Parvovirus B19 antibodies and correlates of infection in pregnant women attending an antenatal clinic in central Nigeria

Human parvovirus B19 infection is associated with spontaneous abortion, hydrops foetalis, intrauterine foetal death, erythema infectiosum (5th disease), aplastic crisis and acute symmetric polyarthropathy. However, data concerning Nigerian patients with B19 infection have not been published yet. The purpose of this study was to establish the prevalence of B19 IgG and IgM antibodies, including correlates of infection, among pregnant women attending an antenatal clinic in Nigeria. Subsequent to clearance from an ethical committee, blood samples were collected between August-November 2008 from 273 pregnant women between the ages of 15-40 years who have given their informed consent and completed self-administered questionnaires. Recombinant IgG and IgM enzyme linked immunosorbent assay kits (Demeditec Diagnostics, Germany) were used for the assays. Out of the 273 participants, 111 (40.7 percent) had either IgG or IgM antibodies. Out of these, 75 (27.5 percent) had IgG antibodies whereas 36 (13.2 percent) had IgM antibodies, and those aged 36-40 years had the highest prevalence of IgG antibodies. Significant determinants of infection (p < 0.05) included the receipt of a blood transfusion, occupation and the presence of a large number of children in the household. Our findings have important implications for transfusion and foeto-maternal health policy in Nigeria. Routine screening for B19 IgM antibodies and accompanying clinical management of positive cases should be made mandatory for all Nigerian blood donors and women of childbearing age.

Association Between Neuropsychiatric Morbidity and Streptococcal Infections in Children.

We conducted a case control study to study the association between neuropsychiatric morbidity and group A streptococcal infections in children. Twenty two cases of neuropsychiatric morbidity were compared with 64 controls. Fourteen (63.6%) of the 22 cases were positive for ASO and/or ADNB while 21 of the 64 controls (32.8%) were positive for either or both antibodies (OR = 3.428; CI: 1.15 – 10.18; P=0.026). We conclude that there is a statistically significant association between neuropsychiatric morbidity and streptococcal infection in children.

Comparative effectiveness of tepid sponging and antipyretic drug versus only antipyretic drug in the management of Fever among children: a randomized controlled trial.

OBJECTIVE: To compare the effectiveness of tepid sponging and antipyretic drug versus only antipyretic drug among febrile children. DESIGN: Randomized controlled trial. SETTING: Tertiary care hospital. PARTICIPANTS: 150 children 6 mo - 12 yr age with axillary temperature 101F. INTERVENTION: Tepid sponging and antipyretic drug (Paracetamol) (n=73) or only antipyretic drug (Paracetamol) (n=77). MAIN OUTCOME MEASURES: Reduction of body temperature and level of comfort. RESULTS: The reduction of body temperature in the tepid sponging and antipyretic drug group was significantly faster than only antipyretic group; however, by the end of 2 hours both groups had reached the same degree of temperature. The children in tepid sponging and antipyretic drug had significantly higher discomfort than only antipyretic group, but the discomfort was mostly mild. CONCLUSION: Apart from the initial rapid temperature reduction, addition of tepid sponging to antipyretic administration does not offer any advantage in ultimate reduction of temperature; moreover it may result in additional discomfort.

Human immunonodeficiency virus, hepatitis B virus and hepatitis C virus: sero-prevalence, co-infection and risk factors among prison inmates in Nasarawa State, Nigeria

Background: Published data on HIV; HBV; and HCV in correctional facilities in Nigeria is scarce. We set out to establish the seroprevalence; co-infection; and risk factors for these infections for the first time among prison inmates in Nasarawa State; Nigeria. Methodology: In a cross-sectional study conducted between April and May; 2007; blood samples were collected from 300 male prisoners of a mean age of 29.2 years; in the state's four medium-security prisons (overall population: 587). Prior to the study; ethical clearance and informed consent were obtained and structured questionnaires were administered. Samples were analyzed for HIV; HBsAg; and HCV using anti-HIV 1 +2-EIA- avicenna; ShantestTM-HBsAg ELISA; and anti-HCV-EIA-avicenna; respectively. Specimens initially reactive for HIV were retested with vironostika microelisa. Data were analyzed using SPSS version 13.0. P values = 0.05 were considered significant. Results: Of the 300 subjects; 54 (18.0); 69 (23.0); and 37 (12.3) tested positive for HIV; HBV; and HCV; respectively. Co-infections were eight (2.7) for HIV/HBV and two (0.7) for HBV/HCV. Those aged 21-26 years were more likely to be infected with HIV and HBV; while those aged 33-38 years had the highest HCV infection. Associated risk factors included duration in prison; previous incarceration (for HIV; HBV and HCV); intra-prison anal sex; multiple sex partners (for HIV and HBV); ignorance of transmission modes; blood transfusion; and alcohol consumption (for HBV and HCV). No inmate injected drugs. Conclusions: The overall outcome represents the need for prison-focused intervention initiatives in Nigeria. Injected drug use is an unlikely major transmission mode among Nigerian inmates

Acute pancreatitis in a child with idiopathic ulcerative colitis on long-term 5-aminosalicylic acid therapy.

Acute pancreatitis is a rare but known complication of inflammatory bowel disease in adults. In children, only a few cases with this complication have been reported. We describe a 10-year-old boy with ulcerative colitis who developed acute pancreatitis while on long-term treatment with 5-aminosalicylic acid.

Evaluation of an ELISA for the diagnosis of brucellosis.

Brucela serology using ELISA and standard agglutination test was performed on 23 patients with prolonged fever where the test was requested, on 26 randomly chosen patients with prolonged fever where it was not requested and on 17 controls. ELISA was positive in 39.1, 26.9 and 0 per cent respectively in these groups. Brucellosis may often be unsuspected because of its varied clinical manifestations and may be a more important cause of fever than previously considered. Our data reaffirm that ELISA is superior to the standard agglutination test for the diagnosis of brucellosis.