High Genetic Diversity of Carbapenem-Resistant Acinetobacter baumannii Isolates Recovered in Nigerian Hospitals in 2016 to 2020.

Acinetobacter baumannii causes difficult-to-treat infections mostly among immunocompromised patients. Clinically relevant A. baumannii lineages and their carbapenem resistance mechanisms are sparsely described in Nigeria. This study aimed to characterize the diversity and genetic mechanisms of carbapenem resistance among A. baumannii strains isolated from hospitals in southwestern Nigeria. We sequenced the genomes of all A. baumannii isolates submitted to Nigeria's antimicrobial resistance surveillance reference laboratory between 2016 and 2020 on an Illumina platform and performed in silico genomic characterization. Selected strains were sequenced using the Oxford Nanopore technology to characterize the genetic context of carbapenem resistance genes. The 86 A. baumannii isolates were phylogenetically diverse and belonged to 35 distinct Oxford sequence types (oxfSTs), 16 of which were novel, and 28 Institut Pasteur STs (pasSTs). Thirty-eight (44.2%) isolates belonged to none of the known international clones (ICs). Over 50% of the isolates were phenotypically resistant to 10 of 12 tested antimicrobials. The majority (n = 54) of the isolates were carbapenem resistant, particularly the IC7 (pasST25; 100%) and IC9 (pasST85; >91.7%) strains. blaOXA-23 (34.9%) and blaNDM-1 (27.9%) were the most common carbapenem resistance genes detected. All blaOXA-23 genes were carried on Tn2006 or Tn2006-like transposons. Our findings suggest that a 10-kb Tn125 composite transposon is the primary means of blaNDM-1 dissemination. Our findings highlight an increase in blaNDM-1 prevalence and the widespread transposon-facilitated dissemination of carbapenemase genes in diverse A. baumannii lineages in southwestern Nigeria. We make the case for improving surveillance of these pathogens in Nigeria and other understudied settings. IMPORTANCE Acinetobacter baumannii bacteria are increasingly clinically relevant due to their propensity to harbor genes conferring resistance to multiple antimicrobials, as well as their ability to persist and disseminate in hospital environments and cause difficult-to-treat nosocomial infections. Little is known about the molecular epidemiology and antimicrobial resistance profiles of these organisms in Nigeria, largely due to limited capacity for their isolation, identification, and antimicrobial susceptibility testing. Our study characterized the diversity and antimicrobial resistance profiles of clinical A. baumannii in southwestern Nigeria using whole-genome sequencing. We also identified the key genetic elements facilitating the dissemination of carbapenem resistance genes within this species. This study provides key insights into the clinical burden and population dynamics of A. baumannii in hospitals in Nigeria and highlights the importance of routine whole-genome sequencing-based surveillance of this and other previously understudied pathogens in Nigeria and other similar settings.

SARS-CoV-2 variants-associated outbreaks of COVID-19 in a tertiary institution, North-Central Nigeria: Implications for epidemic control.

The COVID-19 global pandemic is being driven by evolving SARS-CoV-2 variants with consequential implications on virus transmissibility, host immunity, and disease severity. Continuous molecular and genomic surveillance of the SARS-CoV-2 variants is therefore necessary for public health interventions toward the management of the pandemic. This study is a retrospective analysis of COVID-19 cases reported in a Nigerian tertiary institution from July to December 2021. In total, 705 suspected COVID-19 cases that comprised 547 students and 158 non-students were investigated by real time PCR (RT-PCR); of which 372 (~52.8%) tested positive for COVID-19. Using a set of selection criteria, 74 (~19.9%) COVID-19 positive samples were selected for next generation sequencing. Data showed that there were two outbreaks of COVID-19 within the university community over the study period, during which more females (56.8%) tested positive than males (47.8%) (p<0.05). Clinical data together with phylogenetic analysis suggested community transmission of SARS-CoV-2 through mostly asymptomatic and/or pre-symptomatic individuals. Confirmed COVID-19 cases were mostly mild, however, SARS-CoV-2 delta (77%) and omicron (4.1%) variants were implicated as major drivers of respective waves of infections during the study period. This study highlights the importance of integrated surveillance of communicable disease during outbreaks.

Genomic characterization of invasive typhoidal and non-typhoidal Salmonella in southwestern Nigeria.

BACKGROUND: Salmonellosis causes significant morbidity and mortality in Africa. Information on lineages of invasive Salmonella circulating in Nigeria is sparse. METHODS: Salmonella enterica isolated from blood (n = 60) and cerebrospinal fluid (CSF, n = 3) between 2016 and 2020 from five tertiary hospitals in southwest Nigeria were antimicrobial susceptibility-tested and Illumina-sequenced. Genomes were analysed using publicly-available bioinformatic tools. RESULTS: Isolates and sequence types (STs) from blood were S. Typhi [ST1, n = 1 and ST2, n = 43] and invasive non-typhoidal Salmonella (iNTS) (S. Enteritidis [ST11, n = 7], S. Durham [ST10, n = 2], S. Rissen [ST8756, n = 2], S. Chester [ST2063, n = 1], S. Dublin [ST10, n = 1], S. Infantis [ST603, n = 1], S. Telelkebir [ST8757, n = 1] and S. Typhimurium [ST313, n = 1]). S. Typhi ST2 (n = 2) and S. Adabraka ST8757 (n = 1) were recovered from CSF. Most S. Typhi belonged to genotype 3.1.1 (n = 44), carried an IncY plasmid, had several antibiotic resistance genes (ARGs) including blaTEM-1 (n = 38), aph(6)-Id (n = 32), tet(A) (n = 33), sul2 (n = 32), dfrA14 (n = 30) as well as quinolone resistance-conferring gyrA_S83Y single-nucleotide polymorphisms (n = 37). All S. Enteritidis harboured aph(3")-Ib, blaTEM-1, catA1, dfrA7, sul1, sul2, tet(B) genes, and a single ARG, qnrB19, was detected in S. Telelkebir. Typhoidal toxins cdtB, pltA and pltB were detected in S. Typhi, Rissen, Chester, and Telelkebir. CONCLUSION: Most invasive salmonelloses in southwest Nigeria are vaccine-preventable infections due to multidrug-resistant, West African dominant S. Typhi lineage 3.1.1. Invasive NTS serovars, including some harbouring typhoidal toxin or resistance genes, represented a third of the isolates emphasizing the need for better diagnosis and surveillance.

Retrospective Analysis of the Serovars and Antibiogram of Vibrio cholerae Isolates of the 2017 Ilorin Cholera Outbreak, Nigeria.

In this retrospective study, we determined the incidence, serovars, and antibiogram of Vibrio cholerae isolated from 102 clinical stool samples collected from rice water diarrheic patients during an outbreak (May - July 2017) in Ilorin metropolis, Nigeria. The culture positive rate of the V. cholerae isolates was 41.2%, with 41 and 1 isolates from O1 (Inaba) and non-O1/O139 serogroups, respectively. The isolates were the most susceptible to ciprofloxacin (76.2%) followed by amoxicillin-clavulanate (71.4%). However, all isolates were resistant to ampicillin and tetracycline. In conclusion, V. cholerae O1 was the predominant circulating serogroup exhibiting multi-drug resistance during the outbreak.

Clinical and microbiological profile of adult inpatients with community acquired pneumonia in Ilorin, North Central, Nigeria.

BACKGROUND: The optimal management of community acquired pneumonia (CAP) depends on the clinical and microbiological profile in the locality. OBJECTIVES: To determine the clinical and microbiological profile of patients admitted with CAP in Ilorin, Nigeria. METHODS: One hundred and two consenting consecutively selected patients with clinical and radiologic confirmation of CAP were recruited in 12 months. The socio-demographic, physical examination and laboratory/radiologic parameters were documented in a questionnaire. Microbiological evaluation of their sputum was done and blood samples were taken for complete blood count, culture, serum urea and serological evaluation for atypical bacteria and some viral pathogens. RESULTS: CAP constituted 5.9% of the total medical admissions during the one-year study period. The mean age of the patients was 49 ± 22 years with the largest frequency in those aged 65 years and above. The commonest symptoms were shortness of breath (96.1%) and cough (94.1%), with a median duration of 3 days from symptom onset to admission. Systemic hypertension was the commonest comorbid illness (25/102; 24.5%). Klebsiella pneumoniae was the predominant pathogen isolated (20/102; 28.1%). The susceptible antibiotics were Imipenem, Ceftazidime and Ceftriaxone. Intra-hospital mortality was 17.6%. CURB - 65 score of ≥ 2 and the presence of complications of CAP were the independent predictors of mortality. CONCLUSION: CAP constitutes a significant disease burden in Ilorin, Nigeria. Typical bacteria accounted for over half of the pathogens isolated from the patients with gram negative agents predominating. This highlights a possible shift in the microbiological profile which could guide empirical treatment.

Cryptococcal antigen among HIV1-infected individuals in north-central Nigeria.

BACKGROUND AND PURPOSE: The potential for the invasion of the central nervous system by Cryptococcus species is underscored by the presence of this organism in the blood of immunocompromised individuals. Early adoption of sensitive methods for the diagnosis of Cryptococcus species will reduce the high morbidity and mortality associated with this disease. Regarding this, the aim of the present research was to detect cryptococcal antigen among HIV1- infected individuals in north-central Nigeria. MATERIALS AND METHODS: This prospective cross-sectional study was carried out on HIV-1 infected individuals accessing care at three health facilities in north-central Nigeria between November 2014 and March 2017. For the purpose of the study, blood samples were collected from 300 HIV1-infected individuals within the age group of 3-65 years. The CD4+ T-cell count was determined, and the samples were analyzed for cryptococcal antigenemia using the methods of lateral flow assay (LFA) and culture technique. RESULTS: Cryptococcus antigen was detected in 19.67% (59/300) of the patients, and only 25.4% (15/59) of the LFA-positive samples showed Cryptococcus species growth on Sabouraud dextrose agar after 3 days. Furthermore, fungal growth was observed in one of the specimens, which was LFA negative. Additionally, 30 of the 59 LFA-positive patients had cryptococcal antigen in their serum with a CD4+ T-cell count of < 150 cells/mm3. CONCLUSION: As the findings of the present study indicated, infection with Cryptococcus species is a problem among HIV-infected patients in the region under study. Therefore, all HIV patients, especially those with a CD4+ T-cell count of < 150 cells/mm3, referring to the HAART clinics in Nigeria, should be screened for cryptococcal antigen.

Pediatric Bacterial Meningitis Surveillance in Nigeria From 2010 to 2016, Prior to and During the Phased Introduction of the 10-Valent Pneumococcal Conjugate Vaccine.

BACKGROUND: Historically, Nigeria has experienced large bacterial meningitis outbreaks with high mortality in children. Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae are major causes of this invasive disease. In collaboration with the World Health Organization, we conducted longitudinal surveillance in sentinel hospitals within Nigeria to establish the burden of pediatric bacterial meningitis (PBM). METHODS: From 2010 to 2016, cerebrospinal fluid was collected from children <5 years of age, admitted to 5 sentinel hospitals in 5 Nigerian states. Microbiological and latex agglutination techniques were performed to detect the presence of pneumococcus, meningococcus, and H. influenzae. Species-specific polymerase chain reaction and serotyping/grouping were conducted to determine specific causative agents of PBM. RESULTS: A total of 5134 children with suspected meningitis were enrolled at the participating hospitals; of these 153 (2.9%) were confirmed PBM cases. The mortality rate for those infected was 15.0% (23/153). The dominant pathogen was pneumococcus (46.4%: 71/153) followed by meningococcus (34.6%: 53/153) and H. influenzae (19.0%: 29/153). Nearly half the pneumococcal meningitis cases successfully serotyped (46.4%: 13/28) were caused by serotypes that are included in the 10-valent pneumococcal conjugate vaccine. The most prevalent meningococcal and H. influenzae strains were serogroup W and serotype b, respectively. CONCLUSIONS: Vaccine-type bacterial meningitis continues to be common among children <5 years in Nigeria. Challenges with vaccine introduction and coverage may explain some of these finding. Continued surveillance is needed to determine the distribution of serotypes/groups of meningeal pathogens across Nigeria and help inform and sustain vaccination policies in the country.

Etiology, clinical characteristics, and management of pleural effusion in Ilorin, Nigeria.

BACKGROUND: Pleural effusion (PE) is a primary manifestation or secondary complication of many disorders. This study reviews the pattern and management of PE in a Nigerian hospital. MATERIALS AND METHODS: The medical records of 213 patients with clinical diagnosis of PE over a period of 3 years were reviewed. RESULTS: PE accounted for 0.5% of the total hospital admissions. The most common cause of PE was tuberculosis (TB) (32.9%), followed by malignancy (29.1%) and pneumonia (15.0%). The male to female ratio was 1.3:1. TB was the leading cause of effusion in males, while it was malignancy in females. Pneumonia accounted for 61.9% of PE in preschool age and 66.7% in school age. Breathlessness (50.0%), cough (39.4%), and chest pain (24.9%) were the common presentations. Most (90.1%) of them were exudative effusion and with half in the right lung. Chest radiography (91.6%), pleural fluid for Ziehl-Neelsen stain (74.7%), cytology (59.2%), and tissue biopsy (57.8%) were the common diagnostic investigations. The majority (92.0%) had closed thoracostomy tube drainage, while 9.9% had chemical pleurodesis. The intra-hospital mortality was 10 (4.7%). CONCLUSION: TB, malignancy, and pneumonia are the leading causes of PE. A multidisciplinary approach is needed for optimal management.

Prevalence of Rifampicin-Resistant Tuberculosis among Patients Previously Treated for Pulmonary Tuberculosis in North-Western, Nigeria.

BACKGROUND: Drug-resistant tuberculosis (TB) is a significant public health problem. Greater than 90% of rifampicin (RIF)-resistant isolates were also isoniazid resistant, and hence, rifampicin resistance (RR) is frequently used as a surrogate for multidrug-resistant TB. SETTING: This study was conducted at Infectious Disease Hospital Kano in North-Western Nigeria. OBJECTIVES: The aim of this study was to determine the prevalence of RR among patients previously treated for pulmonary TB (PTB). MATERIALS AND METHODS: A total of 120 patients previously treated for PTB with current clinical features of PTB were recruited into this study. Relevant clinical information were obtained using a questionnaire. The sputum was collected and analyzed by the Gene Xpert MTB/RIF® machine to detect RR tuberculosis infection and blood screened for HIV infection. RESULTS: The mean (±standard deviation) age of the participants was 35.9 ± 14.3 years and they comprised 73 (60.8%) males and 47 (39.2%) females. HIV-seropositive rate was 11.7% among the participants. Of the 120 participants, PTB was detected in 35 (29.2%) of the participants by Gene Xpert MTB/RIF and 29 of them were cases of relapse. Five patients (4.2%) had RR tuberculosis and 80% of them were below the age of 45 years. CONCLUSION: The prevalence of RR is not high among previously treated PTB patients in this study when compared with other previous studies. This finding is a window for evaluating the efficacy of current interventions in the region and evidence for the consolidation of existing control policies.

Malaria Parasitaemia among Blood Donors in Ilorin, Nigeria.

BACKGROUND: The prevalence of malaria parasitaemia among blood donors in Ilorin has not been documented. In this study, we determined the prevalence of malaria parasitaemia among blood donors in Ilorin, as well as, the sociodemographic and other factors associated with it. METHOD: This was a hospital-based cross sectional study involving 308 consenting blood donors. The sociodemographic characteristics of participants as well as blood donation history were obtained using structured questionnaires specifically designed for this purpose. Giemsastained thick and thin blood films to identify malaria parasites were performed using standard method. ABO blood grouping and haemoglobin electrophoresis tests were also done using standard methods. RESULTS: The prevalence of malaria parasitaemia among blood donors in Ilorin was 27.3%. The parasite species found were more of Plasmodium falciparum(85.7%) than Plasmodium malariae(14.3%) . There was no age or sex difference in malaria parasitaemia. (p-value of 0.8 and 0.32 respectively). A greater proportion of blood group O individuals had malaria parasitaemia than groups A and B but this difference was not significant (p-value = 0.13). There was also no significant difference among haemoglobin genotypes. CONCLUSION: The prevalence of malaria parasites among blood donors in Ilorin is considerably high and lack of routine screening of blood puts recipients at risk. We recommend that routine screening for malaria parasites be commenced in our blood banks. Treatment of donor blood with riboflavin and UV light to inactivate malaria parasites and other infectious pathogens before they are transfused to patients may also be considered in our blood banks.

HEPATITIS C VIRUS (HCV) SEROPREVALENCE, ANTIGENAEMIA AND ASSOCIATED RISK FACTORS AMONG PREGNANT WOMEN IN NIGERIA.

BACKGROUND & AIMS: Hepatitis C viral infection is a significant public health challenge with potential risk of progressing to liver cirrhosis and hepatocellular carcinoma (HCC). Actively infected mothers can transmit the virus to their babies who may develop liver cirrhosis and HCC as young adults. We determined the seroprevalence of HCV, its antigenaemia and associated risk factors among pregnant women. METHODS: We recruited 400 pregnant women and tested their serum for HCV antibodies using immune-chromatographic test and determined the HCV core antigenaemia among HCV sero-positives by enzyme-immunoassay (EIA). The bio-socio-demographic variables of the participants were statistically correlated to the test results. RESULTS: Seroprevalence of HCV was 5.8% (23/400) and the prevalence of HCV core antigenaemia was 73.9% (17/23). None of the bio-socio-demographic variables of the participants and other known risk factors evaluated had. significant influence on either seroprevalence of HCV or its antigenaemia. Only the employment status of the participants' husbands (p = 0.01) significantly affected seropositivity of HCV. CONCLUSION: HCV core antigenaemia is high among pregnant women who have antibodies to HCV in our environment and this signifies an active hepatitis C virus infection.

Sero-prevalence of hepatitis B and C among mentally ill patients attending a tertiary hospital in Nigeria.

BACKGROUND: Mentally ill persons are vulnerable to sexually transmitted infections including hepatitis B and C because of their high level risky behaviors. This study is aimed at establishing the sero-prevalence of hepatitis B and C among the mentally ill individuals (MII) attending psychiatric clinic of the University of Ilorin Teaching Hospital (UITH), Nigeria since it has not been documented. METHODS: A total of 350 MII were recruited. HBsAg testing was by immunoassay test strip (Grand Medical Diagnostic R USA) while hepatitis C was tested by commercially prepared kits from ACON, R USA. Healthy adults who presented as donors in the blood bank of the hospital were used as controls. RESULTS: A total of 700 participants including 350 MII and 350 blood donors (BDs) were recruited for the study. The mean ages of MII and control participants were 36.5 ± 12.3 and 31.4 ± 8.3, respectively.The sero-prevalence of hepatitis B and C among patients with mental illness was 10.0 and 12.6%, respectively, as compared to 10.9% and 1.1% of the blood donors. There was a significant difference in the prevalence of HCV among mentally ill when compared with the blood donors (P = 0.001, χ2 = 33.97; OR (CI) =12.44 (5.33-29.03). CONCLUSION: Mentally ill patients attending UITH were significantly infected with hepatitis C virus. There is need for interventional measures to reduce the prevalence of hepatitis C among the mentally ill population such as health education and early screening of mentally ill in our setting.

Awareness of the Warning Signs, Risk Factors, and Treatment for Tuberculosis among Urban Nigerians.

Objectives. To determine the awareness of the warning signs, risk factors, and treatment of tuberculosis among urban Nigerians. Methods. This was a cross-sectional survey among 574 adults in Ilorin, Nigeria. Semistructured questionnaire was administered by trained interviewers to obtain information about awareness of tuberculosis warning signs, risk factors, and treatment. Results. Majority of the subjects (71.4%) were aware of at least one warning sign of tuberculosis. Cough (66.2%), weight loss (38.0%), and haemoptysis (30.7%) were the most identified warning signs. The predictors of awareness of warning sign were increasing age (r + 0.12), higher family income (r + 0.10), higher level of education (r + 0.10), and belonging to Christian faith (r + 0.11). Awareness of risk factors for tuberculosis was higher for tobacco smokers (77.0%) and history of contact with a case of TB (76.0%). Less than half were aware of HIV infection (49.8%), alcohol consumption (42.5%), chronic kidney disease (40.4%), extremes of ages (39.4%), cancers (36.9%), and diabetes mellitus (27.5%) as risk factors for TB. Tuberculosis was reported to be curable by 74.6% of the subjects and 67.9% knew that there are medications for treatment of tuberculosis, while 11.5% knew the duration of treatment. Conclusion. This study has revealed that the awareness of HIV and noncommunicable diseases as risk factors for TB is poor. This study has therefore demonstrated the need for health education programs that will emphasize recognition, identification, and modification of risk factor for TB.

Pattern of respiratory diseases seen among adults in an emergency room in a resource-poor nation health facility.

INTRODUCTION: There is a paucity of information on utilisation of emergency medical services in Nigeria. This study was conducted to determine the pattern of respiratory diseases seen among adults in an emergency room(ER) and their mortality within twenty- four hours in a health facility in Nigeria. METHODS: We carried out a retrospective study on adult patients that presented with respiratory condition from November 2004 to December 2010 at the emergency room of Federal Medical Centre Ido-Ekiti, south western, Nigeria. RESULTS: A total of 3671 cases were seen, 368 were respiratory cases accounting for 10.2 % of the total emergency room visitations. The male to female patients ratio was 1.2:1 and their mean was 49 9 ± 20.3 years. Pneumonia (34.5%) was the most common cases seen in the ER, followed PTB (29.4%), acute asthma (24.5%) , acute exacerbation of COPD (10.3%), upper airway tract obstruction and malignant pleural effusion were 0.5% respectively. Fourteen of the PTB cases (3.8%) were complicated by cor-pulmonale, 9(2.5%) by pleural effusion, 4(1.1%) by massive haemoptysis and 2(0.5%) by pneumothorax. Twenty-four hours mortality was 7.4% and 44.4% of the death was due to PTB, 37.0% was due to pneumonia and 14.8% due to acute asthma attack. The overall mortalities also had a bimodal age group distribution as the highest death was recorded in ages 30-39 and ≥ 70 years. CONCLUSION: Pneumonia and PTB were the leading respiratory diseases among adults causing of emergency room visit and early mortality in this health facility in Nigeria.

Factors associated with nocturnal, productive and dry cough in the young adult population of Nigeria.

OBJECTIVE: The aim of this study was to determine the factors associated with nocturnal, productive and dry cough among young adults in Nigeria. METHODS: We evaluated 498 subjects, 20-44 years of age, in Ilorin, Nigeria, using the European Community Respiratory Health Survey (ECRHS) questionnaire, administered by trained interviewers. RESULTS: Nocturnal cough was associated with asthma (OR = 10.87; p < 0.01), nasal allergy (OR = 6.33; p < 0.01), smoking (OR = 3.10; p < 0.01), skilled manual and non-manual work (OR = 2.86 and 2.10, respectively; p < 0.01 for both) and female gender (OR = 1.33; p = 0.17). Productive cough was associated with skilled manual and non-manual work (OR = 3.82 and 3.03, respectively; p < 0.01 for both), smoking (OR = 3.10; p < 0.01), asthma (OR = 3.27; p < 0.01) and nasal allergy (OR = 5.81; p < 0.01). Dry cough was associated with asthma (OR =5.18; p < 0.01) obesity (OR =1.88; p = 0.19), smoking (OR = 1.77; p = 1.44), nasal allergy (OR = 1.45; p = 0.26) and female gender (OR =1.36; p = 0.33). Age, gender, type of residence and obesity were not significantly associated with any type of cough (p > 0.05). CONCLUSIONS: Early prevention and treatment of conditions associated with cough, as well as the modification of social factors commonly associated with cough, are needed in order to reduce respiratory morbidity.

Factors influencing adherence to antiretroviral medication in Ilorin, Nigeria.

BACKGROUND: Good adherence to highly active antiretroviral therapy (HAART) is required for viral suppression and prevention of drug resistance. Patients' adherence to HAART has not been determined since the commencement of HAART at the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria, over 5 years ago. OBJECTIVES: To determine the adherence level of people living with HIV/AIDS (PLWHA) to HAART and identify associated factors. METHODOLOGY: A semistructured questionnaire was administered to PLWHA, who were accessing treatment. Sociodemographic, lifestyle, HIV medical, and drug history were obtained from them. Adherence was self-reported. Good adherence was taking of 95% of the prescribed doses of HAART over the preceding 30 days before consultation. RESULTS: Study participants were 253; majority, 58.5%, were females. About 70.8% of them had good adherence. Older age and male sex correlated better with adherence. CONCLUSION: People living with HIV/AIDS were quite adherent to HAART. Male sex and older age were positive predictors of adherence. Adherence among the young age and females needs strengthening.

Fatores associados à tosse seca, tosse produtiva e tosse noturna em adultos jovens na Nigéria / Factors associated with nocturnal, productive and dry cough in the young adult population of Nigeria

OBJETIVO: Determinar os fatores associados à tosse seca, tosse produtiva e tosse noturna entre jovens adultos na Nigéria. MÉTODOS: Foram avaliados 498 indivíduos com 20-44 anos de idade em Ilorin, Nigéria, utilizando-se o questionário European Community Respiratory Health Survey (ECRHS), administrado por entrevistadores treinados. RESULTADOS: A tosse noturna apresentou associações com asma (OR = 10,87; p < 0,01), alergia nasal (OR = 6,33; p < 0,01), tabagismo (OR = 3,10; p < 0,01), trabalho manual e trabalho não manual especializados (OR = 2,86 e 2,10, respectivamente; p < 0,01 para ambos) e gênero feminino (OR = 1,33; p = 0,17). A tosse produtiva apresentou associações com trabalho manual e trabalho não manual especializados (OR = 3,82 e 3,03, respectivamente; p < 0,01 para ambos), tabagismo (OR = 3,10; p < 0,01), asma (OR = 3,27; p < 0,01) e alergia nasal (OR = 5,81; p < 0,01). A tosse seca apresentou associações com asma (OR =5,18; p < 0,01) obesidade (OR =1,88; p = 0,19), tabagismo (OR = 1,77; p = 1,44), alergia nasal (OR = 1,45; p = 0,26) e gênero feminino (OR =1,36; p = 0,33). A idade, o gênero, o tipo de residência e a obesidade não se associaram significativamente a nenhum tipo de tosse (p > 0,05). CONCLUSÕES: A prevenção precoce e o tratamento de condições associadas à tosse, assim como a modificação de fatores sociais comumente associados à tosse, são necessários a fim de reduzir a morbidade respiratória.

OBJECTIVE: The aim of this study was to determine the factors associated with nocturnal, productive and dry cough among young adults in Nigeria. METHODS: We evaluated 498 subjects, 20-44 years of age, in Ilorin, Nigeria, using the European Community Respiratory Health Survey (ECRHS) questionnaire, administered by trained interviewers. RESULTS: Nocturnal cough was associated with asthma (OR = 10.87; p < 0.01), nasal allergy (OR = 6.33; p < 0.01), smoking (OR = 3.10; p < 0.01), skilled manual and non-manual work (OR = 2.86 and 2.10, respectively; p < 0.01 for both) and female gender (OR = 1.33; p = 0.17). Productive cough was associated with skilled manual and non-manual work (OR = 3.82 and 3.03, respectively; p < 0.01 for both), smoking (OR = 3.10; p < 0.01), asthma (OR = 3.27; p < 0.01) and nasal allergy (OR = 5.81; p < 0.01). Dry cough was associated with asthma (OR =5.18; p < 0.01) obesity (OR =1.88; p = 0.19), smoking (OR = 1.77; p = 1.44), nasal allergy (OR = 1.45; p = 0.26) and female gender (OR =1.36; p = 0.33). Age, gender, type of residence and obesity were not significantly associated with any type of cough (p > 0.05). CONCLUSIONS: Early prevention and treatment of conditions associated with cough, as well as the modification of social factors commonly associated with cough, are needed in order to reduce respiratory morbidity.