Association between maternal serum homocysteine concentrations in early pregnancy and adverse pregnancy outcomes

There is still conflicting evidence on the extent to which maternal hyperhomocysteinemia is a risk factor for pregnancy complications. Aims: The study aimed to investigate the impact of elevated maternal homocysteine concentrations on adverse pregnancy outcomes among Nigerian women in Lagos. Materials and Methods: This was a prospective cohort study conducted at the Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria. Participants were enrolled during the first trimester of pregnancy following which relevant data were obtained by the interview. Fasting blood samples were collected for the measurement of maternal homocysteine concentration using the enzyme-linked immunosorbent assay method. Pregnancy outcomes and complications were obtained by abstracting the antenatal, delivery, and newborn medical records. Preterm births, low-birth weight (LBW), and antepartum fetal death were used as confirmatory outcome variables in the final analysis. Descriptive statistics for all data were computed using SPSS version 22.0. The associations between the variables were tested and multivariate analyses were used to study the effects of the major baseline characteristics on the pregnancy outcome. P < 0.05 was considered statistically significant. Results: Hyperhomocysteinemia was recorded in 41 (24.6%) patients. Women with a high homocysteine concentration and those with a normal homocysteine level did not differ significantly in terms of age (P = 0.684), level of education (P = 0.866), and parity (P = 0.647). Women with hyperhomocysteinemia had an approximately twelve-fold higher risk of preterm birth (P = 0.001) and a ten-fold higher risk of delivering a term neonate with LBW (P = 0.004), but had no risk of antepartum fetal death (P = 0.118) compared to women with a normal homocysteine concentration. Conclusions: The prevalence of hyperhomocysteinemia among mothers in Lagos was relatively low. The associations between hyperhomocysteinemia and adverse pregnancy outcomes could have implications in future for the prevention of these adverse outcomes

Risk factors associated with hepatitis B and C in rural population of Burera district, Rwanda

Introduction: several studies have shown that older people have a higher risk of exposure to viral hepatitis B and C than younger people. This study aimed to determine the seroprevalence of hepatitis B and C and their associated factors in people aged 45+ years old in Burera, a rural district of Rwanda.Methods: a cross sectional study was conducted from July to December 2017 during a mass campaign of hepititis B (HBV) and hepititis C (HCV) screening and vaccination of eligible populations against HBV in Burera District. Blood samples were collected and hepatitis B surface antigen (HBsAg) and an antibody against hepatitis C (Anti-HCV) were detected using an Enzyme-Linked Immuno-Sorbent Assay (ELISA). The associated factors were identified using a structured questionnaire and the data was analyzed using SPSS software.Results: of the 374 people included in this study, 53.2% were females. The median age was 56 years old with an Interquartile range (IQR) of 50 - 63 years old. The prevalence of HBV and HCV infection was 6.4% and 9.4%, respectively, with 0.3% co-infection rate. Age, social economic level, history of blood transfusion, history of never using a condom, as well as a history of injury with a used sharp material were significantly associated with HCV infection.Conclusion: the study showed a high seroprevalence of both HBV and HCV in Burera's elderly population aged 45+ years. Several factors associated with HBV and HCV in this study could be prevented through education and improved hygiene

Hepatitis E virus in patients with acute hepatitis in Cape Town, South Africa, 2011

Background. Early hepatitis E virus (HEV) seroprevalence studies in South Africa (SA) showed seroprevalence rates of 2 - 10%, and suggested waterborne transmission. More recent studies in Cape Town, SA, reported HEV seroprevalence rates of 28% and 26% in outpatients without liver disease and blood donors, respectively. An association was found with eating pork or bacon/ham. Only 3 human cases of hepatitis E in SA have been reported in the literature. Objectives. To find evidence of HEV infection in hospitalised patients with acute hepatitis and no other identified cause. Methods. Leftover serum samples were retrieved for patients negative for hepatitis viruses A, B and C, where no other cause of hepatitis was identified. Samples were tested for HEV by polymerase chain reaction (PCR) and IgM and IgG enzyme-linked immunosorbent assay (ELISA). Results. Anti-HEV IgG was detected in 39/132 specimens (29.5%; 95% confidence interval (CI) 22.4 - 37.8), and anti-HEV IgM in 2/125 specimens (1.6%; 95% CI 0.4 - 5.7). No specimen tested positive by PCR. Conclusions. IgG seroprevalence found in this study was similar to that previously reported in Cape Town. IgM positivity in 2 patients was not confirmed by PCR. Locally, hepatitis E may not be a common cause of clinically apparent hepatitis that requires hospitalisation

Seroprevalence of toxoplasma gondii among HIV patients in the University of Benin Teaching Hospital (UBTH), Benin City, Edo State, Nigeria

Background: Toxoplasmosis among the human immunodeficiency virus (HIV) positive individuals with low CD4+cell count can be severe leading to the reactivation of dormant bradyzoites which can lead to morbidity and/or mortality. A reservoir for T. gondii, cat is common around our study area both as pets and stray animals.Study Objective: Is to determine the seroprevalence of T. gondii infection in this community and also to investigate the association between T. gondii infection and CD4 count other risk factors.Methods: Blood specimens were collected from a total of 282 adult HIV positive patients attending a tertiary health facility clinic by systematic sampling and the IgG and IgM levels were detected using the enzyme-linked immunosorbent assay (ELISA) technique. Similarly blood was also collected from 60 healthy blood donors as control group.Results: Out of a total of 282 samples analyzed, 189 were positive for IgG (67%) and 93 were negative. All 282 samples were negative for IgM antibody. A total of 280 had their CD4+cell count above 200cells/microlitre of blood and only 2 recorded less than 200. Nineteen (31.7%) of the 60 blood donors in the control group were positive for IgG and all negative for IgM. The high seroprevalence rate of IgG toxoplasma antibody among HIV positive patients as reported in this study suggests that there should be a high index of suspicion of the recrudescence of toxoplasmosis among HIV and AIDS patients in our environment and possibly elsewhere

Incidence of dengue virus infections in febrile episodes in Ile-Ife, Nigeria

Background: Dengue viruses have been identified as the most important arboviral pathogen in the world. They are transmitted by mosquitoes of Aedes species. While dengue infection is accompanied by little or no subclinical signs in many; about 1-2% may produce clinically severe Dengue Haemorrhagic Fever/Dengue Shock Syndrome. Early recognition; appropriate treatment and elimination of mosquito vectors will help control it. The study is aimed at determining the incidence of dengue infections in Ile-Ife. Materials and Methods: Three millilitres venous blood was collected from each of one hundred and seventy nine patients presenting with fever in the last two weeks; and analyzed for the presence of anti-dengue IgM antibodies using Dengue Virus IgM ELISA kit (DIA.PRO; Italy) according to the manufacturer's instructions while the results and demographic data were analyzed using SPSS version 16. Results: It was observed that 46 (25.7%) of the 179 had detectable IgM antibodies to dengue virus with 9 of them having no detectable malaria parasite. The incidence was 26.5% and 25% in male and female respectively. Further studies will be necessary to confirm the relatedness of blood transfusion as an important risk factor to the transmission of dengue virus.Conclusion: The study established the presence of fresh dengue infections for the first time in Ile-Ife among different groups of people. Clinicians are advised to prioritize laboratory diagnosis; especially of fever

Study of the correlation between Helicobacter pylori infection and Hepatic Encephalopathy in patients with Liver Cirrhosis

Background and study aim: Ammonia plays a major role in hepatic encephalopathy pathogenesis. Most of ammonia is known to be produced by the action of colonic bacteria which possess a urease enzyme activity. H. pylori which infects the stomach possesses a stronger urease activity which produce a large amount of ammonia that may precipitate hepatic encephalopathy (HE). The aim of the present study is to determine the correlation between Helicobacter pylori infection and HE in patients with liver cirrhosis.Patients and Methods: One hundred patients (50 patients of liver cirrhosis with hepatic encephalopathy and 50 patients of liver cirrhosis without hepatic encephalo-pathy) were evaluated for presence of H. pylori by stool antigen test (ELISA method) and for blood ammonia level estimation.Results: Prevalence of H. pylori infection in the study groups (patients of liver cirrhosis with and without hepatic encephalopathy) was 70% (liver cirrhosis with hepatic encephalopathy group (A) 80%, and liver cirrhosis without hepatic encephalopathy group (B) 60%). Mean blood ammonia levels were: 82.14± 47.9 mmol/l for group A (liver cirrhosis with hepatic encephalopathy) and 36.44± 17.9 mmol/l for group B (liver cirrhosis without hepatic encephalopathy). Prevalence of H. pylori and blood ammonia level were found significantly increasing with the severity and the degree of hepatic encephalopathy.Conclusion: There is a significant association between H. pylori and hepatic encephalopathy in patients with liver cirrhosis. There may be a role of anti-H. pylori therapy in patients of hepatic encephalopathy and should be investigated further

Pre-Donation Screening of Blood for Transfusion Transmissible Infections: The Gains and the Pains - Experience at a Resource Limited Blood Bank

Objective: To determine whether or not pre-donation testing of blood donors affords substantial cost savings without compromise to blood transfusion safety. Predonation testing of blood donors for Transfusion Transmissible Infections (TTIs) is done in most developing countries because substantial cost savings are made from resources; materials and man-hours which would have been spent to procure infected blood units. Simple rapid test kits used in pre-donation testing is not as sensitive as the Enzyme Linked Immuno-sorbent Assay (ELISA) method used in post-donation screening in a quality assured manner. Design: It is a retrospective study where records of pre- and post-donation tests done in donor clinic of University of Ilorin Teaching Hospital; between January and December 2010 were retrieved. All processes and inputs were evaluated and costs calculated for predonation testing by simple rapid techniques and post donation screening by ELISA. Results: 5000 prospective donors were tested in the study period. The cost of single rapid Pre-donation testing was less than that of single ELISA Postdonation screen. The cost of double rapid Pre-donation and Post donation ELISA screen exceeded the cost of single post donation ELISA screen. Substantial cost savings were made when single rapid Pre-donation testing is relied on. More blood units were found reactive for the TTIs with the more expensive Postdonation ELISA. Conclusion: Pre-donation testing of blood donors was not cost effective. Although; there is an apparent savings if pre-donation testing is not followed by postdonation ELISA testing; it is done at a compromise to blood transfusion safety

Reliability of Anti-Cyclic Citrullinated Peptide Antibodies (Anti-CCP) for the Diagnosis of Rheumatoid Arthritis as Compared to that of Rheumatoid Factor Test

Background: Rheumatoid factor (RF) is commonly used for diagnosis of rheumatoid arthritis (RA). RF positivity is nonspecific for diagnosis of RA because it can be detected in 3-5of normal individuals. Recent studies indicated that anti-Cyclic-Citrullinated protein (Anti-CCP) antibodies are more specific to diagnose rheumatoid arthritis and have the capacity to diagnose RA in early stages of the disease; or even before the onset of the disease when the arthritis is undifferentiated. Objectives: This study has been conducted to assess the reliability and specificity of anti- CCP in the Sudanese as an indicator of RA. Patients and methods: In this study; patients were diagnosed as RA patients according to the American College of Rheumatology (ACR) criteria. To get further insight on the sensitivity and specificity of Anti-CCP test as compared to that of RF test in the diagnosis of RA; analysis of samples obtained was perform negative rate reached 21.2. Although anti-CCP test is more accurate compared with RF; it may sometimes fail to diagnose some patients with rheumatoid antibodies were scarce

Interrelationship of growth hormone; glucose and lipid metabolism

BACKGROUND:The relationship between Growth hormone (GH) and the metabolism of glucose and lipid is not completely understood. OBJECTIVE:The present study is to obtain further information that will clarify the relationships between growth hormone and the metabolism of glucose and lipid.METHODS:The subjects were randomly selected 25 male (11) and female (14) healthy individuals aged 35.96 +/- 8.05 years. After an overnight fast (10-12 hours), blood was taken from the subjects into heparinised tubes, centrifuged at 5,000 rpm for 5 minutes and the plasma separated. Fasting plasma glucose (FBS) was determined by glucose oxidase method,, total cholesterol, LDL, HDL and, Triglyceride were determined by enzymatic methods. Hormone sensitive lipase was determined by, using dilaural-glycero-glutaric acid methyresoruffin as substrate and Cobas Integra 800 Auto-analyser. Growth Hormone was determined by Enzyme linked immunoassay method by using monoclonal antibodies and Access 2 Immunoassay system. All reagents were supplied by Roche Company.RESULT:The results showedpositive correlations between GH vs age and GH vs BMI. On the contrary, negative correlations were shown between GH vs the fasting levels of glucose,GH vs lipid and GH vs HSL.CONCLUSION:). GH caused the reduction of the blood levels of glucose and, lipid using HSL as mediator, by inhibiting gluconeogenesis and stimulating lipolysis, respectively

A Review of the Impact of Cost and Quality of HIV Kits on HIV Testing in a Nigerian Teaching Hospital

Background: When HIV antibodies testing was introduced in Aminu Kano Teaching Hospital; Kano a couple of years ago; Double ELISA was used to test blood samples before a particular specimen was diagnosed as reactive or non-reactive. A time came when immunoconfirmatory test was introduced into HIV antibodies testing for confirmations of the presence of HIV. Objectives: This present retospective study is to review the impact of cost and quality of HIV reagent kits in the two periods A and B on the patients and confidence on the health care provider. Methods: We collated and compared laboratory records for both periods of HIV antibodies testing at Aminu Kano Teaching Hospital Kano consisting of period A from November 1997 to May 1998 (7 months) and period B from November 1998 to May 1999 (7months). In period A; double ELISA was used (Genie II and Immunocomb Bispot) while in period B; Immunocomb Bispot and Immunoconfirm II were used Results: The results show that the cost per test increased from two hundred and fifty Naira($2) to five hundred Naira($4). There was a reduction on the number of patients from 289 to 258 within the two periods. But the prevalence of reactive HIV antibodies decreased from 43.6to 36.8. Conclusion: The period when Immunoconfirmatory technique was introduced brought assurance; reliability and confidence to HIV diagnosis test in the centre

Laboratory Capacity in 2012 for Diagnosis of Epidemic Prone Diseases in the Context of Integrated Disease Surveillance and Response in the WHO African Region

This paper provides the status of laboratory capacity for diagnosis of epidemic prone diseases in the context of Integrated Disease Surveillance and Response (IDSR) in 46 countries in the WHO African Region as of end of 2012 through self-assessment questionnaires. The findings from this assessment revealed that 98 (45/46) of the countries have the capacity for isolation; identification and antimicrobial susceptibility testing of common bacterial causes of enteric diseases and meningitis in the Region. Forty three countries performed standard enzyme-linked immunosorbent assay (ELISA) for confirming suspected cases of pathogens such as Morbillivirus responsible of measles through the detection of specific immunoglobulin M (IgM) and 30 countries had at least polymerase chain reaction (PCR) capacity for detection of influenza viruses. However; the number of countries with an appropriate department of virology providing comprehensive diagnostic services is still limited especially for dangerous viral pathogens requiring high-level containment facilities. The collection and analysis of critical information on the existing diagnostic capacity were used to propose key recommendations for strengthening the laboratory confirmation of outbreaks in line with the IDSR Strategy and the International Health Regulations (IHR; 2005). The proposed key actions were focused in the following areas: high-level advocacy for country ownership; human resource development; laboratory space and equipment; quality assurance and laboratory networking

Apport de l'ELISA et du Test Immunoblot deuxieme generation dans le diagnostic des hepatopathies virales C : a propos de 13 cas colliges au C.N.H.U. de Cotonou

Treize patients presentant une hepathopathie ont ete soumis au depistage des marqueurs seriques du virus de l'hepatite C (VHC) par la methode ELISA suivie de la confirmation par un test immunoblot de deuxieme generation. Cinq patients sur les treize etaient porteurs d'anticorps specifiques anti-VHC. Ce resultat preliminaire suggere que le VHC jouerait un role non negligeable dans le developpement des hepatopathies au Benin

Etude de la prevalence des anticorps anti-CMV seriques parmi la population congolaise seronegative et seropositive pour le VIH 1

L'objet de cette etude est d'apprecier la seroprevalence des anticorps de classe IgG et IgM dirigee contre le CMV parmi la population generale congolaise et de la comparer a celle observee chez les patients febriles seropositifs pour le VIH 1. Les bilans bacteriologiques; mycologiques et parasitaires sont negatifs. Les serums proviennent de 100 patients seropositifs pour le VIH 1 en ELISA; confirmes en WESTERN-BLOT et d'un groupe temoin de 100 sujets seronegatifs pour le VIH 1 en ELISA. [abstract terminated]

Deteccao de IgG antitoxina colerica por ELISA e sua utilidade no diagnostico de surtos de epidemicosSergio Stakteas; Jorge Barreto

The authors evaluated the utility of IgG cholera anti-toxin for serological diagnosis of Vibrio cholerae 01 El Tor infection during an epidemic which occurred in the city of Maputo in 1992. The IgG anti-toxin was sought in serum of hospitalized cholera patients (n= 172; average length of internment= 3 days) and in healthy adult individuals observed during the previous inter-epidemic period (n= 100) through an immunoenzyme assay (ELISA) previously described by Young and Cols (Infection and Immunity 27(1): 492-496; 1980) and modified by Levine and Cols (J. Clin. Microbiol. 21 : 174-179; 1985). Taking with reference to the bacteriological culture of stools samples; the ELISA showed sensitivity of 71.1 and a specificity of 97.3 when applied in the first three days of hospitalization. 20/28 patients with previous isolation of Vibrio cholerae 01 and negative serology; showed a pattern of ELISA seroconversion for cholera anti-toxin when retested 4-8 days after hospitalization. Taking into account these results; the ELISA showed an overall sensitivity of 91.8 and a specificity of 97.3. The presence of IgG cholera anti-toxin in the acute or convalescent phases of choleric disease has a high predictive value for the infection (ppv= 97.8; 95 CI95.6-100). A negative serological result in the acute phase requires a second ELISA test 4-8 days later to confirm an antibody seroconversion. This ELISA could provide provisional diagnosis of c cholera outbreak and information about its course

Anaplasmosis in Uganda. II. Prevalence of bovine anaplasmosis

The prevalence of bovine anaplasmosis was studied in 320 Zebu cattle randomly selected from three regions of Uganda (central; south-western and north-western) using DOT-ELISA; Western immunoblotting; Rapid Card Agglutination Test (RCAT); Capillary Tube Agglutination Test (CAT); Complement Fixation Test (CFT); and parasitological techniques. Dried blood on Whatman filter paper no. 1 was eluated in PBS 0.05pc Tween 20 prior to testing at an initial dilution of 1:25. The incidence of parasitaemia ranged from 25pc in the central region to 35pc in the north-western region and the serological prevalence was lower in the central region and highest in the north-west. Prevalence rates assayed by DOT-ELISA and Western immunoblotting were 1.5-fold greater than those tested with RCAT and 3-fold greater than in CAT. The overall prevalence rates by DOT-ELISA and Western immunoblotting compared favourably with CFT data. The present data utilizing dried blood on filter papers indicate that there is a high prevalence of anaplasmosis in those regions of Uganda surveyed and it confirms our observations and those of others that collecting blood on filter papers is a suitable technique for large-scale screening and for seroepidemiological studies

Anaplasmosis in Uganda. I. Use of dried blood on filter paper and serum samples for serodiagnosis of anaplasmosis--a comparative study

The suitability of blood collected on filter papers in comparison with corresponding conventional serum samples in the diagnosis of bovine anaplasmosis was studied using the Complement Fixation Test (CFT); DOT-ELISA; Western immunoblot and Rapid Card Agglutination Test (RCAT). Dried blood on Whatman filter paper no. 1 was eluted in 1.8 ml of PBS 0.05pc Tween 20 given an initial dilution of 1:100. The reactivity in both DOT-ELISA and Western immunoblotting was similar to that obtained with the sera diluted 1:100. Filter paper samples gave lower reactivity in all the tests as compared with corresponding serum samples. There was no significant difference in the reactivity between the eluates from filter papers stored at room temperature and those stored at 4 degrees C. Storage at room temperature did not significantly affect reactivity for up to 6 months. Eluates from filter papers stored for 6 months at room temperature continued to give similar reactivity to those from freshly prepared filter papers in both DOT-ELISA and Western blot; and in the Rapid Card Agglutination Test. It is concluded that collecting blood on filter papers is a suitable technique for large-scale screening and for seroepidemiological studies on anaplasmosis; and offers many advantages especially in developing countries where transport and cold chain facilities are a major constraint

Anaplasmosis in Uganda. I. Use of dried blood on filter papers and serum samples for serodiagnosis of anaplasmosis--a comparative study

The suitability of blood collected on filter papers in comparison with corresponding conventional serum samples in the diagnosis of bovine anaplasmosis was studied using the complement fixation test; DOT-ELISA; Western immunoblot and rapid card agglutination test. Dried blood on Whatman filter paper no. 1 was eluted in PBS 0.05pc Tween 20 giving an initial dilution of 1:10. The reactivity of the eluted samples in both DOT-ELISA and Western immunoblotting were similar to those obtained with the corresponding straight serum sample dilutions. Filter paper samples gave lower reactivity in the remaining tests when compared with corresponding serum samples. There was no significant difference in the reactivity between the eluates from filter papers stored at temperatures ranging between 15.5 and 24 degrees C and those kept refrigerated. Storage at 15.5 to 24 degrees C did not significantly affect reactivity for up to six months. Eluates from filter papers stored for six months at 15.5 to 24 degrees C continued to give similar reactivity as those from freshly prepared filter papers in both DOT-ELISA and Western blot; and in the rapid card agglutination test. It is concluded that collecting blood on filter papers is a suitable technique for large scale seroepidemiological studies on anaplasmosis and offers many advantages in developing countries where transport and cold chain facilities are a major constraint