Favour Osazuwa

The prevalence of hepatitis B and C viral infections among pregnant women

Background: Viral hepatitis during pregnancy is associated with high risk of maternal complications and has become a leading cause of foetal death. Aims: This study aimed at determining the prevalence of hepatitis B and C viral infections among pregnant women attending the antenatal clinic of the University of Benin Teaching Hospital. Patients and Methods: This was a hospital based cross-sectional study that included 5760 pregnant women who attended the antenatal clinic of the hospital during the periods of October 2009 - October 2010. Relevant data was gathered and women having history of previous liver diseases, diabetes and pre-eclamptic toxemia were excluded from the study. Rapid diagnostic test kits were used to screen for Hepatitis B surface antigen (HBsAg) and anti-Hepatitis C virus (HCV) antibodies. Results: 720 (12.5%) and 206 (3.6%) out of 5,760 pregnant women included in the study were found to be positive for Serum antibodies to hepatitis B and C respectively. 33 (0.57%) were found to have mixed infections of hepatitis B and C. None of the expected risk factors had significant outcome. Conclusion: This study showed that the prevalence of the Hepatitis B virus (HBV) among pregnant women in this study area is of intermediate endemicity (12.5%).

A significant association between intestinal helminth infection and anaemia burden in children in rural communities of Edo state, Nigeria

Background: Anaemia is estimated to affect half the school-age children and adolescents in developing countries. Aim: This study aimed to determine the prevalence of anaemia and evaluate the relationship of intestinal helminth infection on the anaemia status of children in the rural communities of Evbuomore, Isiohor, and Ekosodin. in the Ovia North East local government area of Edo State, Nigeria. Subjects and Methods: Faecal samples and blood samples were obtained from 316 children aged 1-15 years. Faecal samples were examined using standard parasitological techniques, and anaemia was defined as blood haemoglobin <11 g/dL. Results: Of the 316 children, 38.6% were anaemic: 75.9% of children in Evbuomore, 42.3% in Isiohor and 26.8% in Ekosodin. The overall parasite prevalence in the three communities were: Ascaris lumbricoides (75.6%), hookworm (16.19%) and Trichuris trichiura (7.3%). Malnutrition was patent; 37.0% of the children were stunted, 19.3% wasted, and 44.0% underweight. There was a statistically significant association between hookworm and Ascaris lumbricoides infection and anaemia (P < .001). Serum ferritin levels were more sensitive than haemoglobin in detecting anemia and were correlated with intestinal helminth infection. Conclusion: Intestinal helminth infection in a concomitant state of malnutrition is observed in this population. Intervention programmes should be aimed at control of intestinal helminth infection and iron supplementation.

Screening for Cryptococcal Antigenemia in Anti-Retroviral Naïve AIDS Patients in Benin City, Nigeria

OBJECTIVES Cryptococcus neoformans is the most incriminated fungal pathogen causing meningitis in acquired immune deficiency syndrome (AIDS) patients, and is known to constitute a major cause of deaths in AIDS patients. This study thus aimed to determine the baseline sero-prevalence of Cryptococcus neoformans infection in anti-retroviral naïve (ART-naïve) AIDS patients using the serum Cryptococcal antigen (crag) detection method. Baseline effect of variation in CD4 counts, as well as sex and age with sero-positivity for crag were also determined. METHODS This descriptive cross-sectional study included 150 (61 males and 89 females) ART-naïve AIDS patients attending the Human Immunodeficiency Virus clinic (HIV) at the University of Benin Teaching hospital, Benin City, Nigeria, within the period from February 2011- July 2011. Forty (18 males and 22 females) HIV positive outpatients with CD4 counts >200 cells/µl who were ART-naive were recruited and used as controls. The sero-prevalence of crag in the patients and the control group was measured using the cryptococcal antigen latex agglutination system (CALAS) (Meridian Bioscience, Europe) and CD4 counts were measured using flow cytometry (Partec flow cytometer, Germany). RESULTS Of the 150 ART-naïve AIDS patients with CD4 counts ≤200 cells/µL; 19 (12.7%) were positive for serum Cryptococcal antigen. ART-naïve AIDS patients with CD4 count ≤50 cells/µl had the highest prevalence of serum crag. Lower CD4 counts were significantly associated with positivity for serum crag (p<0.001). Age and sex had no significant effect on the sero-positivity for serum crag. One (2.5%) of the controls was sero-positive for crag. Thus, serum crag was significantly associated with AIDS but not with HIV (p<0.001). CONCLUSION This study uncovers a high prevalence of crag in ART- naïve AIDS patients in Benin City. The prevalence of crag was higher in ART-naïve AIDS patients with lower CD4 counts. There is an urgent need to introduce routine screening for crag in ART- naïve AIDS patients in our locality to reduce the rapid mortality from Cryptococcal meningitis which accounts for a majority of the morbidity factor if undiagnosed during ART therapy.

Etiologic agents of otitis media in Benin city, Nigeria

Background: Otitis Media continues to be a major presentation in the ear, nose and throat clinic. Aim: This study aimed to isolate, characterize and identify the bacteriological and mycological etiologic agents of otitis media in Benin city. Patients and Methods: Ear discharge from 569 (299 males and 270 females) patients diagnosed clinically of otitis media between August 2009 and August 2010 were processed to recover the bacterial and fungal etiologic agents. Susceptibility test was performed on all bacterial isolate. Result: Pseudomonas aeruginosa (28.3%) was the predominant bacteria isolate causing otitis media followed by Staphylococcus aureus (21.0%), Klebsiella sp (8.9%), Proteus sp (8.2%), Alkaligenes spp (4.3%), Streptococcus pneumoniae (3.9%), Escherichia coli (3.0%) and Citrobacter freundi (1.7%). Fungi isolated were Aspergillus niger (9.2%), Candida albicans (5.4%), Candida tropicalis (3.0%), Aspergillus flavus (2.1%) and Candida parasilopsis (1.5%). 413 had a single organism isolated from the middle ear culture while twenty (3.51%) patients had mixed organisms isolated. Infection was highest among 0 - 5 years, and lowest among aged 18 - 23. All bacterial isolates were poorly susceptible to the antibacterial agents. Conclusion: The study uncovers a high frequency of bacteria associated otitis media with the finding of fungi too as a significant etiologic agent.

Contribution of malnutrition and malaria to anemia in children in rural communities of Edo state, Nigeria

Background: The most common cause of anemia is an iron deficiency; however, the condition may also be caused by deficiencies in folate, vitamin B12 and protein. Some anemia is not caused by nutritional factors, but by congenital factors and parasitic diseases such as malaria. Aim: This study attempted to estimate the prevalence of anemia among children in three rural communities of the Ovia North East Local government area, and to determine whether its cause was nutritional or could be attributed to malaria. Patients and Methods: A total of 316 children between the ages of 1 and 15 years were included in the study. Children were examined for malaria parasites by microscopy. The World Health Organization (WHO) age-adjusted cut-off for hemoglobin was used to classify anemia. Results: 38.6% of the children were anemic, with hemoglobin levels lower than 11g/dL, although parasite prevalence and density were low. Malnutrition was patent; 37.0% of the children were stunted, 19.3% wasted and 44.0% underweight. Serum ferritin was more sensitive than hemoglobin concentration in detecting anemic children. Anemia was also significantly higher in the Evbuomore village school than in the Ekosodin and Isiohor villages (P<0.001). Conclusion: Anemia detected in this population may be due more to malnutrition than to malaria.

Total antioxidant status of zinc, manganese, copper and selenium levels in rats exposed to premium motor spirit fumes.

Background: Frequent exposure to premium motor spirit (PMS) is common and could be a risk factor for liver dysfunction in those occupationally exposed. A possible association between PMS fumes and plasma total antioxidant status as well as plasma levels of zinc, manganese, copper and selenium using a rodent model could provide new insights into the pathology of the liver where cellular dysfunction is an established risk factor. Aim: This study aimed to determine the total antioxidant status and plasma levels of zinc, copper, selenium and manganese in those occupationally exposed using rodent model. Materials and Methods: 25 albino Wistar rats of both sexes were used for this study. The animals were divided into five groups of five rats in each group. Group 1 rats were not exposed to PMS fumes (control group), group 2 rats were exposed for 1 hour daily, group 3 for 3 hours daily, group 4 for 5 hours daily and group 5 for 7 hours daily. The experiment lasted for a period of 4 weeks. Blood samples obtained from all the groups after 4 weeks of exposure were used for the determination of plasma total antioxidant status as well as plasma levels of zinc, manganese, copper and selenium. Results: Results showed significant increases in means of plasma copper (69.70±0.99 for test and 69.20±1.02 for control, P < 0.05) and selenium (72.70±1.58 for test and 68.20±0.86 for control, P < 0.05) in the exposed rats when respective mean values were compared with those of corresponding controls. Mean body weight index (BWI) and percentage weight increase (PWI) were significantly lower (P < 0.05) in exposed rats when compared with the unexposed group. The mean plasma levels of zinc (137.40±4.06 for test and 147.80±2.52 for control) and manganese (65.75±1.02 for test and 70.00±0.71 for control) showed significant decrease (P < 0.05) when compared with control. Plasma level of total antioxidant status (TAS) did not differ significantly in exposed rats when compared with the control group. Conclusion: This study showed that frequent exposure to PMS fumes may lead to increase plasma levels of copper and selenium probably due to liver dysfunction and decrease in plasma levels of zinc and manganese probably as a result of interference in their metabolic pathway of the exposed groups.

Early determination of human immunodeficiency virus status by routine voluntary counseling and testing in Benin City, Nigeria

Background: To reduce the burden of human immunodeficiency virus (HIV), the popularization of voluntary counseling and testing (VCT) for early determination of human immunodeficiency virus status will be of immense benefit. Aim: To evaluate the uptake of voluntary counseling and testing and sero-prevalence of human immunodeficiency virus among status naïve outpatients and self-presenting VCT clients in Benin City, Nigeria. Materials and Methods: This study was carried out in the period of May 2010 to April 2011 at the University of Benin teaching hospital, Benin City. Subjects who consented were included and screened for HIV. Pre and post-test counseling was done following the world health organization guidelines. Results: Out of 10,533 subjects (7783 outpatients and 2750 self-presenting VCT clients) counseled for VCT, a total of 4651(44.2%) subjects; (3971(51.0%) outpatients and 680 (24.7%) self-presenting VCT clients), consented and accepted HIV VCT. Overall HIV prevalence was 6.4%. 270 (6.8%) outpatients and 29 (4.3%) self-presenting VCT clients were HIV positive. HIV was significantly associated with female gender among the outpatients (P<0.001). Conclusion: VCT uptake was low; the sero-prevalence of HIV was high. The need to employ an expanded and more purpose oriented public enlightenment campaign on the usefulness of HIV VCT should be a priority for HIV control agencies in our area.

A Survey of prevalence of serum antibodies to human immunodeficiency deficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among blood donors

Background: It is a well known fact that HIV, HBV and HCV are global infectious pathogens contributing to mortality and morbidity in all ages thereby making them infections of grievous public health importance. As donors potend a possible risk of transfusing these infections of global importance, it makes it imperative for the screening of blood and blood products for these pathogens. Aim: This study aims at determining the seroprevalence of HIV, HBV and HCV among intending blood donors. Subjects and Methods: A retrospective data analysis for seroprevalence of antibodies to HIV, HBV and HCV was carried out between the 2nd of January and 15th of June 2010 among intending blood donors aged 18-45 and the association of these infections with age group and blood group were analyzed. Sterile venous anticoagulated blood was collected from each of the donors and analyzed for HIV, HBV and HCV using highly sensitive and specific kits. All the positive samples for HIV- 1/2 were sent for reconfirmation using polymerase chain reaction. Results: Of the 427 samples analyzed, 203 were positive for HIV, 200 for HBV and 24 for HCV, representing a prevalence of 47.54%, 46.83% and 5.71% respectively among intending blood donors. Among them, blood group O “positive” was the most common blood group with 59.25% followed by blood group B “positive”, A “positive” and O “negative” respectively (p<0.001). The analysis of relationship showed a tendency of high association of these infections in subjects with O “positive” blood group. Conclusion: This study emphasizes the need for proper screening of blood donors for HIV, HBV and HCV.

Triglycerides, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol in rats exposed to premium motor spirit fumes

Background: Deliberate and regular exposure to premium motor spirit fumes is common and could be a risk factor for liver disease in those who are occupationally exposed. A possible association between premium motor spirit fumes and plasma levels of triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol using a rodent model could provide new insights in the pathology of diseases where cellular dysfunction is an established risk factor. Aim: The aim of this study was to evaluate the possible effect of premium motor spirit fumes on lipids and lipoproteins in workers occupationally exposed to premium motor spirit fumes using rodent model. Materials and Methods: Twenty-five Wister albino rats (of both sexes) were used for this study between the 4th of August and 7th of September, 2010. The rats were divided into five groups of five rats each. Group 1 rats were not exposed to premium motor spirit fumes (control group), group 2 rats were exposed for 1 hour daily, group 3 for 3 hours daily, group 4 for 5 hours daily and group 5 for 7 hours daily. The experiment lasted for a period of 4 weeks. Blood samples obtained from all the groups after 4 weeks of exposure were used for the estimation of plasma levels of triglyceride, total cholesterol, high density lipoprotein- cholesterol and low density lipoprotein- cholesterol. Result: Results showed significant increase in means of plasma total cholesterol and low density lipoprotein levels (P<0.05). The mean triglyceride and total body weight were significantly lower (P<0.05) in the exposed group when compared with the unexposed. The plasma level of high density lipoprotein, the ratio of low density lipoprotein to high density lipoprotein and the ratio of total cholesterol to high density lipoprotein did not differ significantly in exposed subjects when compared with the control group. Conclusion: These results showed that frequent exposure to petrol fumes may be highly deleterious to the liver cells.

Risk reduction approach for the prevention of maternal-infant transmission of viral hepatitis B in high endemic areas

S 21 ANNUAL CONFERENCE —2013 V ra lH ep a itis in bilirubin and reduction in pruritus by 2 grades. Mean time to clearance of jaundice and pruritus were compared. Statistical analysis was done using per protocol method. Results: Forty patients (34 males) were studied (group A = 20, group B = 20). Two were excluded, one due to protocol violation and another due to steroid induced pancreatitis. Mean time to clearance of jaundice was 49.7 days (21-85) in group A versus 36.3 days (14-82) in Group B (p=0.02). Maximum treatment response was seen at day 17 in steroid arm (p<0.01).Mean time to resolution of pruritus was 34.9 days (16-62) versus 20.7 (7-69) respectively (p<0.01). Average cost permg reduction in bilirubinwas 30 times less for prednisolone. Adverse effects noted were acne vulgaris in 2, facial puffiness in 1 and pedal edema in 1 patient in the steroid arm and 2 patients with skin infection in the UDCA arm. Conclusion: Short course prednisolone treatment hastens recovery in patients with acute cholestatic hepatitis A. It is cost effective and superior to UDCA in the management of this condition. Corresponding author. Varghese Thomas. E-mail: drvarghesethomas@gmail.com RISK REDUCTION APPROACH FOR THE PREVENTION OF MATERNAL-INFANT TRANSMISSION OF VIRAL HEPATITIS B IN HIGH ENDEMIC AREAS Osemenim Uzochukwu Ugbebor, Favour Osazuwa, Omorogbe Zabayo Global Hepatitis-Prevention Initiative, Nigeria, Pathology Department, Lily Hospital, Warri Nigeria, National Blood Transfusion Service, Kano