Rapid screening for co-infection of HIV and HCV in pregnant women in Benin City, Edo State, Nigeria.

BACKGROUND: Human Immunodeficiency virus (HIV) and Hepatitis C virus (HCV) are both major global health concerns as they cause high mortality and morbidity in the developing countries. However, while data exists for the co-infection in other countries, little or no information can be found with regard to the sero-prevalence of HIV and HCV co-infection in Nigeria, albeit in pregnant women attending antenatal care clinics in Benin City, Nigeria. OBJECTIVE: The objective of the study was to determine the sero-prevalence of HIV and HCV among pregnant women seeking antenatal care in Benin City. METHODS: In determining the sero-prevalence in a cross-sectional study, 200 pregnant women, aged between 15 and 49 years were screened for HIV and HCV using rapid screening test kits. Using closed ended structured questionnaires; the respondents volunteered socio-demographic information associated with risk factors of HIV and HCV acquisition. RESULTS: Results indicated sero-prevalence of HIV and HCV in the sampled population was 3% and 5% respectively. Thirty three percent of the pregnant women that were HCV positive were co-infected with HIV-1 infection. HIV sero-prevalence was highest in the age group, 25-29 representing 5.1%, while HCV sero-prevalence was noted highest among the women in the age group 30-34 years, representing 7.9%. Two percent of the pregnant women had equivocal (ambivalent) HIV-1 results. CONCLUSION: The study has shown a prevalence of HIV-HCV co-infection among the tested pregnant women in Benin City and more epidemiological surveys are needed in larger scale to decipher the prevalence in other states of Nigeria.

Characterization and management of solid medical wastes in the Federal Capital Territory, Abuja Nigeria.

BACKGROUND: Medical establishment such as hospitals and research institutes generate sizable amount of hazardous waste. Health care workers, patients are at risk of acquiring infection from sharps and contamination of environment with multiple drug resistant microorganisms if wastes are not properly managed. OBJECTIVES: To characterize types and evaluate waste disposal techniques employed in the management of solid medical wastes in five selected hospitals in the Federal Capital Territory, Abuja. METHODS: This was a cross section study involving the use of questionnaires, in-depth interview, meetings, discussions and participant observed strategy. It also involved the collection, sorting (segregation), identification and characterization and weighing of waste types from wards and units in the selected hospitals. RESULTS: The average waste generation rate per bed/day was determined and found to be 2.78 kg of solid waste, 26.5% of the total waste was hazardous in nature. Waste segregation was found not to be practiced by any of the hospitals surveyed, 18.3% of the hospitals incinerated waste in a locally built brick incinerator; 9.1% bury; 36.3% burn waste in open pits while 36.3% dispose of a waste into municipal dumpsites. CONCLUSION: Waste management officers do not have formal training in waste management techniques; and hospital administrators pay very little attention to appropriate management of medical waste. Therefore, we must educate waste generators of their responsibility to properly manage the waste so that their staff, patients, environment and community is protected.

The trend of pulmonary tuberculosis in patients seen at DOTS clinics in the Federal Capital Territory, Abuja, Nigeria.

We evaluated the pattern of sputum smear positivity and assessed the effects of directly observed treatment short course (DOTS) among tuberculosis (TB) patients at the DOTS clinics in the Federal Capital Territory (FCT), Abuja. In total, 1391 patients were seen at six microscopy and treatment centres across the FCT between January and December 2003. Their sputa were screened microscopically for the presence of acid-fast bacilli (AFB) using the Ziehl-Neelsen staining technique. In total, 296 (21.3%) patients were smear positive; 201 (67.9%) were new cases and 95 (32.1%) were follow-up cases. The highest incidence of sputum smear positivity (24.8%) was found in those aged 21-30 years and the lowest incidence (6%) was found in those aged 71 years and above. No incidence of smear positivity was recorded in children aged 0-10 years. In total, 160 of the men screened were AFB positive (75% new cases, 25% follow-up cases). In comparison, 136 women were AFB positive (59.6% new cases, 40.4% follow-up cases). During the 1-year study period, two deaths were recorded. Men pose a serious threat to public health as most of the follow-up cases result in the tubercle bacilli developing resistance to available anti-TB drugs. This study demonstrated a high prevalence of infectious TB in the population screened, and therefore underlines the need for capacity building through a multisectoral approach in the fight against the disease. Cohort analysis should be the cardinal management strategy in evaluating the effectiveness of TB control through systemic follow-up and reporting of certain indicators in treatment progress and success.

Polar lipids of strains of Prevotella, Bacteroides and Capnocytophaga analysed by fast atom bombardment mass spectrometry.

The polar lipid composition of representative strains of Bacteroides fragilis, Prevotella intermedia, P. melaninogenica and Capnocytophaga ochracea was determined. Samples were analysed by FAB-MS. Forty major peaks had m/z values expected for known carboxylate anions, ranging from m/z 211 (tridecenoate) to m/z 381 (pentacontanoate). A further fifty-five major peaks were studied between m/z 561 and m/z 722. Forty-five anionic phospholipids of several series were identified. The Pearson coefficient of linear correlation revealed the similarity of the P. intermedia spectra from repeat experiments (r = 0.98), as opposed to inter-species comparisons (0.55, 0.22, 0.20). Thus, FAB-MS rapidly yields data on molecular species within phospholipid families not readily obtained by other means. The data obtained may have chemotaxonomic potential.

Analysis of polar lipids from some representative enterobacteria, Plesiomonas and Acinetobacter by fast atom bombardment-mass spectrometry.

Fast atom bombardment-mass spectrometry (FAB-MS) was used to analyse lipid extracts of bacteria to assess its usefulness for analysing anionic phospholipids of potential chemotaxonomic value. The following micro-organisms were tested: Acinetobacter calcoaceticus, Acinetobacter sp., Citrobacter freundii, Enterobacter cloacae (2 strains), Escherichia coli (3 strains), Hafnia alvei, Klebsiella oxytoca, Klebsiella pneumoniae, Morganella morganii, Plesiomonas shigelloides, Proteus mirabilis (3 strains), Serratia liquefaciens and Serratia marcescens. Negative-ion spectra provide data for twenty-seven major carboxylate anions (m/z 209-325) and for thirty-seven major phospholipid anions (m/z 645-774). Generally, the largest carboxylate peaks were due to 16:1, 16:0, cyc17 and 18:1 while the largest phospholipid anion peaks were due to PE(32:1), PE(33:1), PE(34:1), PE(34:2), PG(30:2), PG(31:2), PG(32:2), PG(34:1) and PS(33:0). However, quantitative differences were observed. For example, Acinetobacter lacked PE (33:1) but had exceptionally high peaks at m/z 748, PS(33:0), and m/z 281, octadecanoate. Unknown 'carboxylate' peaks were detected at m/z 254, 256, 261, 268, 282 and 301. In some cases, unknown peaks appeared to constitute possible homologous series being separated by delta m/z of 14(identical to methylene). For chemotaxonomic purposes, the complexity of the data required numerical analysis. Using the Pearson coefficient of linear correlation, as a measure of association, it was possible to compare all strains analysed. Typical results for strain comparisons were as follows: Ent. cloacae vs Ent. cloacae, r = 0.90 (Ent. cloacae vs Ac. calcoaceticus, r = 0.46). Thus FAB-MS represents an excellent means of obtaining large quantities of data on polar lipids of a range of bacterial isolates, which may be suitable for chemotaxonomic purposes.

Lethal synergistic action of toxins of bacteria isolated from sudden infant death syndrome.

AIM: To test the hypothesis that lethal toxins of bacteria associated with sudden infant death syndrome (SIDS) can act synergistically. METHODS: Bacteria occurring together in the nasopharynx of cases of cot death were studied. The lethal toxicity of crude toxin preparations was determined over a range of dilutions by injections into the chorioallantoic vein of the chick embryo. Toxin preparations of low lethality for the chick embryo SIDS model were then tested in combination. RESULTS: Staphylococcus aureus toxin preparations showed low lethality when tested alone, even at low dilution. At 1 in 100 dilution S aureus toxin was lethal to one out of 15 chick embryos. Escherichia coli toxin preparations showed high lethality except on high dilution (1 in 80) when lethality fell to two out of 15 of chick embryos. When the same toxin preparations were tested simultaneously in combination, lethality rose to 14 out of 15. Similar findings were observed over a range of toxin dilutions. This finding was highly significant (p = 0.0012). CONCLUSIONS: That synergy between toxins can enhance the lethality of toxins elaborated by bacteria associated with SIDS.

Fast atom bombardment-mass spectrometry for bacterial chemotaxonomy: influence of culture age, growth temperature, gaseous environment and extraction technique.

Extracted phospholipids of Escherichia coli, Proteus mirabilis and Enterobacter cloacae were examined by fast atom bombardment-mass spectrometry which yielded major peaks between m/z 225 and 761. The result of extracting freeze-dried or 'wet' cells showed that freeze-drying may be omitted although weighing of dried cells offers a useful means of standardizing the extraction procedure. Anaerobic growth quantitatively altered the chemical finger-print as a result of increase in ratio of saturated: unsaturated carboxylic acids. Growth temperature also affected profiles over the temperature range 24-45 degrees C. A less drastic influence on mass spectra was culture age, over the range 16-48 h. Comparison of spectra was possible with Pearson's coefficient of linear correlation which yielded the following values: wet and lyophilized cells, r = 0.97; aerobic and anaerobic growth, r = 0.82; 24 degrees C and 45 degrees C, r = 0.76; 16 h and 48 h, r = 0.95. These results show that although quantitative differences do occur between spectra for the same organism prepared in different ways, they are less than interspecies variation, e.g. with E. coli and P. mirabilis, r = 0.46. Any differences which are due preparation method can be overcome by standardization of technique.

Trimethylsilyl-sugar profiles of Streptococcus milleri and Streptococcus mitis.

Seventy strains of 'viridans-group' streptococci were analysed gas chromatographically after preparation of trimethylsilyl ethers of their cellular sugars. The resulting profiles were evaluated as a possible aid to taxonomy. Glycerol, glucose, galactose, N-acetyl-glucosamine and N-acetylmuramic acid were found in all strains, in varying amounts. Rhamnose was the major neutral sugar in most strains, other than representatives of Streptococcus mitis, which invariably had ribose and usually anhydroribitol but no rhamnose. One strain of Strep. mitis possessed arabitol. Some strains of Strep. mitis and 'Strep. milleri' were alone in containing N-acetylgalactosamine. A combination of N-acetylgalactosamine and rhamnose in the absence of ribose was diagnostic for strains of 'Strep. milleri'.

Effect of cultural conditions on trimethylsilyl-sugar profiles of Streptococcus mutans.

The cellular carbohydrates of Streptococcus mutans NCTC 10832 were converted to methyl glycoside trimethylsilyl ethers and analyzed by gas-liquid chromatography. The resulting profiles revealed the presence of glycerol, xylose, rhamnose, galactose, glucose, N-acetylglucosamine, and N-acetylmuramic acid. The proportions of monosaccharides in the profile were found to be stable with respect to changing growth temperature or duration of growth. However, the type of medium used, and its carbohydrate content, did significantly alter the profile, whereas gaseous atmosphere exerted a lesser effect on carbohydrate composition. By controlling growth parameters, we obtained reproducible profiles. Whole cells are probably a satisfactory alternative to highly purified cell walls.

Characterization and management of solid medical wastes in the Federal Capital Territory, Abuja Nigeria

Background: Medical establishment such as hospitals and research institutes generate sizable amount of hazardous waste. Health care workers; patients are at risk of acquiring infection from sharps and contamination of environment with multiple drug resistant microorganisms if wastes are not properly managed. Objectives:To characterize types and evaluate waste disposal techniques employed in the management of solid medical wastes in five selected hospitals in the Federal Capital Territory;Abuja; Methods:This was a cross section study involving the use of questionnaires; in-depth interview; meetings; discussions and participant observed strategy. It also involved the collection; sorting (segregation); identification and characterization and weighing of waste types from wards and units in the selected hospitals. Results:The average waste generation rate per bed/day was determined and found to be 2.78kg of solid waste; 26.5of the total waste was hazardous in nature.Waste segregation was found not to be practiced by any of the hospitals surveyed; 18.3of the hospitals incinerated waste in a locally built brick incinerator; 9.1bury; 36.3burn waste in open pits while 36.3dispose of a waste into municipal dumpsites. Conclusion:Waste management officers do not have formal training in waste management techniques; and hospital administrators pay very little attention to appropriate management of medical waste.Therefore; we must educate waste generators of their responsibility to properly manage the waste so that their staff; patients; environment and community is protected