Posted on

Clinical neglect of aspergillosis in pulmonary tuberculosis coinfection: a case report of avoidable mortality in a resourceconstrained setting

*[1]Adeyemo, A. T., 1Obadare, T. O., [2]Edward, S. S., 1Ibrahim, A. O., 1Irek, E. O., 1Amupitan, A. A., 2Olorunsogo, O. A., 1Anuforo, A. C., 2,3Obiajunwa, P. O., and 1,4Aboderin, A. O.

     1Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching  Hospitals Complex, Ile-Ife, Nigeria                                                                                

2Department of Paediatrics, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

3Department of Paediatrics, Obafemi Awolowo University, Ile-Ife, Nigeria                             

4Department of Medical Microbiology and Parasitology, Obafemi Awolowo University, Ile-Ife, Nigeria  

*Correspondence to: adeyemiadeyemo3@gmail.com; ORCiD: //orcid.org/0000–0003–3544–2530

Abstract:

Background: Pulmonary aspergillosis (PA) is common among patients with tuberculosis (TB). With both infections presenting with similar clinical and radiologic features, diagnosis of PA is often made too late or missed completely due to lack of clinical suspicion and poor diagnostic laboratory capacity for mycotic infections prevalent in our settings. We present a case of preventable mortality caused by delayed diagnosis and treatment of PA in a patient with pulmonary TB (PTB). Continue reading “Clinical neglect of aspergillosis in pulmonary tuberculosis coinfection: a case report of avoidable mortality in a resourceconstrained setting”

Posted on

Salmonella Kentucky: prevalence and challenges in Nigeria and the Africa continent

Igomu, E. E.
Bacterial Vaccine Production Division, National Veterinary Research Institute, P. M. B. 01 Vom, Nigeria Correspondence to: elayonigomu@gmail.com; +2348032786224

Abstract:

Salmonella Kentucky is ubiquitous in most African countries and the multidrug resistant (MDR) strains remain underreported across the continent. In Nigeria, poverty, inter country livestock trades, nomadic system of cattle production, indiscriminate use of antibiotics and prevalent immuno-compromising diseases such as human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and tuberculosis are factors that have enabled ease of transmission and complications of S. Kentucky infections. In the present decade, S. Kentucky is reported to be the most prevalent serovar associated with poultry in Nigeria, but very few reports underline the risk associated with consumption of poultry and acquisition of MDR S. Kentucky strains. The Nigerian poultry is one of the most commercialized subsectors of Nigerian agriculture, therefore, the presence of S. Kentucky especially strains carrying broad spectrum antimicrobial resistance pose a great risk to public health. The lack of proper monitoring, surveillance, isolation and control of the multidrug resistant S. Kentucky will remain a challenge to the export potential of the Nigerian poultry subsector and livestock in general. As a nation, modalities and actions against the smuggling of poultry products, indiscriminate use of antibiotics and nomadic system for the production of dairy and beef that promotes spread of virulent strains of Salmonellae must change. The impact of non-typhoidal salmonellosis in humans in Nigeria also remains under studied and under reported, especially those caused by S. Kentucky ST198. Compounding these concerns is the lack of commercial veterinary or human vaccines against S. Kentucky or where vaccines against the broad serogroup C non-typhoidal Salmonella (NTS) are available, they are rarely supplied, with no evidence they could be cross-protective. This review emphasizes the emergence and widespread occurrence of MDR S. Kentucky strains on the African continent, and discussed risk factors contributing to its spread in Nigeria and the potential public health challenge especially to high-risk immunocompromised individuals.
Keywords: Salmonella Kentucky, ST198 strain, multidrug resistant, tuberculosis, HIV/AIDS, Nigeria, Africa
Received April 30, 2020; Revised May 8, 2020; Accepted May 10, 2020
Copyright 2020 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License <a rel=”license” href=”//creativecommons.org/licenses/by/4.0/”, which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.
Salmonella Kentucky: prévalence et défis au Nigeria et sur le continent africain
Igomu, E. E.
Division de la production de vaccins bactériens, Institut national de recherche vétérinaire, P. M. B. 01 Vom, Nigéria Correspondance à: elayonigomu@gmail.com; +2348032786224 Continue reading “Salmonella Kentucky: prevalence and challenges in Nigeria and the Africa continent”

Posted on

Phenotypic characterization of mycobacteria isolates from tuberculosis patients in Kaduna State, Nigeria

1,2Ahmadu, I., 1Olonitola, O. S., 1Suleiman, A. B., 3Lawan, M. K., and 4Makolo, D. 1Department of Microbiology, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Nigeria 2National Tuberculosis Reference Laboratory, Zaria, Nigeria 3Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Ahmadu Bello University, Zaria, Nigeria 4Department of Sciences, School of Preliminary Studies, Kogi State Polytechnic, Lokoja, Nigeria

Correspondence to: isiyakuadabka@yahoo.com Abstract: Background: Tuberculosis (TB) remains one of the leading public health challenges in Nigeria and the burden is still high. There is hence a need for continuous characterization of mycobacteria to obtain current data that will aid the ongoing TB prevention and control programme. The aim of this study was to phenotypically characterize mycobacteria isolates recovered from clinical specimens of patients with tuberculosis in Kaduna State, Nigeria.

Methods: Two thousand, two hundred and twelve (2212) sputum samples were collected from patients clinically suspected to have TB in three different zones of Kaduna State, Nigeria, between May 2017 and October, 2018. Samples were processed by decontaminating with NaOH-Citrate N-acetyl-L-Cystein method for Ziehl Neelsen (ZN) AFB microscopy and culture on Lowenstein Jensen (LJ) slants which were incubated at 37ᵒC for 8 weeks. Positive LJ cultures were further analyzed with a rapid TB antigen assay (SD-Bioline) to differentiate Mycobacterium tuberculosis complex (MTBC) from Non Tuberculous Mycobacteria (NTM). Results: Out of the 2212 patients with suspected TB, 300 (13.6%) were positive for AFB by microscopy with Zone A (Kaduna North) having the highest AFB positive cases of 169 (15.2%). Of the 300 AFB positive samples, 272 (91.0%) were culture positive on LJ medium, 18 (6.0%) were culture negative and 10 (3.0%) were culture contaminated. Result of the distribution of mycobacteria among infected patients within the study area revealed that 219 (80.5%) were infected with MTBC, 42 (15.4%) with NTM and 11 (4.0%) with both MTBC and NTM. Conclusion: A relatively high number of TB in the study area was caused by NTM. There is need for advanced diagnostic tools that can differentiate MTBC and NTM strains among TB patients in all TB Reference Laboratories in Nigeria.

Keywords: Phenotypic, Characterization, Tuberculosis, Mycobacteria

Received May 25, 2019; Revised July 24, 2019; Accepted July 26, 2019
Copyright 2019 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License (//creativecommmons.org/licenses/by/4.0), which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.

Caractérisation phénotypique d’isolats de mycobactéries provenant de patients atteints de tuberculose dans l’État de Kaduna, au Nigéria

1,2Ahmadu, I., 1Olonitola, O. S., 1Suleiman, A. B., 3Lawan, M. K., et 4Makolo, D.
1Département de microbiologie, Faculté des sciences de la vie, Université Ahmadu Bello, Zaria, Nigeria 2Laboratoire national de référence sur la tuberculose, Zaria, Nigéria 3Département de santé publique vétérinaire et de médecine préventive, Faculté de médecine vétérinaire, Université Ahmadu Bello, Zaria, Nigéria 4Département des sciences, École d’études préliminaires, École polytechnique d’État de Kogi, Lokoja, Nigéria Correspondance à: isiyakuadabka@yahoo.com

Abstrait:

Contexte: La tuberculose reste l’un des principaux problèmes de santé publique au Nigéria et le fardeau est encore lourd. Il est donc nécessaire de caractériser en permanence les mycobactéries pour obtenir les données actuelles qui aideront le programme de prévention et de contrôle de la tuberculose en cours. Le but de cette étude était de caractériser phénotypiquement les isolats de mycobactéries récupérés à partir d’échantillons cliniques de patients atteints de tuberculose dans l’État de Kaduna, au Nigéria. Méthodes: Deux mille douze cent douze (2212) échantillons d’expectorations ont été prélevés chez des patients cliniquement suspects de tuberculose dans trois zones différentes de l’État de Kaduna, au Nigéria, entre mai 2017 et octobre 2018. Les échantillons ont été traités par décontamination au NaOH-citrate. Méthode N-acétyl-L-Cystéine pour la microscopie AFB de Ziehl Neelsen (ZN) et culture sur des pentes de Lowenstein Jensen (LJ) qui ont été incubées à 37 ° C pendant 8 semaines. Les cultures de LJ positives ont ensuite été analysées avec un dosage rapide de l’antigène de la tuberculose (SD-Bioline) afin de différencier le complexe Mycobacterium tuberculosis (MTBC) des mycobactéries non tuberculeuses (NTM). Résultats: Sur les 2212 patients suspects de tuberculose, 300 (13,6%) étaient positifs pour AFB par microscopie, la zone A (Kaduna North) présentant le plus grand nombre de cas positifs avec 169 (15,2%). Sur les 300 échantillons AFB positifs, 272 (91,0%) étaient positifs en culture sur le milieu LJ, 18 (6,0%) étaient négatifs en culture et 10 (3,0%) étaient contaminés par la culture. Le résultat de la distribution des mycobactéries parmi les patients infectés dans la zone d’étude a révélé que 219 (80,5%) étaient infectés par le MTBC, 42 (15,4%) avec les NTM et 11 (4,0%) avec les deux types de MTBC. Conclusion: Un nombre relativement élevé de tuberculose dans la zone d’étude a été causée par les MNT. Il existe un besoin d’outils de diagnostic avancés permettant de différencier les souches de MTBC et de MNT parmi les patients atteints de tuberculose dans tous les laboratoires de référence pour la tuberculose au Nigeria.

Mots-clés: Phénotypique, Caractérisation, Tuberculose, Mycobactéries

Download full journal in PDF below

Phenotypic characterization of mycobacteria isolates from tuberculosis patients in Kaduna State, Nigeria

 

Posted on

Prevalence of HIV/Sputum AFB positivity among patients attending University of Benin Teaching Hospital (UBTH), Benin City, Nigeria

O Iyoha, WO Osarogiagbon

 

Abstract

Human Immunodeficiency Virus (HIV) and Tuberculosis(TB) have synergistic interactions that speedily accelerate decline of the host’s immune system and accentuate the progression of each other. Eight hundred and ninety five patients referred from different units of University of Benin Teaching Hospital, Nigeria were screened for antibodies to HIV-1 and HIV-2 using ELISA and sputum microscopy for acid-fast bacilli. The result showed that, 92(10.3%) were HIV positive with females 68(14.2%) higher than males 24(5.8%) though not statistically significant (p=0.066), 123(13.7%) patients were AFB positive, with males 75(18.1%) significantly higher than females 48(10%) (p=0.046) and 14(1.6%) patients were co-infected. Although the co-infection rate was higher among females 9(1.9%) than males 5(1.2%), there was no significant difference (p=0.450). The age group 40-49 and 50-59 had the highest TB/HIV co-infection (2.5% each).Regular screening for TB in HIV patients and HIV in TB patients would demonstrate the true burden of TB disease amongst HIV infected patients.

Key words: prevalence, TB, HIV, co-infection, Nigeria.

LA PREVALENCE DE LA POSITIVITE DU VIH/EXPECTORATIONS AFB CHEZ LES PATIENTS QUI
FREQUENT L’UNIVERSITE HOPITAL D’ENSEIGNEMENT DE BENIN (UBTH), BENIN CITY, NIGERIA.

Le virus de l’immunodéficience humaine(VIH) et la tuberculose (TB) ont des interactions synergiques qui rapidement accélèrent le déclin du système immunitaire de l’hôte et accentuent la progression de l’un l’autre. Huit cent quatre – vingt quinze patients des différentes unités de l’université hôpital  d’enseignement de Benin, Nigeria, ont été criblés pour les anticorps a VIH – 1 et VIH – 2 en utilisant ELISA microscopique des expectorations pour les bacilles acide – Résistant. Le résultat a montrée que 92 (10,3%) étaient séropositifs avec des femelles 68(14,2%) plus élevé que les males 24(5,8%), mais pas
statiquement significatif, (p=0,066), 123(13,7%) patients étaient AFB positif, avec les males 75(18,1%) significativement plus élevés que les femelles 48 (10%) (p=0,046) et 14 (1,6%) patients ont été Co – infectés. Bien que le taux de la Co – infection était plus élevé parmi les femelles 9(1,9%) que les males 5 (1,2%), il n y avait pas de différence significative (p=0,450). Le groupe d’âges 40 – 49 et 50 – 59 avait la plus forte Co – infection de TB/HIV (2,5%). Le dépistage régulier de la tuberculose chez les patients VIH et VIH chez les patients tuberculeux démontrerait le véritable fardeau de la maladie de la tuberculose chez les patients infectés par le VIH.

Mots Clés : Prevalence, Tuberculose, VIH, Co – infection, Nigeria.

Download full journal in PDF below

Prevalence of HIVSputum AFB positivity among patients attending University of Benin Teaching Hospital (UBTH), Benin City, Nigeria