A Review of the Impact of Cost and Quality of HIV Kits on HIV Testing in a Nigerian Teaching Hospital

Background: When HIV antibodies testing was introduced in Aminu Kano Teaching Hospital; Kano a couple of years ago; Double ELISA was used to test blood samples before a particular specimen was diagnosed as reactive or non-reactive. A time came when immunoconfirmatory test was introduced into HIV antibodies testing for confirmations of the presence of HIV. Objectives: This present retospective study is to review the impact of cost and quality of HIV reagent kits in the two periods A and B on the patients and confidence on the health care provider. Methods: We collated and compared laboratory records for both periods of HIV antibodies testing at Aminu Kano Teaching Hospital Kano consisting of period A from November 1997 to May 1998 (7 months) and period B from November 1998 to May 1999 (7months). In period A; double ELISA was used (Genie II and Immunocomb Bispot) while in period B; Immunocomb Bispot and Immunoconfirm II were used Results: The results show that the cost per test increased from two hundred and fifty Naira($2) to five hundred Naira($4). There was a reduction on the number of patients from 289 to 258 within the two periods. But the prevalence of reactive HIV antibodies decreased from 43.6to 36.8. Conclusion: The period when Immunoconfirmatory technique was introduced brought assurance; reliability and confidence to HIV diagnosis test in the centre

The trend of HIV infection in Kano, Nigeria--a seven-year study of adult attendees of Aminu Kano Teaching Hospital.

BACKGROUND: Human immunodeficiency virus (HIV) infection is a huge concern with increasing epidemic proportions The consequences are devastating in developing countries particularly in large areas of southeast Asia and sub Saharan Africa including decrease in life-expectancy, huge loss of manpower and a heavy economic and social burden. Sub-Saharan Africa has been hit harder by HIV/AIDS pandemic than any other region of the world At the end of 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that, globally 39.5 million people were living with HIV/AIDS, out of which 24.7 million were in sub-Saharan Africa. To determine the annual trend of HIV infection in Kano as well as the seroprevalence rates over the years. METHOD: This retrospective study includes all adults that are 15years and above, who are also AKTH attendees and. patients referred from other hospitals in Kano, who, based on clinical suspicion, were sent to the serology laboratory of the hospital for HIV screening and confirmation between January, 1997 and December, 2003. It however, excludes all pediatrics, antenatal care clinic attendees and all blood donors screened for HIV antibodies within the period. These have been collated under various risk groups elsewhere. RESULTS: Of 9241 subjects tested, 3217 (34.8%) were confirmed seropositive for HIV antibodies consisting of 1908 (36.7%) and 1441 (35.7%) males and females respectively Analysis of results on yearly basis shows prevalence rates of 37.1% in 1997, 40% in 1998 and 47.9% in 1999. However, the HIV seroprevalence rates declined to 22.6% among these subjects in 2000 before rising to the peak (48.8%) in 2002 from 30% seroprevalence of the previous year, 2001. The prevalence rate for 2003 was 32.1%. effective control strategies aimed at curbing the spread of HIV infection.

Human immunodeficiency virus and hepatitis B virus co-infection among patients in Kano Nigeria.

BACKGROUND: Human immunodeficiency virus and hepatitis B virus are widespread in the developing countries and patients with dual infection of HIV and HBV are increasingly being diagnosed among hospital patients. Reports have indicated that hepatitis will contribute significantly to morbidity and mortality in HIV infected patients because of increased use and accessibility of highly active antiretroviral therapy (HAART). The objective of this study is to determine the prevalence of HIV and HBV co-infection in patients in Kano Nigeria and to highlight the reciprocal interactions between the HIVand HBV. METHODS: Three hundred patients consisting of 152 males and 148 females were recruited into the study at the Aminu Kano Teaching Hospital Kano, Nigeria between February 2002 and March 2003. RESULTS: Out of a total of three hundred HIV positive patients, two hundred and eleven (70.3%) were HBV positive. Of the 152 males that are HIV positive, 102 (67.1%) were HBVpositive while out of 148 females that are HIVpositive, 109 (73.6%) were HBV positive. CONCLUSION: A co-infection rate of 70.5% was observed in this study. Since HIV infected patients with HBV co-infection respond less to HAART additional concern and care must be taken in order to minimize the complications associated with the increasing use of HAART The testing of HIV positive patients for HBV will help in the choice of therapy in these patients's.

Bladder cancer in Kano--a histopathological review.

Malignant tumours of the bladder have been observed to be quite common in Kano but there has been no formal study. This four-year (1998-2001) retrospective review sought to document the pattern of these neoplasms. Vesical malignancies constituted 6.4% of all cancers in Kano with squamous (53%) and transitional (35%) carcinomas as the most common histological types. Males outnumbered females more than five times (M:F = 5.2.:1). Cancer of the bladder was most prevalent in the 5th and 6th decades with a mean age of 48.8 years. In general our findings are similar to bladder cancer in other schistosomal endemic regions of Africa.

A review of medico-legal deaths in Kano.

Medicolegal death (MLD) is a relatively uncommon subject of study in Nigeria. This prospective review of 200 cases in Kano found the commonest cause to be road traffic accidents (48.5%) followed by homicides (34%) and natural deaths (5%). Gang violence among local youths with blunt and sharp weapons accounted for most of the homicides. MLDs most frequently (60.5%) occurred in the 3rd to 5th decades of life and males were predominant (M:F = 3.5:1). Our findings differed significantly from MLDs in the developed world where natural deaths were overwhelmingly preponderant. The prevalence of MLDs in Kano can be substantially reduced if the recommendations of this study are implemented.

Widespread antibiotic resistance in savannah Nigeria.

There is minimal data on antibiotic resistance from savannah northern Nigeria. A retrospective study of 438 patients seen in 12 months (2000) with microbial pathogens from urinary and respiratory tracts was undertaken. Antibiotic susceptibilities were determined using stokes disc diffusion technique. Resistance in Escherichia coli (E. coli) reached 91-96% to cotrimoxazole, tetracycline and ampicillin but was 11%, 17% and 28% to colistin, nitrofurantoin and nalidixic acid. Resistance of other uropathogens (Klebsiella and Proteus spp) reached 83-99% to cotrimoxazole, tetracycline and ampicillin but was 14-40% to colistin, nitrofurantoin and nalidixic acid. Pneumococci were non-susceptible to penicillin (93%), cotrimoxazole (92%), tetracycline (84%), ampicillin (53%), chloramphenicol (21%) and cefazolin (8%). Antibiotic resistance is widespread in savannah northern Nigeria. Resistance is less to chloramphenicol, colistin, nalidixic acid, nitrofurantoin and the latter generation cephalosporins and quinolones than to penicillin, ampicillin, cotrimoxazole and tetracycline.