Zero tolerance for complacency by government of West African countries in the face of COVID-19.

A novel Coronavirus (SARS-CoV-2) causing a cluster of respiratory infections (Coronavirus Disease 2019, COVID-19) first discovered in Wuhan, China, is responsible for a new illness that has been found to affect the lungs and airways of patients with associated symptoms of fever, cough and shortness of breath. In the light of few cases recorded so far in West Africa there is tendency for complacency. The region needs to make strategic plans based on available evidence to enable them effectively deal with this rapidly evolving pandemic. At this very moment countries like China, Italy, France, Spain, Iran, UK and many others are witnessing sustained and intensive community transmission of this virus and increasing numbers of severe disease and death particularly among elderly patients with other comorbidities. The reality of the seriousness of this pandemic is alarming. Government of member states of ECOWAS need to prepare themselves by building capacity as well as implement evidenced-based steps to mitigate this rapidly evolving pandemic by testing persons presenting with symptoms (fever, cough and shortness of breath), isolating and treating those found positive, tracing and quarantining contacts, implementing social distancing as well as optimizing human and material endowment to allow healthcare workers offer safe quality clinical care for affected patients to prevent secondary infection among healthcare workers.

Prevalence of some hepatitis B virus markers among pregnant women attending antenatal clinic in Specialist Hospital Sokoto Nigeria.

BACKGROUND: Hepatitis B virus infection is a global public health problem. The virus has infected more than one-third of the global population. It has been estimated that 360 million chronic carriers are living around the world with a high risk for developing cirrhosis, hepatic carcinoma and hepatic failure. OBJECTIVE: The aim of this study was to determine the prevalence of some hepatitis B markers among pregnant women attending antenatal clinic in Sokoto Specialist Hospital, Nigeria. METHODS: The hepatitis testing was carried out using the Skytec-Rapid Diagnostic HBV-5 rapid kit (Skytec-Rapid Diagnostic, USA). The kit is based on lateral flow chromatographic immunoassay for the qualitative detection of HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb in human serum or plasma. Panel format can conveniently test for five targets at once and utilizes all markers to help distinguish between acute and chronic infections. RESULTS: Out of 117 pregnant women tested, 15 were positive for HBsAg (12.8%), 6 positive for HBsAb (5.1%), 1 for HBeAg (0.9%), 14 tested positive for HBeAb (12.0%), and 14 tested for HBcAb (12.0%). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on ethnicity. HBsAb was significantly higher among the Hausa ethnic group (p= 0.001). The prevalence of HBsAb, HBeAg, HBcAb and HBcAb was not affected by ethnicity (p> 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on age. Infection by the hepatitis B virus markers was higher among young adult and middle age groups. The difference was however not statistically significant (p> 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on the educational status, previous history of blood transfusion, jaundice, employment status and previous history of still births among the pregnant subjects. There were no statistically significant differences in the prevalence of Hepatitis B virus markers (p> 0.05). CONCLUSION: The study observed a high prevalence of various hepatitis B viral markers among pregnant women attending antenatal care in Specialist Hospital Sokoto. There is need for routine screening of all pregnant women and infants born to hepatitis B positive mothers. Government and non-governmental organizations should intensify efforts to enlighten the general population on the public health importance of the disease and the importance of hepatitis screening. There is also need for the development of a treatment protocol for the management of pregnant women positive for hepatitis B to prevent mother to child transmission. There is an urgent need for the implementation of evidenced-based best practice of providing universal vaccination against hepatitis B for all hepatitis B negative women of child bearing age in particular and all Nigerians in general.

Anaemia and thrombocytopenia among pregnant women attending Aminu Kano Teaching Hospital, Kano State, North Western Nigeria.

BACKGROUND: Pregnancy induces a number of physiologic changes either directly or indirectly that affect the haematologic parameters. The most frequent haematologic complication associated with pregnancy is anaemia and thrombocytopenia. OBJECTIVES: The aim of this case-control study was to investigate the prevalence of anaemia and thrombocytopenia among one hundred and twenty consecutively-recruited pregnant subjects and sixty age-matched non-pregnant controls. METHOD: Socio-demographic and clinical data were obtained using a questionnaire. Three milliliters of blood were obtained from both the pregnant subjects and non-pregnant controls and distributed into EDTA and used for full blood count was determined using the fully automated Mythic 18 3-part differential haematology analyzer. RESULT: The socio-demographic distribution among the subjects showed that the age group 25-29 years had the higher number of participants 41 (34.2%) followed by 30-34 years 39 (32.5%). Distribution based on socio-demography indicated that majority of the subjects were of Hausa ethnic group 47 (78.3), had no formal or Islamic education 53 (44.2%) and predominantly housewives 74 (61.7%). Distribution based on obstetric variables indicated that majority of the subjects were multiparous 86 (71.7%), had no problem in their previous pregnancies 99 (82.5%) and are not having problem in this current pregnancy 109 (90.8%). The HBG and HCT were significantly lower among the pregnant subjects compared to controls (p= 0.05 and 0.0308) respectively. The prevalence of anaemia and thrombocytopenia among the pregnant subjects was 75% and 6.7% respectively. The prevalence of anaemia (80%) and thrombocytopenia (8.0%) was higher among pregnant women in the second trimester compared to those in the first and third trimesters. CONCLUSION: The values obtained from this research showed an increase in prevalence of anaemia and thrombocytopenia among pregnant women compared to the non-pregnant controls. It is vital to routinely monitor the indices of anaemia and thrombocytopenia among pregnant women to reduce the incidence of these diseases and of their complications.

Some haematological parameters, manganese and zinc levels among diabetic patients of African descent attending Specialist Hospital Sokoto, Nigeria.

BACKGROUND: World Health Organization statistics identifies that there are about 150 million people with diabetes mellitus worldwide and suggest that this figure may double by 2025. OBJECTIVE: This research was conducted to determine the status of full blood count, zinc and manganese levels among Diabetic patients attending Specialist Hospital, Sokoto. METHODS: The participants were divided into two groups; 58 diabetic subjects and 29 non-diabetic controls. Five milliliters of blood were collected into EDTA and plain containers for full blood count, serum zinc and manganese analysis. The FBC investigation was carried out using automated Mythic Haematology analyzer (Orphee, Switzerland) while Zn and Mn investigations were carried out using Atomic Absorption Spectrometry (AAS). The FBC, Zn and Mn status of both control and subjects were compared statistically. RESULTS: The results obtained in this study showed a significant increase in RBC, PCV, Hb, Basophils, Eosinophil, Lymphocyte count and Manganese levels of diabetic subjects (p⩽ 0.05) when compared with controls. There was no statistically significant difference in the other FBC parameters and Zinc levels between diabetic subjects and non-diabetic controls (p> 0.05). There was a statistically significant difference in the Hb, PCV and lymphocyte of diabetic patients based on gender (p< 0.05). FBC, Manganese and Zinc have no effect based on age group, while other socio-demographic factors also have no effect on the FBC, Manganese and Zinc parameters of diabetic patients. The study also showed no statistical difference in the FBC, Manganese and Zinc of smokers and non-smokers (p> 0.05, respectively). In conclusion, this research shows that some haematological parameters (RBC count, Basophils, Eosinophil, Lymphocyte, Hb and Manganese) of the diabetic patients are significantly higher compared to non-diabetic controls. Marital status had a significant effect on the Hb, PCV and Lymphocyte of the diabetic patients (p< 0.05). The age group had no significant effect on the Hb, PCV and Lymphocyte of diabetic subjects (p> 0.05).CONCLUSIONS There is need to routinely monitor the full blood count, zinc and manganese levels among diabetic subjects in the area to optimize the care offered to these patients.

Prevalence of Hepatitis B surface antigen among biomedical students of African descent in Usmanu Danfodiyo University, Sokoto, Nigeria.

BACKGROUND: Hepatitis B (HB) is a serious global public health problem that put health professionals particularly at risk. OBJECTIVE: The aim of this study was to investigate the prevalence of Hepatitis B surface antigen (HBsAg) among Biomedical Students of African descent attending Usmanu Danfodiyo University Sokoto in North-Western Nigeria. METHODS: The Onsite HBsAg (CTK Biotech, USA) was used to detect the presence of hepatitis B surface antigen. RESULTS: We tested 186 consecutively-recruited students consisting of 147 males and 39 females aged 18-35 years (mean age 26 ± 2.0 years). Of the 186 students tested, 25 (13.4%) were positive for HBsAg. The prevalence of HBsAg was significantly higher among students in the 21-25 years age group. Hepatitis B vaccination uptake among students was 7%. Majority of subjects were single 173(93.1%) compared to married 13 (6.9%). Ethnic distribution of the subjects indicated that 104(55.9%) were Hausa compared to Yoruba 32 (17.2%), other ethnic groups 21(11.3%), Fulani 20(10.8%) and Igbo 9(4.8%). CONCLUSIONS: This study indicates a high prevalence of hepatitis B virus infection among Biomedical students in Sokoto, North Western, Nigeria. Finding from this study is enough justification for the implementation of a policy to routinely test students entering into the biomedical professions for Hepatitis B virus infection. There is the need to provide hepatitis B vaccination universally to all those who are found negative prior to commencement of their biomedical training. There is also need to educate students entering biomedical professions and healthcare workers on the modes of transmission and prevention, importance of being compliant with protective vaccination as well as the need to observe universal precaution and infection control guidelines during their training and future professional practice.

Evaluation of the QBC Star centrifugal three-part differential haematology system.

The QBC Star haematology system includes the QBC Star centrifugal analytical analyser and the QBC Star tube system. Together, they are capable of producing a haematology profile on venous or capillary whole blood. The aim of this study is to compare full blood count (FBC) including differential white cell count performance between the QBC Star analyser and a gold standard Sysmex XE-2100 haematology analyser. The FBC performance was evaluated according to the National Committee for Clinical Laboratory Standards (NCCLS) document H20-A. Imprecision, correlation and linearity studies all showed excellent results. Overall, the haemoglobin, haematocrit, white cell count (WCC) and platelet count parameters showed excellent correlation. Mean corpuscular haemoglobin concentration (MCHC) results showed poor comparability. The white cell differential parameters showed good correlation within certain clinically significant limits. Imprecision for haemoglobin, haematocrit, WCC, MCHC and platelet count was considered acceptable. The re-read function was found to be stable over the five-hour testing period under the authors' laboratory environmental conditions. The subjective assessment by biomedical scientist staff demonstrated that the system was user friendly, required little maintenance, and no user calibration was required. Staff considered the user manual to be excellent. Overall, the QBC Star appears to be an excellent point-of-care (POC) dry haematology analyser that delivers clinically significant nine-parameter complete blood count and will make a good POC analyser for use in field hospitals, research, screening programmes, GP surgeries as well as in emergency and intensive care units. It is a health and safety-friendly analyser considering the fact that it uses dry haematology reagents instead of the bulky wet reagents that are often associated with liquid biohazard waste.

Some hemostatic parameters in women with obstetric hemorrhage in Sokoto, Nigeria.

Obstetric hemorrhage is the leading cause of maternal mortality and morbidity worldwide. This study was carried out to investigate the effect of obstetric hemorrhage on the prothrombin time (PT), activated partial thromboplastin time (APTT), and platelet count (PLC). Women with obstetric hemorrhage were divided into two categories, women with antepartum hemorrhage (APH) and those with postpartum hemorrhage (PPH). Pregnant women without hemorrhage were included as controls. Eighty-six pregnant women aged 18-45 years (mean age 36.25 ± 10.50 years) were presented to the Obstetrics and Gynaecology Department of Maryam Abacha Women and Children Hospital in Sokoto Metropolis, Sokoto State, Nigeria with history of obstetric hemorrhage. Forty-three age-matched nonhemorrhaging parturient women were included as controls. The determination of PT and APTT was done by manual methods using commercially prepared Diagen reagent kits, whereas PLC was done by manual methods using a hemocytometer. The results of PT and APTT were significantly higher among women with APH (20.7 ± 4.226 seconds and 46.04 ± 8.689 seconds, respectively) and among women with PPH (23.17 ± 2.708 seconds and 53.78 ± 4.089 seconds, respectively) compared to normal pregnant women (15.85 ± 0.8930 seconds and 36.225 ± 5.010 seconds, respectively) (P = 0.0001). Similarly, the PLC was significantly higher among normal pregnant women compared to those with APH and PPH (291.425 ± 75.980 × 10(9) compared to 154.83 ± 47.019 × 10(9) and 136.43 ± 43.894 × 10(9), respectively) (P = 0.0001). The PT and APTT of women who presented with PPH were significantly higher compared to those who presented with APH (23.17 ± 2.708 seconds and 53.78 ± 4.089 seconds versus 20.7 ± 4.226 seconds and 46.04 ± 8.689 seconds, respectively) (P = 0.02 and P = 0.04, respectively). The PLC was significantly higher among women who presented with APH compared to those who presented with PPH (P = 0.01). The PT and APTT values were higher in the third trimester among women with APH (24.38 ± 2.33 seconds and 52.25 ± 6.71 seconds, respectively), PPH (24.75 ± 2.63 seconds and 58.25 ± 2.53 seconds, respectively), and control women (16.00 ± 0.82 seconds and 34.42 ± 5.59 seconds, respectively) compared to those in first and second trimester. The PLC was significantly lower in the third trimester among APH, PPH, and normal pregnant women (131 ± 23.02 × 10(9), 99 ± 21.46 × 10(9), and 192.86 ± 25.44 × 10(9), respectively). PT and APTT values correlated positively and significantly with trimester (r = 0.52 and 0.65, respectively; P = 0.01). The PLC of women with APH, PPH, and normal control women correlated negatively with trimester (r = -0.36, -0.54, and -0.28, respectively; P = 0.05). Obstetrics hemorrhage compounded the hemostatic status of pregnant women in Sokoto, Nigeria. There is need for the provision of rapid diagnosis of coagulopathy to guide the provision of best therapeutic management options.

A study of the fish fauna of Tagwai Lake Minna, Nigeria, in relation to gear selectivity.

The fish fauna of Tagwai Lake Minna, Nigeria, was studied from July to September, 2010. Sampling was carried out during the day using different gears. A total of 1,669 specimens were sampled made up of 8 species in 7 genera and 6 families. Variation in the mesh size used greatly influenced catch in the lake. Cash net recorded the highest amount of catch (1,435) and gill net recorded the highest amount of fish species (6). Two Cichlids species, Tilapia zilli and Sarotherodon galilaeus were the most abundant in the catch, amounting to 33.01 and 26.06%, respectively. The families of Cichlidae and Mormyridae were the most abundant constituting 59.18 and 29.95% of the total catch respectively. Fish abundance showed low catches during the raining season (33.01%) and daytime.

Malaria parasitaemia among long distance truck drivers in the Niger delta of Nigeria.

BACKGROUND: Malaria is the leading cause of morbidity and mortality in sub-Saharan Africa. OBJECTIVE: The aim of this study was to determine the prevalence of malaria among long distance truck drivers in the Niger Delta of Nigeria. METHODS: A total of one hundred consecutively recruited long distance truck drivers aged 21-60 years, with a mean age of 42.36 ± 5.23 years were screened for the presence of malaria parasitaemia. RESULTS: Out of the 100 truck drivers screened, 35 (35%) were positive for malaria while 65 (65%) were negative. Plasmodium falciparum was responsible for all cases of malaria infection. The highest prevalence of malaria occurred among drivers in the 51-60 years age group (40.5%). The mean and standard deviation (SD) of parasite load was 1 020 (125) parasites/ìl in subjects positive for malaria. The mean CD4 count was significantly higher among non-parasitized truck drivers compared to P. falciparum parasitized drivers 820 ± 42.0 (731-902 cells/ µl) and 570 ± 30.0 (510-630 cells/ µl) respectively (chi square = 74.00; p = 0.03). We observed a significant negative correlation between plasmodial infection and CD4 lymphocyte count among Plasmodium falciparum-infected subjects with r = - 0.56 (p= 0.001). CONCLUSION: Preventative strategies including regular chemoprophylaxis, intermittent preventive treatment with antimalarials and provision of insecticide-treated bed nets should be implemented.

HIV among military personnel in the Niger Delta of Nigeria.

The military community is considered a high-risk environment for HIV transmission. In this study, a total of One hundred and fifty military personnel aged between 20 and 55 years attending the Nigerian army Hospital, Air Force Clinic and Police Clinic in the Niger Delta of Nigeria were randomly recruited for the study. Samples were tested for HIV using an immunochromatographic assay. The CD4 cell count was estimated using the Partec Cyflow Counter (Partec, Germany). Results of the study showed an overall HIV prevalence rate of 14.67%. The prevalence of HIV was significantly higher among subjects in the ≥40 years age group (P = 0.03). The HIV prevalence was higher among female subjects compared to male military personnel (P = 0.05). Also, there was a significant negative correlation between the CD4 count and HIV positivity (r = -0.443, P<0.01). Out of the 22 subjects positive for HIV, 9.1% were severely immune compromised with CD4 count below<200 cells/µL while 72.7 and 18.2% had CD4 count of 200-350 and 350-500 cells/µL respectively. There is need for the development of a strategic plan that integrates HIV/AIDS and other STIs programs into existing systems and structures to foster behavior change through information dissemination. Policies should be instituted to make condoms regularly available and freely distributed, with the goal of achieving a 100%-condom-use rate. There is the need for an effective voluntary counseling and testing (VCT) and sentinel surveillance survey in the Nigerian military. Also critical is the establishment of a fully integrated and comprehensive care and support system including universal access of antiretroviral treatment for infected people.

From whole blood to component therapy: the economic, supply/demand need for implementation of component therapy in sub-Saharan Africa.

Blood may be transfused as whole blood or as one of its components. Because patients seldom require all of the components of whole blood, it makes sense to transfuse only that portion needed by the patient for a specific condition or disease. This treatment, known as "blood component therapy", allows several patients to benefit from one unit of donated whole blood. Blood components include red blood cells, plasma, platelets, and cryoprecipitate. A considerable literature has accumulated over the past decade indicating that leukocytes present in allogeneic cellular blood components, intended for transfusion, are associated with adverse effects to the recipient. These include the development of febrile transfusion reactions, graft-versus-host disease, alloimmunization to leukocyte antigens, and the immunomodulatory effects that might influence the prognosis of patients with a malignancy. Moreover, it has become evident that such leukocytes may be the vector of infectious agents such as cytomegalovirus (CMV), Human T-Lymphotrophic Virus 1/11 (HTLV-I/II), and Epstein Barr (EBV) as well as other viruses. Effective stewardship of blood ensuring that several patients potentially benefit from components derived from one unit of donated whole blood is important for economic, supply/demand reasons and to protect the national inventory at times of national blood shortage. Blood safety in developing countries can be improved by more appropriate use of blood components rather than whole blood transfusion and the provision of alternatives such as oral and intravenous iron, erythropoietin, saline and colloids. This will facilitate the optimal use of the limited blood supply. Political will and open-mindedness to innovative ways to improve supply, appropriateness, optimal use and safety of blood from all types of donors are essential to promote more evidence-based approaches to blood transfusion practice in sub-Saharan Africa.

Cryptosporidiosis among HIV-infected persons in the Niger Delta of Nigeria.

BACKGROUND: Since the discovery of acquired immunodeficiency syndrome (AIDS), many studies demonstrated that intestinal parasites were frequently associated with pictures of severe diarrhoea in patients with HIV. OBJECTIVES: To determine the prevalence of Cryptosporidiosis among HIV-infected persons in the Niger Delta of Nigeria. METHOD: Faecal samples from One hundred and five HIV/AIDS infected subjects made up of 48 males and 57 females aged 18-54 years, mean age and CD4 count of 36.14 +/- 8.46 years and 320 +/- 140 cells/microl respectively were evaluated for Cryptosporidiosis using the Modified Ziehl-Neelsen staining method. RESULTS: Of the one hundred and five faecal samples examined, 3 (2.9%) were positive for cryptosporidium oocyst. Prevalence was significantly higher among females 2/57 (3.5%) compared to males 1/48 (2.1%), among subjects with diarrhoea 3(11.5%) and among subjects with CD4 lymphocyte count < 200 cells/microl (p < 0.01). CD4 count of subjects positive for cryptosporidium oocyst was significantly lower (150 +/- 50 cells/microl). The mean CD4 count of subjects with diarrhoea was significantly lower (mean 180 cells/microl) compared to those without diarrhoea (360 cells/microl). CONCLUSION: Our study indicates that the prevalence of intestinal colonization due to Cryptosporidium is significantly higher among HIV-infected persons presenting with diarrhoea and low CD4 lymphocyte count of < 200cells/microl and re-emphasizes the need to incorporate routine faecal parasitological examination (FPE) in the follow up management of patients with HIV/AIDS. This is likely to optimise treatments in these patients by eradicating opportunistic pathogens and improve the quality of life of these patients.

Alloantibodies to glycoprotein La/LLa (anti-HPA-5a and -5b) and IIb/IIIa (anti-HPA1a, -3a and -4a) in Nigerian parous women.

Human platelet antibodies are often implicated in conditions such as neonatal alloimmune thrombocytopenia (NAIT), idiopathic thrombocytopenic purpura (ITP) and platelet refractoriness; however, the frequency of such alloantibodies has not been reported in Nigeria and West Africa. A cross section of apparently healthy adult female staff at a tertiary health facility in the Niger Delta, Nigeria, was screened for alloantibodies to human platelet antigens (HPA) using the GTI PakPlus qualitative solid-phase enzyme-linked immunosorbent assay (ELISA) method. Among the 100 women screened, no anti-glycoprotein IIb/IIIa (anti-HPA-Ia,-3a and -4a) antibodies were detected; however, prevalence of anti-glycoprotein Ia/IIa (anti-HPA-5b) was 30% and pf anti-glycoprotein Ia/IIa (anti-HPA-5a) was 18%. Parity had a significant influence on the development to HPA antibodies (Fisher's Exact test: 11.683, P < 0.05; 13.577, P < 0.01). Platelet count did not have an influence on the development of antibodies (P > 0.05). Clearly, there is need to initiate platelet serology in this setting and also a need to educate women about the risk associated with frequent pregnancies. Furthermore, caution should be exercised when recruiting parous women as blood donors

Effect of amlodipine, a calcium channel antagonist, on gonadal steroid of male Wistar albino rats.

This study was carried out to investigate the effect of prolonged intake of calcium-channel blocker amlodipine, an antihypertensive drug on gonadal steroid hormone (testosterone) of male albino rats. Three different concentrations of amlodipine (0.01, 0.02 and 0.03 mg/kg body weight) was administered orally to three different groups (B, C, and D) of experimental male Wistar albino rats (n = 8) for six weeks. Group A rats were fed normal diet without amlodipine (n = 8) served as the control. The administration of amlodipine significantly reduced testosterone level in the following order, group A (0.22 ± 0.01) > B (0.18 ± 0.01) > C (0.14 ± 0.01) > D (0.10 ± 0.01). The reduction in testosterone levels corresponded with an increase in the concentration of amlodipine administered to male Wistar albino rats. The observation in this study reveals that long-term treatment of male Wistar rats with calcium-channel blocker and antihypertensive (amlodipine) produces a significant reduction in the level of testosterone a hormone associated with decreased ability of men to enjoy sex and to develop good quality erections. There is the need for a large scale study to investigate the potential effect of long-term antihypertensive therapy with amlodipine on sexual dysfunction in men.

The prevalence of human immunodeficiency virus infection among TB patients in Port Harcourt Nigeria.

The joint statement by the American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America recommends that all patients with tuberculosis (TB) undergo testing for human immunodeficiency virus (HIV) infection after counseling. In this study, we investigated the prevalence of HIV infection among 120 patients diagnosed with microbiologically proven TB aged 18 to 54 years with a mean age of 39.5 years (standard deviation 6.75). The subjects studied were 36 male (30%) and 84 females (70%). Enzyme-linked immunosorbent assay methods were used to screen for HIV infection among the subjects. Of the 120 TB patients tested 30 (25%) were positive for HIV infection. The prevalence of HIV was higher in females 24 (80%) compared to males 6 (20%) and among singles (66.7%) compared to married subjects (33.3%) (χ(2) = 83.5 and χ(2) = 126.2, respectively P = 0.001). HIV-1 was the predominant viral subtype. HIV prevalence was significantly higher in subjects in the 38-47 year and 28-37 year age groups (both 40%) followed by the 18-28 year age group (20%) (χ(2) = 42.6, P = 0.05). The mean CD4 lymphocyte count of the HIV-infected TB subjects was significantly lower (195 ± 40.5 cells/µL) compared to the non-HIV infected (288 ± 35.25 cells/µL P = 0.01). This study has shown a high prevalence of HIV among TB patients. Reactivation of TB among people living with HIV can be reduced by TB preventive therapy and by universal access to antiretroviral therapy.

Seroprevalence of hepatitis B surface antigenaemia in children in a tertiary health institution in the Niger Delta of Nigeria.

BACKGROUND: There is paucity of data on the seroprevalence of HBV infection in children living in urban areas of the Niger Delta of Nigeria. The aim of this study is to determine the seroprevalence of hepatitis B surface antigenaemia among children presenting to the University of Port Harcourt Teaching Hospital (UPTH), to determine the trend in the seroprevalence of HBsAg over a five-year period and to correlate serological findings to clinical features. METHODS: Serum samples from 251 consecutively recruited children in UPTH aged =16 years were tested for Hepatitis B surface antigen using Clinotech HBsAg kits and confirmed using the Trinity Biotec enzyme linked immunosorbent assay based HBsAg kits. Medical records of the children were also obtained. RESULTS: The overall prevalence of HBsAg among children tested was 12.4%. HBsAg prevalence was highest in the 11-15 years age group (24.5%) and the lowest in the 6-10 years age group (11.0%). There was a statistically significant difference in the prevalence of HB V positivity based on age groups (?2, = 8.47, p = 0.014). Prevalence rate was relatively higher among males (13.7%) compared to females (10.7%). There is a statistically significant trend in the decline of HBsAg prevalence 1999 to 2004 (?2, for trend = 11.38, p = 0.001). The predominant symptoms among children positive for HBsAg were hepatosplenomegaly (75%) and jaundice (64.5%). CONCLUSION: This study indicates a high prevalence of HBsAg among children presenting to a tertiary health facility in Port Harcourt.

Epidemiology and management of occupational exposure to blood borne viral infections in a resource poor setting: the case for availability of post exposure prophylaxis.

OBJECTIVES: The aim of this study was to demonstrate the epidemiology and risk of occupational exposure to HIV, HBV and HCV among health care workers (HCWs) and highlight areas where greater training is required. METHODS: The study population included 13 health care workers; 5 males (38.5%) and 8 females (61.5%), mean age 34.15 +/- 6.8 years including 3 doctors (23.1%), 2 laboratory scientist (15.4%), 1 laboratory technician (7.7%), 6 medical students (46.2%) and 1 trainee laboratory assistant (7.7%). The care and follow-up provided to the health care workers in the 500 -bed tertiary health hospital that had percutaneous exposure to patient's blood between June 2002 and June 2005 were analyzed. All exposed health care workers were evaluated and offered follow up counseling. Five milliliters of blood from each of the HCWs and the source patients were screened by immmuno-enzymatic testing for HIV, HBV, and HCV. RESULTS: Exposures were concentrated in few areas of the hospital; pediatrics (46.2%); surgery (15.4%); obstetrics and gynecology (7.7%) and laboratory unit (30.8%) (divided by 2 = 7.72, p = 0.05). Risk of exposure was significantly higher among females (61.5%) compared to males (38.5%) (divided by 2 = 29.96, p = 0.001). All exposed HCWs were seen and offered post exposure prophylaxis within 24 hours of exposure. All the exposed health care workers were sero-negative to HIV, HBsAg and anti-HCV at exposure. The source patients were known in all cases. Evidence of HIV was present in 5 (38.5%); 1 (7.7%) had HBV while none had HCV infection. Of all the HCWs who completed the follow-up, only 1(7.7%) confirmed case of HBV seroconversion occurred in a HCW who was not previously vaccinated against HBV but who received post exposure HBV vaccination. Exposure rate was significantly higher among house officers 7 (53.9%) followed by registrars 3 (23.1%) and laboratory scientist 3 (23.1) (divided by 2 = 74.79, p = 0.0001). CONCLUSIONS: There is need to address the issue of occupational exposure in Africa by providing training on universal precaution, phlebotomy, modifying procedures that have high risk, developing institutional policy for handling of sharps and post-exposure management of health care workers, provision of protective HBV vaccine for all HCWs coupled with the provision of post exposure prophylaxis for exposed HCWs.

Seroprevalence of Hepatitis B Surface Antigenaemia in Children in a Tertiary Health Institution in the Niger Delta of Nigeria

BACKGROUND: There is paucity of data on the seroprevalence of HBV infection in children living in urban areas of the Niger Delta of Nigeria. The aim of this study is to determine the seroprevalence of hepatitis B surface antigenaemia among children presenting to the University of Port Harcourt Teaching Hospital (UPTH), to determine the trend in the seroprevalence of HBsAg over a five-year period and to correlate serological findings to clinical features. METHODS: Serum samples from 251 consecutively recruited children in UPTH aged =16 years were tested for Hepatitis B surface antigen using Clinotech HBsAg kits and confirmed using the Trinity Biotec enzyme linked immunosorbent assay based HBsAg kits. Medical records of the children were also obtained. RESULTS: The overall prevalence of HBsAg among children tested was 12.4%. HBsAg prevalence was highest in the 11-15 years age group (24.5%) and the lowest in the 6-10 years age group (11.0%). There was a statistically significant difference in the prevalence of HB V positivity based on age groups (?2, = 8.47, p = 0.014). Prevalence rate was relatively higher among males (13.7%) compared to females (10.7%). There is a statistically significant trend in the decline of HBsAg prevalence 1999 to 2004 (?2, for trend = 11.38, p = 0.001). The predominant symptoms among children positive for HBsAg were hepatosplenomegaly (75%) and jaundice (64.5%). CONCLUSION: This study indicates a high prevalence of HBsAg among children presenting to a tertiary health facility in Port Harcourt

Anaemia in human immunodeficiency virus infection: a review.

BACKGROUND: Human immunodeficiency virus infection is associated with myriads of haematological abnormalities and complications, including anaemia. This review aims at presenting the epidemiologic evidence of HIV associated anaemia, and also examine its effects on patients' survival and the need for specific diagnosis and treatment. METHODS: A review of relevant literature on the subject was sourced manually and by PUBMED internet search. The following keywords were used for internet search: anaemia, chronic disease, highly active antiretroviral therapy human immunodeficiency virus, haematological abnormalities, and AIDS. RESULTS: Human immunodeficiency virus (HIV) is associated with numerous abnormalities of red blood cells production and lifespan. One of these consequences is anaemia. The prevalence of these estimates varies widely from one population to another; however, anaemia was consistently shown to be a predictor for increased disease progression and decreased survival of patient infected by HIV. CONCLUSION: Regular evaluation of patients infected by HIV is necessary, to determine the specific causes of anaemia in order to ensure the institution of appropriate intervention.

The risk of transfusion-acquired hepatitis-C virus infection among blood donors in Port Harcourt: the question of blood safety in Nigeria.

OBJECTIVE: This study was undertaken to establish the sero-epidemology of Hepatitis C Virus (HCV) antibodies among blood donors in Port Harcourt, Nigeria. METHODS: One Thousand Five Hundred consecutive blood donors presenting to the blood transfusion unit of the University of Port Harcourt Teaching Hospital between January and April, 2003 comprising of 1481 males and 19 females were screened for hepatitis C antibodies using the commercially available Clinotech anti-HCV test strips. All initially positive samples were subsequently tested using a second-generation Trinity Biotec enzyme linked immunosorbent assay. RESULTS: HCV antibodies were detected in 7 (0.5%) of donors. Although statistically not significant, the overall sero prevalence of HCV antibodies was higher in males 7 (0.5%) compared to zero prevalence among females. (chi-squared = 1.94, p = 1.000). Commercial remunerated donors had a higher prevalence of anti-HCV anti-bodies 5 (0.8%) compared to family replacement donors (0.2%) (chi-squared = 1.25, p = 0.26). The highest infection rate occurred in the 18 - 27 years age group 7 (0.7%). CONCLUSION: This study shows a 0.5% prevalence of HCV antibodies among blood donors and describes their demographic characteristics. This calls for urgent implementation of a universal donor screening for HCV antibodies and setting up of a national blood transfusion service run on the basis of voluntary, non-remunerated low risk donors.