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Objective: We evaluated the susceptibility status of Anopheles gambiae in two communities of Ikorodu, Lagos, Nigeria to DDT, deltamethrin, lambda cyhalothrin and bendiocarb. Methods: Anopheles immature stages were collected from their habitats in the surveyed community and allowed to emerge before exposure adult females to discriminating doses of WHO insecticides including DDT, deltamethrin, lambda cyhalothrin, bendiocarb and malathion. PBO synergistic bioassay was conducted for insecticides where the mosquito samples showed resistance. PCR assay was used for the detection of kdr mutation in the mosquitoes. Results: Resistance to DDT (40% and 86%) and lambda cyhalothrin (75% and 84%) in Oke-Ota and Majidun respectively. Suspected resistance to deltamethrin (94.9%) and bendiocarb (93.5%) was recorded in Oke-Ota community and the mosquitoes were susceptible to malathion in both communities. KDR mutation (L1014F) from resistance samples from both locations though with a low frequency that significantly departs from Hardy-Weinberg's probability (P> 0.01). PBO synergized bioassay was able to increase knockdown, percentage mortality and restore full susceptibility to deltamethrin and bendiocarb. Conclusion: Results from this study indicates that the metabolic resistance mechanism is highly implicated in the resistance to different classes of insecticide in Ikorodu and this should be taken into consideration when implementing vector control activities in this area.

Asunto(s)

Anopheles , Insecticidas , Animales , Femenino , Humanos , Insecticidas/farmacología , Anopheles/genética , DDT , Resistencia a los Insecticidas/genética , Malatión , Nigeria , Mosquitos Vectores/genética , Mutación

RESUMEN

BACKGROUND: QTc interval prolongation signifies an increased risk of life-threatening arrhythmia and sudden cardiac death. Cardiac manifestations of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome have become increasingly important causes of morbidity and mortality. We investigated HIV-positive patients to determine the effects of HIV infection, antiretroviral drugs, and identifiable confounders on QTc prolongation. MATERIALS AND METHODS: A case-control study was conducted in a rural tertiary health center in Nigeria. Data collected included demographic variables, body mass index, blood pressure, HIV status, antiretroviral treatment (ART), duration of HIV infection and treatment, CD4 T-lymphocyte count, heart rate (HR), and QT interval. QT was corrected for HR using Bazett's formula. RESULTS: The sample frame comprised 89 (42.4%) HIV-negative subjects (39.3% male, 60.7% female; mean age, 36.28 ± 7.03 years); 45 (21.4%) HIV-positive, ART-naïve patients (31.1% male, 68.9% female; mean age, 36.48 ± 9.12 years); and 76 (36.2%) HIV-positive patients on ART (27.6% male, 72.4% female; mean age, 39.00 ± 7.68 years). The QTc interval and resting HR were higher in HIV-positive, drug-naïve patients than in the other two groups (P < 0.001). Female sex was associated with prolonged QTc intervals in all groups. CONCLUSION: HIV-positive patients may be at higher risk of sudden cardiac death due to fatal arrhythmia secondary to QTc interval-related cardiac events. Healthcare providers should be aware that a prolonged QTc interval is a potential indicator of increased cardiovascular risk and should exercise caution in prescribing potentially QT-prolonging medications to HIV-positive patients.

Asunto(s)

Terapia Antirretroviral Altamente Activa , Electrocardiografía/métodos , Infecciones por VIH/tratamiento farmacológico , Síndrome de QT Prolongado/fisiopatología , Adulto , Presión Sanguínea , Índice de Masa Corporal , Enfermedades Cardiovasculares , Estudios de Casos y Controles , Electrocardiografía/efectos de los fármacos , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/fisiopatología , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Síndrome de QT Prolongado/complicaciones , Síndrome de QT Prolongado/diagnóstico , Masculino , Persona de Mediana Edad , Nigeria , Factores de Riesgo

RESUMEN

BACKGROUND: There is a scarcity of data in rural health centers in Nigeria regarding the relationship between socioeconomic status (SES) and HIV infection. We investigated this relationship using indicators of SES. METHODS: An analytical case-control study was conducted in the HIV clinic of a rural tertiary health center. Data collection included demographic variables, educational attainment, employment status, monthly income, marital status, and religion. HIV was diagnosed by conventional methods. Data were analyzed with the SPSS version 16 software. RESULTS: A total of 115 (48.5%) HIV-negative subjects with a mean age of 35.49±7.63 years (range: 15-54 years), and 122 (51.5%) HIV-positive subjects with a mean age of 36.35±8.31 years (range: 15-53 years) were involved in the study. Participants consisted of 47 (40.9%) men and 68 (59.1%) women who were HIV negative. Those who were HIV positive consisted of 35 (28.7%) men and 87 (71.3%) women. Attainment of secondary school levels of education, and all categories of monthly income showed statistically significant relationships with HIV infection (P=0.018 and P<0.05, respectively) after analysis using a logistic regression model. Employment status did not show any significant relationship with HIV infection. CONCLUSION: Our findings suggested that some indicators of SES are differently related to HIV infection. Prevalent HIV infections are now concentrated among those with low incomes. Urgent measures to improve HIV prevention among low income earners are necessary. Further research in this area requires multiple measures in relation to partners' SES (measured by education, employment, and income) to further define this relationship.

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Acute dystonic reactions (ADR) are extrapyramidal effects that usually occur after the initiation of a wide variety of drugs or triggering factors besides neuroleptics. We report the case of a 54-year-old man who was admitted with an approximately 10-hour history of muscle twitching around the eyes, face and neck after he took the first dose of oral chloroquine phosphate (1 g [600 mg base]) prescribed for uncomplicated malaria. He was given intravenous diazepam (10 mg statum) followed by 10 mg of oral diazepam 3 times a day. The symptoms improved within 30 minutes of treatment, and he was discharged 14 hours later after a complete recovery.

RESUMEN

BACKGROUND: Microalbuminuria has been described as a marker of generalized vascular damage. AIMS: The aim of the present study was to determine the prevalence of erectile dysfunction (ED) and microalbuminuria in adult male Nigerians with newly diagnosed hypertension. We also evaluated the relations between ED and microalbuminuria, electrocardiographic left ventricular hypertrophy, serum lipids, and cigarette smoking. MATERIALS AND METHODS: A total of 81 male adult Nigerians with newly diagnosed hypertension were recruited into the study. There were also 75 age- and sex-matched healthy normotensive controls. ED was evaluated using a standardized questionnaire of the International Index of Erectile Function and microalbuminuria was determined using the Micra Test strips (Boehringer Manneheim GMBh, Mannheim, Germany). RESULTS: Eighty-one hypertensive patients and 75 normotensive controls were studied. Mean age of the patients and the controls was 53.8 ± 5.6 and 51.2 ± 7.1 respectively. ED was found in 32.1% of the hypertensive patients and 16% of normotensive controls (P < 0.001). The prevalence of microalbuminuria was significantly higher in patients with ED than in those without it (65.4% vs. 23.6%, P < 0.0001). CONCLUSION: The study shows that ED and microalbuminuria are common in male adult Nigerians with hypertension. It also demonstrates that male ED is associated with an increased risk of cardiovascular disease.