A review of the disease burden, impact and prevention of typhoid fever in Nigeria.

BACKGROUND: Typhoid fever is still a common infection in many parts of the world, especially in developing countries where sanitation and water supply are a common problem. A recent study placed the disease burden at 21650 974 illnesses and 216510 deaths during 2000. The infection is a major cause of morbidity and mortality in Nigeria. OBJECTIVE: This review set out to present in one concise volume a review of the major findings from published articles on the burden and impact of typhoid fever in Nigeria to aid easy reference for researchers. It highlights the disease burden, the different diagnostic methods and their sensitivities, complications, treatment methods as well as the various preventive measures including the use of typhoid vaccine in the control of the disease. METHODS: Several published articles covering a period of 40 years were accessed different journals and reviewed, and their major findings presented in this review. RESULTS: The disease burden from typhoid fever in Nigeria is still high with associated serious complications, which in most cases have been managed effectively with the use of potent antibiotics and surgical intervention. However, the typhoid problem has been compounded by the emergence and circulation of multi-drug resistant strains of the organism being sensitive only to the newer generation antibiotics. CONCLUSION: Typhoid fever remains a major public health problem in Nigeria. The infection however can be prevented by good sanitation, improving good water supply, the provision of proper sewage disposal system, as well as the effective use of the available typhoid vaccines. The government and people of Nigeria should rise up to the challenge of stamping out this ugly trend.

A review of the epidemiology, prevention and treatment of human immunodeficiency virus infection in Nigeria

In order to amalgamate research findings on HIV/AIDS in Nigeria as well as the trend of the infection in a concise manner, we reviewed published articles on the HIV/AIDS situation in Nigeria. We categorized this review into several subheadings. The HIV prevalence rate has continued to rise steadily from less than 0.1 percent in 1987, to 5.8 percent in 2001, with a slight decrease in 2003 to 5.0 percent. Although the knowledge about HIV and its mode of transmission is widespread, it is however disheartening to note that this did not result into appreciable attitudinal change and behavior modification among Nigerians. Both HIV-1 and HIV-2 have been identified in Nigeria, with HIV-1 being the predominant type. Furthermore, several subtypes like subtypes A, B, C, G and J have been identified in Nigeria, with several recombinant forms like the CRF02_AG; the major ones being A, G and CRF02_AG. HIV-infected patients in Nigeria are also co-infected with other viral and bacterial infections, the commonly reported ones being co infections with hepatitis B and C. Although treatment of infected patients has increased recently, more effort is needed, especially in the area of patients monitoring, to maximize the benefits of ART in Nigeria. Finally, Nigeria has made appreciable efforts in vaccine development and candidate HIV DNA vaccines have been developed utilizing the sequences from predominant subtypes, and these candidates have been shown to be immunogenic in animal models. It is therefore clear that only the integration of prevention and antiretroviral research programmes into a coherent programme that is needed to address the public health needs that HIV/AIDS crisis represents for Nigeria.

The role of triple infection with hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV) type-1 on CD4+ lymphocyte levels in the highly HIV infected population of North-Central Nigeria.

We set out to determine the seroprevalence of hepatitis B and C among human immunodeficiency virus type-1 (HIV-1) infected individuals in North-Central Nigeria to define the influence of these infections on CD4+ lymphocytes cells among our patients as access to antiretroviral therapy improves across the Nigerian nation. The CD4+ values of 180 confirmed HIV-1 infected individuals were enumerated using a superior fluorescence-activated cell sorter system. These patients were tested for the presence of hepatitis B surface antigen and anti-hepatitis C virus (HCV) using third generation enzyme-linked immunosorbent assays. Fifty (27.8%) patients had active hepatitis B virus (HBV) infection while 33 (18.3%) tested positive for anti-HCV antibody. Of these infections, 110 (61.1%), 37 (20.6%), and 20 (11.1%) had HIV only, HBV/HIV-only, and HCV/HIV-only respectively. A HBV/HCV/HIV coinfection prevalence of 7.2% (13 patients) was recorded. Patients coinfected with HIV/HBV/HCV appeared to have lower CD4+ counts (mean = 107 cells/microl; AIDS defining) when compared to HBV/HIV-only (mean = 377 cells/microl), HCV/HIV-only (mean = 373 cells/microl) and patients with mono HIV infection (mean = 478 cells/microl). Coinfection with HBV or HCV is relatively common among HIV-infected patients in Nigeria and should be a big consideration in the initiation and choice of therapy.

The role of triple infection with hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV) type-1 on CD4+ lymphocyte levels in the highly HIV infected population of North-Central Nigeria

We set out to determine the seroprevalence of hepatitis B and C among human immunodeficiency virus type-1 (HIV-1) infected individuals in North-Central Nigeria to define the influence of these infections on CD4+ lymphocytes cells among our patients as access to antiretroviral therapy improves across the Nigerian nation. The CD4+ values of 180 confirmed HIV-1 infected individuals were enumerated using a superior fluorescence-activated cell sorter system. These patients were tested for the presence of hepatitis B surface antigen and anti-hepatitis C virus (HCV) using third generation enzyme-linked immunosorbent assays. Fifty (27.8 percent) patients had active hepatitis B virus (HBV) infection while 33 (18.3 percent) tested positive for anti-HCV antibody. Of these infections, 110 (61.1 percent), 37 (20.6 percent), and 20 (11.1 percent) had HIV only, HBV/HIV-only, and HCV/HIV-only respectively. A HBV/HCV/HIV coinfection prevalence of 7.2 percent (13 patients) was recorded. Patients coinfected with HIV/HBV/HCV appeared to have lower CD4+ counts (mean = 107 cells/æl; AIDS defining) when compared to HBV/HIV-only (mean = 377 cells/æl), HCV/HIV-only (mean = 373 cells/æl) and patients with mono HIV infection (mean = 478 cells/æl). Coinfection with HBV or HCV is relatively common among HIV-infected patients in Nigeria and should be a big consideration in the initiation and choice of therapy.

A review of the epidemiology, prevention and treatment of human immunodeficiency virus infection in Nigeria.

In order to amalgamate research findings on HIV/AIDS in Nigeria as well as the trend of the infection in a concise manner, we reviewed published articles on the HIV/AIDS situation in Nigeria. We categorized this review into several subheadings. The HIV prevalence rate has continued to rise steadily from less than 0.1% in 1987, to 5.8% in 2001, with a slight decrease in 2003 to 5.0%. Although the knowledge about HIV and its mode of transmission is widespread, it is however disheartening to note that this did not result into appreciable attitudinal change and behavior modification among Nigerians. Both HIV-1 and HIV-2 have been identified in Nigeria, with HIV-1 being the predominant type. Furthermore, several subtypes like subtypes A, B, C, G and J have been identified in Nigeria, with several recombinant forms like the CRF02_AG; the major ones being A, G and CRF02_AG. HIV-infected patients in Nigeria are also co-infected with other viral and bacterial infections, the commonly reported ones being co infections with hepatitis B and C. Although treatment of infected patients has increased recently, more effort is needed, especially in the area of patients monitoring, to maximize the benefits of ART in Nigeria. Finally, Nigeria has made appreciable efforts in vaccine development and candidate HIV DNA vaccines have been developed utilizing the sequences from predominant subtypes, and these candidates have been shown to be immunogenic in animal models. It is therefore clear that only the integration of prevention and antiretroviral research programmes into a coherent programme that is needed to address the public health needs that HIV/AIDS crisis represents for Nigeria.