Multidrug-resistant tuberculosis in Imo State, Southeast, Nigeria.

BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is a global health challenge. The emergence of MDR TB has contributed remarkably to the spread of tuberculosis and also poses a threat, which if not effectively addressed may wipe out the achievements of previous efforts in controlling tuberculosis. OBJECTIVE: This study was aimed at detecting MDR-TB among patients in a setting prevalent with tuberculosis and HIV in Southeast, Nigeria. METHOD: Sputum specimens collected from 740 suspected tuberculosis (TB) patients were screened for acid-fast bacilli (AFB). All the 111 AFB positive samples were subjected to culture on Lowenstein-Jensen (LJ) medium and Mycobacterium Growth Indicator Tube (MGIT) 960 TB system. The isolates were then confirmed as Mycobacterium tuberculosis using SD Bioline Rapid Diagnostic Tests before being subjected to drug susceptibility testing to first-line anti-TB drugs. MDR-TB was determined by isolates being resistant to both isoniazid and rifampicin. HIV testing was performed for participants included in the study using standard rapid diagnostic tests. RESULT: Out of the 111 AFB-positive sputum samples, 65 (58.6%) were culture-positive for Mycobacterium tuberculosis. MDR-TB was found in 2 ([3.1%] 95% CI = 0.0-7.3) of the culture-positive samples. The rate of TB and HIV coinfection was 7.7%. Maximum single-drug resistance was seen in ethambutol 12 ([18.5%] 95% CI = 9.0-27.9). CONCLUSION: The MDR-TB rate of 3.1% found in this study was relatively low and efforts should be intensified to keep it low.

Awareness and Knowledge of Ergonomics Among Medical Laboratory Scientists in Nigeria.

BACKGROUND: Ergonomics awareness helps in its right application and contributes significantly to general wellbeing and safety of worker at workplace. AIM: This cross-sectional descriptive study aimed at assessing the level of awareness and knowledge of the science of ergonomics among Medical Laboratory Scientists in Benin City, Nigeria. SUBJECTS AND METHODS: A total of 106 medical laboratory scientists comprising 64 and 42 in public and private laboratories, respectively, were recruited for this study using systematic random sampling technique. Data were obtained from the study participants using a questionnaire and subsequently analyzed with the statistical software INSTAT(®). RESULTS: Out of 106 study participants, 27 (25.5%) were reported to have heard of the term ergonomics. Awareness was significantly associated with gender (male vs. female: 38.5% [15/39] vs. 17.9% [12/67]; odds ratio = 2.9; 95% confidence interval = 1.2, 7.1;P = 0.02). Awareness of ergonomics was not significantly affected by affiliation (P = 0.18), area of specialization (P = 0.78), post-qualification experience (P = 0.43), and educational qualification (P = 0.23) of the study participants. Irrespective of the affiliation of the participant, only 6 of 27 (22.2%) participants who were aware of ergonomics knew at least a benefit of right application of ergonomics in the laboratory. Knowledge of risk factors for the development of musculoskeletal disorders was reported by 8 of 27 (29.6%) persons who claimed to be aware of ergonomics. CONCLUSIONS: Awareness of ergonomics and knowledge of gains of its right application was poor among the study participants. Regular ergonomic education of medical laboratory scientists in Nigeria is advocated.

Malaria and anaemia in pregnancy in Enugu, south east Nigeria.

Malaria and anaemia contribute tremendously to maternal and prenatal morbidity and mortality. This study was carried out to document the magnitude of the problem in pregnancy with a view to identifying areas of intervention. The subjects were 108 consecutive pregnant women aged 18 to 44 years recruited from the antenatal clinics. 23 (21.3%) had malaria, 35 (32.4%) had anaemia while 20(18.5%) had both malaria and anaemia. The highest incidence of malaria occurred in the second trimester, while anaemia was most prevalent in the third trimester (62.86%) and among primigravidae (37.14%). All the cases of malaria were due to plasmodium falciparum. Six out of the 20 women with both anemia and malaria were admitted and treated. Two low birth weight babies were delivered among the malaria and anaemia group. The incidence rates of malaria and anaemia were 215 and 327 per 1000 pregnant women respectively while the incidence rate of anaemia due to malaria was 571 per 1000 infected pregnant women. There is a need for a more effective intervention to reduce the incidence of both malaria and anaemia in pregnancy.

The pattern of home treatment of malaria in under-fives in south eastern Nigeria.

Malaria remains a major public health problem in most countries of the tropics with high morbidity and mortality. The toll of the disease is highest on the under-fives. The actions mothers take in the management of children with malaria is important in the fight to check the malaria scourge. A cross sectional survey was carried out in two states in southeast Nigeria--Abia and Anambra states. A multi-stage sampling technique was used to select the subjects. One thousand two hundred and sixty mothers with children under five years of age were selected from 6 Local Government Areas in the two states. Trained interviewers were used to conduct the survey. The mean age of the mothers was 30.51 +/- 6.76. Over 95% (1016) of the respondents had at least a primary school education. The first line of actions mothers took when their under-five children had malaria showed that 54.5% (687) of them either procured medicines from the patent medicine dealers or used medicines that were in the home. The two most commonly used drugs for malaria treatment for under-fives were chloroquine 65.4% (824) and pyrimethamine/sulfadoxine 12.3% (155). Between 11.5% and 46% of the mothers used correct doses of chloroquine syrup while 5.3% and 11.5% of them used correct doses of chloroquine tablets. The proportion of mothers that used correct doses of pyrimethamine/sulfadoxine tablets was comparatively higher (36.4% and 75%) than the others. Large proportion of mothers (61%) who manage malaria at home, do so inappropriately. Proper health education needs to be set up to enlighten the populace on mode of home treatment for malaria in order to reduce the disease burden on families.

Human onchocerciasis in the lower Jos Plateau, central Nigeria: the prevalence, geographical distribution and epidemiology in Akwanga and Lafia local government areas.

An investigation of human infection with Onchocerca volvulus and the resulting clinical disease was carried out for the Nigerian National Onchocerciasis Control Programme between July and August 1989 [corrected]. The survey covered 10.6% of the rural population in 41 savanna villages of central Nigeria. Of the 8451 self-selected individuals examined, 900 (10.6%) had skin microfilariae (Mf). There were differences between villages in both endemicity and intensity of infection, but in general the number of both Mf carriers and cases of clinical onchocerciasis increased with age. The disease in the Mf carriers showed as blindness (0.8%), onchocercal nodules (0.6%), leopard skin (1.6%) and pruritus (2.8%). Of 35 persons with lymphatic complications, 19 had hanging groin, 10 had elephantiasis and six had hydrocoele. Onchocerciasis was mesoendemic in the rocky northern escarpments, and became hypoendemic and sporadic in the southern uplands of sedimentary geological origin.

The combined procedures of Ficoll-Paque centrifugation and anion exchange separation for the recovery of trypanosomes from blood and other tissues.

The conventional method of separating African trypanosomes from infected blood using a DEAE-cellulose (Whatman Chromedia, DE-52) column was modified by the inclusion of an initial centrifugation step employing the density gradient medium, Ficoll-Paque. On centrifugation in this medium using diluted infected rodent blood the trypanosomes moved into the buffy coat interphase which consisted mainly of lymphocytes with a few contaminating RBCs and neutrophils. The buffy coat interphase layer was withdrawn, washed, resuspended and the trypanosomes finally separated from the contaminating blood cells by passage through buffer-equilibrated DE-52 packed in a 25 ml syringe barrel, representing a considerable saving of DE-52 over the conventional method. The centrifugation step was applied to the investigation of other tissues of infected rodents, such as bone marrow, brain, spleen, liver, lymph nodes, kidney and testis, for the presence of trypanosomes. Using the combined procedure, high recoveries of purified brucei group trypanosomes were obtained from bone marrow, brain, spleen and lymph nodes.