Daniel Z. Egah

Cytokine-associated neutrophil extracellular traps and antinuclear antibodies in Plasmodium falciparum infected children under six years of age

BackgroundIn Plasmodium falciparum-infected children, the relationships between blood cell histopathology, blood plasma components, development of immunocompetence and disease severity remain poorly understood. Blood from Nigerian children with uncomplicated malaria was analysed to gain insight into these relationships. This investigation presents evidence for circulating neutrophil extracellular traps (NETs) and antinuclear IgG antibodies (ANA). The presence of NETs and ANA to double-stranded DNA along with the cytokine profiles found suggests autoimmune mechanisms that could produce pathogenesis in children, but immunoprotection in adults.MethodsPeripheral blood smear slides and blood samples obtained from 21 Nigerian children under six years of age, presenting with uncomplicated malaria before and seven days after initiation of sulphadoxine-pyrimethamine (SP) treatment were analysed. The slides were stained with Giemsa and with DAPI. Levels of the pro-inflammatory cytokines IFN-γ, IL-2, TNF, CRP, and IL-6, select anti-inflammatory cytokines TGF-β and IL-10, and ANA were determined by immunoassay.ResultsThe children exhibited circulating NETs with adherent parasites and erythrocytes, elevated ANA levels, a Th2 dominated cytokine profile, and left-shifted leukocyte differential counts. Nonspecific ANA levels were significant in 86% of the children pretreatment and in 100% of the children seven days after SP treatment, but in only 33% of age-matched control samples collected during the season of low parasite transmission. Levels of ANA specific for dsDNA were significant in 81% of the children both pre-treatment and post treatment.ConclusionThe results of this investigation suggest that NET formation and ANA to dsDNA may induce pathology in falciparum-infected children, but activate a protective mechanism against falciparum malaria in adults. The significance of in vivo circulating chromatin in NETs and dsDNA ANA as a causative factor in the hyporesponsiveness of CpG oligonucleotide-based malaria vaccines is discussed.

Prevalence of HIV and other sexually transmissible infections in relation to lemon or lime juice douching among female sex workers in Jos, Nigeria

BACKGROUND The rates of sexually transmissible infections (STI), including HIV, are high among female sex workers (FSW) in Nigeria and the use of various local vaginal cleansing agents to prevent infection is a common practice. The present study was aimed at determining whether any association exists between current lime or lemon douching and the prevalence of STI and HIV infections among FSW in Jos, Nigeria. METHODS Consenting FSW who were users of lemon or lime (UL) or non-users (NUL) were recruited for the study between May and September 2006. A structured questionnaire was administered by trained counsellors. Pre-HIV test counselling was done. Participants blood samples were tested for HIV and syphilis. Genital examination was done and high vaginal and endocervical samples were collected. The samples obtained were processed for STI using standard laboratory procedures. FSW found with treatable STI received free drugs. HIV results were disclosed after post-test counselling and positive FSW were referred to a HIV/AIDS facility for care, support and antiretroviral therapy. RESULTS A total of 398 FSW (86 UL and 312 NUL) participated in the study. Their mean age was 27.6+/-7.0 years (range 16-63 years). HIV prevalence was high for both UL and NUL: 48.8 and 48.2%, respectively (odds ratio 1.0; 95% confidence interval 0.6-1.2, P=0.9427). The rates of bacterial vaginosis were not significantly higher in UL (UL 55.8%, NUL 44.0%, odds ratio 1.59, 95% confidence interval 0.96-2.65, P=0.06). There were no associations between the use of citrus douching and other STI. CONCLUSION There were no significant associations between the prevalence of STI and HIV and lime or lemon juice usage.

Comparison of a New, Affordable Flow Cytometric Method and the Manual Magnetic Bead Technique for CD4 T-Lymphocyte Counting in a Northern Nigerian Setting

ABSTRACT We compared two techniques for CD4 T-lymphocyte counting: flow cytometry (Cyflow) and magnetic beads (Dynabead). Similar results with good correlation were obtained from the 40 adult blood samples counted (P = 0.057, r = 0.93). The Cyflow technique is more precise and cost-effective than the Dynabead method (

Use of lemon or lime juice douches in women in Jos, Nigeria

3 to

A 21-Year-Old Student with Fever and Profound Jaundice

5 versus

Bacteriologic profile, antibiotic regimen and clinical outcome of neonatal sepsis in a University Teaching Hospital in North Central Nigeria.

12 to

A diagnostic performance evaluation of rapid diagnostic tests and microscopy for malaria diagnosis using nested polymerase chain reaction as reference standard in a tertiary hospital in Jos, Nigeria

22 per test, respectively), since as many as 200 samples can be measured per day.

Low Zika virus seroprevalence among pregnant women in North Central Nigeria, 2016

OBJECTIVE To describe the use of lemon/lime juice for douching by female sex workers (FSWs) and family planning clients (FPCs) in Jos, Nigeria. METHOD A total of 300 sexually active women comprising 200 FSWs and 100 FPCs were interviewed in June 2004 to determine the mode and rationale for the use of lemon/lime juice for sex. RESULT Majority of the women 167/300 (55.7%, 95% CI = 50-61%) i.e. 163/200 (81.5%, 95% CI = 75-87%) FSWs, 4/100 (4%, 95% CI = 1-10%) FPCs used vaginal lemon/lime douches. Lime juice was used by 105/167 (62.8%, 95% CI = 55-70%), lemon juice by 30/167 (18%, 95% CI = 12-25%) or a mixture by 18/167 (10.8%, 95% CI = 7-25%). The juice was used either neat 44/167 (26%, 95% CI = 20-34%) or diluted in water 75/167 (45%, 95% CI = 37-53%) either before or after sex. Nineteen per cent (32/167) found the juice painful. Over half of the women believed that it protected them from pregnancy and/or sexually transmitted infections; they did not know their HIV status. Eighty-six per cent would recommend it to others, and 71% would be willing to take part in a study to evaluate its safety and efficacy. CONCLUSION Lemon and lime juice are widely used for douches among women at high risk of HIV transmission. There is an urgent need to determine whether or not this practice promotes or prevents HIV infection.

Lassa Fever 2016 Outbreak in Plateau State, Nigeria—The Changing Epidemiology and Clinical Presentation

71Infectious Diseases Unit, Department of Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria, 2Faculty of Medical Sciences, University of Jos, Jos,Plateau State, Nigeria, 3Department of Medical Microbiology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria, 4Leptospirosis Unit, Central DiagnosticsLaboratories National Veterinary Research Institute, Vom, Plateau State, Nigeria, 5Department of Infectious Diseases, Brighton and Sussex University Hospital, Brighton,Southeast England, United Kingdom, 6Global Health Programme, Brighton and Sussex University, Brighton, Southeast England, United Kingdom, 7Royal TropicalInstitute, KIT Biomedical Research, WHO/FAO/OIE and National Collaborating Center for Reference and research on Leptospirosis, Meibergdreef, Amsterdam, TheNetherlands

Risk factors associated with paediatric tuberculosis in an endemic setting

Background and Aims: Neonatal sepsis is an important cause of morbidity and mortality in Nigeria and in most parts of the world. Consequently, we determined the prevalence of the common bacterial pathogens of neonatal sepsis, their antibiotic susceptibility profiles, antibiotic regimen used in treatment and their clinical outcomes in a resource limited environment. Study Design: This was a prospective cross sectional study. Place and Duration of Study: Study was conducted in the Special Care Baby Unit (SCBU), Original Research Article Onyedibe et al.; BJMMR, 7(7): 567-579, 2015; Article no.BJMMR.2015.363 568 Department of Paediatrics and the Department of Medical Microbiology of Jos University Teaching Hospital (JUTH), Jos, Nigeria between May to December 2011. Methodology: Biological samples were collected from 218 neonates suspected of sepsis (119 male, 99 female). The WHO and the Integrated Management of Childhood Illnesses (IMCI) criteria for suspicion of sepsis were used to select subjects into the study. Samples were processed and analyzed by standard methods in the microbiology laboratory. Antibiotic susceptibility testing was done. The antibiotic regimen used for therapy and subsequent clinical outcomes were documented. Results: Prevalence of culture proven sepsis was 34.4% (75/218). The common isolates were Klebsiella pneumoniae (32%), Staphylococcus aureus (30.7%) and Escherichia coli (10.7%). More than 60% of the K. pneumoniae isolates were resistant to the antibiotics tested. The E. coli and Enterobacter isolates were 100% sensitive to meropenem. The Gram positive isolates were most sensitive to ciprofloxacin (85%). Resistance of S. aureus was 6% to cefotaxime and 61% to ampicillin. A total of 173 (79.4%) neonates were discharged home, 15 (6.8%) were discharged against medical advice and 30 (13.8%) died on admission. The antibiotic regimen with the least mortality was a combination of ciprofloxacin and gentamicin. Conclusion: The cultures in this study showed variable antibiogram with complicated patterns of resistance. In all cases of suspected neonatal sepsis, we recommend culture and sensitivity tests to identify the causative pathogen and initiate specific antibiotic therapy. However, cefotaxime in combination with gentamicin is recommended as first line empirical therapy.