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Aims: Ready-to-eat [RTE] animal products like ponmo are preferred by consumers due to its palatability and quality. However, foodborne pathogens particularly Staphylococcus aureus are sources of concern due to cross-contamination of raw and cooked cowhide. This study aimed to investigate the incidence of enterotoxigenic S. aureus in ready-to-eat locally processed cowhide. Methodology: Sixty (60) RTE cowhide samples were collected from different locations in Lagos, Nigeria and analyzed using conventional microbiological and molecular techniques for the detection of toxigenic S. aureus contamination. Suspected S. aureus isolates were confirmed by the presence of thermostable endonuclease [nuc] gene in their genome. Results: Result showed that 25 (41.67%) and 20 (33.50%) samples harbored coagulase-positive S. aureus and 20 other bacterial species different from S. aureus, respectively while 15 (24.83%) of the tested ponmo samples yielded no bacterial growth. Thirteen of the 15 randomly selected from the 25 suspected isolates were confirmed as S. aureus by the presence of thermostable endonuclease [nuc] gene in their genome. Enterotoxigenic genes were confirmed in all the 13 PCR detected S. aureus. Enterotoxin B gene is most prevalent in ponmo. Multiplex PCR detection of S. aureus enterotoxins [SE] genes revealed the molecular detection of different isolates carrying staphylococcal enterotoxin types A and B, mixed strain carrying both staphylococcal enterotoxins type A and type D. Antibiotic susceptibility of 20 S. aureus isolates revealed varying degrees of susceptibility patterns against the antimicrobial agents. Generally, gentamicin 70% (14/20), azithromycin 75% (15/20), co-trimoxazole 85% (17/20), levofloxacin 95% (19/20) were the most effective antibiotics to S. aureus. A low, ?50% susceptibility was recorded to chloramphenicol 55% (11/20) and nitrofurantoin 65% (13/20). A higher resistance to streptomycin (90%; 18/20) and ceftazidime (95%; 19/20) was identified, with resistance to ceftazidime being the highest (95%; 19/20). Conclusion: It can be concluded that RTE ponmo vended in the study sites is of low hygienic quality and may be of health risk to consumers. High level hygiene practice and good manufacturing practices are required during the production, distribution and marketing of ponmo to curb the potential health consequences of eating ponmo.
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BACKGROUND: Autologous stem cell transplantation (autoSCT) can extend remission of mantle cell lymphoma (MCL), but the management of subsequent relapse is challenging.METHODS: We examined consecutive patients with MCL who underwent autoSCT at Veterans Affairs Puget Sound Health Care System between 2009 and 2017 (N=37).RESULTS: Ten patients experienced disease progression after autoSCT and were included in this analysis. Median progression free survival after autoSCT was 1.8 years (range, 0.3–7.1) and median overall survival after progression was only 0.7 years (range, 0.1 to not reached). The 3 patients who survived more than 1 year after progression were treated with ibrutinib.CONCLUSION: Our findings suggest that ibrutinib can achieve relatively prolonged control of MCL progressing after autoSCT.
Subject(s)
Humans , Delivery of Health Care , Disease Progression , Disease-Free Survival , Lymphoma, Mantle-Cell , Recurrence , Stem Cell Transplantation , Stem Cells , VeteransABSTRACT
BACKGROUND: Human Immunodeficiency virus (HIV) is a retrovirus that impairs the immune system by attacking the body's natural defense from infections and diseases. Pediatric HIV continue to be a major public health problem despite the global decline in its seroprevalence rates. The decline in the incidence of new HIV infections is particularly lower in children with a 52% reduction in the last ten years. This is attributed to a wider coverage in the use of antiretroviral therapy (ART) and the prevention of mother to child transmission of HIV (PMTCT) programs. Several programs designed at curtailing mother to child transmission of HIV are yielding positive result. This is not unexpected since most of the HIV infections among children were acquired via maternal to child transmission. With this, the study sets out to determine the prevalence of new HIV infection among patients admitted to the Emergency Pediatrics Unit (EPU) using the provider-initiated testing and counseling approach. METHODS: A prospective cross-sectional descriptive study was conducted at the mini laboratory attached to the EPU of the Dalhatu Araf Specialist Hospital Lafia Nasarawa State between 1st August 2017 to 31st July 2018. Using non-probability sampling, categorical variables were analyzed as frequencies and percentages. The association between categorical variables were analyzed using chi square.RESULTS: A total of 964 children ranging in age from two to less than eighteen years were screened. The total number of males was 550 (57.1%) while females was 414 (42.9%) with a male to female ratio of 1.3:1. Five (0.5%) children were newly diagnosed with HIV of the 964 children tested for the infection. CONCLUSION: The incidence of HIV infection among children admitted into our Emergency Pediatric Unit was 0.5%, comparable to some earlier reports
Subject(s)
HIV Infections , Health Facilities , Infectious Disease Transmission, Vertical , Nigeria , Patient Admission , Pediatric Emergency MedicineABSTRACT
Aim: To determine risk factors for first-line antiretroviral treatment failure in HIV-1 infected children attending Jos University Teaching Hospital, Jos. Study Design: Retrospective cohort study. Place and Duration of Study: Paediatric HIV clinic at the Jos University Teaching Hospital, Jos, between February 2006 and December 2010. Methodology: Data on demographic, clinical and laboratory variables for 580 HIV-1 infected children aged 2 months to 15 years on antiretroviral therapy (ART) were analysed. A comparison of the data on children with and without treatment failure was made. Variables associated with treatment failure in a univariate analysis were then fit in a multivariate logistic model to determine the factors that were associated with treatment failure. Results: The rate of treatment failure among the children was 18.8%. Previous antiretroviral drugs (ARV) exposure for treatment, not receiving cotrimoxazole prophylaxis before commencement of ART and having severe immune suppression at HIV diagnosis were the factors independently associated with treatment failure. Children with previous ARV exposure for treatment were 4 times more likely to fail treatment compared to those without previous exposure (AOR=4.20 (1.93-9.15); p <0.001). Children who did not receive cotrimoxazole prophylaxis were twice more likely to develop treatment failure compared to those who did (AOR=2.26 (1.06-4.79); p=0.03) and children with severe immune suppression at HIV diagnosis were twice more likely to develop treatment failure compared to those without severe immune suppression (AOR=2.34 (1.47-3.72); p<0.001). Conclusion: HIV-infected children with previous ARV exposure for treatment and severe immune suppression should be monitored closely and given frequent adherence counseling to minimize the risk of treatment failure. Cotrimoxazole prophylaxis should be encouraged in HIV-infected children while they await commencement of ART, which may improve ART adherence and thus reduce the risk of treatment failure.
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Aim: To determine the factors associated with a low CD4 count among HIV-1 positive patients. Study Design: Cross-sectional study. Place and Duration of Study: Adult HIV clinic at the Jos University Teaching Hospital, Jos, between October 2010 and April 2011. Methodology: Data on demographic, clinical and laboratory variables for 218 HIV-1 infected patients aged 20 years and older were analysed. A low CD4 cell count was defined as CD4 cell count <200 cells/ml based on the WHO criteria for severe immune suppression. A multivariate logistic regression modeling was fitted to determine the variables that were independently associated with a low CD4 count. Results: Of the 218 HIV-1 infected patients, 119 (54.6%) had a low CD4 count at enrolment. The odds of having a low CD4 count was: 7 times higher in patients with WHO clinical stage 3 or 4 compared to those with stage 1 or 2 (P<.001) and 4 times higher in those with HIV RNA viral load ≥4.6 log10 copies/ml compared to those with less (P<.001); but the odds of having a low CD4 count was reduced by 63% in those patients that were resident in Plateau State compared to those resident outside the state (P=.01). Conclusion: Our study patients were more likely to have a CD4 count <200 cells/ml which would suggest late presentation/ late HIV diagnosis and thus a delayed opportunity for timely access to HIV care and initiation of antiretroviral therapy. There is the need to intensify efforts in early routine HIV counseling and testing not only in health facilities in the cities but also in smaller towns and rural communities, so as to reduce the frequency of late HIV diagnosis with its potential implications.
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Aims: To determine the prevalence of non-B HIV-1 subtype specific mutations in the protease gene among antiretroviral drug-naive individuals in Jos, Nigeria. Study Design: This was a cross-sectional study in which randomly selected blood samples of HIV-1 positive anti-retroviral drug-naïve individuals were used for genotyping assay. Place and Duration of Study: The study was conducted at the adult HIV clinic of the AIDS Prevention Initiative in Nigeria (APIN) programme, Jos University Teaching Hospital (JUTH), Jos, Nigeria between October 2010 and April 2011. Methodology: Of the one hundred and five plasma samples, 100 samples were successfully reverse transcribed and amplified by nested PCR. The amplicons were directly sequenced on an automated ABI genetic analyzer using BigDye Terminator Cycle Sequencing Kit. Subtyping and phylogenetic analyses were performed using the REGA subtyping tool version 2.0 and MEGA 5.0 software. Both the Stanford HIV database algorithm and IAS-USA 2013 drug resistance update were used for interpretation of drug sensitivity. Results: The proportion of the non-B HIV-1 subtypes were as follows: CRF02_AG (48%), G (41%), CRF06_cpx (6%), A (5%). Q58E, a major drug resistance mutation to PI, occurred as a low prevalence mutation in subtype G. The most common mutations observed among the subtypes were I13V, K14R, K20I, M36I, R41K, H69K, V82I and L89M. Conclusion: A non-uniform distribution of non-B HIV-1 subtypes were observed in Jos, Nigeria, with CRF02_AG and G predominating among the antiretroviral drug-naive individuals. Among the different subtypes in circulation, there was a high prevalence of minor mutations and natural polymorphisms associated with the protease gene. Such mutations define the subtype diversity which may impact on virulence and drug ‘responses’, thus further studies are needed to evaluate the clinical implications of these mutations.
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The purpose of this study was to determine if some selected skinfold parameters are visible in predicting body density (BD) of undergraduate female students of Obafemi Awolowo University; lie Ife.Methods: Seventy five non- athletic female students; age ranged from 18 to 30 years old from Obafemi Awolowo University (OAU) lie Ife; Nigeria participated in the study. Underwater weight was measured using Hydrostatic Weighing (HSW) equipment and skinfold was measured with Lange skinfold calipers using standard protocol at chest; biceps; triceps; forearm; mid axillar; subscapular; abdomen; supra illiac; thigh and lateral calf. Body density (BD) was calculated with underwater weight and skinfold measurement using some established equations. Descriptive statistics and Pearson Moment Correlation coefficient was used to analyze the data collected.Results: The result showed that BD by HSW had significant negative correlation with skinfold at chest (r = - .505; p .001); biceps (r