraogo, J Catrayé, P.T. Sanou, C Ki Toe, A.Y. Ky, I Sanou, R Ouédraogo Traoré, L Sangaré

 

Abstract

Background: Burkina Faso is one of the countries in West Africa most affected by the HIV/AIDS pandemic, despite the implementation of a mother-to-child HIV transmission prevention program as a strategy to reduce the risk of vertical transmission of the disease.

Objective: To assess the current risk of mother-to-child transmission of HIV in Burkina Faso.

Materials and methods: A prospective study was conducted between December 2014 and July 2016, in the 13 health regions of Burkina Faso. Women who were screened HIV-positive during a prenatal consultation were followed until delivery. Their babies received dry blood spot (DBS) at birth, at week 6 and at 1year, to screen for HIV.

Results: Overall, 186 pregnant women were included in the study, with a mean age of 29.17±6.13 years. Of their children, 430 DBS actually received a PCR test, giving a 91.1% PCR implementation rate. After analyses, 6 (1.3%) babies were identified as carriers of HIV1. The newborn’s serological status was associated with delivery pattern (p=0.000), the administration of antiretroviral drugs to the mother after delivery (p=0.0064), the administration of Nevirapine to the newborn at birth (p=0.022), the use of contraceptive methods after delivery (p=0.028) and the presence of breast affections/infections since delivery (p=0.013).

Conclusion: The results of our study are encouraging and demonstrate the effectiveness of interventions in the mother-tochild prevention program (PMTCT) for HIV-positive pregnant women can be improved through early initiation of triple therapy in early pregnancy and improved adherence to antiretroviral (ARV) therapy.

Keywords: Burkina Faso, HIV/AIDS, mother-to-child transmission, antiretroviral drugs, pregnant women

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Residual mother-to-child transmission of HIV in Burkina Faso

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School based mass de-worming initiative in south-west Nigeria

A.M. Efunshile

 

Abstract

Background: The public health implications of helmintic infection in developing countries were generally agreed by many researchers to include poor growth and poor school performance among others. But the role of school based mass de-worming in combating the menace of helminthiasis remains controversial. Several studies have assessed the impacts of mass de-worming with conflicting results. This study was designed to evaluate the impact of antihelminthic mass chemotherapy on changes in growth indices and school absenteeism.

Materials and methods: Albendazole tablets were administered by school teachers to pupils after data and stool sample collection. Follow up data were collected 6 months later for impact assessment. Ponderal growth retardation was defined as BMI under 5-percentile.

Results: Overall helminth infection rate was 373/1442 (39%) of the pupils before the intervention. Ascaris lumbricoides (n=247; 25.8%) and hookworm (n=89; 9.3%) were the most common. At enrolment 19.6% of children with and 11.8% without helminth infections had BMI below the 5-percentile. These figures were reduced to 9.2% and 8.8% after de-worming respectively. No effect of de-worming was seen on longitudinal growth. The number of helminth infected children with >25% absenteeism reduced by 12.5%, while the reduction rate was 6.8% in the uninfected group.

Discussion: The difference in response to de-worming between infected and uninfected children strongly support the beneficial effect of de-worming on growth and school absenteeism. The intervention could be administered by school teachers without formal healthcare training, thus allowing integration of the programme into existing structures.

Keywords: Helminthes, Absenteeism, Preventive Chemotherapy

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School based mass de-worming initiative in south-west Nigeria

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Lateral geniculate nucleus histopathology in the rat experimental model of African trypanosomosis

C.I. Maina, G.M. Ng’wena

 

Abstract

Trypanosomosis is an infectious disease of humans and animals characterized by sleep/wake disturbances and disruptions in other circadian rhythm activities. The disease is caused by protozoan parasites of the genus Trypanosoma and transmitted by the bite of infected tsetse flies of the Glossina species. Although trypanosomosis has a well knownaetiology, histopathological studies on brain regions involved in the control of circadian rhythms are scanty. Lateral geniculate nucleus works in conjunction with the suprachiasmatic nucleus, the master circadian rhythm pacemaker, in regulating circadian rhythms. The purpose of this study was to investigate the effect of T.b.brucei infection on the histology of the lateral geniculate nucleus, a brain region that can serve as an alternative secondary circadian rhythm pacemaker when the master pacemaker fails. Twelve control and twelve experimental male albino rats were used in this study. The experimental rats were inoculated intraperitoneally with 0.2ml of infected blood containing 1 x 104T.b.bruceiparasites. The infected animals were allowed to go through the full course of infection and sacrificed when they were in extremis. Each rat was decapitated and the brain immediately extracted from the skull. The brain was fixed in 10% buffered neutral formalin for at least 48 hours. The brain was later removed from the formalin solution and a coronal section made. The coronal section was processed histologically and stained using the haematoxylin and eosin method. The stained slides were observed under a microscope and photomicrographs taken. Histological alterations, including tissue degeneration, infiltration and proliferation of cells, and perivascular cuffing were observed in the lateral geniculate nucleus of infected rats. Lateral geniculate nucleus cannot, therefore, serve as an alternative secondary circadian rhythm pacemaker during trypanosome infection.

Keywords: Trypanosomosis, Lateral geniculate nucleus, Histopathology, Circadian rhythm

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Lateral geniculate nucleus histopathology in the rat experimental model of African trypanosomosis

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Prevalence of trypanosomiasis in sheep in the Kachia Grazing Reserve, Kachia, Kaduna State, Nigeria

B Wayo, S.M. Samdi, A.O. Fajinmi, R Bizi, H Dauda, A.A. Muhammad, J.O. Kalejaiye

 

Abstract

An investigation was carried out in the Kachia grazing reserve in Kaduna, Nigeria, to determine the prevalence of trypanosomiasis among sheep. The reserve has had a history of high prevalence of the disease and farmers in the area are known to ignore the control of trypanosomiasis in sheep and goats and focus more on cattle. The sheep studied showed lacrimation, pale mucous membranes, hair loss, lameness and tick infestation. Blood samples from 110 sheep were collected and examined by using the Standard Trypanosome Detection Method i.e. Haematocrit Centrifugation Technique (HCT),Buffy Coat Method (BCM), and Giemsa stained thick and thin blood films.The packed cell volume (PCV) of each animal was also determined.An overall point prevalence rate of 40.9%(45 positive) was recorded. The average PCV of the infected sheep (19.6±0.45) appeared lower but statistically not significant (p>0.05)than that (18.6±0.51) in those non-infected.The trypanosomes observed were T. congolense (40.0%),T. Brucei (28.8%), T.vivax (17.7%) and mixed infections (13.3%). The potential of small ruminants serving as reservoirs of infection for cattle, insufficiency of professional Veterinary services, absence of alternative trypanosomiasis control methods other than chemotherapy and poor land use practices which forces migration of herds and complicates the control of the disease in the area were discussed.

Keywords: Prevalence, Trypanosomiasis, Sheep, Grazing reserve, Chemotherapy, Reservoir

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Prevalence of trypanosomiasis in sheep in the Kachia Grazing Reserve, Kachia, Kaduna State, Nigeria

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Comparative bone marrow responses of albino rats experimentally infected with single and mixed species of Trypanosoma congolense and Trypanosoma brucei and ability to control anaemia

J.N. Abenga, S.M. Samd, F.O. Fajinmi, A.M. Kalgo

 

Abstract

Effect of Trypanosoma congolence and T. brucei mixed infection on ability of the bone marrow to respond to anemia was investigated in albino rats. This was with the view of assessing the possible impact on recovery rate from anemia following chemotherapy of African trypanosomosis. The investigation involved descriptive evaluation of packed cell volume and corresponding bone marrow cytological changes associated with single and mixed infection of T. congolense and T. brucei. It involved laboratory based experimental infection of albino rats as research models. A total of 32 adult albino rats of mixed sexes were used for this investigation. The rats were randomly grouped into three groups, A, B, C made up of 8 rats each, and infected with T. congolense, T brucei and mixed infection of these species.. Eight other rats served as the uninfected control group.Parameters measured included weekly packed cell volume (PCV) and differential bone marrow cytology of the different groups of infected and control rats at the end of 21 days post infection (PI). At the end of 21 days PI, the anemia characterized by drop in PCV was most severe in the mixed infection group, and least in T. brucei group with tendency for self-recovery from anemia. The bone marrow responses in the mixed infection group was however weak and inferior to that of T. brucei and T. Congolense groups. Poor erythropoietic response in the mixed infection group despite significant fall (P < 0.05) in PCV level was believed to arise from severe renal and hepatic pathology resulting to subnormal erythropoietin release and severe stem cell injury. This is believed would cause longer time to be taken by mixed infection animals to recover from anemia after chemotherapy. It is concluded that T. congolense and T. brucei mixed infection result to marked incapacitation of the bone marrow and ability for recovery from anemia. This suggests that supportive administration of synthetic erythropoietin may be required in trypanosome specie mixed infection situation due to severe pathological effects on the kidney and liver resulting to impaired erythropoietinbiosynthesis and slow recovery from anemia following chemotherapy in African trypanosomiasis.

Keywords: Anemia, bone marrow, mixed infection, rats, trypanosomiasis, erythropoietin

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Comparative bone marrow responses of albino rats experimentally infected with single and mixed species of Trypanosoma congolense and Trypanosoma brucei and ability to control anaemia

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Trypanosomiasis in a migrating herd of cattle in Kaduna State Nigeria

M.K. Haruna, A.U. Malala, B Wayo, U.O. Adamu, H.M. Sumayin, F.T. Shettima, J.O. Kalejaiye

 

Abstract

The aim of this study is to evaluate the prevalence and impact of Trypanosomiasis on a herd of migrating/pastoral cattle. A herd of 50 white Fulani cattle migrating from a suburban area of Abuja to Afaka in Igabi Local Government Area of Kaduna State, Northern Nigeria, were examined and screened for Trypanosomiasis on request. The animals showed clinical symptoms of lacrimation, emaciation, depression, lethargy and enlarged superficial lymphnodes which were reportedly not present before the trek. 40 of the animals were screened by parasitological means (hematocrit, buffy coat methods and thin and thick blood smears). 15 out of the 40 animals sampled were positive for trypanosomes (37.5% prevalence). Trypanosoma congolense was the only Trypanosoma species identified. Trypanosomiasis was observed in the herd examined and laboratory examination corroborated the observed clinical signs. The results, as well as the role of migration and transhumance pastoralism in disease occurrence are discussed.

Keywords: Trypanosomiasis, trypanosomes, cattle, Fulani, migration, Nigeria

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Trypanosomiasis in a migrating herd of cattle in Kaduna State Nigeria

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A review of the virulence factors of pathogenic fungi

C. Iyalla

 

Abstract

Fungal infections are becoming more prevalent especially with increase in immunodeficiency disorders, immunosuppression following transplantation, cancers and cancer treatment. They are ubiquitous and cause infections which may be trivial or more deep seated and severe infections associated with mortality. The ability of some fungal species to cause disease is due to various virulence factors which help with fungal survival and persistence in the host resulting in tissue damage and disease. This review discusses these virulence factors. These factors include an ability to adhere to hosts’ tissues, production of enzymes that cause tissue damage and direct interference with host defences. Pathogenic fungi produce catalases and Mannitol which protect against reactive oxygen species (ROS). Some fungi notably, dimorphic fungi and C. albicans have the ability to switch from one form to another. Thermotolerance, at least to 370C, is critical for survival in mammalian host and contributes to dissemination. Melanin is produced by a number of pathogenic fungi, and protects against harsh conditions such as UV radiation, increased temperature and ROS. The ability to obtain Iron (Fe) from the storage or transport forms in the host is also a virulence factor and calcineurin acts as a sensor for pathogenic fungi.

Keywords: Fungi, virulence, pathogenic, infections, dimorphism, thermotolerance

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A review of the virulence factors of pathogenic fungi

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Trends in profiles of bacteria causing neonatal sepsis in Central Nigeria Hospital

N. Medugu, K.C. Iregbu

 

Abstract

Developing countries suffer from a huge burden of neonatal sepsis. Neonatal  mortality and long term sequelae or morbidity portends huge costs for the poor Nigerian economy. We identified trends in bacterial agents implicated in neonatal sepsis and their antibiotic susceptibility profiles at the National Hospital Abuja over two periods of three years each a decade apart. A retrospective study of bacterial agents of sepsis from 2013-2015 was carried out and this was compared to an already published study from the same hospital ten years earlier(2002-2004) to determine changing trends using standard statistical methods. We identified a significant shift to predominance of gram positive organisms especially Staphylococcus aureus (59% vs 40%) as against the predominance of gram negative organisms especially Klebsiella pneumoniae (11% vs 44%) in the previous decade. Almost all antibiotics tested (92%) had reduced susceptibility in the later review compared to the former. Surveillance of bacterial agents of neonatal sepsis is vital for the detection of trends in causative organisms and their susceptibilities. This is important to direct empiric therapy and also to encourage implementation and monitoring of antibiotic stewardship programs.
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Comparing antibody responses to Onchocerca volvulus and non-parasite antigens in placebo-controlled and ivermectin-treated onchocerciasis patients

H.O Osue, F.N.C Enwezor, B.T. Idowu, A. Cassel-Brown, B. Jones, A. Abiose, F Engelbrecht, H. Edeghere

 

Abstract

Serum antibodies to parasite-specific and non-parasite antigens were evaluated  using enzyme-linked immunosorbent assay (ELISA). Out of the 470 sera collected, 409 were from residents of an onchocerciasis hyper-endemic area, 55 non-endemic and 6 European normal sera served as control. The patients’ age, sex, skin  microfilaria densities, dermal and ocular clinical manifestations (colour of optic disc) have been well characterised. The study population had participated in a  placebocontrolled (n=191) trial of ivermectin (Mectizan®) treatment (n=218). The parasite antigens are phosphate buffered saline crude extract of adult worms of Onchocerca volvulus, a recombinant antigen (Ov1.9) and a monoclonal antibody purified antigen (Cam 1). The non-parasite antigens are deoxycholate citrate extract of optic nerve (nerve-DOC) and commercially available IgA, IgM and IgG were used to assay for rheumatoid factor (Rh-F) auto-antibodies. Generally, antibodies to parasite antigens in onchocerciasis patients were remarkably higher than control group (p<0.05) using exact F-test. There was no significant difference (p>0.05) in antibodies to nerve-DOC and Rh-F in patients compared to control. Antibodies increased with increasing skin snip microfilaria load from 0.69±0.28 with 0mf/mg (n=54) as against 0.80±0.26 for those with 4-20mf/mg. Observed slight negative correlation in IgG antibody levels and severity of disc colour with mean OD values of 0.26±0.22 in those graded as having no optic nerve disease (OND) (disc 1, n=86) and 0.17±0.19 for those with severe changes (disc 3, n=49) was not statistically significant (P>0.05). An age dependent significant decrease (P<0.05) in antibodies were observed with 0.64±0.34 for 15-30yr old (n=48) compared to 0.48±0.35 for those 50yr (n=50) for PBS with a similar trend for IgG to Ov1.9 and Cam1. In conclusion, serum parasite-specific and non-parasite antibodies may not be responsible for the pathology of optic nerve disease. Onchocerciasis patients were apparently not at higher risk of developing rheumatoid arthritis than the control.

Keywords: Onchocerciasis; Antibodies; Antigens; Immune responses; Ivermectin.

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Comparing antibody responses to Onchocerca volvulus and non-parasite antigens in placebo-controlled and ivermectin-treated onchocerciasis patients