Iheanyi Omezuruike Okonko

High seropositivity of IgG and IgM antibodies against cytomegalovirus (CMV) among HIV-1 seropositive patients in Ilorin, Nigeria.

BACKGROUND Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is a major public health problem in sub-saharan Africa. Cytomegalovirus (CMV) has been reported to enhance HIV replication and accelerate the progression of HIV infection to AIDS. OBJECTIVE This study reports on the high seropositivity of immunoglobulin (Ig) G and M antibodies against CMV and the risk factors for CMV infection among HIV/AIDS patients in Ilorin, Nigeria. METHOD A total of 180 consented HIV-1 seropositive patients (age-range 16-56 years; 108 females and 72 males) were consecutively recruited. Socio-demographic/behavioral data and 5 ml blood samples were collected from each patient. Plasma of each sample was assayed for anti-CMV IgG/IgM using a CMV IgG and IgM Enzyme Linked ImmunoSorbent Assay (ELISA) kit. RESULTS Twenty (11.1%) of the 180 HIV-1 seropositive subjects were positive for anti-CMV IgM antibody while 169(93.9%) were positive for anti-CMV IgG antibody. Age, marital status, number of sexual partners, CD4 cells counts and previous history of blood transfusion were the main correlates of CMV seropositivity among these patients. However, occupation, sex, highly active antiretroviral therapy (HAART) were not statistically associated with CMV seropositivity in this study. CONCLUSION This study has shown that greater percentages of HIV-1 seropositive patients had active CMV infection. It has further shown that CMV is hyperendemic in HIV-1 seropositive patients in Ilorin, Nigeria.

Measles Vaccine Potency and Sero-Conversion Rates among Infants Receiving Measles Immunization in Ilorin, Kwara State, Nigeria

This study was designed to assess the seroconversion rate of measles vaccine among infants receiving measles immunization in Ilorin, Nigeria. The pre- and post-measles vaccination sera of the children were tested using the Haemagglutination Inhibition test. The measles vaccines administered at the immunization centre were also tested for their potency using in-vitro titration method. Only 286 (71.5%) of the vacinees returned to give post-vaccination samples. All the infants screened had low pre-vaccination measles antibody titers. Thirty one (8.0%) of the infants had measles prior to vaccination. The seroconversion pattern showed that 196 (68.6%) of the infants developed protective antibody titers. Low seroconversion rate reported in this study was due to low vaccine potency. The titers of vaccines with low potency ranged between log10−1.0–log10−2.25 TCID/per dose. This was beside other non specific antiviral substances exhibited virus neutralizing activity. Only 3 (50%) of the 6 vaccine vials tested had virus titers of log10−3.25 to log10−3.5, which fell above the cut-off point recommended by the World Health Organization for measles vaccines. The sero-conversion rate of 68.6% observed among vaccinees is far lower than the immunity level of 95% required stopping measles transmission in an endemic community. Failure of 31.4% of these infants to sero-convert post vaccination can be attributed partly to administration of sub-potent vaccines. There is need for improvement and maintenance of effective vaccine cold chain system in Nigeria. There is need also for periodic monitoring of post-vaccination antibody titers as well as vaccine potency status in order to ensure development of protective seroconversion rates.

Resistant plasmid profile analysis of multidrug resistant Escherichia coli isolated from urinary tract infections in Abeokuta, Nigeria.

BACKGROUND Multi-drug resistant Escherichia coli has become a major threat and cause of many urinary tract infections (UTIs) in Abeokuta, Nigeria. OBJECTIVES This study was carried out to determine the resistant plasmids of multidrug resistant Escherichia coli isolated from (Urinary tract infections)UTIs in Abeokuta. METHODS A total of 120 Escherichia coli isolates were obtained from urine samples collected from patients attending inpatient and outpatient clinics presenting UTI; with their biodata. Antibiotics susceptibility was performed and multi-drug resistant isolates were selected for plasmid profiling. Plasmids were extracted by the alkaline lysis method, electrophoresed on 0.8% agarose gel and profiled using a gel-photo documentation system gel. RESULTS Escherichia coli isolates obtained shows high resistance to cloxacillin (92.5%), amoxicillin (90.8%), ampicillin (90.8%), erythromycin (75.8%), cotrimoxazole (70.0%), streptomycin (70.0%) and tetracycline (68.3%) while 85.8% and 84.2% were susceptible to gentamycin and ceftazidime respectively. Sixteen Escherichia coli strains were observed to be resistant to more than two classes of antibiotics. The resistant plasmid DNA was detectable in 6(37.5%) of the 16 multidrug resistant Escherichia coli having single sized plasmids of the same weight 854bp and were all resistant to erythromycin, cefuroxime, cloxacillin, amoxicillin, ampicillin and cotrimoxazole. CONCLUSION This study has highlighted the emergence of multidrug resistant R-plasmids among Escherichia coli causing urinary tract infections in Abeokuta, Nigeria. There is a high level of resistance to many antimicrobials that are frequently used in Abeokuta, Nigeria.

Seropositivity and determinants of immunoglobulin-G (IgG) antibodies against Herpes simplex virus (HSV) types -1 and -2 in pregnant women in Port Harcourt, Nigeria.

BACKGROUND This study is the first documented prevalence of IgG antibody against HSV-1&-2 in Port Harcourt, Nigeria and thus provides baseline data for future in-depth studies on HSV infection in South-South, Nigeria. OBJECTIVE This study determined the seropositivity and determinants of serum IgG antibody against HSV-1 & HIV-2 among pregnant women attending BMSH, Port Harcourt, Rivers State, Nigeria. METHODS Serum samples from 180 pregnant women attending antenatal clinic at Braithwaite Memorial Specialist Hospital (BMSH) in Port Harcourt, Nigeria. Serum samples were analysed with commercial HSV type-1&-2 specific IgG Enzyme Linked Immunosorbent Assay (ELISA) kits. Chi-square analysis was used to determine the association of infection with socio-demographic variables. RESULTS Of the 180 pregnant women, 179 (99.4%) were seropositive and 1(0.6%) was seronegative for HSV 1&2 IgG antibody. No statistical association existed between the prevalence of HSV-1&-2 IgG antibodies and the socio-demographic variables studied (p>0.05) except for marital status which was significantly associated (p<0.05). CONCLUSION Our data shows that HSV-1 & 2 seropositivity among pregnant women in Port Harcourt is high; thus serological screening for HSV-1&-2 might be advisable for antenatal attendees.

Anti-HCV antibody among newly diagnosed HIV patients in Ughelli, a suburban area of Delta State Nigeria

BACKGROUND Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) share common routes of infection and as such, co-infection is expected. Co-infection of the two viruses is of great medical importance as it determines the effect of drugs used for treatment at various stages. OBJECTIVE This interplay between HIV and HCV sets the tone for the objective of this study which is to ascertain the seroprevalence of HCV among newly diagnosed HIV patients in Ughelli, a suburban area of Delta State, Nigeria. METHODS A total of 200 newly diagnosed HIV-positive patients were recruited for this study. Each of the sera was tested for anti-HCV antibody using SWE-life HCV ultra rapid test strip. Appropriate questionnaires were used to ascertain other important information which include social behaviour such as whether the patients were MSM (males), IDU, tattoo and/or have received blood transfusion in the past. RESULTS The prevalence of HCV among the study population was determined to be 15.0%. A higher seroprevalence was observed among females (16.5%) than in males (13.0%). A higher seroprevalence was also observed among age groups >26 years (16.0%) than in age-groups 14-25 years (13.0%) and 2-13 years (0.0%). Of the 7 patients with tattoos, 1(14.3%) tested positive for HCV compared to 29(15.0%) with no tattoos. We found no significant correlation with transfusion, intravenous drug use (IDU), men that have sex with men (MSM), tattooing and the seroprevalence of HCV. However, significant correlation existed with age, sex and HCV prevalence. CONCLUSION This study reports a 15.0% seroprevalence of HCV among newly diagnosed HIV patients and that is alarmingly well above several other studies done in the past in Nigeria and other countries of sub-Saharan Africa. Planned preven tion, screening, and treatment are needed to reduce further transmission and morbidity. Future studies involving HCV-RNA assays are needed.

Triple positivity of HBsAg, anti-HCV antibody, and HIV and their influence on CD4+ lymphocyte levels in the highly HIV infected population of Abeokuta, Nigeria

BACKGROUND Few studies exist on hospital-based seroprevalence of triple positivity of HIV/HBV/HCV in Nigeria. OBJECTIVES The study aimed at determining the triple positivity of HIV, HBsAg and HCV among HIV-infected individuals in Abeokuta, Nigeria and defining the influence of these triple infections on CD4+ counts of HIV-infected individuals as antiretroviral therapy improves in Nigeria. METHODS Enumeration of CD4+ levels in 183 HIV-infected persons was done with Partec Flow Cytometer. Seropositivity of HBsAg and anti-HCV antibody was detected with rapid kits. RESULTS From the result obtained, significance variance (p<0.05) existed between HIV positive persons and persons who tested positive to HIV/HBV/HCV triple infection before and after the commencement of HAART. Of these infections, 31(16.9%) had HBV/HCV/HIV triple infection, while 152(83.1%) had HIV mono infection only, 56(30.6%) had HBV/HIV dual infection only and 43(23.5%) had HCV/HIV dual infection only. Significant variance (p<0.05) also existed between subjects with CD4 counts of <200 cells/µl, 200-499 cells/µl and >500 cells/µl. Highest seroprevalence of HIV (35.0%) was found in age groups 35-44 years and >65 years had the least (2.7%). Significant variance (p<0.05) also existed in the progression of CD4+ lymphocytes cells between subjects with persistent decrease (32.3%) in CD4+ lymphocytes cells and those with fluctuation in their CD4+ lymphocytes cells (12.9%) after the commencement of ART. CONCLUSION The study further confirms that triple positivity of HIV/HBV/HCV infection is common in Abeokuta, Nigeria. Testing of these triple infections should be a big concern in the best choice and commencement of ART. Also, the study showed that consistent and prolonged use of HAART had a positive impact on the CD4 count of HIV-infected individuals.

Antibiogram and plasmid profiling of carbapenemase and extended spectrum Beta-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae in Abeokuta, South western, Nigeria.

BACKGROUND The increased reports of ESBL dissemination from various centres in south western, Nigeria and the recent emergence of carbapenem resistant bacteria prompted the conception of this study. OBJECTIVES To demonstrate the relationship between high molecular weight plasmids and the expression of antibiotic multi-resistance including ESBL and carbapenemase. METHODS We investigated 97 isolates of selected organisms consisting of 67 E. coli and 30 Klebseilla spp for the presence of plasmids expressing ESBL including carbapenem-hydrolysing enzymes. Beta-lactamase was determined using acidometric method, while ESBL and carbapenemase activity was determined using the double-disk diffusion test as well as the Modified Hodge test (MHT). Plasmid profiles of ESBL and carbapenemase positive isolates were determined according to standard protocols. RESULTS An ESBL prevalence rate of 21.6% and carbapenem- resistance rate of 9.3% was recorded. Antibiotic susceptibility profile of ESBL isolates showed 100.0% resistance against Amoxicillin, Cotrimoxazole and Erythromycin. Moderate susceptibility was recorded against the Quinolone class of antibiotics; Meropenem remained the most active antibiotic against ESBL isolates with 62.5% against E. coli and 60% against K. pneumoniae. The plasmid profiles of our study isolates ranged from 11.8kbp to 35.5kbp. CONCLUSION Due to the relationship between high molecular weight plasmids and multi-drug resistance, we hereby recommend regular molecular surveillance of this form in our study setting.

Evaluation of Immunity and Seropositivity of IgG Antibodies to Canine Parvoviruses in Vaccinated and Unvaccinated Dogs in Abeokuta, Nigeria

Canine Parvovirus (CPV) is a very contagious and virulent viral disease affecting domestic dogs all over the world causing high morbidity and mortality in dogs, especially puppies. This study aimed at determining the seropositivity of IgG antibodies against CPV in vaccinated and unvaccinated dogs and to evaluate the immune status of dogs presented in Abeokuta. Forty-eight dogs were enrolled in this study. These dogs were presented at random for treatment, routine checkup, and vaccination at the State Veterinary Hospital and Veterinary Teaching Hospital all in Abeokuta. All the dogs were fully maintained under domestic setting. Selection for study was done based on thorough examination of the dogs and their medical records. The clients were informed of the nature of the investigation. Blood samples were collected and analyzed for anti-CPV-IgG. In principle, protective immunity correlates with high antibody titers and this was determined using a commercially available immunocomb® test kit for anti-CPV IgG antibody. Of 48 dogs sampled, 38 (79.2%) had high level of anti-CPV antibody titer and 10 (20.8%) had low level of anti-CPV antibody titer. Twenty six (54.2%) were males while 22 (45.8%) were females. Forty-five (93.75%) dogs were exotic breeds while 3 (6.25%) dogs were mongrels. Thirty (62.5%) of the dogs were less than one year old and the age range of all dogs sampled was between 7 weeks and 7 years. There was no significant difference (P > 0.05) between sex and the level of immunity but significant differences (P < 0.05) were observed between ages of dogs, breeds, post-vaccination period, and the level of immunity. In conclusion, this study has further confirmed the presence of IgG antibodies against canine parvovirus among dogs in Abeokuta, Nigeria. Of all variables evaluated, ages of dogs, breeds and post-vaccination period were the main correlates of the level of immunity to CPV. This study also showed agreement with previous studies in the diagnostic value of using the immunoblot ELISA assay for the rapid detection of anti-CPV IgG antibody.

DETERMINATION OF MEASLES HEMAGGLUTINATION INHIBITING ANTIBODY LEVELS AMONG SCHOOL CHILDREN IN IBADAN, NIGERIA

Immune status of school children aged from 10–23 years against measles virus was determined by the hemagglutination-inhibition (HI) test with a view of assessing herd immunity. Blood samples from 500 schoolchildren were collected by finger-pricking in Ropacco filter papers. Sera were extracted in 1 mL of cold phosphate buffered saline and treated with 25% (w/v) kaolin and 50.0% monkey red blood cell (RBC) to a final concentration of 1:10. The measles hemagglutinating antigen used for the test was prepared from measles vaccine. Results showed that 62 (12.4%) were positive for measles HI antibody at a titer of 1:640, and 78 (15.6%) had a titer <1:10. There was no significant relationship (P > 0.05) between antibody titer and the schools, while a significant relationship (P < 0.05) existed between antibody titer and age. Although the majority of the schoolchildren had the measles antibody in their sera, titers were, however, beneath the threshold of protection in 33.4% of them. The significant association between age of the schoolchildren and HI titers showed that those antibodies were waning according to age. The study has shown a considerable high level of protection against measles among schoolchildren. To prevent future outbreak of measles among these schoolchildren, it will be advocated that a second dose of measles vaccine be administered.

Trend of invasive pneumococal disease (IPD) in a South Western, Nigerian hospital

The recent introduction of the Heptavalent-pneumococcal vaccine (PCV-7) by private pharmaceutical companies in Nigeria, has generated interest in invasive bacterial diseases particularly IPD. Our objective in this study is to investigate the trend and occurrence rate of IPD in Abeokuta, Nigeria. Suspected IPD cases were assessed from Jan 2010 to Dec 2010 for demographic and Microbiological characteristics. Bacterial isolations and antibiotics susceptibility testing followed standard bacteriological procedure. Overall 471 cases of probable IPD was assessed, with 21(4.5%) cases of suspected pneumonia, 109(23.1%) cases of suspected meningitis, and 341(72.4%) cases of suspected septicaemia. Confirmed IPD cases were 9 with 2 cases of meningitis, 3 cases of septicaemia and 4 cases of pneumonia. Age range distribution showed, high distribution of IPD cases among children >1 with 5(55.6%) there was a statistically significant difference in gender p< 0.05 (X2 test) with females recording a higher occurrence than males. We conclude by advocating for better detection methods against IPD meningitis cases, and continuous surveillance into the serotypes of streptococcus pneumonia as well inclusion of the PCV vaccine into our childhood immunization program.