Potential for parasite and bacteria transmission by paper currency in Nigeria.

The authors assessed the potential of Nigerian currency notes to act as environmental vehicles for the transmission of pathogenic parasites and bacteria. Currency notes obtained from four major cities in Nigeria were evaluated according to standard techniques. Fifty-four (21.6 percent [95 percent CI: 16.50-26.70]) of the first batch of 250 notes, which underwent parasitological analysis, were contaminated with enteric parasites; 133 (53.2 percent [95 percent CI: 47.02-59.39]) of the second batch of 250 notes, which underwent bacteriological analysis, were found to be contaminated with bacteria. Parasites that were isolated from the notes included Ascaris lumbricoides (8.0 percent), Enterobius vermicularis (6.8 percent), Trichuris trichiura (2.8 percent), and Taenia species (4.0 percent). Bacteria that were isolated were Streptococcus species (21.6 percent), Staphylococcus species (12.8 percent), Escherichia coli (13.2 percent), and Bacillus species (5.6 percent). Among dirty/mutilated currency notes, parasite contamination and bacterial contamination were both significantly (p < .05) more pervasive (30.6 percent and 73.8 percent, respectively) than they were among clean and mint currency notes. Lower-denomination notes were more likely to be contaminated than were higher-denomination notes, although the difference was not statistically significant (p > .05). Parasite contamination and bacteria contamination were both most frequent in notes obtained from butchers and beggars. These results suggest that currency notes may be contaminated, especially with bacteria and enteric parasites, and may serve as sources of infection. Personal hygiene to reduce risk of infection is recommended.

Lassa fever in West African sub-region: an overview.

Lassa fever is an acute viral zoonotic illness caused by Lassa virus, an arenavirus known to be responsible for a severe haemorrhagic fever characterised by fever, muscle aches, sore throat, nausea, vomiting and, chest and abdominal pain. The virus exhibits persistent, asymptomatic infection with profuse urinary virus excretion in the ubiquitous rodent vector, Mastomys natalensis. Lassa fever is endemic in West Africa and has been reported from Sierra Leone, Guinea, Liberia, and Nigeria. Some studies indicate that 300,000 to 500,000 cases of Lassa fever and 5000 deaths occur yearly across West Africa. Studies reported in English, that investigated Lassa fever with reference to West Africa were identified using the Medline Entrez-PubMed search and were used for this review. The scarcity of resources available for health care delivery system and the political instability that characterise the West African countries would continue to impede efforts for the control of Lassa fever in the sub-region. There is need for adequate training of health care workers regarding diagnostics, intensive care of patients under isolation, contact tracing, adequate precautionary measures in handling infectious laboratory specimens, control of the vector as well as care and disposal of infectious waste.

Mandatory pre-marital HIV testing in Nigeria: the public health and social implications.

The prevalence of HIV infection among individuals referred from faith-based organizations (FBOs) in south-eastern Nigeria for mandatory pre-marital HIV screening was determined. Of the total of 319 individuals (148 males, 171 females) screened, 25 (7.8%, 95%CI: 4.9-10.7%) were confirmed HIV-positive, comprising 13 (8.8%, 95%CI: 4.2-13.4%) males and 12 (7%, 95%CI: 3.2-10.8%) females. No significant difference was observed in the association between HIV infection and gender (chi2=0.58, df = 1, P < 0.05). The highest prevalence of HIV infection (8.9%) was recorded among individuals in the 21-30 years age category, while the least HIV infection prevalence (5.3%) was observed among persons above 40 years old. There was no significant difference in the association between HIV infection and age (chi2=0.68, df = 3, P < 0.05). Mandatory pre-marital HIV screening could generate social stigmatization and infringement of the fundamental human rights of infected individuals. Voluntary counselling and confidential HIV testing and especially pre- and post-test counselling as the basis of pre-marital HIV testing are more desirable. Guidelines for the management of test-positive individuals and non-concordant couples and the safeguarding of confidentiality should be developed. Training and capacity building for religious leaders, to appropriately manage social issues associated with HIV/AIDS as it affects their organizations, are recommended.

Public health implication of bacteriuria and antibiotic susceptibility of bacteria isolates in schistosoma haematobium-infected school pupils in Southeast Nigeria.

Schistosoma haematobium infection prevalence of 57% was observed among primary school pupils, with males more infected than females (60.3% vs. 49.5%). Light infection (78.9%) was higher than heavy infection (21.1%). Prevalence of bacteriuria was 88.4% in infected individuals. Escherichia coli (20.5%), Salmonella spp (16.1%), and Staphylococcus aureus (16.1%) were major isolates. A 100% bacterial susceptibility to ciprofloxacin and taravid, was observed and up to 100% resistance with tetracycline, cotrimoxazole and nitrofuratoin. Systematic schistosomicidal/antimicrobial treatment advocated.

Prevalence of hepatitis-B surface antigen among blood donors and human immunodeficiency virus-infected patients in Jos, Nigeria.

Information is very scarce on the prevalence of hepatitis-B virus (HBV) infection among blood donors and patients with human immunodeficiency virus (HIV) infection in Nigeria. Hepatitis-B surface antigen (HBsAg) ELISA was used to determined the prevalence of HBsAg among 175 blood donors (aged 20-40 years) and 490 HIV-infected patients (aged 17-60 years) in Jos, Nigeria. Twenty-five (14.3%) of the blood donors and 127 (25.9%) of the HIV-infected individuals were HBsAg seropositive, indicating a higher HBV infection among HIV-infected persons than among healthy blood donors. A slightly higher HBsAg seroprevalence was recorded in the males (14.6%) than females (12.9%) of the blood donors. Among the HIV-infected patients, the males had considerably higher HBsAg seroprevalence than the females (31.8 vs 22.1%) with the highest prevalence of HBsAg occurring in the 51-60 years age group (44%), followed by those of 31-40 years (28.2%). Results confirmed the high endemicity of HBV infection in Jos, Nigeria and the significantly greater prevalence of HBV infection among HIV-infected patients than among blood donors.

Prevalence of hepatitis-B surface antigen among blood donors and human immunodeficiency virus-infected patients in Jos, Nigeria

Information is very scarce on the prevalence of hepatitis-B virus (HBV) infection among blood donors and patients with human immunodeficiency virus (HIV) infection in Nigeria. Hepatitis-B surface antigen (HBsAg) ELISA was used to determined the prevalence of HBsAg among 175 blood donors (aged 20-40 years) and 490 HIV-infected patients (aged 17-60 years) in Jos, Nigeria. Twenty-five (14.3 percent) of the blood donors and 127 (25.9 percent) of the HIV-infected individuals were HBsAg seropositive, indicating a higher HBV infection among HIV-infected persons than among healthy blood donors. A slightly higher HBsAg seroprevalence was recorded in the males (14.6 percent) than females (12.9 percent) of the blood donors. Among the HIV-infected patients, the males had considerably higher HBsAg seroprevalence than the females (31.8 vs 22.1 percent) with the highest prevalence of HBsAg occurring in the 51-60 years age group (44 percent), followed by those of 31-40 years (28.2 percent). Results confirmed the high endemicity of HBV infection in Jos, Nigeria and the significantly greater prevalence of HBV infection among HIV -infected patients than among blood donors.

Public expenditures and health care in Africa.

Unfavorable economic conditions in most of Africa (in this paper Africa refers to Sub-Saharan Africa only) have meant public austerity and a deceleration in government health spending. Given the dominant role of government in providing health services in Africa there is a need to investigate the links between public spending and the provision of health care. Analyzing information from five Sub-Saharan African countries, namely Botswana, Burkina Faso, Cameroon, Ethiopia and Senegal, we investigate the impacts of shifting expenditure patterns and levels on the process of providing health services as well as on delivery of health care. The country analyses indicate that in addition to the level of public spending, the expenditure mix (i.e. salaries, drugs, supplies etc.), the composition of the health infrastructure (hospitals, clinics, health posts etc.), community efforts, and the availability of private health care all influence health care delivery. Consequently, per capita public expenditure (the most important indicator in a number of related studies) alone as a measure of the availability of health care and especially for cross-country comparisons is inadequate. Reductions in government resources for health care often result in less efficient mixing of resources and hence less health care delivery, in quality and quantity terms. With the recent trends in health care spending in Africa there should be greater effort to increase the efficient use of these increasingly scarce resources, yet the trend in resource mix has been in the opposite direction. Given the input to public health care of local communities, as well as the provision of private health care, it would seem that government spending on health care should be counter-cyclical, i.e. government health spending should accelerate during periods of economic down turns. Such counter-cyclical spending would tend to offset the difficulties facing local communities and the declining ability of individuals to pay for private health care. Recommending counter-cyclical health spending may seem wishful, but it points up the necessity of understanding what is likely to happen to health care in African countries in the face of economic difficulties, and particularly in the face of fiscal austerity.