Asymptomatic Bacteriuria amongst Geriatrics in Calabar, Cross River State, Nigeria.

Aims: To investigate the prevalence of asymptomatic bacteriuria among Geriatric patients in Calabar, the predisposing factors associated with this infection, the incriminating bacterial pathogens and their antibiotic susceptibility pattern. Study Design: Ethical approval, consent from the patients, questionnaire administration, collection and processing of clean catch mid-stream urine specimens. Place and Duration of Study: Calabar, the capital city of Cross River State, Nigeria between May, 2014 and February, 2015. Methodology: Urine samples from randomly selected 200 subjects (92 men and 108 women) between the ages of 60 to 90 years were cultured by Leigh and Williams’s method. Questionnaires were also administered. Results: 92 (46%) subjects had asymptomatic bacteriuria. Subjects between the age group 71 – 75 years had the highest level of infection but the difference was not statistically significant (P=0.165). Females 52 (48.1%) were more infected than the males 40 (43.4%) but this was not statistically significant (p=0.641). Among the diabetics only 22 (47.8%) had infection while 20 (41.6%) hypertensive subjects had infection. There was a negative correlation between diabetic subjects and the presence of infection (r=-0.2) and also a negative correlation between the hypertensive subjects and the presence of infection (r=-0.3). Escherichia coli 24 (26.1%) and Proteus spp 24 (26.1%) were the most commonly isolated bacteria. Conclusion: This work revealed a high prevalence rate of asymptomatic bacteriuria among geriatric subjects in Calabar but no association between infection and diabetes or hypertention was observed.

Cytological Findings in Urine of Adult Residents of Urinary Schistosomiasis Endemic Community in Cross River State, Nigeria.

Aims: To investigate urinary cytological abnormalities among adult residents of a urinary schistosomiasis endemic community. Study Design: Ethical approval, consent from the village Head/villagers, parasitological survey and cytological analysis of urine. Place and Duration of Study: Adim Community in Cross River State, Nigeria between May and November 2014 Methodology: Urine samples from 160 sex matched adults aged 18–85 years were examined using standard parasitological techniques for the presence of ova of Schistosoma haematobium. The urine smears were stained with Papanicolaou and Alcian Blue (PH 2.5) staining techniques and examined for cytological abnormalities and the presence of Hyaluronic acid respectively. Results: 18 (11.3%) subjects were infected. Subjects in the age groups >35 – 45 years had the highest prevalence rate 9(20.5%) while those in the age group >75 – 85 years had the lowest prevalence rate 0(0%) and the difference was statistically significant (P = 0.359). The infection rate was higher among females 11(12.5%) than the males 7(9.7%) but the difference was not statistically significant (P = 0.580). Males had a higher mean egg count (18±25.7 egg/10 ml of urine) than the females (17±15.5 egg/10 ml of urine). Subjects in the age group >35–45 years had the highest level of abnormal epithelial cells 1(11.1%). Males had a higher prevalence of abnormal cells 3(42.9%) than the females 1(9.1%). There was a positive correlation between the occurrence of infection and abnormal epithelial cells (r = 0.5). 3(1.9%) of the subjects were positive for hyaluronic acid. Male subjects had a higher level of epithelial cells positive for hyaluronic acid 2(2.8%) than the female subjects 1(1.14%) but this was not statistically significant (p<0.05). Conclusion: This study has reconfirmed the endemicity of urinary schistosomiasis and has also revealed the presence of abnormal epithelial cells as an indicator for bladder cancer in the urine of residents in Adim community.

Height as a Surrogate for Bodyweight for Estimating the Dosage of Praziquantel and Artesunate in theTreatment of Urinary Schistosomiasis in School-Age Children

World Health Organization recommends mass treatment of all school children in areas where the prevalence of schistosomiasis is greater than 50. Praziquantel and artesunate are reported to display broad-spectrum antischistosomal activities. Since the susceptibilities of the different stages of schistosomes to the two drugs are distinctively different; it has been established that the use of these two drugs in combination will be beneficial for the treatment of urinary schistosomiasis. Dosage is determined by weight; which can be difficult to determine in field conditions. The use of calibrated height meter with height-based dosage calibration will make the work less cumbersome in field settings. Data on age; weight; and height from 264 school children who were screened and found to be infected with Schistosoma haematobium; diagnosed by the presence of the ova in their urine; were used to predict an alternative to bodyweight and thus the dosage of praziquantel and artesunate required to treat this disease. A very strong positive correlation (r = 0.8) was obtained for the height of treated children measured against weight while a moderately positive correlation coefficient (r = 0.6) was obtained for weight against age measurements; depicting that height can be used in lieu of weight for correct dose determination. A height meter calibrated with the equivalent number of tablets of praziquantel and artesunate could thus be used as a simple measurement to determine the dosage of praziquantel and artesunate needed to treat children in the field. This calibrated height will expedite treating large population of children in mass treatment campaigns in an endemic community

Histochemical Characterization of Rain-Forest Strain of Onchocerca Volvulus Microfilariae Isolated in Akamkpa; Cross River State; Nigeria

The histochemical characterization of rain-forest strain of Onchocerca volvulus isolated in Akamkpa of Cross River State; Nigeria was studied. In a preliminary survey of 350 persons from eight villages; 75(21.4) were found to be positive for the parasite. Males (23.6) were more infected than the females but there was no statistically significant difference in the presence of infection by gender (p=0.506). Staining pattern of the parasite using Lead nitrate method for the demonstration of acid phosphatase activity revealed that of the six patterns; four corresponded to the enzyme types already described by some authors in West African rain-forest; and Sudan. One corresponded to the type found in Guinea savannas while the remaining did not correspond to any of the strains described elsewhere. The multiple enzyme staining patterns of Onchocerca volvulus microfilariae in the study area is indicative of polymorphic strain than that of West African strains. This variation in strain might contribute to the degree of pathogenicity and clinical manifestation of onchocerciasis in this endemic zone

Prevalence of Urinary Schistosomiasis among School Children in Ukwelo-Obudu and Abini communities in Cross River State; Nigeria

Background: The prevalence and intensity of Schistosoma haematobium infection were studied in Ukwelo-Obudu; and Abini communities of Cross River State; Nigeria. Aim: To screen for the presence of ova of S. haematobium in the urine of school children in the two communities. Method: Six hundred urine specimens (400 in Abini and 200 in Ukwelo-Obudu community) were collected by random sampling from school children aged 5-17 years from the two communities and screened for ova of Schistosoma haematobium by filtration of urine and counting of filtered carbol fuchsin-stained eggs of Schistosoma haematobium. Retrospective study of Schistosoma haematobium infection was also carried out in Ukwelo-Obudu community. Results: Infection with S. haematobium was not found in Ukwelo-Obudu whereas in Abini community; a prevalence of 4.5was found. The highest prevalence of infection (7.7) occurred in the age group of 11-13 years. There was a strong positive correlation between the presence of infection (ova of S. haematobium) and existence of haematuria (r = 0.81) and proteinuria (r = 0.71) in Abini community. There was a statistically significant difference in the prevalence of proteinuria between male and female subjects examined (P=0.0008). A retrospective study of Schistosoma haematobium infection in Ukwelo-Obudu community showed 2006 as the year with the highest record of infection [11(35.5)] whereas the year 2004 recorded the lowest number of infection. Conclusion: This study has revealed a low prevalence of Schistosoma haematobium infection in Abini and the absence of infection in Ukwelo-Obudu communities respectively