Epidemiology of malaria among HIV/AIDS patients in sub-Saharan Africa: A systematic review and meta-analysis of observational studies.

Malaria related HIV morbidity and death is a concern in sub-Saharan Africa. Understanding the epidemiology of malaria among people living with HIV is vital for adequate intervention. We conducted a systematic review and meta-analysis to estimate the prevalence of malaria in HIV patients in sub-Saharan Africa. We searched PubMed, AJOL, Web of Science and Google Scholar databases. The overall pooled prevalence and pooled Odds Ratio (OR) with their 95% Confidence Intervals (CI) were estimated using the random-effects model and potential causes of heterogeneity in prevalence estimates were investigated using subgroup and meta-regression analysis. 58 studies, including 23,911 HIV patients, were identified between January 1990 and October 2020. The overall pooled prevalence of malaria in HIV patients was 22.7% (95% CI 18.0; 28.1). The Prevalence of malaria among HIV/AIDS patients was 33.1%, 30.2%, 15.3%, and 12.6% in Southern, Western, Central, and Eastern regions of SSA respectively. Prevalence of malaria in the central and western was higher [26.7% (95% CI 20.6; 33.9)] than 13.6% reported in the southern and eastern regions (95% CI 8.8; 20.5). There was a significant decrease in malaria prevalence among HIV/AIDS patients in the Eastern and Southern SSA regions from 21.9% (95% CI 15.5; 30.0) in the 2000-2010 period to 9.7% (95% CI 5.5-16.4) in the post-2010 period compared to the central and western regions. HIV infected patients with low CD4 + T cell count (CD4 < 200 cells/mm3) were 2.19 times more likely to become infected with malaria than those with high CD4 + T cell count (CD4 ≥ 200 cells/mm3) (pooled odds ratio (POR): 2.19 (95%CI 1.20;3.98), while patients on antiretroviral therapy (POR): 0.37 (0.23; 0.59), and in WHO clinical stages I and II (POR): 0.64 (0.28; 1.46), had a lower odds of been infected with malaria. Our review suggests that due consideration should be given to malaria among HIV/AIDS patients in SSA. In particular, the assessment and improvement of preventive measures for malaria/HIV co-infection in high-prevalence regions is important. For the treatment of both diseases, prophylaxis with cotrimoxazole and antiretroviral therapy should also be encouraged.

Molecular characterisation of Cryptosporidium isolates from rivers, water treatment plants and abattoirs in Ibadan, Nigeria.

To understand the molecular characteristics of Cryptosporidium species contaminating rivers, water treatment plants and abattoirs in Ibadan Nigeria, water samples were obtained from ten rivers used for household and agricultural purposes, three major functional water treatment plants and three major abattoirs located within Ibadan metropolis during dry and rainy seasons between November, 2016 to October, 2017. Obtained samples were examined for Cryptosporidium oocysts using microscopy after using modified formalin-ether concentration method and modified acid-fast staining. Cryptosporidium oocysts were detected in samples from five rivers with mean oocyst count/field ranging from 7.70 ±â€¯0.57-1.34 ±â€¯0.57, oocysts were also detected in samples from two abattoirs with mean oocyst count/field ranging from 4.60 ±â€¯0.33-2.50 ±â€¯0.33. Genomic DNA were extracted from microscopy positive river and abattoir samples using sucrose gradient purification method and genotypes and subtypes of parasites were detected by nested PCR amplification and nucleotide sequence analysis of both 18S rRNA and 60-kDa glycoprotein (gp60) genes. Cryptosporidium parvum, C. muris and C. fragile were the only genotypes detected in some river samples, while gp60 gene sequence analysis showed that the C. parvum strain detected was subtype IIa. This study provides evidence that rivers used for household and agricultural purposes in studied area may be potential reservoirs and infection sources for Cryptosporidium species and zoonotic subtypes of public health importance.

Prevalence of asymptomatic Plasmodium falciparum infection in pregnant women in Nigeria: a systematic review and meta-analysis.

Asymptomatic Plasmodium falciparum infection during pregnancy is a major cause of foetal and maternal morbidity and mortality. The current study estimated the prevalence of asymptomatic P. falciparum infection among pregnant women in Nigeria. We systematically searched the PubMed, Web of Science, Google Scholar and AJOL databases for studies that estimated the prevalence of asymptomatic P. falciparum infection in pregnant women up to December, 2019, and identified additional studies from reference lists. Twenty-seven studies which fulfilled eligibility criteria were included in final systematic review and meta-analysis. The prevalence of asymptomatic P. falciparum infection of individual study varied from 2.1% to 95.4%. Most surveys were performed in the southern parts of Nigeria. We observed a high degree of heterogeneity in most pooled estimates (I2 > 75%; p < 0.01). The pooled estimate of asymptomatic P. falciparum infection prevalence across studies for the entire period was 34.3% (95% CI: 24.0-46.3), ranging from 34.7% (95% CI: 22.8-48.9) in primigravida to 28.5% (95% CI: 15.8-45.8%) in the first trimester. Studies conducted from 2000-2009 (51.3%; 95% CI: 29.1-73.0), southern Nigeria (41.8%; 95% CI: 28.2-56.7), rural areas (52.1%; 95% CI: 19.4-83.0), and median sample size ≥ 246 (41.5; 95% CI: 25.9-58.9), had the highest pooled prevalence. Asymptomatic P. falciparum infection is considered high in pregnant women in Nigeria. This results, therefore, emphasize the need to actively diagnose and treat asymptomatic malaria infection during all antenatal care visits.

Parasitic contamination and public health risk of commonly consumed vegetables in Ibadan-Nigeria.

INTRODUCTION: vegetables form a major component of the human diet. However, poor agronomic practices may put consumers at risk of parasitic infections. This study evaluated the parasitic contamination of vegetables grown in selected farms in Ibadan, Nigeria. METHODS: Two hundred and eighty vegetable species: African eggplant (Solanum macrocarpon), lettuce (Lactuca sativa), cucumber (Brassica oleracea), spinach (Amaranthus cruentus), white jute (Corchorus olitorius), pumpkin (Telfaria occidentalis), green pepper (Capsicum sp.), okro (Abelmoschus esculentus), quill grass (Celosia argenta L), tomato (Lycopersicum sativus) were collected from farms within Ibadan. Samples were washed in water, and the resulting washing solution was filtered and centrifuged to concentrate the parasitic stages. Sediments were examined by iodine and modified Ziehl-Neelsen stained smears technique. RESULTS: parasites were detected in 14 (5.0%, 95% CI 32.6%-67.3%) of samples. The highest contaminated vegetable was white jute 32.1 (95% CI 17.9%-50.6%), followed by pumpkin 7.1(95% CI 1.9-22.6), quill grass 7.1% (95% CI 1.9-22.6) and lettuce 3.5 (95% CI 0.6-17.7). The commonest parasites were Strongyloides stercoralis larvae 42.9 (95% CI 21.3-67.4), Entamoeba histolytica/E.dipaar 21.4 (95% CI 7.5-47.5), Trichostrongylus spp 21.4 (95% CI 21.3-67.4), and Ascaris sp. 14.3 (95% CI 4.0-39.9). CONCLUSION: these findings provide evidence of contamination of vegetables from farms in Ibadan with parasites of public health importance. Information on best practices should be designed, packaged and disseminated through appropriate channels to enhance positive behavior change among farmers.