Overview of human and animal brucellosis in Nigeria and its economic impacts on production

Brucellosis is a wide spread zoonotic bacterial disease of humans and animals. In humans the disease is recognized commonly as undulant fever, characterized by headache malaise, and arthritis. Brucellosis can occur in any age group, but mainly found in young men between the ages of 20 and 40 years because of occupational hazards. Domestic animals (cattle, sheep and goat, pigs, dogs etc) are highly susceptible to brucellosis. Generally, brucellosis manifest in female animals as abortion, retained placenta, stillbirth and death of young ones soon after birth. In males, the main features are vesiculitis, orchitis, and epididymitis, which may render infected male infertile for life. The endemicity of brucellosis has remained a threat in low- income countries of sub-Saharan Africa and South Asia and has multiple economic implications across agriculture and public health sectors, and broader implications on economic and social development sectors. Google and Google Scholar were used to retrieve articles used for this review, which included published research articles and local, national and international reports on brucellosis. In this review, we summarised human and animal brucellosis, prevalence of infections in Nigeria, and economic impacts on production. It is believed that this review will guide researchers on the state of brucellosis in developing countries where the disease is still endemic, using Nigeria as a case study.

What are the triggers of household decision-making on waste disposal choices? A gender differentiated analysis.

Across the African continent especially in Nigeria, solid waste disposal has created significant environmental and health issues. Studies on household decision-making on waste disposal choices are insignificant. This study uses the most recent 2018/2019 General Household Survey (GHS) - a national representative sample of 5000 households collected by the Nigerian Bureau of Statistics (NBS) and World Bank - to offer greater insight on the socio-economic drivers of household's decision-making on the choice of alternative refuse disposal systems and how these choices vary across male-headed households (MHHs) and female-headed households (FHHs) in Nigeria. Adopting the Multinomial Logit and Exogenous Switching Treatment Effects Regression (ESTER) models, estimates show that education, family sizes, non-home ownerships, water availability, toilet locations, electricity connections within buildings, geopolitical zones, and urban areas are some determinants of household waste disposal choices which also varies by household types. However, quite a significant number of FHHs are observed to utilize informal refuse disposal systems than the MHHs representing a gender gap in the informal waste usage of 9%. In the counterfactual scenario FHHs average probability of adopting compound (informal) refuse disposal choices, would have increased by 4.2% (decreased by 5.4%) if they had the same socio-economic characteristics as MHHs. These results present some interesting factors related to the heterogeneity of alternative refuse disposal choices the heterogeneous effects of gender on such decisions. The study thus offers some policy inputs on how to ensure a clean and safe environment through proper disposal options.

Agricultural production and CO2 emissions from two sources in the ECOWAS region: New insights from quantile regression and decomposition analysis.

Agriculture being the dominant economic activity of the West African economies is responsible for the most greenhouse gasses emitted in the region. Are there heterogeneous determinants of environmental degradation across low, intermediate, and high CO2 emitters in West Africa? Considering the significance of agriculture, industrial activities, renewable energy consumption and economic growth in West-Africa, this paper investigates the conditional determinants of environmental degradation from two sources (per-capita CO2 emission and CO2 emission from liquid sources) using panel data from 15 ECOWAS countries for the period 1990-2015. The study adopts a panel quantile regression technique with non-additive fixed effects as well as quintile decomposition techniques to explore if the relationship between agricultural and economic factors differs across low, intermediate, and high CO2 emitters and the extent of CO2 emission gap between Low Income Group (LIG) and Lower-Middle Income Groups (LmIG). Results from the mean estimators show that while agricultural production impedes CO2 emissions from liquid sources, it however increases total emissions implying a shift from mechanized farming to more traditional farming methods and the burning and use of biomass from agricultural produce as an energy source. Estimates of the conditional determinants of environmental degradation vary along the quantiles signifying heterogeneity of the determinants of environmental degradation across, low, intermediate, and high CO2 emitters. Additionally, results emanating from the quantile decomposition procedure show that lower-income West African economies have superseded their lower-middle income counterparts at higher quantiles of CO2 emissions.

Determinants of household fuel choices among Nigerian family heads: are there gender-differentiated impacts?

The consensus in the literature holds that female-headed households (FHHs) are more vulnerable to social and economic exclusion than male-headed households (MHHs). This paper investigates the socioeconomic determinants of household cooking fuel choices across MHHs and FHHs, using the rich Nigerian Demographic Health Survey data. Using the exogenous switching treatment effect regression (ESTER) technique, the study is able to unravel differences in socioeconomic effects of gender inequality on cooking fuel choices in Nigeria. The results validate the energy ladder hypothesis in the Nigerian case and show that the choices of dirty fuel (biomass) is more prevalent among the de-jure FHH when compared with the de-facto FHH and MHHs. Also, the probability of biomass-use among MHHs would have fallen by 1.3% if MHHs had similar socioeconomic attributes as the FHHs. In the same vain for FHHs, the probability of kerosene-use would have increased by 2%. The study observed no gender gap in kerosene-use. Thus, the established gender gap in biomass- and kerosene-use would have reduced to 6.7% and 2.8%, respectively, if the de-facto FHHs had same socioeconomic attributes as the de-jures. Considering the traditional gendered household division of labor within the households, de-jure FHHs' energy choices may be due to limited economic opportunities that guarantees cleaner energy options.

Obstetric outcomes of human herpes virus-2 infection among pregnant women in Benin, Nigeria.

OBJECTIVE: This study investigated the obstetric outcomes of herpes simplex virus (HSV-2) infection among pregnant women. MATERIALS AND METHODS: In this prospective cohort study, a total of 674 consenting pregnant women attending ante-natal clinic in the University of Benin Teaching Hospital and Central Hospital Benin were recruited between November 2011 and December, 2012. The women were screened for HSV-1, and HSV-2 using glycoprotein-G-based type-specific Enzyme Linked Immunosorbent Assay on archived blood samples; and were followed up to the delivery period and postnatal clinic. The HSV-2-seronegative participants underwent second blood sampling for HSV-2 IgG and IgM assay during the delivery period. The patients were thus categorized into "HSV-2 seropositive", "HSV-2-seronegative," and "incident HSV-2 infection" cohorts. The pregnancy outcomes were assessed by review of hospital records. Data analysis was with SPSS version 16 software. RESULTS: Of 674 pregnant women surveyed, 312 (46.3%) were HSV-2 seropositive; while 362 (56.7%) were HSV-2 seronegative. Comparing the "HSV-2 seropositive" and "HSV-seronegative" groups, there were no significant differences in occurrence of low birth weight (LBW), prematurity, spontaneous abortions, and stillbirth events (P=0.96; 0.95; 1.0; and 0.77, respectively). Comparing the "incident HSV-2 infection" with the "HSV-2 seronegative" groups, the relative risks of occurrence of LBW deliveries, preterm deliveries, and stillbirths were 12.6, 25.1, and 4.5, respectively. CONCLUSION: First episode HSV-2 infection among pregnant women in Benin, Nigeria is associated with an increased risk of occurrence of spontaneous abortion, LBW delivery, stillbirths, and preterm delivery.

Co-infections of hepatitis B and C with human immunodeficiency virus among adult patients attending human immunodeficiency virus outpatients clinic in Benin City, Nigeria.

BACKGROUND: Hepatitis B and C viral co-infections with human immunodeficiency virus (HIV) are known to affect progression, management, and outcome of HIV infection. This study was aimed to access the prevalence of hepatitis B and C co-infections in HIV-infected adult patients in the University of Benin Teaching Hospital with a view of understanding the gravity of this problem in the local population. METHODS: The descriptive cross-sectional study was carried out on 342 HIV-infected adult patients on highly active antiretroviral therapy attending HIV Outpatients Clinic of University of Benin Teaching Hospital, between April and September, 2011. Patients' sera were screened for hepatitis B surface antigen (HBsAg) and anti-hepatitis C virus (HCV) using immunochromatographic-based kits. Clinical stage of HIV and CD4+ cell counts were equally evaluated. Data were analyzed using SPSS version 17. RESULTS: Of the 324 HIV-infected patients screened, 53 (15.5%) were positive for HBsAg, 24 (7.0%) positive for hepatitis C virus antibodies (HCV-Ab), while 2 (0.6%) were positive for both viruses. Seroprevalence of HBsAg was higher in male (17.8%) than in female (14.7%) (χ2=0.49, P=0.49), while the reverse is the case for HCV-Ab; 7.1% for female and 6.7% for male (χ2=0.02, P=0.88). Seroprevalences of HBsAg and HCV-Ab were also higher among patients in World Health Organization disease stages 3-4 and patients with CD4+ cell count≤200 cell/ml compared to those in stages 1-2 and with CD4+ cell count>200 cell/ml. CONCLUSION: Co-infection with hepatitis B virus and HCV among HIV/acquired immune deficiency syndrome (AIDS) patients is still a problem in our environment. Screening for these viruses among HIV/AIDS patients will allow for early detection and proper management.

Microbiology of cysts/abscesses of Bartholin's gland: review of empirical antibiotic therapy against microbial culture.

Bartholin's glands are prone to obstruction at their opening into the vestibule, forming cysts which could be infected to become gland abscess. In our unit, treatment of Bartholin's abscess is usually surgical. In addition to surgical treatment, antimicrobial agents are often administered before microbial culture results are known. In this study, we aimed to determine the most common pathogens in Bartholin's glands abscess in our local population so that empiric antimicrobial therapy, if required, could be correctly directed. Among the 78 cases reviewed, there was positive microbial culture in 73.9%. Bartholin's abscess was commonly caused by opportunistic organisms, either as single agents or polymicrobial infections. Aerobic organisms were the commonest with coliforms being the most common bacteria. No cases of N. gonorrhoea or C. trachomatis were encountered. Flucloxacillin as a single agent was the most frequently prescribed antibiotic. Poly-pharmacy was common practice. It was concluded that whether adjuvant antibiotic therapy is necessary following surgical treatment of Bartholin's abscess is still controversial. Where antibiotics are required, the optimal initial therapy is not known. As poly-microbial infections are common, a broad spectrum agent like co-amoxiclav may be suitable for empirical treatment until culture results are known.

Effect of matrix molecular weight on the coarsening mechanism of polymer-grafted gold nanocrystals.

A systematic evaluation of the effect of polymer matrix molecular weight on the coarsening kinetics of uniformly dispersed polystyrene-grafted gold nanoparticles is presented. Particle coarsening is found to proceed via three stages (i.e., atomic-diffusion-based Ostwald ripening (OR), particle-migration-based collision-coalescence, and the subsequent reshaping of particle assemblies). The relative significance of each stage and hence the evolution of particle size and shape have been found to depend sensitively upon time, temperature, and the molecular weight of the host polymer. At temperatures close to the matrix glass-transition temperature, Ostwald ripening has been observed to be dominant on all experimental timescales. With increasing annealing temperature, collision coalescence becomes the dominant mode of coarsening, leading to rapid particle growth. The onset of the latter process is found to be increasingly delayed with increasing molecular weight of the polymer host. Particle coalescence is observed to proceed via two fundamental modes (i.e., diffusion-limited aggregation and growth resulting in the formation of fractal particle clusters and the subsequent recrystallization into more spherical monolithic aggregate structures). Interestingly, particle coarsening in high-molecular-weight matrix polymers is found to proceed significantly faster than predicted on the basis of the bulk polymer viscosity; this acceleration is interpreted to be a consequence of the network characteristics of high-molecular-weight polymers by analogy to the phenomenon of nanoviscosity that has been reported in the context of nanoparticle diffusion within high-molecular-weight polymers.

Fertility needs and funding in couples with blood-borne viral infection.

BACKGROUND: Couples infected with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are increasingly seeking assisted conception. These couples avoid unprotected intercourse and use condoms at all times in order to minimize the risk of infecting their partner. As this practice inhibits pregnancy, assisted procreation is generally required for safe conception. For many couples, access to such services is restricted on ethical, geographical and financial grounds. OBJECTIVE: The aim of the study was to assess the fertility needs, geographical origin and state funding of patients with blood-borne viral infection. METHODS: A retrospective review of the medical records of couples referred for fertility treatment between January 1999 and December 2006, where one or both partners were infected with HIV, HBV and/or HCV, was carried out. RESULTS: Of the 205 couples included in the study, 44% lived in London, 51% came from elsewhere in the United Kingdom and 5% travelled from outside the United Kingdom to seek treatment. Genitourinary medicine clinics were the main source of referral. 85.8% of couples had HIV infection, 15.1% were infected with HBV and 13.6% had HCV infection. Fertility screening identified a high incidence of male factor infertility (33.3%) in HIV-infected men and tubal disease (40.8%) in HIV-infected women. Only 23.6% of HIV-infected couples, 20% of HBV-infected couples and 12.5% of HCV-infected couples obtained state funding for assisted conception. CONCLUSION: Fertility screening identified a high incidence of male and tubal factor subfertility among couples living with HIV, HBV and HCV. Limited access to specialist clinics equipped to cater for these couples and restricted funding may impact negatively on couples obtaining risk-reducing assisted reproduction treatment. This may have long-term public health implications as individuals attempt to conceive through unprotected intercourse.

Elevated basal FSH and embryo quality: lessons from extended culture embryos: raised FSH and blastocyst quality.

BACKGROUND: The relationship between elevated basal FSH and embryo quality remains a topic of heated discussion among practitioners of ART. Some authors suggest a negative effect of raised FSH on the quality of embryos and therefore on IVF treatment outcome. We postulate that women with elevated FSH who respond well to ovarian stimulation and have embryos to transfer, have the same chance of conceiving like women of a similar age with normal FSH. To test this hypothesis, we studied women with elevated basal FSH who made enough embryos to qualify for blastocyst culture and day 5 embryo transfer. METHODS: Analysis of data collected prospectively, on women age 25-43 years, who underwent IVF between January 2005 and December 2006. The women were divided into: those with high FSH (> or = 10 IU/L) and women with normal FSH (<10 IU/L). We analysed data to show treatment outcome in the two groups, following embryo transfer on day 3 and after transfer on day 5. Outcome measures include number of oocytes retrieved, number of embryos available, implantation rate, pregnancy and live birth rate. RESULTS: Among the 1,858 women who under-went a day 3 transfer, 1,368 had basal FSH < or = 10 IU/L, and in 492 basal FSH was above 10 IU/L. The average number of oocytes retrieved was lower among women with elevated FSH (10.12 +/- 5.6 Vs 6.16 +/- 3.9). Women with a normal FSH, had a higher pregnant and live birth rate than those with elevated FSH (43.3% vs 27.9% p = 0.021) and (30.8% vs 17.6% p = 0.028) respectively. 398 women made enough embryos to qualify for extended embryo culture to blastocysts. Of these 366 had an FSH < or = 10 IU/L and 32 had FSH > 10 IU/L. In this group, there was no significant difference in the pregnancy and live birth rates between women with elevated and those with normal FSH, (67.2% vs 65.6%) and (51.9% vs 43.8%) respectively. In this selected group of women where quantity is not an issue, the quality of embryos was same irrespective of whether the basal FSH was low or high. CONCLUSION: Women with elevated basal FSH who respond well to stimulation and generate a good number of oocytes / embryos have a chance of becoming pregnant and having a live birth similar to that of women of their age. Women should therefore not be denied the benefits of IVF based solely on the basal FSH level as a subset may respond well and therefore have a good chance of taking home a baby.

Fetal macrosomia in non-diabetic mothers: antenatal diagnosis and delivery outcome.

This is a retrospective study of 74 non-diabetic women that delivered babies in excess of 4,500 g. The women were divided into two groups, depending on whether there had been suspected macrosomia antenatally or not. Mode of delivery and rates of induction of labour were examined. Women diagnosed with a macrosomic fetus were more likely to have elective caesarean sections or premature induction of labour. Those women in whom macrosomia was not suspected had higher rates of vaginal deliveries without any increase in neonatal morbidity.

Reducing multiple pregnancy in assisted reproduction technology: towards a policy of single blastocyst transfer in younger women.

OBJECTIVES: To investigate the effects of single blastocyst transfer (SBT) on live birth and multiple pregnancy in women undergoing in vitro fertilisation (IVF). DESIGN: Descriptive cohort study. SETTING: A London private IVF/postgraduate training unit. SAMPLE: A total of 700 fresh and 102 frozen blastocyst cycles performed between January 2005 and December 2006. METHODS: Young women aged 25-37 years and those aged 38-43 years were further divided into those who had SBT and those who received two blastocysts (double blastocyst transfer [DBT]). Live birth and multiple pregnancy rates were compared between groups. Cumulative live birth was compared between women who had DBT and those who received a SBT followed by a frozen blastocyst if the fresh cycle was unsuccessful. MAIN OUTCOME MEASURES: Live birth rate, cumulative live birth rate, multiple pregnancy rate, uptake of SBT. RESULTS: Among women aged 25-37 years, live birth rate following SBT was 59.0 versus 60.7% following DBT. The twin pregnancy rate in this group was 2.3 and 47.6% respectively. For women aged 38-43 years, live birth following SBT was 29.4% and multiple pregnancy rate was 33.3%. DBT in older women gave a higher live birth rate (44.3%) and a multiple pregnancy rate of 36.4%. Cumulative live birth following SBT in women aged 25-37 years was 72.8% versus 60.5% following DBT. Among the women aged 38-43 years, cumulative live birth was higher (63.3%) following DBT versus 28.6% following SBT. CONCLUSION: Single blastocyst transfer followed by transfer of a frozen blastocyst if the preceding fresh cycle was unsuccessful resulted in a better cumulative live birth and lower twin pregnancy in young women. In older women, two fresh blastocysts gave better results than one fresh followed by a frozen cycle. Older women should have the option of replacing two fresh blastocysts as this optimises their chances of taking home a baby.

Intrauterine insemination in natural cycle may give better results in older women.

BACKGROUND: Controlled ovarian hyper-stimulation (COH) in combination with intrauterine insemination (IUI) has been shown to result in significantly higher pregnancy rates compared to un-stimulated (natural cycle) IUI. This may however not be true in all ages. METHODS: We performed a retrospective cohort study and analysed data collected prospectively on 1759 IUI cycles in couples with unexplained infertility. The results were analysed to show the outcome of IUI with COH, and IUI in natural cycle (unstimulated), in younger women compared to their older counterparts. RESULTS: In women age 37 and younger, COH resulted in a significantly higher pregnancy rate (13.0% vs 6.5%) and live-birth rate (10.7% vs 5.2%) compared to natural cycle IUI (p = 0.025, p = 0.045 respectively). However for older women age >37 years, natural cycle (unstimulated) IUI, resulted in a significantly higher pregnancy rate (12.0% vs 8.5%) live-birth rate (7.5%vs 3.5%) than IUI with COH ((p = 0.0037). This difference is even more significant when COH was performed with clomiphene citrate (7.5% vs 2.1%) (p = 0.0017). CONCLUSION: COH was associated with a lower live birth rate in older women, irrespective of the agent used, and it seems to be worse when the anti-oestrogenic drug clomiphene citrate was used for COH. Older women may benefit more from natural cycle (unstimulated) IUI. A randomised controlled trial is required to confirm this observation.

Best practice in primary care pathology: review 4.

This fourth best practice review examines four series of common primary care questions in laboratory medicine are examined in this review: (1) safety monitoring for three common drugs; (2) use of prostate-specific antigen; (3) investigation of vaginal discharge; and (4) investigation of subfertility. The review is presented in question-answer format, referenced for each question series. The recommendations represent a precis of the guidance found using a standardised literature search of national and international guidance notes, consensus statements, health policy documents and evidence-based medicine reviews, supplemented by Medline Embase searches to identify relevant primary research documents. They are not standards but form a guide to be set in the clinical context. Most of them are consensus based rather than evidence based. They will be updated periodically to take account of new information.

Commencement and maintenance compliance of patients on hormone replacement therapy (HRT) following bilateral oophorectomy.

In a survey in 1989 Spector observed that 70% of women who had had bilateral oophorectomy had never received hormone replacement therapy. Ten years after his survey we decided to audit not only the number of women who started hormone replacement therapy following bilateral oophorectomy, but also to determine long-term compliance, as this is vital if the full benefits of oestrogen replacement are to be obtained. We carried out a survey of 91 women age 45 years and below who had bilateral oophorectomy in a teaching hospital and who were under the care of GPs in 53 general practices in the north-east of England. Of these women, 72.4% were prescribed oestrogen replacement therapy in hospital before discharge. However, within 2 months following bilateral oophorectomy, 97.4% of these women had commenced hormone replacement; 88.4% have maintained hormone replacement for 5 years or more, 11.8% who had started hormone replacement had discontinued within 5 years and 2.6% have never been on hormone replacement therapy, despite the lack of any medical contraindication. This survey shows a marked improvement in the long-term compliance of women on hormone replacement following bilateral oophorectomy. Continuous education of medical staff and patients on the benefits of hormone replacement therapy, preoperative counseling of patients with the opportunity for them to choose the route of administration that best suits them, and regular review of patients on hormone replacement therapy may further enhance long-term compliance.