Human T-cell lymphotropic virus types I and II infections in patients with leukaemia/lymphoma and in subjects with sexually transmitted diseases in Nigeria.

Serological assays that distinguish antibodies to human T-cell lymphotropic virus types I (HTLV-I) and type II (HTLV-II), and polymerase chain reaction (PCR) tests were used to investigate association of these two human retroviruses with several well-defined clinical conditions in Nigeria. We compared the frequency of HTLV-I and HTLV-II infections among patients with lymphopholiferative disorders (n=65), individuals with various sexually transmitted diseases (n=40), patients with genitals candidiasis (n=25) and apparently healthy individuals (n=60). Serological analysis of blood samples from all four groups showed that 10 of the 190 (5.3%) individuals tested were confirmed positive for the presence of antibodies to HTLV-I(6) or HTLV-II(4). Using the PCR technique, specific HTLV-I or HTLV-II sequences were amplified from the genomic DNA of 4 of 6 HTLV-I seropositive and 3 of the 4 HTLV-II seropositive individuals respectively. However, sequences of both viruses were amplified from the genomic DNAs of the remaining 3 seropositive individuals. Since one of the 5 sets of primer pairs [SK110(II)/SK111(II)], which is used for specific identification of HTLV-II did not amplify the target sequence from the genomic DNAs of any of the 4 HTLV-II confirmed seropositive individuals in this study, it suggested sequence diversity of these viruses in Nigeria. The virus-infected individuals identified in this study were one (1.5%) of the 65 patients with leukaemia/lymphoma (HTLV-I), 6 of 40 (15.0%) individuals (HTLV-I = 1 , HTLV-II = 3, HTLV-I/II = 2) with sexually transmitted diseases (STD), one of 25(4.0%) subjects with genital candidiasis for HTLV-I and 2 of 60 (33.3%) healthy individuals (one for HTLV-I and one for HTLV-I/II). There was a significant difference (P < 0.025) between the prevalence of HTLV-I/II infections among patients with lymphoma/leukaemia and those who attended STD clinic in Ibadan, Nigeria. This study also suggests that while HTLV-I and HTLV-II may be important sexually transmitted viruses, they may not be specific aetiological agents of the common lymphoproliferative disorders in Nigeria.

Clinico-epidemiological patterns of HIV infection in STD patients in Ibadan.

The HIV-seropositive subjects identified among the STD Clinic patients seen at a Special Treatment Clinic between 1989 and 1990 were studied to determine the epidemiological and clinical trends of HIV infection in these patients, and to demonstrate any association between the STDs and HIV- seropositivity. Thirty-seven out of the 581 patients investigated have been confirmed HIV-seropositive by Western bolt. The prevalence of HIV infection was 6.4%. Anti-HIV-1 antibody prevalence (3.6%) was higher than that of anti-HIV-2 antibody (2.8%). The age-range of the patients investigated was from 2 weeks to 49 years, and the HIV-seropositive cases were in the age-range 15-49 years, with peak incidence of HIV infection in the 21-30 years age-bracket. The male: female ratio of HIV-seropositive subjects was practically the same (1.01:1). HIV antibody-positive cases consisted of residents from towns in both Northern and Southern Nigeria. Only one of the HIV antibody-positive cases has developed clinical AIDS-progressive weight loss fourteen months after he was found positive for HIV antibody.

PIP: To identify epidemiologic and clinical patterns associated with human immunodeficiency virus (HIV) infection in sexually transmitted disease (STD) patients in Nigeria, serologic testing was performed on 581 men and women seen at Ibadan's Special Treatment Clinic during 1989-90. Of these, 37 (6.4%) were confirmed HIV-positive; 21 (3.6%) had HIV-1 antibodies and the remaining 16 (2.8%) had HIV-2 antibodies. Peak HIV incidence (24 cases, or 65%) was in the 21-30 year age group; the male to female ratio was 1.01 to 1.00. Presenting symptoms in HIV-positive cases included urethral discharge, vaginal discharge, dysuria, and genital ulcers. The prevalences of gonococcal infection, nonspecific urethritis and cervicitis, genital ulcer disease, and trichomoniasis were 27.0%, 18.9%, 16.2%, and 10.8%, respectively, among HIV-infected STD patients; none of the associations between specific STDs and HIV were statistically significant. Only 1 patient had developed clinical signs of acquired immunodeficiency syndrome (AIDS). The 6.4% prevalence rate detected among STD patients in this study was considered high since HIV is new to Nigeria (436 cases reported to date). Overall, these findings suggest that the AIDS epidemic is in an early stage in Nigeria and the major mode of HIV transmission is heterosexual sex. Routine HIV screening for high-risk groups in Nigeria, including STD patients, is recommended.

Urinary tract pathogens and antimicrobial sensitivity patterns in children in Ibadan, Nigeria.

A study of bacterial organisms isolated from 65 Nigerian children who had urinary tract infection (UTI) is reported. The predominant isolate in both inpatients and outpatients was Klebsiella species which accounted for 52.8% of cases. Escherichia coli, Pseudomonas spp and Proteus spp accounted for 25.0%, 15.3% and 5.5% of isolates, respectively. All isolates were poorly sensitive to the common first-line drugs used in UTI in our environment, namely, cotrimoxazole and ampicillin, but exhibited good sensitivity to nalidixic acid, nitrofurantoin and ofloxacin. It is recommended that nitrofurantoin and nalidixic acid be used for blind treatment of UTI in Nigerian children in Ibadan while results of culture and sensitivity are awaited. Continuous monitoring of the pattern of organisms isolated in childhood UTI and their antibiotic resistance patterns is recommended as an essential step in guiding blind antibiotic therapy in such cases.

Childhood infections in Nigeria: an autopsy study.

Infections are the leading cause of childhood morbidity and mortality in developing countries. Bronchopneumonia, meningitis and gastroenteritis are the commonest fatal infections encountered in Ibadan. Tuberculous lymphadenitis, bronchopneumonia and meningitis are other frequent causes of death. The predominant sequela of measles is respiratory tract infection. Another important cause of childhood mortality is cerebral malaria. In half of the cases of tetanus no obvious portal of entry can be found. It is advocated that the implementation of immunization schedules should be vigorously pursued to curtail childhood mortality resulting from infection.