ABSTRACT
Aims: A commercial rapid test kit for anti-Hepatitis C Virus (anti-HCV) detection was evaluated and compared for diagnosis of hepatitis C by detection of immunoglobulin G(IgG) antibodies against a third generation Enzyme Immunoassay(EIA) as gold standard. Methodology: A total of 560 patient serum samples were subjected to rapid screening with rapid test (immunochromatographic) strip supplied by Global Diagnostics and commercially prepared IgG capture EIA by DIA.PRO, Italy. Results: Of the 560 samples, anti HCV was detected in 31(5.54%) by ELISA, whereas only 17(3.04%) by strip method. This gives 100% specificity as no false positive was observed, but with 68.8% sensitivity. The number of false negative results was 14. The positive and negative predictive values were 100% and 97.42% respectively. Conclusion: The result pattern shows that sensitivity is compromised. It is therefore recommended that third generation ELISA is used for blood donors screening, to reduce transmission of hepatitis C virus through blood transfusion. When need arises to use strip for anti-HCV testing, such strip should be validated locally before its adoption because kits are directed against known range of strains of HCV and have minimum titer of antibody below which detection becomes impossible.
ABSTRACT
The complex interactions between Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) infections may be magnified, in the presence of another potentially stressful condition like pregnancy. Though co-infection among pregnant women is rare, treatment outcomes may depend on accessibility to comprehensive treatment modalities. The objective of this study is to determine treatment outcomes among pregnant HIV and TB co-infected pregnant women in Lagos, South-western Nigeria. This retrospective, analytical study was carried out among ninety four (94) eligible pregnant women co-infected with HIV and TB at selected health-care facilities in Lagos state between January, 2008 and December, 2009. A standard checklist for data collection was used and analysis was carried out using the EPI info software. Mean age of respondents was 30.8 (±3.9) years. Sixteen (17.1%) TB cases were clinically diagnosed for tuberculosis. Among tuberculosis cases identified through sputum microscopy, 60(63.8%) were acid fast bacilli (AFB) positive and 21(22.3%) were identified in the first trimester. The mean percentage adherence to anti-retroviral drugs was 95.9% (±5.3). None of the participant smoked cigarette. Seventy three {73 (77.7%)} had contact with TB infected or suspected person in the last three months. Treatment outcome in mother showed that 74(78.7%) were cured, 8(8.5%) relapsed while 12 (12.8%) had treatment failures. Among the babies, 83(88.3%) were born alive. Women with both poor adherence (<90%) and with positive TB contact, but neither factor alone, were half-fold less likely to be cured compared with women with both good adherence (>95%) and no TB contact (OR=0.59, CI=0.45-0.95 and p=0.014). Cure rate was substantially lower in this study. This calls for extra strategies such as routine TB screening in antenatal clinics, strict adherence to national guidelines in the treatment of HIV/TB co-infections, focused antenatal care and comprehensive Prevention of Mother to Child Transmission (PMTCT) care and treatment