The risk of transfusion transmitted malaria and the need for malaria screening of blood donors in Abuja, Nigeria

Background: Blood transfusion saves life but it is also a major risk factor in the transmission of certain infections such as malaria, which remains a public health problem in tropical and sub-Saharan Africa. Methodology: This study investigated the prevalence of malaria among 550 blood donors aged 18 to 60 years from blood bank units of some selected hospitals in Federal Capital Territory (FCT), Abuja, using gold standard microscopy for malaria parasite detection. Results: Two hundred and fifty two (45.8%) donors were positive for malaria parasites. Replacement donors had higher prevalence rate of malaria compared to voluntary donors. The distribution of infection on the basis of age revealed the highest prevalence rate of malaria among the 20- 29yrs age group. The rate of infection among the males and the females was not significantly different (p>0.05). No association was observed between the blood group types and the rate of malaria infection (p > 0.05). Conclusion: A high prevalence of malaria parasitaemia was observed among blood donors in FCT, Abuja, Nigeria in this study. The introduction of malaria screening as part of routine screening for blood donation and the provision of modern blood screening equipment within healthcare facilities are highly advocated

Corneal endothelial changes by specular microscopy after uncomplicated phaco-emulsification of hard senile cataract graded by pentacam

Background: Cataract is the most prevalent ophthalmic cause of reversible blindness and it is one of the primary concerns of the public health perspective surgery which is the primary and only treatment method known.Objective: Assessment of corneal endothelial changes by using specular microscopy, after uncomplicated phacoemulsification in moderately hard nuclear 3 senile cataract.Patients and Methods: The present study was performed on 30 eyes of 30 individuals preoperative assessed by pentacam to detect grade 3 nuclear cataract to be selected in our study, then corneal endothelium assessed by specular microscopy to evaluate the corneal endothelium to be reference and to be compared to 1st and 3rd month.Results: A highly significant decrease in ECD 1st month post-operative and a significant decrease in ECD 3rd month in relation to pre-operative state. Highly significant increase in the coefficient of variation 1st month postoperative and non-significant increase in the 3rd month in relation to preoperative state. Highly significant decrease in the percentage of hexagonality 1st month and 3rd month post operatively. There is a highly significant reciprocal correlation between age and pre-operative endothelial cell density. 3rd month post-operative decrease in ECD is significant correlated to male sex.Conclusion: A major finding of our manuscript is that the harder the senile cataract the more time and surgical manipulation was done in spite of the same surgeon and the same operative condition lead to more endothelium lost and the more variation between the cells and decrease in the percentage of hexagonal post-operative

Place du détermine TB-LAM Ag dans le diagnostic de la tuberculose en République du Congo

Objectif :évaluer la sensibilité et la spécificité du test Determine TB-LAM Ag à Brazzaville, République du Congo. Méthodologie :cent soixante-dix patients suspectés de tuberculose pulmonaire et âgés de plus de 18 ans ont été recrutés au Centre Antituberculeux de Brazzaville dans la période allant de Janvier à Mai 2013. Des prélèvements d'urines et des crachats ont été faits respectivement pour réaliser la recherche d'une protéine (lipo-arabinomannane) de Mycobacteriumtuberculosis, la recherche des BAAR et la mise en culture des mycobactéries.Résultats :lesproportions de patients dépistés tuberculose (TB)ont été respectivement de 54,1% pour le test Determine TB-LAM Ag et de 34,1% pour la microscopie.En considérant les deux tests, 112 patients (65,88%) ont été détectés TB; ils sont répartis comme suit : (i) 38 patients ont été détectés par les deux tests, (ii) 20 l'ont été uniquement par la microscopie et (iii) 54 par le test Determine TB-LAM Ag seul.La culture a permis d'isoler les mycobactéries tuberculeuses dans les expectorations de 9 des 19 patients chez qui seule la microscopie était positive ; il en a été de même des expectorations de 9 des 46 malades testés positifs uniquement au Determine.Ainsi, nous avons constaté que le test Determine TB-LAM Ag et la microscopie avaient la même sensibilité (83,9%) ; leurs spécificités ont été respectivement de 64,76% et90,47%. Les valeurs prédictives positive et négative de la microscopie étaient de 82,45% et 91,34%; pour le test Determine TB-LAM Ag elles étaient de 55,95% et88,31%. Par ailleurs, en considérant les deux tests, la sensibilité augmente à 100% alors que la spécificité baisse à 55,23% ; les valeurs prédictives positive et négative deviennent 54,36% et 100%.Conclusion : le test Determine TB-LAM Ag complète la microscopie pour le diagnostic de la TB. Ce test, intégré dans le système de prise en charge des patients, permettra de rattraper des cas de TB à microscopie négative, surtout lorsque la culture n'est pas inclue dans l'algorithme de prise en charge de la TB

Accuracy of an Immunochromatographic Diagnostic Test (ICT Malaria Combo Cassette Test) Compared to Microscopy among under Five-Year-Old Children when Diagnosing Malaria in Equatorial Guinea

Conventional malaria diagnosis based on microscopy raises serious difficulties in weak health systems. Cost-effective and sensitive rapid diagnostic tests have been recently proposed as alternatives to microscopy. In Equatorial Guinea; a study was conducted to assess the reliability of a rapid diagnostic test compared to microscopy. The study was designed in accordance with the directives of the Standards for Reporting Diagnostic Accuracy Initiative (STARD). Peripheral thick and thin films for the microscopy diagnosis and a rapid immunochromatographic test (ICT Malaria Combo Cassette Test) were performed on under five-year-old children with malaria suspicion. The ICT test detected Plasmodium spp. infection with a sensitivity of 81.5and a specificity of 81.9while P. falciparum diagnosis occurred with a sensitivity of 69.7and a specificity of 73.7. The sensitivity of the ICT test increased with higher parasitemias. The general results showed little concordance between the ICT test and microscopy (kappa = 0.28; se: 0.04). In Equatorial Guinea; the ICT Malaria Combo Cassette Test has proven to be an acceptable test to detect high P. falciparum parasitemias. However; the decrease of sensitivity at medium and low parasitemias hampers that ICT can replace properly performed microscopy at present in the diagnosis of malaria in children

Low Reliability of Home-Based Diagnosis of Malaria in a Rural Community in Western Kenya

Introduction: Home-based management of malaria is promoted as a major strategy for improving prompt delivery of effective malaria treatment in Africa. This study aimed to determine the proportion of children who tested positive for malaria with routine light microscopy among those whose mothers had made a home-based diagnosis in a rural community in Western Kenya. Methodology: This cross-sectional study was conducted at Bokoli location; Bungoma East District in November and December 2007. Mothers of children five years of age or under with malaria diagnosed by their mothers were interviewed (n = 96). Duplicate blood smears were collected; stained by field stain A (Methylene blue; Azure) and B (Eosin); and examined for malaria parasites using light microscopy. Results: Only 30/96 (31.2) specimens were positive for Plasmodium falciparum. Elevated temperature (70/96; 72.9) in their children was the most commonly cited criterion for diagnosis of malaria by the mothers. In 57 of the 96 cases; information was given by the mothers regarding treatment during the current malaria episode; of these; 10 (17.5) had received treatment for malaria; but six (60) of these were parasite negative. This means that only 4/21 (19.0) with positive smear microscopy received treatment. The most common anti-malaria drugs used were Fansidar (37.8) and Metakelfin (29.7).Conclusion: The difficulty of diagnosing malaria accurately at home increases the urgent need for improved diagnostic tools that can be used at the community level in poor populations. Intervention measures are needed to increase the treatment rate to reduce reservoirs and malaria parasite transmission

Chlamydia and Vaginitis in Sexually Active Females: Classical Identification Methods for Effective Control

Laboratory diagnosis of Chlamydia and vaginitis in sexually active females has been limited by unavailability of a sequential method/rapid technique for simple diagnosis. Six hundred (600) adult females from hotel/brothel; Sexually Transmitted Infections (STIs) Clinic; Obstetrics/Gynaecology Clinic; Family Planning Clinic and Healthy controls were investigated for Chlamydia; Candida; trichomoniasis and bacterial vaginosis (BV). This was done using microscopy: wet mount; stained vaginal secretion and stained smear after culture. Results showed that there were 72infections in the female groups. The brothel and STI group had infection in the range (70-86). Chlamydial infection was highest in the STI group while Candida infection was highest in the healthy (control) females. Bacterial vaginosis was distributed in all groups. As p-value increased; f-value increased indicating constant co-infection of Candida and BV in Chlamydia positive females. Microscopy by direct detection from sample and stained smear after culture were in the range: 56-86. Direct microscopy for BV was 78.5and stained smear after culture; 57.1. Sensitivity and specificity of the techniques showed that detection of Chlamydia was less sensitive by direct microscopy of sample but sensitivity and specificity of stained smear after culture were high. Immunoassay (32.2) was also less sensitive. Sensitivity and specificity of wet mount microscopy for Candida; Trichomoniasis and BV were in the range 62.5 - 80and 62.5-97.8respectively. Wet mount has high sensitivity and specificity for detecting agents of vaginitis and may be useful for routine use and for diagnosis where disease is absent; thus; making identification more cost effective

A Synopsis of Current Malaria Diagnosis Trends

Malaria has remained a major cause of morbidity and mortality in the under developed and developing countries of the tropical and sub-tropical regions of the world. Globally 3.3 billion people live in areas where malaria exists; affecting 300-500 million people annually and it is estimated to be killing approximately 1-3 million people each year and 90of these mortalities occur in African children especially in sub Saharan Africa. Currently; although several control methods are beginning to result in downward trends in incidence in some countries; the gross number of malaria cases is still on the increase due to several factors including poor and ineffective diagnosis. Prompt and effective diagnosis is essential for the management and control of malaria. Over the years evidence has shown that traditional methods for diagnosing malaria remain problematic with a number of limitations. In this synoptic review an update of malaria diagnosis is presented and discussed highlighting the limitations and difficulties of both clinical (symptoms/ clinical signs-based) and laboratory (parasite-based) diagnosis of malaria. Enhancement of accurate malaria diagnosis is now more imperative than ever not only in the background of the current new era of malaria treatment with relatively expensive artemisinin-based combination therapies (ACTs); but more so in the heightened global campaign to effectively control; manage and possibly eradicate malaria from the face of the globe

Impact of Introducing Integrated Quality Assessment for Tuberculosis and Malaria Microscopy in Kano; Nigeria

Background: The World Health Organization (WHO) has recommended the integration of malaria microscopy quality assessment (QA) with that of other microscopically diagnosed diseases; but there is no evidence that it has been attempted. We assessed the feasibility of linking malaria microscopy into the existing tuberculosis (TB) microscopy QA system in Kano; Nigeria. Methodology: Five TB microscopy centres were selected for implementing the integrated TB and malaria microscopy QA scheme in the state. A model system was designed for selecting and blinded rechecking of TB and malaria slides from these laboratories. Supervision and evaluation was conducted at 3-month intervals for 24 months. Results: TB microscopy QA was strengthened in four laboratories. Full integration of the QA for TB and malaria microscopy was achieved in two laboratories; and partial malaria microscopy results. At the final assessment; 100specificity was achieved for TB microscopy results in four laboratories. There was an increased concordance rate and decreased false positivity and false negativity rates of TB microscopy results in all five laboratories. Conclusions: It is feasible to integrate the QA system and training for TB and malaria microscopy for assessing and improving quality of both services. However; the integrated system needs testing in different settings in order to be able to develop sound recommendations to guide the complex scaling-up process

Analyse des déterminants de la qualité de la microscopie pour la lutte contre la tuberculose dans les laboratoires des centres de santé de la région de Dakar

Introduction : Dans le but d'améliorer la qualité de la microscopie dans le cadre du dépistage et du suivi des patients atteints de tuberculose pulmonaire; une étude des déterminants de la qualité de la microscopie a été réalisée dans les laboratoires des centres de santé de Dakar; Sénégal. Matériels et Méthodes : Il s'agit d'une étude épidémiologique de type transversal qui s'est déroulée dans la période du 19 avril au 05 mai 2004. Elle a consisté en une série d'observations; d'entretiens; de revue des registres de laboratoire et a une relecture et recoloration; au niveau du Laboratoire National de Reference du Programme National de lutte contre la Tuberculose (LNR); de 50 lames collectées au hasard dans les centres de santé de Dakar. Résultats: Il ressort de cette étude qu'il n'y avait pas de lien statistiquement significatif entre les facteurs de risque d' erreurs tels que la surcharge du travail; le mauvais état du microscope; le manque de compétence et les erreurs observées dans certains laboratoires. Par contre l'aspect des frottis; l'épaisseur des frottis et la présence de cristaux pouvait altérer la qualité de la microscopie car on a trouve qu'il existait une liaison statistiquement significative entre la qualité de la microscopie et ces différents déterminants. Par ailleurs on a noté une bonne concordance des résultats de ces laboratoires avec ceux du LNR (test Kappa = 0;981; p 0;0001). Conclusions : Au vu de ces résultats; nous recommandons : un renforcement des compétences (formation/recyclage) régulier des laborantins et une mise en place d'un système de contrôle de la qualité de la microscopie; interne au sein des laboratoires mais aussi externe par le biais du Laboratoire National de Référence

Controle de qualite inter-laboratoires centraux pour le diagnostic microscopique de la tuberculose a Madagascar en 2000

"Tuberculosis diagnosis by microscopy in Madagascar : quality control comparison of the two central laboratories"" : Since June 1997; a quarterly quality control of sputum smear exam for the tubercle diagnosis; depending on double reading of slides; was implemented between both central laboratories of the Mycobacteria National Reference Centre in Madagascar (mycobactoria laboratories of Institut Pasteur Madagascar [IPM] and Institut Hygiene Sociale [IHS] - Health Ministry). In 2000; four controls were done; in the course of which 240 slides were coloured by auramine; coming both from IPM and IHS; and another 80 slides from IHS were coloured by Ziehl-Neelsen. All the results were in agreement for the samples stained with auramine; while two false negatives were found for the samples stained with Ziehl-Neelsen. The maintenance of this quality control between the two laboratories is necessary to insure the reliability of their results and the controls that they make for the peripheral laboratories."

Intérêts et difficultés de la microscopie pour le diagnostic de présomption de la peste

Le diagnostic bactériologique de la peste est basé sur la microscopie et l'isolement de Yersinia pestis à partir de prélèvements suspects. Lorsque la culture et l'inoculation à la souris sont négatives, l'examen direct du frottis permet de poser un diagnostic de présomption de peste. Examen simple à réaliser a priori, la microscopie pose cependant de réelles difficultés de lecture et de reproductibilité entre deux laboratoires. Cette étude compare les résultats obtenus au Centre Hospitalier Universitaire (CHU) de Mahajanga et au Laboratoire Central de la Peste (LCP), lors des deux épidémies successives de peste en 1995 et 1996.En prenant la culture comme référence, la microscopie réalisée à Mahajanga est plus sensible mais moins spécifique que celle réalisée au LCP. Entre l'année 1995 (350 patients) et 1996 (245 patients), la concordance entre les 2 laboratoires s'est améliorée, passant de 55% à 75%. Malgré une sensibilité et une spécificité assez faibles par rapport à la culture (elle-même peu sensible aussi en raison des conditions de transport des prélèvements), la microscopie conserve toute sa valeur pour le diagnostic de présomption de la peste lorsqu'elle est faite par un personnel entraîné. La solution idéale à terme sera un test immunodiagnostique simple et rapide, réalisable par des agents de santé non biologistes

Examen microscopique urinaire normal de l'adulte zairois aux Cliniques Universitaires de Kinshasa

Les objectifs ont ete de proposer une methode standardisee de l'examen microscopique de l'urine et de determiner les valeurs de reference. Cent dix-neuf echantillons recoltes lors de la premiere et/ou de la seconde miction matinale provenant de 100 sujets sains. Les urines etaient d'aspect limpide chez tous les sujets et de coloration jaune clair (58;80 pour cent); jaune fonce (27;7 pour cent) (jaune paille (13;4 pour cent). L'urine de la premiere et de la seconde miction constitue l'echantillon ideal pour l'examen microscopique urinaire. Les valeurs de reference obtenues sont comparables a celles rapportees dans la litterature. Ces resultats suscitent l'interet de la vulgarisation de la methode standardisee

Infections genitales basses a clamydia [sic] trachomatis chez la femme a Cotonou

Deux techniques de diagnostic des infections genitales basses a chlamydia trachomatis ont ete utilisees a Cotonou sur une population de 246 patientes. Il s'agit de la recherche par immunofluorescence directe a partir des prelevements endocervicaux; positive dans 15;5 pour cent des cas et de la recherche serologique par immunofluorescence indirecte; positive dans 39;13 pour cent des cas. La concordance des resultats au niveau de ces deux methodes est retrouvee dans 71;74 pour cent des cas

Inquerito-soro epidemiologico da malaria na regiao do Rio Limpopo; Mocambique

The authors present the results of a seroepid emiological survey of malaria in seven villages of the Limpopo river balley (Mozambique); in some of which the fight to the endemy has already started a few years ago. The methods used was that of immunofluorescence