Paul Erhunmwunse Imade

Asymptomatic bacteriuria among pregnant women.

Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim: This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3%) were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001). Trimester did not show any significant difference (P = 0.2006) in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion: Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.

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.

HIV Seroprevalence Among Pregnant Women Attending Ante- Natal Clinic in a Tertiary Health Institution in Benin City, Nigeria

HIV Seroprevalence Among Pregnant Women Attending Ante- Natal Clinic in a Tertiary Health Institution in Benin City, Nigeria Aim. Maternal to child transmission of Human Immunodeficiency Virus (HIV) is a continuous source of new HIV infection and one of the most common complications of pregnancy in some developing countries. This study was aimed at investigating the seroprevalence of HIV in pregnant women in Benin City, Nigeria. Materials and Methods. Sera of 3,410 pregnant women were tested for the presence of HIV antibodies using rapid test algorithm method between January 2008 and June 2009. Results. A total of 176 (5.2%) were sero-positive to HIV. Infection was recorded in all age groups but there was no statistical significance between age group and infection (P = 0.076). History of sexually transmitted disease, high social economic status and being literate were risk factors for acquiring HIV infection. Conclusion. The prevalence rate recorded in this study suggests that HIV screening of pregnant women should be an on-going exercise. This measure will help minimized mother to child transmission of the disease.

Viral Agents of Diarrhea in Young Children in Two Primary Health Centers in Edo State, Nigeria

Enteric viruses have been shown to be responsible for diarrhea among children during their early childhood. This study was carried out to determine the prevalence of rotavirus, adenovirus, and norovirus infection in young children with diarrhea in two primary health centers in Edo State, Nigeria. A total of 223 stool specimens were collected from children aged 0–36 months with clinical signs of diarrhea and 59 apparently healthy age-matched children as control. These specimens were investigated for three viral agents using immunochromatographic technique (ICT). The overall results showed that at least one viral agent was detected in 95/223 (42.6%) of the children with diarrhea while the control had none. The prevalence of rotavirus was 28.3%, adenovirus 19.3%, and norovirus 3.6%. There was a significant association between age group and infection (P < 0.0001). Seasonal pattern of enteric viruses was not statistically significant (P = 0.17). The overall coinfection rate was 7.6% and rotavirus-adenovirus coinfection had the highest with 5.4%. Rotavirus was the most prevalent viral agent. Coinfections are not uncommon among the population studied. The most commonly associated clinical symptom of viral diarrhea in this study was vomiting. Viral diagnostic tests are advocated for primary health care facilities in this locality.

Effect of Prevention of the Mother to Child Transmission Program on the Prevalence of Postnatal HIV Infection in Benin City, Nigeria

The aim of this study was to determine the effect of prevention of the mother to child transmission (PMTCT) program in Benin City, Nigeria on the prevalence of postnatal infant HIV. Effects of the duration of PMTCT, place of birth and sex of the infants on the prevalence of postnatal HIV were also assessed. Dried blood spots were collected from 318 infants (6–8 weeks old) born to HIV-positive mothers and were screened for the presence of HIV using a qualitative polymerase chain reaction method. A questionnaire was used to obtain information about the duration of highly active antiretroviral therapy (HAART) and place of delivery. Male infants had a significantly ( p = 0.032) higher prevalence of postnatal HIV infection than females. Nonparticipation of mothers in the PMTCT program was a significant risk factor for acquiring postnatal HIV (odds ratio = 4.519; 95% confidence interval = 2.422, 8.429; p p = 0.010) affected the prevalence of postnatal HIV with an inverse relationship. The place of delivery had no effect on the prevalence of postnatal HIV. An overall prevalence of 16.98% of postnatal HIV was observed in this study. Male sex and no participation in the PMTCT program were significant risk factors for acquiring postnatal HIV, while a lower prevalence of postnatal HIV infection was associated with longer use of HAART in the PMTCT program. We recommend an early diagnosis of maternal HIV status and commencement of HAART.

Post-natal maternal antiretroviral therapy and HIV prevalence among breast-fed infants in Benin, Nigeria

Background: Breastfeeding is an established mode of transmission of human immunodeficiency virus (HIV) infection resulting in clash between socio-cultural values and medical practice. Aims: This study aims to determine the effect of post-natal maternal antiretroviral therapy on transmission of HIV through breastfeeding. Patients and Methods: A total of 318 pregnant women were followed from pregnancy to 6 months post- partum. The women were divided into breast-fed and those who did not breast-feed, while the breast-fed were further divided into those on antiretroviral (ARV) and those not on ARV. After 6 months post-partum, dried blood spots were collected from infants born to these women and tested for HIV using polymerase chain reaction. Results: Generally, breast-feeding had 4 to 13 fold increase risk of transmission of HIV to infants (OR =7.079 95% CI = 3.768, 13.300; P <0.0001). However, among breast-fed infants, post-natal maternal ARV resulted in reduced prevalence of HIV compared to mothers who did not use ARV during breast-feeding (17.31% VS 92.00%; P<0.0001). Conclusion: The study demonstrates the effectiveness of post–natal maternal ARV. However, research into better feeding options to prevent mother to child transmission of HIV via breast-feeding is advocated.