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Bridging diagnostic gaps of drug-resistant pulmonary tuberculosis with clinical diagnosis in a low-and middle-income state, southwest Nigeria: A secondary data analysis

*[1]Irek, E. O., [2]Isinkaye, A. O., and [3]Orojo, J. A.

1Department of Medical Microbiology and Parasitology, Afe Babalola University/Afe Babalola University Multi-System Hospital, Ado-Ekiti, Nigeria

2Department of Community Medicine, Federal Teaching Hospital, Ido, Ekiti, Nigeria

3Tuberculosis Leprosy and Buruli Control Programme, Primary Health Care Development Agency, Ado-Ekiti, Nigeria

*Correspondence to: dj1irek@yahoo.com; +2348136833485; ORCID: 0000-0001-6363-6645

 

Abstract:

Background: Drug-resistant tuberculosis (DR-TB) poses a significant challenge to global TB control efforts, particularly in low- and middle-income countries (LMICs) where diagnostic resources are limited, thereby widening treatment gap. This has increased morbidity and mortality due to TB in Sub-Saharan Africa. We sought to evaluate the role of clinical diagnosis in identifying DR-TB in pulmonary TB cases missed by the sputum GeneXpert MTB/RIF assay in Ekiti State, Nigeria. Continue reading “Bridging diagnostic gaps of drug-resistant pulmonary tuberculosis with clinical diagnosis in a low-and middle-income state, southwest Nigeria: A secondary data analysis”

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Assessment of markers of platelet immune activation in malaria, tuberculosis and human immunodeficiency virus infection

*Akpan, P. A., Asemota, E. A., and Etura, J. E.

Department of Haematology and Blood Transfusion Science, Faculty of Medical Laboratory Science,

University of Calabar, PMB 115, Calabar, Nigeria.

*Correspondence to: apu0520@unical.edu.ng; pecu0520@gmail.com; +2348027321305

ORCID: 0000-0002-4571-8804

Abstract:

Background: Malaria, tuberculosis (TB) and human immunodeficiency virus (HIV) infection remain issues of public health concern in Nigeria. This study assessed parameters of platelet immune function with a view to understanding their role in the immune response against malaria, TB and HIV infection at the University of Calabar Teaching Hospital and Dr Lawrence Henshaw Memorial Hospital, Calabar, Nigeria.  Continue reading “Assessment of markers of platelet immune activation in malaria, tuberculosis and human immunodeficiency virus infection”

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Evaluation of serum concentration of essential trace elements during therapy among tuberculosis patients in Uyo, Nigeria

*[1]Umo, A. N., [2]Umoh, S. G., 2Jimmy, N. F., and 2Adie, S. A.

1Department of Medical Laboratory Science, College of Health Sciences, University of Uyo, Nigeria

2Department of Medical Microbiology and Parasitology, Faculty of Basic Clinical Sciences, University of Uyo, Nigeria

*Correspondence to: anthonyumo@uniuyo.edu.ng

Abstract:

Background: Nutritional status is one of the most important determinants of immune response to infection. The objective of this study was to assess the serum concentrations of selected trace elements in selected patients on anti-tuberculosis (TB) therapy in Uyo, Akwa Ibom State, Nigeria Continue reading “Evaluation of serum concentration of essential trace elements during therapy among tuberculosis patients in Uyo, Nigeria”

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Outcomes of tuberculosis treatment in a tertiary health facility in north-central Nigeria

*1Audu, E. S., 2Adiukwu, C. V., 3Dick, S. N., 4Bello, S. O., 5Aboki, D. M., 6Ashuku, Y. A., and 7Tomen, E. A.

1Special Treatment Clinic, Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria

2Department of Internal Medicine, Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria

3TB/DOTS Unit, Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria

4Department of Paediatrics, Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria

5TBLCP, Nasarawa State Ministry of Health, Nasarawa State, Nigeria

6College of Medicine, Federal University Lafia, Nasarawa State, Nigeria

7Department of Family Medicine, Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria *Correspondence to: estanamo@gmail.com; +2347030969315

Abstract:
Background: Tuberculosis (TB) remains a major public health concern despite being a curable and preventable disease. The treatment of TB using a cocktail of drugs over a period of six months under the directly observed treatment short-course strategy has led to a reduction in cases but is plagued by some challenges that leads to unsuccessful or poor outcomes, which can ultimately result in spread of infections, development of drug resistance and increase in morbidity and mortality. The objectives of this study are to determine outcomes of TB treatment in Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria and the factors that may be associated with the outcomes. Continue reading “Outcomes of tuberculosis treatment in a tertiary health facility in north-central Nigeria”

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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=”http://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”

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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 (http://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

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

 

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Etiologic agents of lower respiratory tract infections among patients attending tuberculosis clinic in Benin City, Nigeria

E.E. Ibadin, H.O. Ogefere, T.O. Ehondor

 

Abstract

The emergence of HIV has reawakened the tuberculosis (TB) scourge and infected patients are prone to opportunistic infections, this study was carried out to determine the HIV status and etiologic agents of Lower respiratory tract infections (LRTI) among tuberculosis suspected patients in Benin City, Nigeria. The study was cross sectional. A total of 276 patients attending tuberculosis clinic were recruited. Questionnaires were filled for each patient. Blood and sputum specimens were collected in plain and sterile containers respectively and transported immediately to the laboratory. Blood samples were screened for the presence of HIV antibodies. The sputum specimens were then cultured following standard microbiological procedure, and thereafter processed using the GeneXpert MTB/RIF assay. Emergent bacterial colonies were identified and susceptibility testing was carried out following standard microbiological techniques. A total of 118 (42.8%) non-mycobacterial bacterial agents were recovered from the patients. Patients were more likely to be culture positive for LRTI in comparison with TB infection (p < 0.0001). There was no association between TB and HIV status (OR = 0.6161, 95%CI = 0.226, 1.648, p = 0.4474). HIV positive patients were more likely to be culture positive for bacterial agents and Klebsiella pneumoniae was more likely to be recovered (p = 0.0338). The fluoroquinolones, gentamicin and ceftriaxone-sulbactam were the most active antibacterial agents against bacterial isolates. The prevalence of LRTI in this study was 52.2%. The study draws attention on the need for physicians to request for bacteriological culture (non-mycobacterial) alongside the TB diagnostic algorithm in suspected TB cases.

Keywords: Tuberculosis, HIV, opportunistic infections, patients, bacteria

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Etiologic agents of lower respiratory tract infections among patients attending tuberculosis clinic in Benin City, Nigeria

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Prevalence studies of human T-Lymphotrophic virus type 1 among pulmonary tuberculosis patients in Dutse metropolis, north-western Nigeria

M. Yahaya, U.A. Dutsinma, Y. Mohammed

 

Abstract

Human T-lymphotrophic virus type 1 (HTLV-1) is a causative agent of tropic spastic paraparesis and adult Tcell leukaemia, Information regarding the involvement of HTLV-1 in presentation of some subclinical immune  suppression that may results in increased rate of HIV and TB infections has long been documented. Sixty (60) Confirmed Pulmonary TB subjects  consisting of 41 males and 19 females were recruited in this study,  Tuberculosis was confirmed by collecting their sputum samples and analysed using GeneXpert. The prevalence of HTLV-1 IgG antibodies among TB subjects was 6.6%, while that of IgM was 1.6%. Accordingly, sexually active couple  group has the highest prevalence of 2.3% when compared to single and widow categories, age group 15-24 has the highest percentage of 3.3% for HTLV-1 IgG antibodies.

Key words: HTLV-1, Tuberculosis, IgG, IgM.

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Prevalence studies of human T-Lymphotrophic virus type 1 among pulmonary tuberculosis patients in Dutse metropolis, north-western Nigeria

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Prevalence studies of human T-Lymphotrophic virus type 1 among pulmonary tuberculosis patients in Dutse metropolis, north-western Nigeria

M. Yahaya, U.A. Dutsinma, Y. Mohammed

 

Abstract

Human T-lymphotrophic virus type 1 (HTLV-1) is a causative agent of tropic spastic paraparesis and adult Tcell leukaemia, Information regarding the involvement of HTLV-1 in presentation of some subclinical immune  suppression that may results in increased rate of HIV and TB infections has long been documented. Sixty (60) Confirmed Pulmonary TB subjects  consisting of 41 males and 19 females were recruited in this study,  Tuberculosis was confirmed by collecting their sputum samples and analysed using GeneXpert. The prevalence of HTLV-1 IgG antibodies among TB subjects was 6.6%, while that of IgM was 1.6%. Accordingly, sexually active couple  group has the highest prevalence of 2.3% when compared to single and widow categories, age group 15-24 has the highest percentage of 3.3% for HTLV-1 IgG antibodies.

Key words: HTLV-1, Tuberculosis, IgG, IgM.

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Prevalence studies of human T-Lymphotrophic virus type 1 among pulmonary tuberculosis patients in Dutse metropolis, north-western Nigeria

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Serum and sputum surfactants -A and -D in multidrug-resistant and drugsensitive tuberculosis patients

A.A. Onifade, V.F. Edem, O.G. Arinola

 

Abstract

Abnormal production and function of surfactants are associated with pulmonary diseases. Also, pulmonary infections alter surfactant metabolism. Due to lack of information on the levels of surfactants A (SP-A) and D (SP-D) in Nigerian tuberculosis (TB) patients, this study assessed these surfactants in both sputum and serum of drug sensitive- and multidrug resistant- TB patients using ELISA. The aim is to explore the diagnostic or therapeutic potential of SP-A and SP-D in TB patients. Also, to find out appropriate sample for the analyses of SP-A and SP-D in TB patients.

The mean serum levels of SP-A and SP-D were not significantly reduced in MDR-TB (n=30) and DS-TB patients (n=30) compared with non-TB apparently healthy controls (n=30) (p > 0.05). Mean sputum levels of SP-A and SP-D were significantly reduced in DS-TB patients compared with the levels in MDR-TB patients (p < 0.05). These findings suggest that the sputum SP-D and SP-A levels but not serum SP-D and SP-A levels are useful indicators of the disease activity in pulmonary TB patients.

Keywords: Tuberculosis, Surfactants, Diagnosis, Nigeria

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Serum and sputum surfactants -A and -D in multidrug-resistant and drugsensitive tuberculosis patients