Epidemiology and pattern of superficial fungal infections among primary school children in Enugu, south-east Nigeria.

Background: Superficial fungal infections (SFIs) are prevalent among schoolchildren and result in significant morbidities that may lead to school absenteeism or school drop-out and hence setback in the education of the child. Differences exist in the epidemiology and pattern of SFIs among children in various geographical locations. Community-based studies on diseases are a true reflection of their pattern in that locality. There are no recent studies on this regard in south-east Nigeria despite the high prevalence reported in the country. Aim: This study aimed to determine the epidemiology and pattern of SFIs among children in rural and urban communities in Enugu, south-east Nigeria, for evidence-based effective interventions in this region. Methods: A comparative and descriptive cross-sectional study of primary school children from three randomly selected urban communities and three randomly selected rural communities was conducted. The sample size was determined with use of the formula for comparison of two proportions. A total of 1662 pupils were recruited through a multistage sampling method, with 831 from urban primary school populations and 831 from rural primary school populations. Data were analysed with IBM SPSS Statistics version 24. Results: Of the 1662 children recruited, 748 had SFIs, with 502 (60.4%) seen in urban communities and 246 (29.6%) seen in rural communities. Tinea capitis was the most prevalent SFI (73.7%), and there was a statistically significant difference between urban (40.3%) and rural (26.1%) communities (P<0.001). The prevalence of SFIs was higher among urban female and rural male pupils. Children aged 9-12 years and 5-8 years were most commonly affected in the urban and rural communities, respectively. The personal hygiene of the children was poor in both communities. Conclusion: Emphasis on health education for SFIs and good personal hygiene will reduce the incidence of SFIs in the communities, especially among urban dwellers, which will encourage school attendance, concentration in class and child education.

Epidemiology of skin diseases in University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State.

Background: Several studies have been carried out to determine the patterns of skin diseases across Nigeria and results have shown changing patterns with the trend reflecting a higher tendency for allergic dermatoses in a majority of these studies. This study was carried out to evaluate the current clinical picture of patients presenting to our clinic. Materials and Methods: A prospective study of new patients seen in the skin clinic of University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, between November 2013 and August 2014 was carried out. A total of 387 patients' data was analysed. Data collected on patients' sociodemographic status and diagnosis were entered into SPSS Version 17 and analyzed. Diagnosis was based on clinical findings, laboratory diagnosis including biopsy and histopathology were requested when necessary to make a diagnosis. Results: There were more females 245 (63%) than males 142 (37%). Most of the patients (81.9%) were aged above 16years and the commonest skin disease was infections (29.5%) followed by allergic skin diseases (13.6%). There was a significant difference in levels of income of study participants across gender and females who were engaged in unskilled labour were more likely to earn lower than males. Conclusion: Comparing the study findings with an earlier one from the same center, there is a change in pattern with infections being the most common skin disease. These are largely preventable; public enlightenment campaigns and policies to discourage over the counter purchase of prescription strength corticosteroid creams are highly desirable.

Factors influencing herpes simplex virus type 2 infection among females in Enugu, Enugu State, Nigeria.

BACKGROUND: Herpes Simplex Virus infection is a chronic infection of the sensory ganglia with variable levels of epithelial expression. An important feature of HSV infection is the recurrence of disease as a result of periodic or sporadic activation of viral replication. In addition, asymptomatic shedding of herpes viruses may play a significant role in transmission from person to person. This infection being lifelong manifests only in a small proportion of those infected. It has presented public health concern because of its progressively increasing prevalence which some reports say is of epidemic proportion in developing countries and also for its synergistic effect with HIV infection. OBJECTIVES: Determination of antibody prevalence to HSV-2/co-infection with HIV among females attending skin and ANC clinics in UNTH and ESUTH. MATERIALS AND METHODS: One hundred and eighty suitably qualified subjects were appropriately recruited over a period of six months into this study. Essential information was collected using a questionnaire. Venous blood was also obtained for HSV 2 serology, HIV screening, and confirmation, if positive. RESULTS: The antibody prevalence of HSV 2 was found to be 77.8% (n = 137) and 14.6% (n = 20) had clinical diagnosis. The HIV and HSV-2 co-infection rate was 5.11% (n = 9). The risk factors for groups 1 [HSV2 Infection] and 2 [HSV2 & HIV co-infection] were similar with few differences, thus buttressing the fact that their modes of transmission are similar. CONCLUSION: Factors influencing Herpes simplex virus type 2 infection among females in Enugu included among other things older age and increasing number of lifetime sexual partners.

Herpes simplex virus type 2 infection among females in Enugu, Enugu State.

BACKGROUND: Herpes simplex virus type 2 infecion is life long with manifestation in a small proportion of those infected. It has presented public health concern because of its progressively increasing prevalence which some authorities say is of epidemic proportion in developing countries. Herpes simplex virus type 2 has recently been found to have synergistic effect with human immunodeficiency virus (HIV) and co-infection of the two presents more severe burden to the immunity of the victim. This leads to much morbidity and mortality with negative economic impact. In this study, we set out to determine antibody prevalence of HSV-2 in women attending skin and ante natal care [ANC] clinics in University of Nigeria Teaching Hospital [UNTH] and Enugu State University Teaching Hospital [ESUTH]. MATERIALS AND METHODS: 180 female patients/clients attending skin and ANC clinics in UNTH and ESUTH were enrolled in this descriptive study. Sociodemographic data and medical history were collected using a questionnaire. They were also examined for signs of HSV 2 manifestation, other STIs and WHO staging if HIV positive. Samples were also taken for serology, Gram staining and CD4 T-lymphocyte count. RESULTS: The prevalence of HSV 2 was found to be 77.8% (n=137) and 14.6% (n=20) had clinical diagnosis of HSV-2.The HIV and HSV-2 co-infection rate was 5.11% (n=9) and out of 11 that were HIV positive, 9 (81.82%) were HSV-2 antibody positive. The HIV prevalence in this study was 6.3%. CONCLUSION: Herpes simplex virus type 2 infection is common among females in Enugu, Enugu State and is commoner among those with HIV infection.

Hansen's disease: the need for increased healthcare provider awareness and re-training.

CONTEXT: Leprosy continues to be a challenge worldwide. In 2009, the World Health Organisation (WHO) reported 244,796 new cases worldwide. Of this, South East Asia, South Americas and Africa have the highest number of new cases. OBJECTIVE: To highlight misdiagnosis of Hansen's disease as a drawback to eradication of leprosy. MATERIALS: A retrospective study of cases of Hansen's disease misdiagnosed by clinicians who were seen in the skin clinics of two tertiary institutions in South-East Nigeria over a one year period. RESULTS: Of the nine misdiagnosed cases, three were females while six were males. Apart from one child of six years old, the rest of the patients were adults. Referring diagnoses included chronic osteomyelitis, acromegaly, dermatitis and depression. One of the patients presented with a reversal reaction (erythema nodosum leprosum) following treatment in a peripheral health facility. Confirmation of the diagnosis was based on slit skin smears for Acid Fast Bacilli carried out in the side laboratory of skin clinic UNTH, Ituku-Ozalla, Enugu state (four patients) and mile four hospital, Abakaliki, Ebonyi State( three patients). All the smears were positive. Patients were commenced on multi drug therapy and all showed marked clinical improvement following drug therapy. CONCLUSION: Eradication of leprosy may not be feasible if health care providers are ignorant of the different presentations of the disease. A high index of suspicion for leprosy is needed among health care workers in endemic areas. Development of tools for early diagnosis and detection of infection, improvement in existing tools for data collection, provision of guidelines and training materials on vital information for leprosy control will all contribute to the continued success of the National Tuberculosis and Leprosy Control Programme in Nigeria.