Jesse A. Otegbayo

Phylogenetic Analysis of Human Parvovirus B19 Sequences from Eleven Different Countries Confirms the Predominance of Genotype 1 and Suggests the Spread of Genotype 3b

ABSTRACT Phylogenetic analysis of 166 human parvovirus B19 sequences from 11 different countries attributed 91.57% to genotype 1, 5.42% to genotype 3b, and 3.01% to genotype 3a. Very similar viruses of genotype 1 circulated widely in Europe and Israel. Genotype 3b seems to show an increasing spread outside of Africa.

Characterization of Hepatitis Delta Virus in Sub-Saharan Africa

ABSTRACT Hepatitis D virus (HDV) is a satellite of hepatitis B virus (HBV), and infection with this virus aggravates acute and chronic liver disease. While HBV seroprevalence is very high across sub-Saharan Africa, much less is known about HDV in the region. In this study, almost 2,300 blood serum samples from Burkina Faso (n = 1,131), Nigeria (n = 974), Chad (n = 50), and the Central African Republic (n = 118) were screened for HBV and HDV. Among 743 HBsAg-positive serum samples, 74 were positive for HDV antibodies and/or HDV RNA, with considerable differences in prevalence, ranging from <2% (pregnant women from Burkina Faso) to 50% (liver patients from Central African Republic). HDV seems to be much more common in chronic liver disease patients in the Central African Republic (CAR) than in similar cohorts in Nigeria. In a large nested mother-child cohort in Burkina Faso, the prevalence of HDV antibodies was 10 times higher in the children than in their mothers, despite similar HBsAg prevalences, excluding vertical transmission as an important route of infection. The genotyping of 16 full-length and 8 partial HDV strains revealed clade 1 (17/24) in three of the four countries, while clades 5 (5/24) and 6 (2/24) were, at least in this study, confined to Central Nigeria. On the amino acid level, almost all our clade 1 strains exhibited a serine at position 202 in the hepatitis D antigen, supporting the hypothesis of an ancient African HDV-1 subgroup. Further studies are required to understand the public health significance of the highly varied HDV prevalences in different cohorts and countries in sub-Saharan Africa.

Comparative diagnostic efficacy of serum squamous cell carcinoma antigen in hepatocellular carcinoma

BackgroundHepatocellular carcinoma (HCC) is a common liver malignancy in Nigeria. Hepatitis B and C viruses, alcohol and Aflatoxin B are among the various aetiologies. More work needs to be done in the search for markers that will aid early detection of this condition as it is uniformly fatal once advanced. Alphafetoprotein (AFP) remains the most widely used tumour marker of HCC detection in spite of its known shortcomings. The objective of this study was to determine the efficacy of serum squamous cell carcinoma antigen (SCCA) , in comparison to alphafetoprotein in the detection of HCC.MethodSixty patients with HCC and thirty apparently healthy controls attending the Medical Outpatient Department(MOPD) of the University College Hospital Ibadan(UCH) Nigeria were selected for the study. Questionnaire was used to collect clinical data while AFP, SCCA levels, serum HBsAg and anti-HCV were determined using ELISA method- (Diagnostic Automation Inc. Canada). Abdominal ultrasound scan was also done.ResultThirty one (51.7%) out of 60 selected cases were positive for HBsAg while six (20%) out of 30 controls were positive for HBsAg(p = 0.004). Out of the 60 cases selected for this study, only 2 (3.3.%) cases were positive for hepatitis C virus, while only 1(3.3%) out of 30 control was positive for hepatitis C virus(p = 0.74).The mean AFP value for cases with HCC was 393.21 ng/ml ±386.97 compared to the control group which was 5.60 ± 13.03 ng/ml (p value 0.001). The mean SCCA level was 0.64 ± 0.56 ng/ml and 0.71 ± 0.65 ng/ml for cases and controls respectively (p = 0.631).ConclusionAlphafetoprotein remains a good tumour marker for the diagnosis of HCC. Serum squamous cell carcinoma antigen(SCCA) has no discriminatory power and may not be useful as a tumour marker for Nigerians with hepatocellular carcinoma.

Helicobacter pylori strains from a Nigerian cohort show divergent antibiotic resistance rates and a uniform pathogenicity profile

Antibiotic resistance in Helicobacter pylori is a factor preventing its successful eradication. Particularly in developing countries, resistance against commonly used antibiotics is widespread. Here, we present an epidemiological study from Nigeria with 111 isolates. We analyzed the associated disease outcome, and performed a detailed characterization of these isolated strains with respect to their antibiotic susceptibility and their virulence characteristics. Furthermore, statistical analysis was performed on microbiological data as well as patient information and the results of the gastroenterological examination. We found that the variability concerning the production of virulence factors between strains was minimal, with 96.4% of isolates being CagA-positive and 92.8% producing detectable VacA levels. In addition, high frequency of bacterial resistance was observed for metronidazole (99.1%), followed by amoxicillin (33.3%), clarithromycin (14.4%) and tetracycline (4.5%). In conclusion, this study indicated that the infection rate of H. pylori infection within the cohort in the present study was surprisingly low (36.6%). Furthermore, an average gastric pathology was observed by histological grading and bacterial isolates showed a uniform pathogenicity profile while indicating divergent antibiotic resistance rates.

Lymphocytic colitis presenting as difficult diarrhoea in an African woman: a case report and review of the literature

IntroductionLymphocytic colitis is an uncommon intestinal disorder that presents with chronic diarrhoea. It is treatable, but in the developing world, its diagnosis may often prove difficult. Data and reports of this condition in Africa are scarce because most medical centres lack a functional gastrointestinal endoscopy unit that would aid in the diagnosis.Case presentationWe present the case of a 53-year-old Nigerian woman with pathogen-negative chronic diarrhoea and a family history of chronic diarrhoea. She responded well to treatment after colonoscopy and colonic biopsy successfully diagnosed her illness.ConclusionReferral of patients with pathogen-negative chronic diarrhoea to medical centres that have facilities for colonoscopy and biopsy is important in the developing world.

Terminal ileum intubation during colonoscopy: Should it be routinely performed on all patients?

Aim: The aim of this study was to evaluate the diagnostic yield and the usefulness of ileoscopy in a tropical setting. Patients and Methods: Colonoscopy was performed on consenting patients using Olympus Exera III Videocolonoscope (CF HQ190 L, Olympus UK). Terminal ileum intubation was attempted in all the patients who had cecal intubation. A pro forma was used to record information such as biodata of the patients, indications for the procedure, and the findings, including that of the intubated terminal ileum. Results: The colonoscopy results of 305 patients comprising 168 (55.1%) males and 137 (44.9%) females were analyzed. Cecum was reached in 272 (89.2%) patients and successful terminal ileum intubation was achieved in 84/272 (30.9%) patients. Macroscopically, 82 (97.6%) patients had normal ileum, while abnormal findings were recorded in two patients, giving a diagnostic yield of 2.4% (2/84). The various abnormalities were ulcers, polypoid lesions, and cobblestone appearance. Of the 16 (19%) patients who had a biopsy of the terminal ileum, microscopic abnormalities were seen in 15 (93.7%) patients while 1 (6.3%) patient had normal ileal histology. Conclusion: The diagnostic yield of ileoscopy in this study was very low, and hence, it may not be routinely necessary in all patients in our practice.

Echocardiographic study of left ventricular structure and function in Nigerian patients with chronic liver disease

Background: The concept of cirrhotic cardiomyopathy includes impaired cardiac contractility, decreased beta-adrenergic receptor function, abnormal beta-adrenergic postreceptor function, defective excitation-contraction coupling, and cardiac conduction abnormalities. This study was aimed to assess the cardiac structure and function in adult Nigerians with chronic liver disease (CLD). Methods: This was a cross-sectional descriptive study of consecutive patients with CLD without any known cardiac disease attending the Liver Clinic of the Medical Out-patient Department of the University College Hospital. Apparently, normal individuals with comparable age and sex distribution were recruited as controls. The subjects and controls underwent two-dimensional, M-mode and Doppler echocardiographic studies to determine the cardiac structure in relation to both systolic and diastolic cardiac functions. Results: A total of 46 subjects and 50 normal controls were recruited. There was no difference in the blood pressure parameters of the two groups. The septal wall thickness was statistically higher in control, but this difference was lost when adjusted for body mass index. On the other hand, the adjusted left atrial diameter and aortic root dimension were statistically larger in the subjects than the controls. There was no difference in the left ventricular (LV) fractional shortening or ejection fraction, relative wall thickness, and deceleration time of the E-wave. Conclusions: We demonstrated an increase in cardiac index at rest in the subjects, but there was no significant difference in the LV diastolic or systolic dysfunction using traditional methods. Studies using newer modalities of the assessment of cardiac structure and function are needed in our environment.

Nutritional status as a determinant of cognitive development among preschool children in South-Western Nigeria

Purpose – Improving the health of children under the age of five is one of the main objectives of primary healthcare services in most developing countries. The purpose of this paper is to identify the nutritional status of children under the age of five and its impact on cognitive function. Design/methodology/approach – The cross-sectional study was carried out in a semi-urban community in south-western Nigeria. The sample consisted of 220 school children under the age of five. Anthropometric measurements including weight, height and mid arm circumference were carried out to determine the nutritional status of the children. Cognitive function of the children was assessed using a developmental checklist developed by the American Academy of Pediatrics and their performance was graded as good, fair and poor. Findings – The overall prevalence of malnutrition in this study was low with stunting, underweight and wasting recording 8.2, 6.8 and 1.8 percent, respectively thereby making stunting the most common mal...

How relevant is pre‑gastrointestinal endoscopy screening for HBV and HIV infections?

Aim: To determine the prevalence of HBV and HIV infections among patients referred for gastrointestinal (GI) endoscopy and evaluate the need for prescreening of patients prior to this procedure. Settings and Design: Retrospective study carried out in a teaching hospital. Methodology: The data of 772 patients referred for GI endoscopy were retrospectively reviewed, but the screening results of only 711 patients were available for review. Statistical Analysis Used: SPSS version 7. Results: The 772 patients, consisted of 420 (54.4%) males and 352 (45.6%) females with a mean age of 50.4 ± 16.5 years (range 10-100). Of the 711 patients with screening results, 574 (80.7%) had UGI endoscopy, while 137 (19.3%) had Colonoscopy. It showed that 82 (11.5%) had HBV and 26 (3.7%) had HIV, while 8 (1.1%) patients had co-infection. Conclusion: The high prevalence of HBV and HIV infections observed calls for high level precaution to prevent transmission of these infections to other patients and health care personnel.