Adamu Babayo

Molecular Detection and Clinical Implications of HTLV-1 Infections among Antiretroviral Therapy-Naïve HIV-1-Infected Individuals in Abuja, Nigeria

Background Individuals with human T-cell lymphotrophic virus type-1 (HTLV-1)/HIV-1 coinfection have been demonstrated to undergo CD4+ lymphocytosis even in the face of immunodeficiency and increased vulnerability to opportunistic pathogens that can lead to poor prognosis. Objective This study investigated the prevalence as well as the effects of HIV-1/HTLV-1 coinfection on CD4+ cell counts, routine hematology, and biochemical parameters of study participants. Materials and Methods This prospective cross-sectional study involved 184 blood samples collected from HIV-1-seropositive individuals attending HIV-special clinic of the University of Abuja Teaching Hospital, Gwagwalada, Nigeria. These samples were analyzed for anti-HTLV-1/2 IgM antibodies using enzyme-linked immunosorbent assay, CD4+ cell counts, and some routine hematological and biochemical parameters. All samples were also tested for HTLV-1 provirus DNA using real-time polymerase chain reaction (PCR) assay. Results Of the 184 subjects studied, 9 (4.9%) were anti-HTLV-1/2 IgM seropositive; however, upon real-time PCR testing, 12 (6.5%) had detectable HTLV-1 provirus DNA. The CD4+ cell count was significantly high in HTLV-1-positive (742 ± 40.2) subjects compared to their HTLV-1-negative (380 ± 28.5) counterpart (P-value = 0.025). However, there was no significant association between HTLV-1 positivity with other hematology and biochemical parameters studied (P > 0.05). Conclusion All subjects (100%) who were HTLV-1/HIV-1-coinfected had normal CD4+ counts. This gives contrasting finding on the true extent of immunodeficiency of subjects. So it is suggested to be very careful in using only CD4+ counts to monitor disease progression and as indicators for antiretroviral therapy (ART) in resource-limited settings. In such conditions, there may be a need to test for HTLV-1 alongside HIV viral loads in order to begin appropriate ART regimens that contain both pathogens.

Clinical Significance of IgG Avidity Testing and Other Considerations in the Diagnosis of Congenital Cytomegalovirus Infection: A Review Update

Prompt and accurate laboratory testing of women before or during antenatal days is necessary for detecting humoral immunological responses against cytomegalovirus (CMV) infection and assessing risk of congenital transmission. CMV is the most common viral etiology with the greatest propensity to induce neonatal pathologies. Most healthcare facilities in developing countries rely solely on anti-CMV IgM and IgG assays in diagnosing CMV infections. However, these parameters have some worrisome limitations. This study reviewed the significance of IgG avidity testing as a highly sensitive and specific tool that improves decisions regarding diagnosis of maternal and congenital CMV infections. We conducted this review from relevant published articles using an extensive literature search made through PubMed, Scopus and Google scholar on the concepts of congenital CMV (CCMV) transmission and clinical significance of IgG avidity testing in diagnosis of CCMV infections. Findings from our review revealed that IgG avidity testing in some developed societies was frequently utilized to resolve dilemmas associated with serodiagnosis of CMV infections, however, there is paucity of information in regards to its use in developing countries. The non-inclusion of IgG avidity testing during serological investigations of CMV could be a reason why congenital CMV infections and associated pathologies often go underdiagnosed in developing countries.

Prevalence of malaria parasitaemia among residents proximal to environmental waste dumpsites in Gwagwalada metropolis, Abuja, Nigeria

Background: Malaria is a widely explored public health topic which has been documented to constitute more burden among communities residing in proximity to environmental waste dumpsites and poor drainage systems. Objective: This present study sets to examine and compare whether there are more cases of malaria parasitemia burden among people residing proximal and those not proximal to dump sites at Gwagwalada metropolis. Materials and Methods: This was a cross-sectional comparative survey which involved 100 blood samples collected from 25 households proximal to environmental waste dumpsites (test subjects) and another 100 from 25 households that are not proximal to dumpsites (control subjects) in Gwagwalada metropolis of Federal Capital Territory Abuja. These samples were analyzed using standard malaria microscopy. Results: Prevalence of malaria parasitemia was 82.0% among test subjects and 26.0% among control subjects. The highest malaria density recorded was >10,000 parasites/μL in 34 test subjects whereas none was observed from control subjects. Malaria parasitemia among test subjects was common among children (1-10 years) and least among 41-50 years. There was statistical relationship between malaria parasitemia among residents proximal to environmental waste dumpsites, more so with their age distribution (P < 0.05) but not with sex distribution (P > 0.05). Conclusion: The findings of this study are a clear demonstration that accumulation of waste dumpsites in proximity to residential areas constitutes a pathway to malaria burden, consequently dumpsites should be properly located and managed to minimize their effects on the environment and health of man.

Bacterial pathogens and their antibiotic susceptibility pattern in Intensive Care Units of the University of Maiduguri Teaching Hospital, Nigeria

Background: Nosocomial infections are among leading causes of morbidity and mortality and are associated with increased antibiotic resistance in Intensive Care Units (ICUs). This prospective study was conducted between March and October 2014 in the ICUs of the University of Maiduguri Teaching Hospital to assess the rate, types, and antibiotic susceptibility pattern of airborne and surface-borne bacterial contamination before and after fumigation. Materials and Methods: Sixty samples were collected and investigated from fomites by surface swabbing and open plate air exposure in the ICUs before and after fumigation using standard microbiological methods. Results: Out of the sixty samples investigated, 38 (63.3%) yielded positive bacterial growth. Twenty-six (68%) were before fumigation of the ICU and 31.5% (n = 12) from postfumigation culture. Coagulase-negative Staphylococci spp.(CoNS) accounted for 39.4% (n = 15) of the positive cultures, Bacillus spp. 15% (n = 9), Klebsiella pneumoniae 13.2% (n = 5), Escherichia coli 10.5% (n = 4), Klebsiella oxytoca 7.9% (n = 3), and Streptococcus pyogenes 5.3% (n = 2). The antibiotic susceptibility test results of the isolates revealed that CoNS were resistant to amoxicillin, ampicillin-cloxacillin, and cefuroxime. K. pneumoniae was also resistance to chloramphenicol, aminoglycosides, and penicillins, whereas E. coli showed resistance to fluoroquinolones, particularly pefloxacin and ofloxacin. Conversely, Bacillus spp., K. oxytoca, and S. pyogenes were susceptibility to all test antibiotics. Conclusion: The high level of bacterial contamination of equipment and inanimate objects in the ICUs and the presence of multidrug resistant bacteria calls for prompt and a holistic infection control interventions.

Effects of adopting preventive measures on malaria parasitemia among pregnant women in Kaduna state, Nigeria

Background There are several malaria preventive measures. The availability of a particular method does not guarantee its adherence and effective usage. This eventually may not provide the desired results for the fight against malaria. Pregnant women are at higher risk of contracting malaria, and therefore it is necessary that they should be protected against the infection. Objective of the study This cross-sectional study investigated the significant roles of various preventive measures against malaria infection among pregnant women attending four selected secondary health facilities in Kaduna state, Nigeria. Materials and methods Blood samples were collected from 353 pregnant women attending selected hospitals. Malaria parasite microscopy was conducted on the basis of standard protocols. Structured questionnaires were used to obtain data with regard to subject knowledge and practice of preventive measures against malaria. Results Out of the 353 subjects tested, 79 (22.4%) had malaria parasitaemia. One hundred and fifteen (32.6%) subjects used no preventive measure, 45 (12.7%) used sulfadoxine-pyrimethamine prophylaxis, 53 (15.0%) used insecticide treated nets (ITNs), 72 (20.4%) used indoor insecticide house spray, while 68 (19.3%) used > 1 preventive measures. Out of the 79 subjects infected with malaria, 57 (72.2%) do not know how to prevent malaria, while 22 (27.8%) had prior knowledge of malaria prevention. Highest cases (41 [51.9%]) of malaria parasitaemia were recorded in women with no knowledge of preventive measures during pregnancy, while women who used > 1 measures have the least cases (5 [6.3%]) of malaria parasitaemia. There was statistical association between the use of preventive measures and decreased malaria parasitaemia (P < 0.0001). Conclusion Findings from this study revealed that there is need for more sensitization campaigns on available malaria preventive measures. Also, the combination of preventive methods should be considered by pregnant women in order to minimize their chances of acquiring malaria.

Evaluation of Prothrombin Time and Activated Partial Thromboplastin Time in Hypertensive Patients Attending a Tertiary Hospital in Calabar, Nigeria

Introduction. Several biomedical findings have established the effects of hypertension on haemostasis and roles of blood coagulation products in the clinical course of hypertension. Methods. This cross-sectional study aimed at determining effects of hypertension on prothrombin time (PT) and activated partial thromboplastin time (APTT) in hypertensive patients in comparison with normotensive subjects attending a tertiary hospital in Calabar. Forty-two (42) hypertensive patients and thirty-nine (39) normotensive control subjects were investigated for PT and APTT using Quick one-stage methods. Results. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) correlated positively with APTT (r = 0.3072, r = 0.4988; P < 0.05) in hypertensive patients. DBP, SBP, PT, and APTT were significantly higher in hypertensive patients when compared to normotensive subjects (P < 0.05). DBP correlated negatively with duration of illness (r = −0.3097; P < 0.05) in hypertensive patients and positively with age of normotensive subjects (r = 0.3523; P < 0.05). Conclusion. The results obtained indicated that measurements of PT and APTT may serve as indices for evaluating hemostatic abnormalities in hypertensive patients and guide for antihypertensive therapy. However, to have better understanding of hemostatic activities in hypertension, it is recommended to conduct D-dimer, platelet factors, and protein assays.