Knowledge of, and Attitude towards Breast Cancer aetiology and Breast Self-examination among female students in a Tertiary Institution in South Western Nigeria

@#Breast cancer (CA) is the commonest malignancy occurring in women, and constitutes a major disease burden in low income countries of the world, including Nigeria, where the mortality rates are high. A good knowledge of the etiological risk factors, coupled with the uptake of screening tests, are important in attaining prevention of breast CA and also reducing the morbidity and mortality associated with the disease. This study therefore set out to assess the knowledge and attitude of the female students of a tertiary institution in South-western Nigeria towards breast cancer etiology and breast-self-examination (BSE). This was a descriptive cross-sectional study that recruited 350 respondents using multi-stage sampling technique. The study instrument was a pre-tested, semi-structured, self-administered questionnaire. Data analysis was done using IBM SPSS version 20 and results were presented using frequency tables and charts. Chi square tests and logistic regression analyses were also done as appropriate. Majority (80.6%) of the study respondents had heard of breast cancer, 78.4% of which had poor knowledge about breast cancer etiology and about two-thirds of these had a good attitude towards BSE. Only 18 (6.4%) of the 282 respondents who had ever heard of breast CA knew how to perform BSE correctly, while only 159 (56.4%) of them had ever carried out BSE. Age, knowing anyone with breast CA, previous exposure to information on BSE, and previous clinical breast examination were found to have statistically significant association with respondents’ knowledge of, and attitude towards BSE. The study respondents generally had a poor level of knowledge of breast CA etiology, older respondents showed better attitude towards BSE, and only a few knew how to perform BSE correctly. We recommend the early introduction of breast CA prevention education to female students in high school.

Baseline anthropometric measurements and obesity among students in Sagamu, Ogun State, southwest, Nigeria

Objectives: This study was designed to determine the anthropometric characteristics and prevalence of obesity among secondary and undergraduate students in Sagamu. Methods: This cross-sectional study involved a selection of 260 students aged 10 to 33 years in Sagamu using a convenience sampling method. The weight, height, and waist and hip circumferences of each subject were measured. The body mass index was then calculated. Data were analyzed using SPSS version 25.0 and p-values< 0.05 were considered statistically significant. Results: The age ranges were 1o to 17 years (Secondary school (SS) students) and 14 to 33 years (undergraduate students). There were 130 students in each group, comprising 52.7% males and 47.4% females. Underweight was commoner among the SS students (20.8% versus 6.2%). Most of the subjects were of normal weight 52.3% in SS and 68.5% in undergraduates. Only 3.1% of SS students were obese compared to 4.6% of undergraduate students. The mean BMI of SS students (22.2± 0.39 versus 23.24±0.34) was statistically lower (p=0.019). The mean waist circumference of SS students (66.92±0.44 versus 74.64±0.67) was also statistically lower (p=0.000). The mean BMI of SS students was higher in females than in male subjects (23.14±0.62 versus 20.86±0.42). The mean waist and hip circumferences and BMI were lower in female subjects for both study groups. Conclusions: The mean BMI and hip circumferences were higher in female subjects while the mean waist circumferences were lower in females than males in both study groups.

Functional iron status of chronic kidney disease patients at the University of Ilorin Teaching Hospital, Ilorin, Nigeria

Background: Functional iron deficiency has been found to be a common cause of poor response to erythropoiesis stimulating agents in anaemic patients with chronic kidney disease (CKD). Objectives: Assess the functional iron status of patients with chronic kidney disease. Methods: This was a hospital based cross sectional study. The study subjects were chronic kidney disease patients with age and sex matched healthy controls. Full blood count, serum ferritin, soluble transferring receptor, C-reactive protein, serum iron and total iron binding capacity were measured in the patients and healthy controls. Data was analyzed with statistical package for the social sciences software version 22.0. And the level of statistical significance was set at p. value < 0.05. Results: The mean ± SD of the age of patient with CKD was 55.0 + 15.4 years, while that of controls was 52.7 + 13.6 years. The mean serum ferritin, serum iron, TIBC and CRP were significantly higher in patients compared with controls (p<0.001, 0.023, <0.001 and 0.001) respectively. Functional iron deficiency was seen in 19.5% of patients with CKD. Conclusion: The predominant form of iron deficiency in our study was functional iron deficiency

Antiretroviral service delivery at selected community pharmacies in Akwa Ibom State, Nigeria

Community-based Antiretroviral Therapy models have the potentials of providing better coverage, improvingtreatment uptake, and producing good clinical outcome. This study was aimed at assessing the quality of antiretroviralservice delivery at selected community pharmacies in Akwa Ibom State, Nigeria. A systematic cross-sectionalstudy was carried out among Human Immunodeficiency Virus/AIDS clients devolved from hospitals to communitypharmacies for antiretrovirals refills. Community pharmacy with the highest number of clients was selected fromeach of the three senatorial districts of the State. A pre-tested questionnaire was used to obtain socio-demographiccharacteristics, medical and pharmaceutical data, devolvement information, quality of services received, and level ofclients’ satisfaction. Data collected were expressed as proportions and presented graphically. All the participants hadviral load well controlled below 1,000 cells/ml; and 99.43% were on Tenofovir/Lamivudine/Efavirenz or Zidovudine/Lamivudine/Nevirapine, while only 0.57% was on Abacavir/Lamivudine/Efavirenz. As a response to reason foraccepting devolvement, “shorter waiting time” had the highest frequency, while “proximity to residence” had thelowest frequency. Drug pick-up time in hospital ranged from 4 to 10 hours, while in pharmacy, it ranged from 0 to2 hours. Majority of the participants (88.24%–100.00%) from the different districts were satisfied with the differentservices received at the community pharmacies. “Very likely” as the likelihood of recommending the program forothers had the highest frequency. The clients were well controlled on the first line antiretrovirals and were satisfiedwith the services received during medication refill.

Gynaecological bacterial infections: the physical and psychosocial consequences and challenges of management in resource-limited settings

Gynecological bacterial infections (GBIs) are prevalent in our environment and as a result pose a number of physical, social and psychological consequences. These infections are acquired through several ways. Treating GBIs is a daunting task making its control the most important strategy to alleviating its physical and psychosocial consequences. To highlight the physical, social, and psychological consequences of gynaecological bacterial infections in our resource limited setting. To highlight the hugely unresolved challenges associated with the management of gynecological bacterial infections in our resource-limited setting. Several databases (Medline, Google Scholar, Pubmed, WHO’s Hinari and Wikipedia) and some selected websites were searched using the following keywords: gynecological infections, vaginal infections and discharges, vaginal flora, sexually transmitted infections, pelvic inflammatory disease, syndromic management and challenges, psychosocial consequences, alternative medicine. A total of 5470 relevant articles were obtained between 1947 and 2018. Out of these only 256 relevant articles on the topic were reviewed. However, 213 were dropped for having an incomplete submission. Forty-three (43) articles were fully accessed and referenced. The high prevalence of GBIs poses a lot of burden on the reproductive and socio-economic lives of our women. This should be matched by behavioral changes, prompt diagnosis and early treatment; facilitated by accessible and affordable health care through improved government funding.

Burden, psychological well-being and quality of life of caregivers of end stage renal disease patients

BACKGROUND: Caregivers of chronic kidney disease (CKD) patients play an important role in the management of the patients. Their psychological needs are often overlooked and unmet by the managing team. This study assessed the psychosocial well-being and quality of life (QoL) of caregivers of CKD patients in two hospitals in Southern Nigeria. METHODS: Burden of caregiving, QoL, depression, and anxiety were assessed using standardized instruments; modified Zarit questionnaire, modified SF-12 questionnaire and Hospital Anxiety and Depression Scale (HADS) respectively among caregivers of CKD patients on maintenance haemodialysis and controls. RESULTS: Fifty-seven caregivers of CKD patients and aged and sex-matched controls participated in the study. Anxiety was significantly higher in caregivers compared to control (31.6% vs 5.3%, p = 0.004). Also, depression was significantly higher in caregivers (31.6% vs 3.5%, p= <0.001). Twenty-eight (49.1%) of the caregivers had mild to moderate burden and 19 (33.3%) had a high burden. The mean Zarit burden score was higher in female caregivers compared to male caregivers (18.30±8.11 vs 14.83±6.70, p = 0.09). The mean depression score was higher in female caregivers compared to male caregivers (8.58±3.83 vs 6.75±3.80, p= 0.08). There was significant positive correlation between Zarit burden and hospital anxiety score (r = 0.539, p= < 0.001) and depression score (r = 0.472, p = 0.005). CONCLUSION: Depression, anxiety and burden were common among caregivers of CKD patients especially females compared to controls. Supportive interventions for these caregivers should be included in treatment guidelines in order to improve overall patients' outcome

Proliferative effect of the calcium channel blocker Nifedipine on human embryonic kidney cells

Background: Numerous epidemiological studies have shown a positive as well as negative association between chronic use of calcium channel blockers and the increased risk of developing cancer. However, these associations were enmeshed with controversies in the absence of laboratory based studies to back up those claims. The aim was to determine in mechanistic terms the association between the long-term administrations of nifedipineand increased risk of developing cancer with the aid of human embryonic kidney (HEK293) cell line.Methods: Cell counting using the Trypan blue dye exclusion and 3-[4, 5-Dimethylthiazol-2-yl]-2, 5-diphenyl-tetrazolium bromide (MTT) assays were used to investigate the effect of nifedipine on the growth pattern of HEK293 cells.Results: Nifedipine had a proliferative effect on HEK293 cells growth and this proliferation is more profound at low concentrations of nifedipine than high concentrations and the proliferation was statistically significant (p<0.01).Conclusions: The chronic use of nifedipine is associated with increased proliferation of cells with concomitant elevation of polyamines concentration and elevated polyamine levels have been implicated in many malignant transformations and hence, these provide possible explanation on the link between long term use of nifedipine and development of some human cancers.

Avulsión de bronquio fuente derecho debido a traumatismo torácico cerrado / Right main bronchus avulsion due to thoracic blunt trauma

La incidencia de roturas traqueobronquiales secundarias a un traumatismo torácico cerrado es baja, y la mayoría de estos pacientes no llegan con vida a los centros de atención hospitalaria. La presentación clínica es variable dependiendo de la localización de las lesiones, los daños asociados y si las estructuras peribronquiales permanecen íntegras. Para su diagnóstico temprano se debe tener un alto índice de sospecha clínica y una correcta interpretación de los hallazgos semiológicos y radiológicos, lo que permite su rápida y correcta resolución. La demora en el tratamiento aumenta tanto la mortalidad como las complicaciones tempranas y tardías.

The incidence of tracheobronchial ruptures secondary to blunt thoracic trauma is low and most affected patients do not arrive alive to hospitals. Clinical presentation varies with the location of lesions, associated injuries and whether the peribronchial structures remain intact. Early diagnosis requires a high index of clinical suspicion and a correct interpretation of semiologic and radiologic findings, which allows for a rapid and correct resolution. Delay in treatment increases the mortality as well as early and late complications.

Perceived and Normative Needs of Facial Cleft Patients Seen in Nigeria

Objective: To evaluate the pattern of presentation and assessing treatment needs of children with facial clefts. Material and Methods: This was a cross sectional study of 49 patients seen at the cleft clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife for a 39-month period of study. Data collected were patient's bio-data including age, date of birth, sex, social class, age of parents, dental findings, associated malformations, treatment given and referral using an interviewer-administered questionnaire. Data was analyzed using the Statistical Package for Social Sciences. Frequency distributions were carried out for all variables and the Pearson Chi-Square Test was applied to assess the significance of differences between groups at a p value of 0.05. Results: Cleft lip and palate had the highest preponderance 23 (47.0%) followed by cleft lip 14 (28.6%) and cleft palate 12 (24.5%). There were more females 28 (57.14%) than males 21 (42.9%) at male to female ratio of 3: 4, though; it was not statistically significant (p-0.73). Most of the patients (73.5%) belong to the low social class. The high social class had 13 (26.5%) cases. Conclusion: The most important treatment needs of cleft patients in this study were: review/follow-up of treatment protocol, oral hygiene instructions, cleft palate repair, cleft lip repair, and referral to the Orthodontist for treatment of varying degrees of malocclusion in descending order. This trend in the treatment needs arose because most of the patients were still ignorant of the implications of managing facial cleft defects through the multi-disciplinary treatment approach.

Impact of Single Dose Praziquantel Treatment on Schistosoma haematobium Infection among School Children in an Endemic Nigerian Community

Schistosomiasis is prevalent in Nigeria, and the foremost pathogen is Schistosoma haematobium, which affects about 29 million people. Single dose of the drug praziquantel is often recommended for treatment but the efficacy has not been documented in certain regions. Therefore, this study was designed to assess the impact of single dose praziquantel treatment on S. haematobium infection among school children in an endemic community of South-Western Nigeria. Urine samples were collected from 434 school children and 10 ml was filtered through Nucleopore filter paper before examination for egg outputs by microscopy. The prevalence was 24.9% at pre-treatment. There was no statistically significant difference for the prevalence of infection between males (14.7%) and females (10.2%), although the mean egg count for the females (9.87) was significantly more (P < 0.05) than the males (6.06). At 6 and 12 months post-treatment there was 74.4% and 86.4% reduction in the mean egg count, respectively. Interestingly, an increased prevalence of infection from 2.1% at 6 months to 7.7% at 12 months post-treatment was observed, nonetheless the mean egg count was reduced to 0.27 at 12th month from 1.98 at 6 months post-treatment. Resurgence in the prevalence rate between 6 and 12 months post-treatment with praziquantel is herein reported and the need for a follow-up treatment in endemic areas for adequate impact on schistosomiasis control is discussed.

Safety and Health Perceptions in Work-related Transport Activities in Ghanaian Industries

BACKGROUND: With the recent rapid industrialization, occupational safety and health (OSH) has become an important issue in all industrial and human activities. However, incidents of injuries and fatality rates in the Ghanaian industry sector continue to increase. Despite this increase, there is no evidence regarding the element of OSH management in transport activities in Ghanaian industries. Thus, this study aims to examine the perceptions regarding the importance of safety and health in work-related transport activities in Ghanaian industries. METHODS: A survey data collection technique was used to gather information on best safety practices over a 5-month period. We randomly selected 298 respondents from industries to answer structured questionnaires. The respondents included drivers, transport managers, and safety engineers. Standard multiple regression model and Pearson product–movement correlation were used to performed the analysis. RESULTS: The result shows that for interventions to improve safety and health, concentration has been on drivers’ safety practice with less attention to safe driving environments and vehicle usage. Additionally, the respondents are aware of the importance of OSH in transport activities, but the level of integration does not measure up to the standard to reduce operational accidents and injuries. Finally, strong commitment to changing unsafe practices at all levels of operations appears to be the effective way to improve safety situations. CONCLUSION: OSH culture is not fully complied in industries transport activities. This study, therefore, supports the use of safety seminars and training sessions for industry workers responsible for transport operations for better integration of safety standards.

Multidetector computed tomography scan for renal cell carcinoma: A review

Renal cell carcinoma (RCC) is the most common renal malignant tumour. Owing to its retroperitoneal location, RCC remains asymptomatic and non-palpable until advanced disease develops. Most cases are identified during radiological examination for other reasons. The management of RCC depends substantially on the effective use of imaging. This is true in all the stages of the RCC, from initial diagnosis to follow-up. This article sets to review the current knowledge about multidetector computed tomography (MDCT) scan and how it characterises the RCC. A search of PubMed database was made to locate the original and review articles in English that address the MDCT scan or RCC, without limit to publication date. Relevant articles and textbook chapters were reviewed, analysed and summarised. MDCT reveals the renal tumour, its extent, venous involvement, status of loco-regional lymph nodes as well as adrenal and liver extension. It is available and relatively affordable presently in some centres across the subregion. MDCT is an essential tool that has aided not only the early diagnosis of RCC, but also the staging and characterisation of the RCC

Lubricating effects of cocoa butter and coconut oil in conventional paracetamol tablets

Background: Due to chemical instability of some Active Pharmaceutical Ingredients often caused by magnesium stearate and its impurities, it is expedient to research into some other materials especially of natural origin, which would probably exhibit better lubricating activity, chemically inactive, less bioactive and less prohibitive.Objective: This work is designed to examine the lubricating properties of cocoa butter and coconut oil as alternative lubricants in comparison with conventional lubricant - magnesium stearate at different concentrations in paracetamol tablets. Materials and Methods: Cocoa butter was extracted from the seeds of Theobroma cacao and coconut oil from the meat of matured coconuts harvested from the coconuts palm (Cocos nucifera).Physicochemical evaluation was carried out on the extracted oils. Thirteen different formulations were prepared using different lubricants; magnesium stearate, cocoa butter and coconut oil at 0 ­ 4 %w/w concentrations. The prepared granules were evaluated for various pre-compression characteristics (bulk density, tapped density, angle of repose, Hausner's quotient and Carr's index) and post-compression characteristics (weight variation, friability, hardness, disintegration and dissolution times).Results: Most of the values obtained from the evaluation of pre- and post- compression characteristics correlate with the pharmacopoeial limits. The values of disintegration time were observed to increase as the lubricant concentration increased but no direct relationship with dissolution time. Tablet hardness values decreased while friability increased as the lubricant concentration increased for all the batches. From the study, cocoa butter and coconut oil at 2 ­ 4 % exhibited effective lubricating effect in the formulation of paracetamol tablet with respect to their values of weight variation, friability, hardness, disintegration and dissolution times.Conclusion: Cocoa butter and coconut oil could be employed as good alternative lubricants to the conventional ones in pharmaceutical tablet formulation

The disposal pattern of domestic medical and pharmaceutical waste in Uyo Metropolis, Southern Nigeria

Abstract: The evaluation of waste treatment practices is an important step in the design interventions to improve the health status of municipalities. Objectives: The purpose of this study was to evaluate national practices in the treatment (disposal) of medical and pharmaceutical waste by households in the Uyo metropolis in Nigeria; and to provide a Informal education on appropriate practices for the community. Methods: The city was delimited into three zones A, B and C equivalent respectively to residential districts High income, middle income and low income. In total, 140 households were selected at random in the zones (40 households each of zones A and B and 60 of zone C). The sampling unit was the head or the representative of each household. A self-administered self-administered questionnaire was used to assess practices for the disposal of domestic medical and pharmaceutical wastes. The chi-square test was assessed differences in disposal practices between the three zones. A p value less than 0.05 was considered significant. Results: The majority of households disposed of medical and pharmaceutical waste with garbage. The rates of households involved in this practice ranged from 85% to 96.67% for medical waste and 73.34% to 82.5% for pharmaceutical waste. Only a small proportion eliminated medical waste by burning or burying them. Disposal by incineration was not practiced at all in the population studied. There was no significant difference in waste disposal practices between the three areas. Conclusion: The waste was not sorted before disposal. The recommended methods were not followed for the disposal of medical and pharmaceutical waste. Disposal of medical waste domestic products, especially sharps, does not meet the international standard

High Doses of PDE5 inhibitors and tramadol reversibly alters haematological parameters in rats.

This study examined the effect of chronic administration of PDE5 inhibitors and tramadol on haematological indices because of their reported high incidence of abuse. Additionally, the possibility of reversal of negative effects following withdrawal of treatment was examined. Fifty male rats (180 - 200g body weight) were grouped into five (n = 10), namely: control, sildenafil, tadalafil, tramadol and sildenafil+tramadol group. The different groups were orally treated with 0.2mL normal saline, sildenafil (1 mg/100gb.w.), tadalafil (1 mg/100gb.w.), tramadol (2 mg/100g b.w.) and sildenafil + tramadol (1 &2 mg/100gb.w. respectively). Treatment was done thrice a week, for 8 weeks and the animals were allowed access to feed and water ad libitum. Five animals were sacrificed per group, while the remaining 5/group continued for another 8 weeks without drug administration (recovery test).Blood samples were collected from each animal via cardiac puncture at the end of both phases for assessment of haematological parameters. Red blood cells (RBC) count, haemoglobin (Hb) concentration, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), red cell distribution wide standard deviation (RDW-SD), white blood cells (WBCs) count, platelets count, mean platelets volume (MPV) and platelets large cell ratio (P-LCR) were significantly reduced in all the treated groups compared with the control. Following withdrawal of treatment, RBC count, Hb concentration, PCV and red cell absolute values were significantly increased in all recovery groups compared with their respective treated groups. Haematological alterations were reversed following withdrawal of treatment. However, platelet indices were poorly reversed in sildenafil and tramadol recovery groups.

Is There a Significant Renal Sonographic Difference between HIV/AIDs Positives and Negatives? A Developing Country Perspective.

Background/Objectives: HIV/AIDS is a major health problem in the developing countries. It is a known cause of kidney failure especially in patients with HIV-Associated Nephropathy (HIVAN). Ultrasonography is a cheap and readily available imaging modality that is invaluable in evaluating the kidneys. Its value in pathological inference of HIV-associated renal diseases in developing countries is well known. Renal diseases in HIV/AIDS patients in developing countries are often underdiagnosed and often identified only at its end stage. In this study, we aim to identify, document and correlate the pre-intervention sonographic features of diseased kidneys of adult HIV/AIDS patients between the ages of 18 and 65 years. Methods: This study was conducted as a prospective & descriptive study to assess the sonographic features in kidneys of 219 HIV-seropositive adults aged between the ages of 18 and 65 years; matched (age & sex), with 219 controls. A 3.5-5.0 MHz curvilinear transducer on a mobile ‘ALOKA’ ultrasound machine was used in the study. Comparison of the findings between HIV-seropositive adults and the controls was done using the chi-square and student T-test analysis to determine any statistical significant difference. Results: Of 219 HIV+ patients studied, 149(68%) were females with an overall mean age of 38.36 years. The modal age group was the 30 – 39 years with a frequency of 94(42.9%). Observed significant features of HIVAN include nephromegaly, increased parenchymal echogenicity and decreased corticomedullary differentiation. Conclusion: The renal sonographic findings in HIV-seropositive research participants are similar to those from other studies within and outside Nigeria. Ultrasound can be a useful tool in the management and care of HIV/AIDS patients.

Combined administration of silymarin and vitamin C stalls acetaminophen-mediated hepatic oxidative insults in Wistar rats

Oxidative insult by free radicals has been implicated in drug-induced hepatic damage and this has resulted in frequent episodes of liver disorders. Therapeutic efficacy of antioxidants may provide a possible solution to this menace. This study was carried out to investigate the effect of combined administration of silymarin and vitamin C in rescuing acetaminophen-induced hepatotoxicity in rats. Hepatotoxic rats were orally administered with silymarin and vitamin C at 100 and 200 mg/kg body weight, respectively. At the end of the experiment, liver function indices, antioxidant parameters and histological analysis were evaluated. We observed that the significantly increased (p < 0.05) activities of alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, as well as levels of thiobarbituric acid reactive substances and serum total bilirubin, were markedly reduced following co-administration of silymarin and vitamin C. The compounds also effectively reversed the reduced activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase and total protein concentration in the hepatotoxic rats. These findings are indicative of hepatoprotective and antioxidant attributes of the two compounds which are also supported by the histological analysis. The available evidences in this study suggest that the complementary effects of silymarin and vitamin C proved to be capable of ameliorating acetaminophen-mediated hepatic oxidative damage and the probable mechanism is via antioxidative action.

Comparing the Effect of Two Promoters on Cassava Somatic Embryo at Transient GUS Assay Level.

35S promoter from the Cauliflower Mosaic Virus (pCaMV) is a constitutive promoter commonly used in plant genetic transformation while Cassava Mosaic Virus (pCsVMV) is another promoter which is underutilized. The combination of the two promoters was used to form (pOYE153). The method adopted includes the insertion of a β–glucuronidase reporter gene (UidA) into a promoter cassette comprising the CsVMV promoter. The second construct (pCAMBIA2310) had (pCaMV) used for the selectable marker and gene of interest. This construct was mobilized into Agrobacterium tumefaciens strain LBA4404 and then tested for expression of the UidA gene in transient assays in cassava somatic embryos. After co-cultivation of these Agrobacterium with the plant tissues, histochemical β–glucuronidase (GUS) assays were performed to determine the level of UidA gene expression in transient assays. The results showed that the pCsVMV was able to drive high gene expression of β–glucuronidase reporter gene (UidA) in the transient assays in cassava somatic embryo. Expression of the gene also increases with the increase in the day of cocultivation and likewise expression of the gene was higher for the sample in the light than the dark.

Improving quality in national reference laboratories: the role of SLMTA and mentorship

Background: The Nigerian Institute of Medical Research houses two reference laboratories: the virology and tuberculosis laboratories. Both were enrolled in the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. Objective: To describe the impact of SLMTA and discuss factors affecting the results; with an emphasis on mentorship Methods: The SLMTA programme was implemented from April 2010 through November 2012. Participants attended three workshops and executed quality improvement projects; laboratory auditors evaluated performance using a standard checklist. The virology laboratory did not receive mentorship; however; the tuberculosis laboratory had an international mentor who visited the laboratory four times during the programme; spending two to four weeks embedded within the laboratory during each visit. Results: There was an overall improvement in the performance of both laboratories; with the virology laboratory increasing 13% (from 80% at baseline to 93% at exit audit) and the tuberculosis laboratory increasing 29% (from 66% to 95%). These scores were maintained nine months later at the surveillance audit. Conclusion: The SLMTA programme resulted in improved and sustained quality management performance for both laboratories. Mentoring was a possible factor in the substantial improvement made by the tuberculosis laboratory and should be considered in order to augment the training received from the SLMTA workshops

Potential for false-positive HIV test results using rapid HIV testing algorithms

Background: In order to scale up access to HIV counselling and testing in Nigeria; an HIV diagnostic algorithm based on rapid testing was adopted. However; there was the need to further evaluate the testing strategy in order to better assess its performance; because of the potential for false positivity.Objectives: The objective of this study was to compare positive HIV test results obtained from the approved rapid testing algorithm with results from western blot tests performed on samples from the same patient.Methodology: A retrospective review was conducted of HIV screening and confirmatory results for patients seen between 2007 and 2008. Rapid test and western blot results were extracted and compared for concordance. Discordant results were further reviewed using a combination of HIV-1 RNA viral load and CD4+ cell count test results and clinical presentation from medical records. Results: Analysis of 2228 western blot results showed that 98.3% (n = 2191) were positive for HIV-1; 0.4% (n = 8) were positive for HIV-2 and 0.3% (n = 7) were dual infections (positive for both HIV-1 and HIV-2); 0.6% (n = 13) were indeterminate and 0.4% (n = 9) were negative. Further investigation of the 13 indeterminate results showed nine to be HIV-1 positive and four to be HIV-negative; for a total of 13 negative results. The positive predictive value of the HIV counselling and testing algorithm was 99.4%.Conclusion: Using the rapid testing algorithm alone; false positives were detected. Therefore; effective measures such as training and retraining of staff should be prioritised in order to minimise false-positive diagnoses and the associated potential for long-term psychological and financial impact on the patients