Oluyinka Oladele Opaleye

Rabies and antirabies immunization in South Western Nigeria: knowledge, attitude and practice

Factors responsible for the continued endemicity of rabies in Nigeria were determined by carrying out a knowledge, attitude and practice study among residents of Osun State. Structured questionnaires were administered to 679 individuals comprising students, traders and civil servants. Only 33.4% of the respondents knew rabies could be prevented by vaccination, while 38.7% believed that the infection could be treated with herbs. Of the 387 victims of dog bite, 240 (62%) never sought prophylactic postexposure treatment. Of the 10 people who received postexposure treatment, only one received the appropriate treatment consisting of washing, disinfection of wounds, tetanus toxoid and complete antirabies immunization.

Occult Hepatitis B Virus Infection among HIV Positive Patients in Nigeria

HIV has been known to interfere with the natural history of hepatitis B virus (HBV) infection. In this study we investigate the prevalence of occult hepatitis B virus infection (OBI) among HIV-infected individuals in Nigeria. Overall, 1200 archived HIV positive samples were screened for detectable HBsAg using rapid technique, in Ikole Ekiti Specialist Hospital. The HBsAg negative samples were tested for HBsAg, anti-HBc, and anti-HCV by ELISA. Polymerase chain reaction was used for HBV DNA amplification and CD4 counts were analyzed by cytometry. Nine hundred and eighty of the HIV samples were HBsAg negative. HBV DNA was detected in 21/188 (11.2%) of patients without detectable HBsAg. CD4 count for the patients ranged from 2 to 2,140 cells/μL of blood (mean = 490 cells/μL of blood). HCV coinfection was detected only in 3/188 (1.6%) of the HIV-infected patients (P > 0.05). Twenty-eight (29.2%) of the 96 HIV samples screened were positive for anti-HBc. Averagely the HBV viral load was <50 copies/mL in the OBI samples examined by quantitative PCR. The prevalence of OBI was significantly high among HIV-infected patients. These findings highlight the significance of nucleic acid testing in HBV diagnosis in HIV patients.

Phenotypic and molecular characteristics of methicillin-resistant Staphylococcus aureus isolates from Ekiti State, Nigeria

Introduction The characteristics and antimicrobial resistance profiles of Staphylococcus aureus differs according to geographical regions and in relation to antibiotic usage. The aim of this study was to determine the biochemical characteristics of the prevalent S. aureus from Ekiti State, Nigeria, and to evaluate three commonly used disk diffusion methods (cefoxitin, oxacillin, and methicillin) for the detection of methicillin resistance in comparison with mecA gene detection by polymerase chain reaction. Materials and methods A total of 208 isolates of S. aureus recovered from clinical specimens were included in this study. Standard microbiological procedures were employed in isolating the strains. Susceptibility of each isolate to methicillin (5 μg), oxacillin (1 μg), and cefoxitin (30 μg) was carried out using the modified Kirby–Bauer/Clinical and Laboratory Standard Institute disk diffusion technique. They were also tested against panels of antibiotics including vancomycin. The conventional polymerase chain reaction method was used to detect the presence of the mecA gene. Results Phenotypic resistance to methicillin, oxacillin, and cefoxitin were 32.7%, 40.3%, and 46.5%, respectively. The mecA gene was detected in 40 isolates, giving a methicillin-resistant S. aureus (MRSA) prevalence of 19.2%. The S. aureus isolates were resistant to penicillin (82.7%) and tetracycline (65.4%), but largely susceptible to erythromycin (78.8% sensitive), pefloxacin (82.7%), and gentamicin (88.5%). When compared to the mecA gene as the gold standard for MRSA detection, methicillin, oxacillin, and cefoxitin gave sensitivity rates of 70%, 80%, and 100%, and specificity rates of 76.2%, 69.1%, and 78.5% respectively. Conclusion When compared with previous studies employing mecA polymerase chain reaction for MRSA detection, the prevalence of 19.2% reported in Ekiti State, Nigeria in this study is an indication of gradual rise in the prevalence of MRSA in Nigeria. A cefoxitin (30 μg) disk diffusion test is recommended above methicillin and oxacillin for the phenotypic detection of MRSA in clinical laboratories.

Seroprevalence of parvovirus B19 IgG and IgM antibodies among pregnant women in Oyo State, Nigeria

INTRODUCTION Human parvovirus B19 causes a wide range of complications in pregnant women including abortion, severe fetal anemia, non-immune hydrops fetalis, and even intrauterine fetal death. However, there is a dearth of information on the prevalence of the virus among pregnant women in southwestern Nigeria. METHODOLOGY Blood samples were collected from 231 pregnant women and screened for antibodies to human parvovirus B19 IgM and IgG using an enzyme immunosorbent assay kits. RESULTS Of the 231 women, 31 were in their first trimester, 146 were in their second trimester, and 54 were in their third trimester. Forty-five (20%) were positive for parvovirus B19 IgG antibodies, 10 (4%) were positive for parvovirus B19 IgM antibodies, and 176 (76%) had no detectable parvovirus B19 antibodies. Twenty-eight (19%) of the 146 pregnant women in their second trimester were positive for parvovirus B19 IgG antibody while three (2%) of the 146 were positive for parvovirus B19 IgM antibody. CONCLUSIONS It is evident that there is a high prevalence of human parvovirus B19 among pregnant women in south-western Nigeria. This suggests that there is an active transmission of the virus in the community; it is therefore necessary to conduct more studies on the virus in pregnant women in Nigeria to ascertain its effect on the fetus.

Seroprevalence of HIV, HBV, HCV, and HTLV among Pregnant Women in Southwestern Nigeria.

Sexually transmitted infections (STIs) are major public health challenge especially in developing countries. This study was designed to determine the prevalence of Hepatitis B virus (HBV), Hepatitis C Virus (HCV), Human immunodeficiency virus (HIV), and Human T-cell lymphotropic Virus type I (HTLV-I) among pregnant women attending antenatal clinic, in Ladoke Akintola University Teaching Hospital, Osogbo, and South-Western Nigeria. One hundred and eighty two randomly selected pregnant women were screened for HBsAg, anti-HCV, anti-HIV and HTLV-1 IgM antibodies using commercially available ELISA kit. Of the182 blood samples of pregnant women screened whose age ranged from 15–49 years, 13 (7.1%), 5 (2.7%), 9 (4.9%), and 44 (24.2%) were positive for HBsAg, anti-HCV, anti-HIV, and HTLV-1 IgM antibodies, respectively. The co-infection rate of 0.5% was obtained for HBV/HCV, HBV/HIV, HIV/HTLV-1, and HCV/HTLV-1 while 1.1% and 0% was recorded for HBV/HTLV-1 and HCV/HIV co-infections, respectively. Expected risk factors such as history of surgery, circumcision, tattooing and incision showed no significant association with any of the viral STIs (P > 0.05). This study shows that there is the need for a comprehensive screening of all pregnant women for HBsAg, anti-HCV, anti-HIV and HTLV-1 to prevent mother to child transmission of these viral infections and its attending consequences.

Prevalence of Plasmodium falciparum Parasitaemia and Its Correlation with Haematological Parameters among HIV-Positive Individuals in Nigeria.

Malaria and HIV are the two most important health challenges of our time. Haematologic abnormalities are features in Plasmodium falciparum infection, and anaemia is a well-known outcome. The prevalence and haematological impact of P. falciparum parasitaemia were determined among HIV-infected individuals in Nigeria. Parasite detection was carried out using microscopy and Polymerase Chain Reaction (PCR). Haemoglobin concentration was determined using an automated machine while CD4+ T-cells count was analyzed using flow cytometer. Thirty-seven (18.5%) out of the 200 HIV individuals enrolled had malaria parasites detected in their blood. All the positive cases were detected by PCR while only 20 (10%) were detected by thick blood microscopy. The mean haemoglobin concentration and packed cell volume (PCV) of HIV individuals with malaria parasitaemia were lower compared to those without malaria parasitaemia but the difference was not statistically significant. Also no significant difference was observed in malaria positivity in respect to sex and mean CD4+ cell count. The study highlights the effects of P. falciparum parasitaemia on the haematologic and immune components of HIV individuals.

Perceptions of Nigerian Women about Human Papilloma Virus, Cervical Cancer, and HPV Vaccine.

Background. Cervical cancer caused by human papilloma virus (HPV) though preventable has claimed the lives of many women worldwide. This study was embarked upon to evaluate the general knowledge and perceptions of Nigerian women on HPV, cervical cancer, and HPV vaccine. Methods. Structured questionnaires were administered to a cross section of 737 women randomly selected from the general population in two southwestern States of Nigeria. Statistical analysis was done using SPSS computer software version 16. A P value >0.05 was considered statistically significant. Results. One hundred and seventy-six (23.9%) of the respondents had knowledge of HPV; 474 (64.3%) are aware of cervical cancer but only 136 (18.5%) know that HPV causes cervical cancer. 200 (27.1%) are aware that there is an HPV vaccine while 300 (40.7%) had knowledge of Pap smear test. Two hundred and sixty (35.3%) of the respondents know that early detection of HPV can prevent cervical cancer and in spite of this, only 110 (14.9%) have taken the Pap smear test before while 151 (20.5%) are not willing to go for the test at all. Conclusions. There is therefore the need to create proper awareness on the HPV and its possible consequence of cervical carcinoma.

genotypes and phenotypes of shiga toxin-producing Escherichia coli (sTec) in abeokuta, southwestern nigeria

Purpose To characterize the prevalence of hemolytic Shiga toxin-producing Escherichia coli (STEC) with a multidrug-resistant pattern in different age groups in Abeokuta, Nigeria. Methods Nonrepetitive E. coli isolates were collected from 202 subjects with or without evidence of diarrhea. Each isolate was biochemically identified and antimicrobial susceptibility testing was performed using the disk diffusion method. A sorbitol fermentation test of all the E. coli isolates was done and the minimum inhibitory concentration of suspected STEC was measured by the standard broth microdilution method to determine antibiotic resistance. The genotypes of stx1, stx2, and hlyA were determined by polymerase chain reaction assay. Results The majority of subjects were aged ≥40 years (41.6%) and were female (61.9%). Of the 202 subjects, 86.1% had STEC isolates (P<0.05). A high rate of STEC isolates resistant to amoxicillin (90.6%), cefotaxime (77.7%), and cefuroxime (75.7%) was observed. Resistance to amoxicillin, gentamicin, and cefotaxime was demonstrated with a minimum inhibitory concentration >16 μg/mL in 13.9%, 11.4%, and 10.4% of the isolates, respectively. The prevalence of stx1, stx2, and hlyA was 13.9%, 6.9%, and 2.0%, respectively; 5.5% of stx1 were in the 0–10-year-old age group, 3.5% of stx2 were aged ≥40 and above, and 1.0% of the hlyA isolates were in the 0–10-year-old age group. Conclusion The prevalence of virulent STEC is a public health concern. The use of polymerase chain reaction assay should aid quick detection of this virulent serotype and help curb the severe epidemic of human diseases associated with STEC infections.

CORRELATION OF HIV-1 P24 ASSAY WITH CD4 T-CELL COUNT, HIV, HBV AND HCV CO-INFECTIONS AND ITS IMPLICATION FOR ART MONITORING IN VASTLY HIV-INFECTED POPULATION OF NIGERIA

Background Reports indicate that extensive genetic diversity of HIV-1 impacts almost every aspect of HIV-1 epidemiology, including laboratory detection, ART/resistance, monitoring of ART and vaccine development. Therefore, in order to support the scale-up of access to HAART to mitigate the HIV-1 scourge, prompt, accurate and cost-effective diagnosis and monitoring of ART is crucial in Nigeria (a resource-limited country). Methods Plasma of 200 confirmed HIV-1 patients on a specified and uniform ART regimen was monitored with P24 antigen assay and CD4 T-cell count as virologic and immunologic assessments of response to ART. The results of the assays (P24 and CD4 count) were compared to assess sensitivity, turn-around time and financial advantages of P24 over the CD4 count. Serological analysis of HBV and HCV were performed according to the manufacturers instructions. Enumeration of CD4+ levels was done with a Partec flow cytometer. Results Of these patients, 77.5% had HIV only, 14.5% had HIV−HBV and 11.5% had HIV-HCV. Evaluation of levels of P24 antigen revealed that lower limits for P24 antigen 0.577–2.308 were detected in the subjects with CD4 cell count >500. However, higher limits for P24 antigen 2.308–2.885 were detected in subjects with CD4 cell count within the range of 200–499. Correlation analysis showed an inverse relationship between CD4 count and level of P24 antigen (CD4 count of 200–499 cells/µl versus 2.308–2.885 of P24, r=–0.319, CD4 count≥500 cells/µl versus 0.577–2.307 of P24, r=–0.088). Conclusions This study suggests that p24 could serve as one of such diagnostic and monitoring facilities that could be used in a resource-limited area like Nigeria. This will in turn lead to selection of more specific ARV options that best suppress viraemia during initiation of ART, as well as for monitoring HIV-1 patients in Nigeria, knowing that the virus subtype impacts effectiveness of ART.

PREVALENCE OF HBV, HIV, AND HIV-HBV CO-INFECTIONS AMONG HEALTHCARE WORKERS IN IBADAN, NIGERIA

Background HIV and HBV are endemic in Nigeria. HBV is globally the leading cause of death due to liver disease amongst HIV-infected persons. The study was done to ascertain the prevalence rate of HIV, HBV and HIV-HBV co-infections amongst health care workers in Ibadan, Nigeria. Methods A total of 217 healthcare workers working in large hospitals in Ibadan, Nigeria were signed up for the study. The socio-demographical data of the health care workers were collected using a questionnaire. HIV antibodies were evaluated using Stat Pak HIV test strips and HBV was evaluated using the ABON HBsAg test strips. Results There were 85 (39.2%) male and 132 (60.8%) female health care workers. Most were 21–35 years of age (109/217, 50.2%). Of the 217 health care workers 103(47.5%) and 21(9.7%) were positive for HBsAg and HIV, respectively, while 3(1.4%) had HIV-HBV co-infections. The prevalence of HBV infection was statistically significant (p<0.005) over HIV infection. Health care workers with ‘other’ level of education had the most predominant HBV prevalence (58/83, 69.9%, p=0.0267) while those with primary level of education had the highest HIV prevalence (2/12, 16.7%, p=0.0267. Females had the most predominant HBV (72/132, 54.5%) and HIV (17/132, 12.9%) (p=0.03). HIV was highest in age groups <20 years (2/16, 12.5%). Only widows/widowers (33.3%) had the highest HIV-HBV co-infection rates. Presence of tattoo in any part of the body, hepatitis B vaccination was significantly associated (p< 0.05) with HBV seropositivity among health care workers. Conclusions This study reveals a high prevalence of HIV, HBV and HIV-HBV co-infections among female health care workers. From our finding, the high infection rates of HBV and HIV noted amongst health care workers indicate the need to regularly screen this group for these viruses to reduce the further transmission of these viral infections.