RESUMEN

Background: Rapid diagnostic tests are frequently used in healthcare settings across Nigeria for diagnosis of Plasmodium falciparum malaria, which is the commonest form of malaria in the country. In this study, the performance of a rapid diagnostic test (RDT) was compared with expert microscopy using the polymerase chain reaction (PCR) as the reference standard in a tertiary hospital in Jos, Nigeria. Methods: This study was a prospective, cross-sectional, hospital-based study. A total of 200 participants of all ages presenting to Jos University Teaching Hospital with a history of fever or an axillary temperature of >37.5°C were recruited. Blood specimens were collected and malaria testing was done using RDT, microscopy and PCR. Results: The prevalence of malaria in this study was 17%, 15% and 13% by PCR, microscopy and RDT, respectively. Compared with microscopy, RDT had lower sensitivity of 75% (95% CI: 56.60-88.54) vs 88.24% (95% CI: 72.55-96.70), lower specificity of 98.80% (95% CI: 95.72-99.85) vs 100.0% (95% CI: 97.80-100.0), lower positive predictive value 92.31 (95% CI: 74.89-97.97) vs 100 (95% CI: 98.0-100.0), and lower negative predictive value 95.35 (95% CI: 91.83-97.39) versus 97.65 (95% CI: 94.30-99.05). Conclusion: The diagnostic performance of expert microscopy was better than RDT in the diagnosis of Plasmodium falciparum malaria. Quality assurance procedures such as using expert microscopy to cross-check a proportion of RDT negative results in patients with clinical features of malaria is desirable.

Asunto(s)

Fiebre/diagnóstico , Malaria Falciparum/diagnóstico , Microscopía , Plasmodium falciparum/genética , Reacción en Cadena de la Polimerasa , Centros de Atención Terciaria , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios Transversales , Femenino , Fiebre/parasitología , Humanos , Lactante , Recién Nacido , Malaria Falciparum/epidemiología , Malaria Falciparum/genética , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Prevalencia , Estudios Prospectivos , Estándares de Referencia , Sensibilidad y Especificidad , Adulto Joven

RESUMEN

INTRODUCTION: Low and middle income countries (LMICs) bear more than 50% of the current cervical cancer burden over the last decade with linkages to lack of HPV vaccination, high levels of poverty, illiteracy and nonexistent or poor screening programs. Governments of LMICs need enough convincing evidence that HPV vaccination will be more cost-effective in reducing the scourge of cervical cancer. AREAS COVERED: A systematic review to identify suitable studies from MEDLINE(via PubMed), EMBASE and Electronic search through GOOGLE for original and review articles from 2007 to 2014 on cost-effectiveness of human papilloma virus vaccination of pre-adolescent girls in LMICs was conducted. A total of 19 full articles were finally selected and reviewed after screening out those not consistent with the inclusion and exclusion criteria. EXPERT COMMENTARY: Most studies on cost-effectiveness of HPV vaccine in LMICs show that lowering cost of HPV vaccination with or without Pap smear screening is cost-effective in areas with high incidence of cervical cancer.

Asunto(s)

Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Neoplasias del Cuello Uterino/prevención & control , Niño , Análisis Costo-Beneficio , Países en Desarrollo , Femenino , Humanos , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/economía , Vacunas contra Papillomavirus/economía , Neoplasias del Cuello Uterino/economía , Neoplasias del Cuello Uterino/virología , Vacunación/economía , Vacunación/métodos

RESUMEN

BACKGROUND/AIMS: Previous studies have observed disturbances in the 1H nuclear magnetic resonance (NMR) blood spectral profiles in malignancy. No study has metabotyped serum or plasma of hepatocellular carcinoma (HCC) patients from two diverse populations. We aimed to delineate the HCC patient metabotype from Nigeria (mostly hepatitis B virus infected) and Egypt (mostly hepatitis C virus infected) to explore lipid and energy metabolite alterations that may be independent of disease aetiology, diet and environment. METHODS: Patients with HCC (53) and cirrhosis (26) and healthy volunteers (19) were recruited from Nigeria and Egypt. Participants provided serum or plasma samples, which were analysed using 600 MHz 1H NMR spectroscopy with nuclear Overhauser enhancement spectroscopy pulse sequences. Median group spectra comparison and multivariate analysis were performed to identify regions of difference. RESULTS: Significant differences between HCC patients and healthy volunteers were detected in levels of low density lipoprotein (P = 0.002), very low density lipoprotein (P < 0.001) and lactate (P = 0.03). N-acetylglycoproteins levels in HCC patients were significantly different from both healthy controls and cirrhosis patients (P < 0.001 and 0.001). CONCLUSION: Metabotype differences were present, pointing to disturbed lipid metabolism and a switch from glycolysis to alternative energy metabolites with malignancy, which supports the Warburg hypothesis of tumour metabolism.

RESUMEN

Background: Nosocomial infections pose a great challenge on healthcare systems. Although surfaces in neonatal wards, umbilical stump wounds and catheter are responsible for a high number of nosocomial infections due to bacteria. The aim of this study was to determine the bacterial profile of air and surface contamination in the special care baby unit of a tertiary hospital in Jos, Nigeria. Methods: Surface and air samples were cultured and antibiotic susceptibility of isolated bacteria were determined. Results: The bacterial profile of air and surface samples showed that Klebsiella was the most common bacteria followed by Staphyllococcus; while the least was Escherichia. Most of the bacteria were isolated from the out-born term area of the special care baby unit. All the bacteria isolated were susceptible to ceftriaxone and meropenem. Conclusion: This study showed that all areas of the special care baby unit of the hospital have bacterial, indicating that these are a potential source of cross-infection from healthcare workers to the neonatal patients.

Asunto(s)

Microbiología del Aire , Bacterias/aislamiento & purificación , Lechos/microbiología , Infección Hospitalaria , Incubadoras para Lactantes/microbiología , Unidades de Cuidado Intensivo Neonatal , Salas Cuna en Hospital , Antibacterianos/farmacología , Bacterias/efectos de los fármacos , Ceftriaxona/farmacología , Escherichia coli/efectos de los fármacos , Escherichia coli/aislamiento & purificación , Humanos , Recién Nacido , Klebsiella/efectos de los fármacos , Klebsiella/aislamiento & purificación , Meropenem , Pruebas de Sensibilidad Microbiana , Nigeria , Pseudomonas aeruginosa/efectos de los fármacos , Pseudomonas aeruginosa/aislamiento & purificación , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificación , Centros de Atención Terciaria , Tienamicinas/farmacología

RESUMEN

Hepatocellular carcinoma (HCC) exhibits a huge disease burden on West Africa, with a large proportion of all HCC cases worldwide occurring in the sub-region. The high HCC prevalence is due to the endemicity of a number of risk factors, most notably hepatitis B, C and HIV. West African HCC also displays a poor prognosis. Generally speaking, this is owing to more aggressive tumours, late patient presentation and inadequate management. Exposure to chronic viral hepatitis, more carcinogenic West African strains of hepatitis B virus and carcinogens such as aflatoxin B1 all encourage tumour growth. Lack of patient confidence in the healthcare system contributes to poor health-seeking behaviors and management of the disease can be lacking, due in part to poor health infrastructure, resources available and lack of access to expensive treatment. There is also much we do not know about West African HCC, especially the effect rising obesity and alcohol use may have on this disease in the future. Suggestions for improvement are discussed, including surveillance of high-risk groups. Although there is much to be done before West African HCC is thought to be a curable disease, many steps have been taken to move in the right direction.

RESUMEN

OBJECTIVE: To compare the laboratory performance of a HIV antibody Rapid Diagnostic Test (RDT) [Determine HIV-1/2] with an Enhanced ELISA [GENSCREEN PLUS HIV Ag-Ab] used for HIV screening among blood donors in a hospital-based transfusion centre in North Central Nigeria. METHODS: The serum of four hundred and forty (440) blood donors of both sexes aged between 18 and 55 years, who fulfilled the conditions to donate blood, were serially tested for HIV using both methods. RESULT: DetermineTM HIV-1/2 detected 16 (3.6%) while GENSCREEN PLUS HIV Ag-Ab ELISA detected 41 (9.3%) blood donors who were HIV sero-positive. The DetermineTM HIV-1/2 missed 25 (61%) blood donors who were positive with the GENSCREENPLUS HIV Ag-Ab ELISA. The calculated sensitivity and specificity of Determine HIV-1/2 were 39.0% and 100% respectively while the positive predictive value and negative predictive values of Determine HIV-1/2 were 100% and 94.1% respectively. CONCLUSION: The HIV Antibody RDT (Determine HIV-1/2) has a very low sensitivity and therefore, inadequate in preventing transfusion transmissible HIV (TT-HIV) in a hospital-based blood transfusion service. The National Blood Transfusion Service (NBTS) in Nigeria should be equipped and supported to provide blood products screened with Enhanced ELISA as well as to embark on regular evaluation of all HIV screening assays used in the country in order to prevent counterfeit and sub standard assays and invariably reduce the risk of TT-HIV infection in the country.

Asunto(s)

Serodiagnóstico del SIDA/métodos , Donantes de Sangre , Ensayo de Inmunoadsorción Enzimática/métodos , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad

RESUMEN

UNLABELLED: There is no clinically applicable biomarker for surveillance of hepatocellular carcinoma (HCC), because the sensitivity of serum alpha-fetoprotein (AFP) is too low for this purpose. Here, we determined the diagnostic performance of a panel of urinary metabolites of HCC patients from West Africa. Urine samples were collected from Nigerian and Gambian patients recruited on the case-control platform of the Prevention of Liver Fibrosis and Cancer in Africa (PROLIFICA) program. Urinary proton nuclear magnetic resonance ((1) H-NMR) spectroscopy was used to metabolically phenotype 290 subjects: 63 with HCC; 32 with cirrhosis (Cir); 107 with noncirrhotic liver disease (DC); and 88 normal control (NC) healthy volunteers. Urine samples from a further cohort of 463 subjects (141 HCC, 56 Cir, 178 DC, and 88 NC) were analyzed, the results of which validated the initial cohort. The urinary metabotype of patients with HCC was distinct from those with Cir, DC, and NC with areas under the receiver operating characteristic (AUROC) curves of 0.86 (0.78-0.94), 0.93 (0.89-0.97), and 0.89 (0.80-0.98) in the training set and 0.81 (0.73-0.89), 0.96 (0.94-0.99), and 0.90 (0.85-0.96), respectively, in the validation cohort. A urinary metabolite panel, comprising inosine, indole-3-acetate, galactose, and an N-acetylated amino acid (NAA), showed a high sensitivity (86.9% [75.8-94.2]) and specificity (90.3% [74.2-98.0]) in the discrimination of HCC from cirrhosis, a finding that was corroborated in a validation cohort (AUROC: urinary panel = 0.72; AFP = 0.58). Metabolites that were significantly increased in urine of HCC patients, and which correlated with clinical stage of HCC, were NAA, dimethylglycine, 1-methylnicotinamide, methionine, acetylcarnitine, 2-oxoglutarate, choline, and creatine. CONCLUSION: The urinary metabotyping of this West African cohort identified and validated a metabolite panel that diagnostically outperforms serum AFP.

Asunto(s)

Biomarcadores de Tumor/orina , Carcinoma Hepatocelular/diagnóstico , Neoplasias Hepáticas/diagnóstico , Metionina/orina , Niacinamida/análogos & derivados , Sarcosina/análogos & derivados , alfa-Fetoproteínas/orina , Acetilcarnitina/orina , Adolescente , Adulto , África Occidental/epidemiología , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/epidemiología , Carcinoma Hepatocelular/orina , Estudios de Casos y Controles , Colina/orina , Creatina/orina , Femenino , Humanos , Ácidos Cetoglutáricos/orina , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/orina , Masculino , Persona de Mediana Edad , Niacinamida/orina , Fenotipo , Reproducibilidad de los Resultados , Sarcosina/orina , Sensibilidad y Especificidad , Adulto Joven

RESUMEN

BACKGROUND: Infection with Herpes Simplex Virus Type-2 (HSV-2) is the primary cause of genital herpes and the most common cause of genital ulcer disease (GUD) worldwide.  There is little information on the prevalence of HSV-2 in Nigeria. METHODOLOGY: Specimens were collected from 162 volunteers attending Jos University Teaching Hospital and tested for HSV-2 antibodies using HSV-2 Type specific IgG EIA test kit (Globalemed LLC Alexandria VA, USA). Data were analyzed using SPSS version 13.0. P values ≤ 0.05 were considered significant number. RESULTS: Out of the 162 individuals tested, 141 (87.0%) were HSV-2 positive. Infected individuals were more likely to be male than female (92.8% versus 86.4%; P > 0.05). There were high rates of infection in all age groups, and the prevalence increased with age. However, multivariate logistic regression analysis showed that HSV-2 prevalence was not significantly associated with increasing age, sex, marital status, occupation, educational status, and number of sex partners (P > 0.05). CONCLUSIONS: The results highlight the potential public health impact of HSV-2 in Nigeria where anti-HSV-2 testing is not generally performed in all populations, especially considering the risk of neonatal transmission and the attendant complications at birth.

Asunto(s)

Anticuerpos Antivirales/sangre , Herpes Genital/epidemiología , Herpesvirus Humano 2/inmunología , Adolescente , Adulto , Niño , Femenino , Humanos , Técnicas para Inmunoenzimas , Inmunoglobulina G/sangre , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Factores de Riesgo , Estudios Seroepidemiológicos , Adulto Joven

RESUMEN

BACKGROUND: Published data on HIV, HBV, and HCV in correctional facilities in Nigeria is scarce. We set out to establish the seroprevalence, co-infection, and risk factors for these infections for the first time among prison inmates in Nasarawa State, Nigeria. METHODOLOGY: In a cross-sectional study conducted between April and May, 2007, blood samples were collected from 300 male prisoners of a mean age of 29.2 years, in the state's four medium-security prisons (overall population: 587). Prior to the study, ethical clearance and informed consent were obtained and structured questionnaires were administered. Samples were analyzed for HIV, HBsAg, and HCV using anti-HIV 1+2-EIA-avicenna, Shantest-HBsAg ELISA, and anti-HCV-EIA-avicenna, respectively. Specimens initially reactive for HIV were retested with vironostika microelisa. Data were analyzed using SPSS version 13.0. P values < or = 0.05 were considered significant. RESULTS: Of the 300 subjects, 54 (18.0 %), 69 (23.0 %), and 37 (12.3 %) tested positive for HIV, HBV, and HCV, respectively. Co-infections were eight (2.7 %) for HIV/HBV and two (0.7 %) for HBV/HCV. Those aged 21-26 years were more likely to be infected with HIV and HBV, while those aged 33-38 years had the highest HCV infection. Associated risk factors included duration in prison, previous incarceration (for HIV, HBV and HCV), intra-prison anal sex, multiple sex partners (for HIV and HBV), ignorance of transmission modes, blood transfusion, and alcohol consumption (for HBV and HCV). No inmate injected drugs. CONCLUSIONS: The overall outcome represents the need for prison-focused intervention initiatives in Nigeria. Injected drug use is an unlikely major transmission mode among Nigerian inmates.

Asunto(s)

Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Hepatitis B/complicaciones , Hepatitis B/epidemiología , Hepatitis C/complicaciones , Hepatitis C/epidemiología , Adolescente , Adulto , Comorbilidad , Estudios Transversales , Anticuerpos Anti-VIH/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Anticuerpos contra la Hepatitis C/sangre , Humanos , Técnicas para Inmunoenzimas/métodos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Prisioneros , Factores de Riesgo , Estudios Seroepidemiológicos , Adulto Joven

RESUMEN

Background: Published data on HIV; HBV; and HCV in correctional facilities in Nigeria is scarce. We set out to establish the seroprevalence; co-infection; and risk factors for these infections for the first time among prison inmates in Nasarawa State; Nigeria. Methodology: In a cross-sectional study conducted between April and May; 2007; blood samples were collected from 300 male prisoners of a mean age of 29.2 years; in the state's four medium-security prisons (overall population: 587). Prior to the study; ethical clearance and informed consent were obtained and structured questionnaires were administered. Samples were analyzed for HIV; HBsAg; and HCV using anti-HIV 1 +2-EIA- avicenna; ShantestTM-HBsAg ELISA; and anti-HCV-EIA-avicenna; respectively. Specimens initially reactive for HIV were retested with vironostika microelisa. Data were analyzed using SPSS version 13.0. P values = 0.05 were considered significant. Results: Of the 300 subjects; 54 (18.0); 69 (23.0); and 37 (12.3) tested positive for HIV; HBV; and HCV; respectively. Co-infections were eight (2.7) for HIV/HBV and two (0.7) for HBV/HCV. Those aged 21-26 years were more likely to be infected with HIV and HBV; while those aged 33-38 years had the highest HCV infection. Associated risk factors included duration in prison; previous incarceration (for HIV; HBV and HCV); intra-prison anal sex; multiple sex partners (for HIV and HBV); ignorance of transmission modes; blood transfusion; and alcohol consumption (for HBV and HCV). No inmate injected drugs. Conclusions: The overall outcome represents the need for prison-focused intervention initiatives in Nigeria. Injected drug use is an unlikely major transmission mode among Nigerian inmates

Asunto(s)

Hepacivirus , Nigeria , Factores de Riesgo , Estudios Seroepidemiológicos