An Evaluation of Platelet Factor 4, Beta-Thromboglobulin and Mean Platelet Volume in the Assessment of Thrombotic Risks in Subjects with Diabetes Mellitus at Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.

BACKGROUND: Beta-thromboglobulin and platelet factor 4 are known platelet-specific proteins that are stored in the platelet alpha-granules and released during platelet activation. The measurement of these proteins can reflect the degree of platelet activation and indirectly suggest a pro-thrombotic state. This study aimed at determining serum levels of Betathromboglobulin, mean platelet volume, and platelet factor 4 in diabetes mellitus and control subjects in Lagos, Nigeria. MATERIALS AND METHODS: Using enzyme-linked immunosorbent assay at Lagos State University Teaching Hospital, Ikeja, this study evaluated serum concentrations of Beta-thromboglobulin, and platelet factor 4, the mean platelet volume was also determined from a Full Blood Count of all participants. Data were analyzed using Statistical Package for Social Sciences, Inc., Chicago, Ill; version 26.0. The continuous variables were given as mean ± standard deviation. The P-value was considered to be statistically significant when ≤0.05. RESULTS: Beta-thromboglobulin concentration was higher and statistically significant (7.82 ± 1.54ng/ml and 6.70 ± 2.23 ng/ml; P = 0.01), platelet factor 4 (39.86 ± 11.25 ng/ml and 47.73 ± 21.73ng/ml, P = 0.06) and mean platelet volume (10.26± 1.06fl and 10.29 ± 1.02fl P = 0.89) were not statistically significant in the diabetes mellitus group compared with non-diabetic participants, platelet factor 4 was higher in the older than younger diabetes mellitus participants. CONCLUSION: Elevated Beta-thromboglobulin may suggest a possible increase in thrombotic risks among diabetes mellitus.

CONTEXTE: La bêta-thromboglobuline et le facteur plaquettaire 4 sont des protéines spécifiques des plaquettes qui sont stockées dans les alpha-granules plaquettaires et libérées lors de l'activation des plaquettes. La mesure de ces protéines peut refléter le degré d'activation des plaquettes et suggérer indirectement un état prothrombotique. Cette étude visait à déterminer les taux sériques de bêta-thromboglobuline, le volume plaquettaire moyen et le facteur plaquettaire 4 chez des sujets atteints de diabète sucré et des sujets témoins à Lagos, au Nigéria. MATÉRIEL ET MÉTHODES: En utilisant le dosage immunoenzymatique au Lagos State University Teaching Hospital, Ikeja, cette étude a évalué les concentrations sériques de bêtathromboglobuline et de facteur plaquettaire 4, le volume plaquettaire moyen a également été déterminé à partir d'une numération globulaire complète de tous les participants. Les données ont été analysées à l'aide du logiciel Statistical Package for Social Sciences, Inc, Chicago,Ill ; version 26.0. Les variables continues ont été exprimées en moyen ± écart-type. La valeur P a été considérée comme statistiquement significative lorsqu'elle était inférieure à ≤0,05. RÉSULTATS: La concentration de bêta-thromboglobuline était plus élevée et statistiquement significative (7,82±1,54ng/ml et 6,70±2,23 ng/ml ; P=0,01), le facteur plaquettaire 4 (39,86±11,25 ng/ml et 47,73±21,73 ng/ml, P=0,06) et le volume plaquettaire moyen (10. 26± 1.06fl et 10.29±1.02fl P= 0.89) n'étaient pas statistiquement significatifs dans le groupe diabète sucré par rapport aux participants non-diabétiques, le facteur plaquettaire 4 était plus élevé chez les participants diabétiques plus âgés que chez les plus jeunes. CONCLUSION: Un taux élevé de bêta-thromboglobuline peutsuggérer une augmentation possible des risques thrombotiques chez les personnes atteintes de diabète sucré. Mots-clés: Bêta-thromboglobuline, facteur plaquettaire 4, volume plaquettaire moyen.

Preliminary evaluation of COVID-19 disease outcomes, test capacities and management approaches among African countries.

BackgroundFollowing the declaration of COVID-19 as a global pandemic and the report of index case in Africa, the number of countries in Africa with confirmed cases of the infection has grown tremendously with disease now being reported in almost all countries on the continent, with the exemption of Lesotho after 75 days. It is therefore necessary to evaluate the disease outcomes among the African countries as the situation unfolds for early identification of best practices for adoption. MethodsIn this study, COVID-19 disease outcomes (confirmed cases, deaths and recoveries), testing capacities and disease management approaches among African countries were evaluated. The relationship between COVID-19 infections in African countries and their performance on global resilient indices including the Human Development Index (HDI), performance on Sustainable Development Goals (SDGs) and the Global Risk Index (GRI) were also examined. Data acquired from various standard databases were evaluated over a period of 75 days from the date of reporting the index case. ResultsThis study has revealed compelling spatial differences in the incidence, deaths and recoveries from COVID-19 among African countries. Egypt, South Africa, Morocco and Algeria were clustered as countries with highest values of COVID-19 disease outcomes on the continent during the 75-day period of observation. The cluster analysis and comparison of countries in terms of percentage recovered cases of confirmed infections revealed that Mauritius, Mauritania, Gambia, Burkina Faso, Madagascar, Togo and Uganda had the highest scores. Comparative analysis of COVID-19 across the world revealed that the parameters were relatively inconsequential in Oceania and Africa continents, while Europe, North America and Asia had significantly higher cases of disease outcomes. For COVID-19 testing capacities, South Africa, Ghana and Egypt are leading in total number of tests carried out. However when the number of tests carried out were related to population number of the countries, Djibouti, Mauritius, Ghana and South Africa are found to be the leading countries. With respect to management of the disease in Africa, all the countries adopted the WHO protocols, personal hygiene, economic palliatives and social distancing measures. Only three countries in Africa (Madagascar, Togo and Burkina Faso) had a state supported initiative to utilise traditional medicines or herbs as alternatives to control COVID-19. Additionally, most of the countries are providing prompt treatment of the patients with a range of drugs especially Hydroxychloroquine, Chloroquine and Chloroquine-Azithromycin combination. The study found that no strong relationship currently exists between the global resilient indicators (HDI, SDG and GRI) and COVID-19 cases across Africa. ConclusionsThis study has revealed compelling spatial differences in disease outcomes among African countries and also found testing capacities for COVID-19 to be abysmally low in relation to the population. During the 75 days of observation, African countries have recorded significantly low number of deaths associated with COVID-19 and relatively high recovery rates. Countries in Africa with higher rate of recovery from the disease were found to have adopted strict adherence to some of WHO protocol to contain the disease, isolate all those who test positive to the disease and provide prompt treatment of the patients with a range of drugs especially Hydroxychloroquine, Chloroquine and Chloroquine-Azithromycin combination. The study recommends that the approaches adopted by the African countries which achieved high recovery rates from COVID-19 should be integrated into healthcare management plans for the disease across the continent even as the situation unfolds.

Cord blood full blood count parameters in Lagos, Nigeria.

INTRODUCTION: Full blood count (FBC), one of the most frequently requested for laboratory investigations, is a simple, fast and cheap test and is a reliable indicator of health. Due to its usefulness in the assessment of health status of individuals, its parameters in cord blood, a major source of haemopoietic stem cell transplantation and an ideal source for laboratory investigations for newborns were determined to provide a useful guide to local neonatologists and stem cell transplant physicians. METHODS: Three millilitres of umbilical cord blood was collected from 130 normal birth weight newborns (69 males and 61 females) whose cord were clamped immediately after delivery, at a teaching hospital in Lagos, Nigeria and full blood count parameters were determined using Sysmex autoanalyzer, model KX-21N. Consented mothers of the newborns were selected based on, age between 18 and 45 years; uneventful pregnancy and delivery and haemoglobin (Hb) concentration ≥ 10 g/dL. RESULTS: There were no statistical gender differences in the mean values of Hb concentrations (M = 13.27 ±1.60 g/dL; F = 13.32±1.61g/dL; p = 0.93), total white cell count (M = 3.16±5.43 × 10(9)/L; F = 13.07±4.98 × 10(9)/L; p= 0.92), platelet count (M= 223.64± 64.21 × 10(9)/L; F = 226.69±80.83 × 10(9)/L; p = 0.81) and other parameters. CONCLUSION: Mean values of full blood count parameters obtained in this study are comparable to reports from other studies in developing countries and could be a useful guide for neonatologists and stem cell transplant physicians in our geographical location.

Cluster of differentiation 4+ cell count mean value, reference range and its influencing factors in Human Immunodeficiency Virus-seronegative pregnant women in Lagos.

BACKGROUND: Immunity in pregnancy is physiologically compromised and this may affect cluster of differentiation four (CD4) count levels. It is well established that several factors affect CD4 count level in pregnancy. This study aims to determine the effects of maternal age, gestational age, parity and level of education as they influence CD4 count in pregnancy and also to determine the mean and reference range of CD4 count in pregnancy in Lagos, Nigeria. MATERIALS AND METHODS: A descriptive cross-sectional study was carried out at Ante-natal clinics in Lagos State, Nigeria. About 5 mls of blood was collected into Ethylene Diamine Tetracetic Acid (EDTA) bottles from HIV-negative pregnant women in various gestational ages of pregnancy. CD4+ cell count and full blood count of all samples were done within 3 hours of collection. The descriptive data was given as means ± standard deviation (SD). Pearson's chi-squared test and correlation were used for analytical assessment. RESULTS: A total of 74 pregnant women were recruited. The age range was 19-41 years and a mean age of 30.42 ± 5.34 years. The CD4+ cell count was not statistically significant when compared with participants ages P = 0.417, neither with gestational ages P = 0.323, nor with parity P = 0.247 nor level of education P = 0.96. An overall mean CD4+ cell count was 771.96 ± 250 cells/µl and the range was 193-1370 cells/µl. CONCLUSION: Maternal age, gestational age, parity and level of education had no significant effects on CD4+ cell count levels in pregnancy. The mean CD4+ cell count of HIV-negative pregnant women in Lagos is 771.96 ± 250 cells/µl.

Prevalence of significant bacteriuria among symptomatic and asymptomatic homozygous sickle cell disease patients in a tertiary hospital in Lagos, Nigeria.

BACKGROUND: Patients with sickle cell disease have an amplified vulnerability to urinary tract infection, because of abnormally dilute and alkaline urine, which favors bacterial proliferation. This is due to altered blood flow in the renal vasculature, which causes papillary necrosis and loss of urinary concentrating and acidifying ability of the nephrons. Asymptomatic bacteriuria is common, but the prevalence in populations varies widely with age, gender, sexual activity and the presence of genitourinary abnormalities. The aim of this study was to determine the prevalence of significant bacteriuria in symptomatic and asymptomatic sickle cell patients in Lagos. MATERIALS AND METHODS: This was a cross-sectional study of patients attending the sickle cell clinics of Lagos State University Teaching Hospital, Ikeja. Single voided aseptically collected mid-stream urine was obtained from each patient and all samples processed immediately, were sent for urinalysis and culture. Isolates were considered significant if there were ≥10 5 colony forming units per milliliter (CFU/ml) with two or less isolates, doubtful significance if ≤10 5 CFU/ml. Significant isolates were selected for identification. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 16.0 (SPSS, Inc., Chicago, Ill). RESULTS: A total of 100 consenting participants were recruited into the study. The mean age was: 23.42 ± 8.31 years and a range of 14-50 years. Only 9% (9/100) had significant bacteriuria while 44.4% (4/9) participants who had significant bacteriuria were asymptomatic. Escherichia coli was isolated in 66.6% (6/9) participants who had significant bacteriuria while Klebsiella oxytoca, Klebsiella pneumonia and Staphylococcus aureus (11.11%) was isolated in each of the remaining three participants. CONCLUSIONS: Significant bacteriuria is found in only one-tenth of sickle cell patients, nearly half of the participants who had significant growth had asymptomatic bacteriuria.

Comparison of the Minimental State Examination Scale and the International HIV Dementia Scale in Assessing Cognitive Function in Nigerian HIV Patients on Antiretroviral Therapy.

Introduction. HIV-associated neurocognitive disorder (HAND) remains common despite the availability of antiretroviral therapy. Routine screening will improve early detections. Objective. To compare the performance of the minimental state examination (MMSE) and international HIV dementia scale (IHDS) in assessing neurocognitive function in HIV/AIDS patients on antiretroviral therapy. Methods. A case-control study of 208 HIV-positive and 121 HIV-negative individuals. Baseline demographic data were documented and cognitive function assessed using the two instruments. CD4 cell counts were recorded. Results. Cases comprised 137 females and 71 males. Controls were 86 females and 35 males. Mean MMSE score of cases was 27.7 ± 1.8 compared to 27.8 ± 1.3 in controls (P = 0.54). Mean IHDS score in cases was 8.36 ± 3.1 compared to 10.7 ± 0.9 in controls (P < 0.001). Using the MMSE scale, 6 cases but no controls had HAND (P = 0.09). Using the IHDS, 113 (54.3%) had HAND compared with 10 (8.3%) controls (P < 0.0001). Using IHDS, 56.5% cases with CD4 count > 200 had HAND compared with 92.5% with CD4 count < 200 (P < 0.001). Conclusion. These findings indicate that the IHDS detects higher rates of HAND and may identify HIV/AIDS patients who require further cognitive assessment using more robust assessment batteries.

Prevalence of activated protein C resistance (Factor V Leiden) in Lagos, Nigeria.

OBJECTIVES: Hereditary resistance to activated Protein C (Factor V Leiden) is the commonest genetic defect known to confer a predisposition to thrombosis. This study aims to determine the prevalence of activated protein C resistance (APCr) in Lagos, and to determine if any association exists between APCr and ABO, Rhesus blood types, and hemoglobin phenotypes. MATERIALS AND METHODS: A functional APCr test was conducted on healthy adult volunteers to get a Factor-V-related activated protein C ratio (APC-V ratio). APCr due to Factor V mutation was indicated when the APC-V ratio is below a cut-off value that was determined by calibration. Subjects' hemoglobin, red cell ABO, and Rhesus phenotypes were determined by standard methods. RESULTS: Six (2%) of 297 participants with normal baseline coagulation screening tests had functional resistance to activated protein C (APC-V ratio < 2). None of the six subjects with APCr had history of venous thromboembolism. One of the six subjects was a female but the male sex did not demonstrate a risk of inheritance of APCr (P = 0.39). Four (67%) of the six subjects with APCr were non-O blood group. Whereas only two (0.9%) of 226 non-A subjects (blood groups 0 and B) had APCr, 4 (6%) of 71 subjects with A gene (blood groups A and AB) had APCr. The inheritance of A gene appears to constitute a risk to inheritance of APCr (P = 0.03). No association was demonstrable between APCr and hemoglobin phenotypes. CONCLUSION: Only 2% of the studied population had resistance to APC. The inheritance of blood group A may be a predisposition to APCr.

Psychosocial Impact of disclosure of HIV Serostatus in heterosexual relationship at the Lagos University teaching Hospital, Nigeria.

OBJECTIVES: To determine the rate and pattern of disclosure and non disclosure of HIV serostatus among people living with HIV and the psychosocial impact of disclosure. METHODS: Participants were drawn from the adult HIV clinic at the Lagos University Teaching Hospital, Lagos, Nigeria. An interviewer-administered questionnaire was used to collect data from consenting participants that included socio-demographic information, pattern and reason for non-disclosure and the possible consequences of disclosure of HIV serostatus to their sexual partners. RESULTS: Four hundred and ninety nine respondents with a mean age of 37.3 ± 9.6 years were recruited into the study. There were 157 males and 342 females. Majority of the participants were married (62%) and belonged to the low socio-economic class. Overall 61.5% (307 of 499) had disclosed their status to sex partner(s). Gender, social class and length of year of diagnosis were not associated with disclosure but number of sexual partners was strongly associated with non disclosure. P=0.0063. The most common reason for non-disclosure was fear of rejection (65%). Majority (96.7%) of those who disclosed their status had no regret and majority (81.1%) of those who had not disclosed had protected sex. After counseling, only18.8% (36 of 192) of those that had not disclosed thought that the counseling had helped them overcome the fear of disclosure and were willing to disclose. CONCLUSION: Many people would disclose their HIV serostatus to sex partner(s). Protected sex (through the use of condom) is widely accepted in our setting.

Open heart surgery: preliminary report of blood transfusion practice and haematological changes. Experience from a Nigerian tertiary teaching hospital.

AIMS AND OBJECTIVES: The study aimed at reviewing the utilisation of blood / blood products and haematological profile changes, with a view to developing a hospital transfusion guideline in open heart surgery in Nigeria. MATERIALS AND METHODS: The surgeries were performed at the intensive care unit theatre of Lagos State University Teaching Hospital. Eligibility for surgery was determined by the Cardiologist and the cardiovascular Surgeon based on clinical presentation, electro- and echocardiography assessments among other tests. Fourteen open-heart surgeries were conducted. Blood products demand for different procedures and several peri-operative laboratory parameters such as full blood count, and coagulation profile were determined. RESULTS: The greatest demand for blood products was found in valvular surgery and atrial septal defect (ASD) where a mean of four units of red cell concentrate, fresh frozen plasma and cryoprecipitate were transfused. Other surgeries such as, patent ductus arteriosus, Tetralogy of Fallot did not require much transfusion of blood products. Overall, the pre-operative and post-operative haematocrit, white cell count, platelet count, and international normalized ratio (INR) mean were 37% /25%,4.9 X 10 9/L / 11.4 X 10 9/L, 182 X 10 9/L/ 97 X 10 9/L, and 1.15/ 2.2 respectively. CONCLUSION: It appears that transfusion requirement in most open heart surgeries aside from valvular surgery and atrial septal defect (ASD) repair, is minimal. Patients for valvular heart surgeries and ASD repair should be evaluated for possible autologous blood transfusion.

The need to incorporate routine cervical cancer counselling and screening in the management of HIV positive women in Nigeria.

OBJECTIVE: The study aimed to assess the awareness and utilization of the Pap smear among HIV positive women in Lagos, Nigeria. MATERIALS AND METHODS: A descriptive cross sectional survey of women attending the anti-retroviral clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria was carried out between 1st September and 30th November 2009 using a pre-tested questionnaire. Data were analysed using the Epi-info 3.5 statistical software of the Centre for Disease Control and Prevention, Atlanta USA. RESULTS: None of the 300 respondents reported having received any form of counselling about cervical cancer and screening during the post HIV test counseling. Seventy six (25.3%) of them had heard of cervical cancer; Forty eight (16%) were aware of the Pap smear and only 15 (31.3%) of these (5% of the total number of respondents) have ever done the test before. The majority (69.7%) of those who had not been screened despite knowledge of the Pap smear, gave non- recommendation by their doctor as the main reason for not doing the test. CONCLUSION: Cervical cancer counseling and screening is not part of the routine management of HIV positive women in Lagos, Nigeria. There is need to address this deficiency with appropriate guidelines.

Haemoglobin and ferritin concentrations of pregnant women at term.

BACKGROUND: Anaemia in pregnancy is defined as haemoglobin (Hb) concentrations of less than 11 g/dL while low ferritin is defined as serum ferritin (SR) levels of less than 10 µg/L. Hb and ferritin concentrations of pregnant women at term were determined to establish their mean values and to determine the prevalence of anaemia in our locality. METHODS: Haemoglobin and ferritin levels of 170 non-smoking and HIV-negative pregnant women were determined at term. The majority 143 of 170 (84.1%) of the pregnant women recruited for the study, booked at the beginning of the second trimester and received 200 mg elemental iron in three divided doses and 5 mg folic acid daily which were commenced at booking. Five millilitres of blood were collected from each patient at term into EDTA bottles for full blood count analysis and another 5 mL into plain bottles for SR assay. RESULTS: The mean Hb and ferritin values were 10.9 ± 1.9 and 47.84 ± 98.39 µg/L, respectively. The prevalence of anaemia at term was 46.4%. Only 11.2% (19 of 170) of pregnant women at term had low SR (iron stores). A statistically significant relationship was found between women's education and SR (P = 0.032). Booking status also correlated directly with SR and haemoglobin concentrations, while increasing age and parity did not. CONCLUSION: About half of the patients were anaemic. Iron deficiency is not the major cause of anaemia in pregnancy in this study because the majority of the pregnant women had normal iron stores. Education and booking status are possible factors that contribute to anaemia.

Haemoglobin and ferritin concentrations in cord blood in a tertiary health centre in Nigeria.

BACKGROUND: Haemoglobin(Hb) and serum ferritin (SF) concentrations of cord blood of babies born at term at the Lagos State University Teaching Hospital, Maternity Centre (Ayinke House), Ikeja in the South-Western part of Nigeria were determined to establish mean values for these substances in our locality. OBJECTIVES: To establish the mean values for haemoglobin and serum ferritin concentrations of cord blood of babies born at term in our environment and to determine the prevalence of foetal anaemia and low iron store in cord blood in our locality. METHODS: Haemoglobin and ferritin levels in cord blood of 142 newborns were determined. Two millilitres of blood was collected from the cord of each newborn into EDTA bottle for complete blood count analysis and another 2mls into a plain bottle for serum ferritin assay. Cut-off values for cord blood Hb and serum ferritin concentrations were 12.5g/dL and 60 microg/L respectively. RESULTS: The mean Hb and ferritin values were 13.024 +/- 2.41 g/dL and 70.85 +/- 97.07 microg/dL respectively. The prevalence of foetal anaemia is 32.4 %. About 59.2% of full term newborns had low iron store. Birth weight was significantly associated with Hb concentration (p=0.039) and apga sscore (p=0.002). CONCLUSION: The prevalence of foetal anaemia was 32.4%. More than half (59.2%) of the newborns had low cord blood serum ferritin.

Chest X- ray findings in HIV patients in relation to the CD4 count.

BACKGROUND: CD4 count measures the degree of immunosupression in HIV-infected patients. Immunosupression results in lack of ability of the body to fight infections thus predisposing the individual to infection; lung is one of the most susceptible organs. An important diagnostic tool in assessing the respiratory complications as well as the manifestations of HIV infection is the chest radiograph. OBJECTIVE: This study is aimed at determining the radiological features seen on chest radiographs of HIV/AIDS patients in relation to their corresponding CD4 count which is a measure of immunosupression. METHODS: This study was conducted at Lagos State University Teaching Hospital (LASUTH) HIV clinic between September 2009 and August 2010 amongst all consenting registered HIV/AIDS patients. A total of one hundred and six consenting participants were recruited consecutively into the study, their blood samples were collected for CD4 count assay, and all the participants were sent for chest xray in the radiology department. They were asked to fill the structured questionnaire to obtain demographic data. RESULTS: More than three-quarters, 87(82.1%) had a normal chest radiographs. The abnormal findings included 13 cases of (12.3%) pulmonary tuberculosis, 3(2.8%) having bronchopneumonia, and 3(2.8%) lobar pneumonia. Majority, 32 of 87 of those with normal chest-x ray had CD4 count <100 cells/il while about half of the patients with pulmonary tuberculosis (5 of 13) had CD4 count >350 cells/il. All the three patients who had lobar pneumonia had CD4 count between 200-350 cells/il, while 2 of 3 patients with bronchopneumonia had CD4 counts between 200-350 cells/il, only 1 of them had CD4 of 100-200 cells/il CONCLUSION: About three-quarters of HIV-infected patients had normal chest radiographs, majority of those with normal chest x-ray were severely immunocompromised. While almost half of those with pulmonary tuberculosis had CD4 count >350 cells/il. The CD4 count level may not be an indicator of pulmonary infection.

Seroprevalence of hepatitis C infection in HIV patients using a rapid one-step test strip kit.

BACKGROUND: Hepatitis C virus (HCV) and HIV are transmitted via similar routes making co-infection with these viruses a common event. In addition, HIV infection and related immunosupression in patients with hepatitis C may be associated with more rapid progression of liver disease to cirrhosis, end-stage liver disease and death. OBJECTIVE: The study is to determine the seroprevalence of HIV/HCV co-infection rate. METHODS: A cross -sectional study was carried out from January to March 2010 at the HIV clinic of the Lagos State University Teaching Hospital. About 5 mls of blood sample was collected from each consenting participant. Sera were subjected to HCV rapid kit as recommended by the manufacturer (Dia Spot HCV one step test strip). The descriptive data was given as means +/- standard deviation (SD). The chi-squared test was used for analytical assessment. The differences were considered statistically significant when P value obtained was < 0.05. RESULTS: The overall seroprevalence rate of HIV/HCV coinfection was 3.3%. Only 6 of 194 female HIV subjects screened tested positive for HCV (3.1%), while 3 of 73 male subjects tested positive for HCV (4.1%) (P value 0.001). None of the 9 co-infected HIV/HCV participants (both male and female) had CD4 count of 350 and above, 3 had a count of 1-100 cells/il., 4 had 100-200, while 2 had 201-350. CONCLUSION: There is the need to include hepatitis C screening routinely in all HIV-infected patients undergoing pre-HAART evaluation in HIV clinics in order to lower liver-related morbidity and mortality associated with them.

Seroprevalence of Toxoplasma gondii antibodies amongst pregnant women at the Lagos State University Teaching Hospital, Nigeria.

BACKGROUND: Toxoplasma gondii (T.gondii), an obligate intracellular parasite found in many species throughout the world, causes a variety of clinical syndromes in humans and animals. It is also associated with morbidity and mortality in pregnancy. Hence the need to determine the seroprevalence of antibody to toxoplasmosis gondii amongst pregnant women. SUBJECTS AND METHODS: A cross- sectional study was carried out using patients attending the ante-natal clinic of Lagos State University Teaching Hospital Ikeja. All consenting newly registered ante-natal patients were recruited consecutively into the study within a time frame of six weeks during which a total of 179 pregnant participants were recruited. Literate participants filled self administered questionnaires whilst the non-literate participants were interviewed by research assistants. Five milliliters of blood was collected from each participant after obtaining patient's consent. Sera were assayed for antitoxoplasmosis IgG antibody by enzyme linked immunosorbent assay. (ELISA.) RESULTS: A total of 179 pregnant women were studied. Almost 50.8% were between the ages of 25-30 years, 70.8% of the patients studied, had tertiary education. An assessment of the patients' status to anti-toxoplasmosis IgG showed 40.8% were positive while 59.2% were negative. Pet-keeping was a practice amongst only 6.1% of patients whilst 90.5% did not keep pets. Out of those who kept pets, 63.6% were positive while 39.5% were negative. Amongst those who did not keep pets, 39.5% were positive while 60.5% were negative. This difference was not statistically significant. (P=0.261) CONCLUSION: It appears that seroprevalence of toxoplasmosis IgG antibody amongst the pregnant women in this study population is high. Therefore, it is valuable to follow up the IgMantibody status of their off springs as its presence indicates recent exposure.