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Need for standardization and compliance to treatment protocols for COVID-19 within the African Region of the World Health Organization

*1Fuller, W. L., 1Mukankubito, I., 1Nikiema, J. B., 1Ali Ahmed, Y., and 2Aboderin, A. O.
1World Health Organization Regional Office for Africa, Brazzaville, Congo 2Department of Medical Microbiology, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria *Correspondence to: wfuller@who.int

Abstract:
COVID-19 pandemic changed the face of global health and brought about new issues in global health security and economy. The World Health Organization published guidelines for clinical management of COVID-19 four months after declaration of COVID-19 as a pandemic. Scholarly reviews and studies from member states within WHO AFRO reveals significant deviation from the WHO published protocols on COVID-19. Assessment of national treatment protocols of 30 of 47 WHO AFRO member states showed widespread inappropriate use of antimicrobial agents for patients, which may worsen the global and concerning threat of antimicrobial resistance. There is need for adopting interventions that optimize antimicrobial use in the context of pre- and post-pandemic preparedness to ensure long-term effectiveness and sustainability for antimicrobials. Treatment guidelines are to be adopted or adapted depending on best clinical evidence available. Non-compliance with guidelines might lead to mismanagement of infectious diseases with attendant negative consequences including antimicrobial resistance and misdirection of critical resources and supplies amongst others. Continue reading “Need for standardization and compliance to treatment protocols for COVID-19 within the African Region of the World Health Organization”

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Prematurity as a secondary immunodeficiency disorder with increased risk of infections: A mini-review

*1Ibraheem, R. M., and 2Issa, A.

1Department of Paediatrics and Child Health, University of Ilorin and University of Ilorin Teaching Hospital, PMB 1515, Ilorin, Nigeria

2Department of Paediatrics, Children Specialist Hospital, Ilorin, Nigeria

*Correspondence to: ibraheem.rm@unilorin.edu.ng;

rasheedahbidmus@yahoo.com +2348033704168; ORCID: 0000-0002-3960-9740

Abstract:
Prematurity significantly increases neonatal mortality in sub-Saharan Africa. Underdeveloped immune systems and prolonged hospitalization elevate the risk of secondary immunodeficiency leading to heightened vulnerability to healthcare-associated infections, including neonatal sepsis from various sources like intrauterine, intrapartum, and postnatal agents. This review explores the impact of prematurity on infection susceptibility and the role of immature immunity. A literature search using PubMed and Google Scholar identified relevant articles published between January 1980 and December 2022, focusing on terms such as “preterm,” “prematurity,” “neonatal sepsis,” and “secondary immunodeficiency.” Despite neonatal susceptibility to sepsis, accurate incidence estimates are lacking in many countries, and preterm infants face higher morbidity and mortality risks compared to full-term babies. Early-onset infections usually manifest within the first 72 hours post-delivery, while late-onset neonatal sepsis occurs after this period. Immaturity affects various immune system components, with gestational age influencing functionality. The compromised innate immune response in preterm infants involves factors such as fragile skin, reduced tear/mucus production, and low antimicrobial peptide levels. Complement deficiencies and impaired neutrophil function increase susceptibility to infections. Macrophages, dendritic cells, and natural killer cells exhibit reduced activity, impacting viral clearance. Preterm infants also have lower immunoglobulin (Ig) G levels, contributing to a weakened adaptive immune response. Hypogammaglobulinaemia heightens susceptibility to infections relying on antibody-mediated protection, while low secretory IgA production and delayed antibody response predispose to gastrointestinal and respiratory infections. The combined effect of immature immunity and medical interventions heightens preterm infants’ susceptibility to pathogens. Recommendations for mitigating infection risks include antimicrobial stewardship, prompt initiation of exclusive breastfeeding, and timely administration of routine vaccinations. Continue reading “Prematurity as a secondary immunodeficiency disorder with increased risk of infections: A mini-review”

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COVID-19 in children aged 0-15 years seen at Amirou Boubacar Diallo National Hospital in Niamey, Niger, 2020-2021

1,2Idé Amadou, H., 3Mahamadou Yacouba, M., 2,4Dodo, B., 5Boua Togola, O., 2,4Aboubacar, S., 6Ousmane, A., 2,4Garba, M., and 2Mainassara, S.

1Medical and Health Research Center (CERMES), BP: 10887, Niamey, Niger

2Amirou Boubacar Diallo National Hospital (HNABD), BP: 10146, Niamey, Niger

3Direction of Surveillance and Response to Epidemics (DSRE), BP: 623, Niamey, Niger

4Faculty of Health Sciences, Abdou Moumouni University of Niamey, BP: 10146, Niamey, Niger 5General Direction of Health and Public Hygiene, BP: 233, Bamako, Mali 6Faculty of Health Sciences, Dan Dicko Dan Koulodo University of Maradi, Niger *Correspondence to: ide.habibatou@yahoo.fr; Tel: 00 227 91 12 50 30/ 98 34 36 68

Abstract:
Background: In 2020, the COVID-19 pandemic affected all age groups. Although COVID-19 is generally benign in children, a diagnostic problem may arise due to clinical similarities with certain pathologies such as malaria, dengue fever and influenza. The objective of this study is to describe the epidemiological profile of COVID 19 in children seen at consultation and to determine the prevalence of influenza, malaria and dengue fever as differential diagnoses. Continue reading “COVID-19 in children aged 0-15 years seen at Amirou Boubacar Diallo National Hospital in Niamey, Niger, 2020-2021”

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Predominant amino acid substitutions in NS5B gene of hepatitis C virus in blood donors and treatment-naïve hepatitis and HIV patients in Nigeria

*1Shenge, J. A., 2Odaibo, G. N., and 2Olaleye, D. O.
1Virology Research Unit, Biological Sciences, Dominican University, Ibadan, Nigeria 2Department of Virology, College of Medicine, University of Ibadan, Nigeria *Correspondence to: jadamma@yahoo.com; +2348099711012

Abstract:
Background: Hepatitis C virus (HCV) genome undergoes high rate of mutation, which results in generation of genetically diverse HCV isolates. There is paucity of data on mutations in the nonstructural 5b (NS5b) gene of circulating HCV and their implications in the Nigerian population. Here, we identified clinically-important mutations in HCV isolates, which may influence response to therapy and disease prognosis. Continue reading “Predominant amino acid substitutions in NS5B gene of hepatitis C virus in blood donors and treatment-naïve hepatitis and HIV patients in Nigeria”

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Serological and molecular detection of hepatitis C virus among students in a tertiary educational institution in Calabar, Nigeria

*1Mbah, M., 1Nwabunike, V. O., 1Akpan, S. S., 2Tangban, E. E., and 1Bassey, E. E.

1Department of Medical Parasitology and Entomology, Faculty of Medical Laboratory Science, University of Calabar, Calabar, Nigeria

2Department of Social Works, University of Calabar, Calabar, Nigeria
*Correspondence to: mauricembah@yahoo.fr; +2347039121644; ORCID: //orcid.org/0000-0001-1985-2925X

Abstract:
Background: Hepatitis C virus (HCV) infection is a global health problem and continues to be a major disease burden in the world, associated with serious health challenges including liver cirrhosis, cancer, lymphomas and death. This study was carried out to determine the prevalence of HCV infection among students of the University of Calabar. Continue reading “Serological and molecular detection of hepatitis C virus among students in a tertiary educational institution in Calabar, Nigeria”

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Molecular detection of antimicrobial resistance genes in multidrug-resistant Gram-negative bacteria isolated from clinical samples in two hospitals in Niger

*1Abdoulaye, O., 2Abdoulaye, I., 3Alassane Halawen, M., 4Ibrahim Mamadou, A. K., 1,5Maman Sani Falissou, S., 5,6Adamou Amatagas, S., 1Boureima, H., 2Boubacar Issaka, B., 2Ide, H., 7Yacouba, A., 1,5Sidi Maman Bacha, B., 3Chaibou, S., 2Hamadou, I., 1Harouna Amadou, M. L., 2Ousmane, S., 5Doutchi, M., and 7Mamadou, S.

1Faculté des Sciences de la Santé, Université de Dan Dicko Dankoulodo de Maradi, BP 465, Niger

2Centre de Recherche Médicale et Sanitaire, Niamey, Niger

3Hôpital Général de Référence de Niamey, Niger

4Centre Hospitalier Régional de Dosso, Niger

5Hôpital National de Zinder, Niger

6Faculté des Sciences de la Santé, Université André Salifou de Zinder, Niger

7Faculté des Sciences de la Santé, Université Abdou Moumouni, Niamey, Niger

*Correspondence to: ousmaneabdoulaye2010@yahoo.com; Cel: (+227) 96354580

Abstract:
Background: According to the World Health Organization (WHO), bacterial resistance to antibiotics is a global public health challenge, which is also developing in Niger. The aim of this study was to determine the prevalence of antibiotic resistance genes in Gram-negative bacilli isolated from clinical samples in the biological laboratories of two selected health facilities in Niger. Continue reading “Molecular detection of antimicrobial resistance genes in multidrug-resistant Gram-negative bacteria isolated from clinical samples in two hospitals in Niger”

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Urinary tract infections in pregnancy caused by carbapenem-resistant Enterobacteriaceae in University of Calabar Teaching Hospital, Nigeria: An emerging therapeutic threat

1,2Ogban, G. I., *1,2Iwuafor, A. A., 3Idemudo, C. U., 2Ben, S. A., 4Ushie, S. N., and 1,2Emanghe, U. E.

1Department of Medical Microbiology and Parasitology, University of Calabar, Calabar, Nigeria

2Department of Medical Microbiology and Parasitology Main Laboratory, University of Calabar Teaching Hospital, Calabar, Nigeria

3Department of Public Health, University of Calabar, Calabar, Nigeria 4Department of Medical Microbiology and Parasitology, Nnamdi Azikiwe University, Awka, Nigeria *Correspondence to: tonyiwuafor@unical.edu.ng; +2348033441539

Abstract:
Background: Severe infections caused by carbapenem-resistant Enterobacteriaceae (CRE) have mortality rate exceeding 50%. On the strength of this, this study sought to determine the prevalence of urinary tract infection (UTI) in pregnancy caused by CRE and associated risk factors in University of Calabar Teaching Hospital (UCTH), Nigeria, with the aim of making recommendations that can stem the tide of UTI caused by this bacterial strain in the hospital. Continue reading “Urinary tract infections in pregnancy caused by carbapenem-resistant Enterobacteriaceae in University of Calabar Teaching Hospital, Nigeria: An emerging therapeutic threat”

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Detection of microbial pathogens colonizing foot ulcers of diabetic patients in Enugu, Nigeria

*1Ugwu, O. B., 1Udeani, T. K. C., 2Anigbo, C. L., and 3Anigbo, C. S.
1Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
2Livingston Specialist Hospital, Ituku Street, New Heaven, Enugu, Nigeria
3Department of Hematology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria

*Correspondence to: cynthiaogochukwu@gmail.com; +234906496450

Abstract:
Background: Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus (DM) which is associated with high morbidity and mortality. There is high rate of bacteria colonization especially in those with tendencies for poor wound dressing. This is accompanied by high rate of inappropriate antibiotic usage. The aim of this study is to characterize microbial pathogens colonizing foot ulcers of diabetic patients in Enugu, Nigeria, and to determine the antibiotic susceptibility of these isolates.

Methodology: This was a descriptive cross-sectional study of consecutively enrolled diabetic patients with foot ulcers in two tertiary healthcare facilities in Enugu, Nigeria, between May 2021 and February 2022. A structured questionnaire was used to obtain socio-demographic and clinical data of the patients. Pus samples and/or tissues were collected from the ulcer lesion of each patient for aerobic and anaerobic microbial cultures and biochemical identification using standard conventional techniques.

Results: A total of 310 diabetic patients with foot ulcers were recruited into the study, with 62.3% (193/310) males and 37.7% (117/310) females, and mean age of 56.0±13.9 years. Bacteria and yeast were isolated from samples of 280 (90.3%) patients while samples of 30 (9.7%) patients had no microbial growth. Males had higher frequency of microbial isolates (90.7%, 175/193) than females (89.7%, 105/117), while the age group ≤ 40 years had higher frequency of microbial isolates (100%, 43/43) compared to other age groups, although the differences are not statistically significant (p>0.05). The distribution of the isolates showed that 15.7% (44/280) were monomicrobial while 84.3% (236/280) were polymicrobial. The highest single isolate was Bacteroides fragilis with 5.0% (14/280), followed by Staphylococcus aureus with 3.2% (9/280). Bacteroides fragilis and S. aureus occurred as the highest combined bacteria isolates with 5.7% (16/280). Most of the patients were colonized by combination of bacterial isolates. The susceptibility indicates that most of the anaerobic bacteria were sensitive to metronidazole while S. aureus isolates were resistant to ofloxacin at a rate of 65.0%. Conclusion: The findings in this study showed that there is high bacteria and fungi colonization of foot ulcers of diabetic patients in Enugu, Nigeria. Routine care of wounds especially frequent changes of dressing materials and the use of potent antiseptics, are recommended.

Keywords: Diabetic foot ulcer; chronic wounds, polymicrobial, antimicrobial resistance

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Detection of microbial pathogens colonizing foot ulcers of diabetic patients in Enugu, Nigeria

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Phylogenetic diversity and susceptibility of Candida species from women using contraceptive devices in northcentral Nigeria

*1,2Adogo, L. Y., 2Chuku, A., 2Joseph, N. F., 3Ombugadu, A., 4,5Reuben, R. C., and 1,2Ajide, B.

1Department of Biological Sciences, Bingham University, Karu, Nigeria

2Department of Microbiology, Federal University of Lafia, Nigeria

3Department of Zoology, Federal University of Lafia, Nigeria

4German Centre of Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103, Leipzig, Germany 5Department of Experimental Interaction Ecology, Institute of Biology, Leipzig University, Puschstraße 4, 04103, Leipzig, Germany *Correspondence to: lillian.adogo@binghamuni.edu.ng

Abstract:
Background: The use of contraceptive devices predisposes women to vulvovaginal candidiasis (VVC) globally. Despite the high incidence of VVC and antifungal resistance to azoles, the genetic diversity and resistance pattern among contraceptive users in Nigeria is poorly investigated. This study therefore sought to characterize and determine the phylogenetic breadth of Candida species as well as their resistance to antifungal agents. Continue reading “Phylogenetic diversity and susceptibility of Candida species from women using contraceptive devices in northcentral Nigeria”

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Hydroxychloroquine and zinc ameliorate interleukin-6 associated hepato-renal toxicity induced by Aspergillus fumigatus in experimental rat models

*Okoye, J. O., Basil, A. T., Okoli, O. G., Achebe, P. O., Obi, C. M., and Ekekwe, N. E.
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria

*Correspondence to: jog.okoye@unizik.edu.ng; +2347031119994; ORCID: 0000-0002-7194-5592

Abstract:
Background: In Nigeria, immunocompromised persons, particularly those living with HIV, are at an increased risk of developing invasive pulmonary aspergillosis caused by Aspergillus fumigatus. Interestingly, this condition produces symptoms that can be easily mistaken for those of COVID-19. This misdiagnosis results in their treatment with zinc and hydroxychloroquine (HCQ). To better understand the pathophysiology of aspergillosis and determine the therapeutic and toxic effects of zinc and HCQ, this study examined liver and renal functions in experimental rat models.

Methodology: Twenty-eight Albino rats, randomised into 7 groups (n=4 each) designated A to G, were used for this study. Group A rats received standardized rat chow and distilled water only. Group B rats received moderate dose of HCQ only. Group C to G rats received immunosuppressive agents (an alkylating agent: cyclo- phosphamide and a steroid: hydrocortisone) to simulate an immunocompromised state before being infected with A. fumigatus suspension (AFS). Group C rats received AFS without treatment. Group D rats simultaneously received AFS and low dose of HCQ. Group E rats simultaneously received AFS and moderate dose of HCQ. Group F rats simultaneously received AFS and high dose of HCQ, and Group G rats simultaneously received AFS and moderate dose of HCQ and zinc. Serum levels of interleukin (IL)-6 and IL-10, liver enzymes, and renal parameters were measured using standard methods. The weights of the lungs, liver, and kidneys of each rat were measured after being sacrificed. One-way analysis of variance (ANOVA) was used to compare the means (±SD) of the biochemical variables and relative weight of the organs, while Post Hoc test was used for group comparison. Pearson’s correlation was used to determine relationship between parameters, with significant levels established at p<0.05. Continue reading “Hydroxychloroquine and zinc ameliorate interleukin-6 associated hepato-renal toxicity induced by Aspergillus fumigatus in experimental rat models”