Predictive model for early detection of type 2 diabetes using patients' clinical symptoms, demographic features, and knowledge of diabetes.

Background and Aims: With the global rise in type 2 diabetes, predictive modeling has become crucial for early detection, particularly in populations with low routine medical checkup profiles. This study aimed to develop a predictive model for type 2 diabetes using health check-up data focusing on clinical details, demographic features, biochemical markers, and diabetes knowledge. Methods: Data from 444 Nigerian patients were collected and analysed. We used 80% of this data set for training, and the remaining 20% for testing. Multivariable penalized logistic regression was employed to predict the disease onset, incorporating waist-hip ratio (WHR), triglycerides (TG), catalase, and atherogenic indices of plasma (AIP). Results: The predictive model demonstrated high accuracy, with an area under the curve of 99% (95% CI = 97%-100%) for the training set and 94% (95% CI = 89%-99%) for the test set. Notably, an increase in WHR (adjusted odds ratio [AOR] = 70.35; 95% CI = 10.04-493.1, p-value < 0.001) and elevated AIP (AOR = 4.55; 95% CI = 1.48-13.95, p-value = 0.008) levels were significantly associated with a higher risk of type 2 diabetes, while higher catalase levels (AOR = 0.33; 95% CI = 0.22-0.49, p < 0.001) correlated with a decreased risk. In contrast, TG levels (AOR = 1.04; 95% CI = 0.40-2.71, p-value = 0.94) were not associated with the disease. Conclusion: This study emphasizes the importance of using distinct clinical and biochemical markers for early type 2 diabetes detection in Nigeria, reflecting global trends in diabetes modeling, and highlighting the need for context-specific methods. The development of a web application based on these results aims to facilitate the early identification of individuals at risk, potentially reducing health complications, and improving diabetes management strategies in diverse settings.

Prediction of malaria positivity using patients' demographic and environmental features and clinical symptoms to complement parasitological confirmation before treatment.

BACKGROUND: Current malaria diagnosis methods that rely on microscopy and Histidine Rich Protein-2 (HRP2)-based rapid diagnostic tests (RDT) have drawbacks that necessitate the development of improved and complementary malaria diagnostic methods to overcome some or all these limitations. Consequently, the addition of automated detection and classification of malaria using laboratory methods can provide patients with more accurate and faster diagnosis. Therefore, this study used a machine-learning model to predict Plasmodium falciparum (Pf) antigen positivity (presence of malaria) based on sociodemographic behaviour, environment, and clinical features. METHOD: Data from 200 Nigerian patients were used to develop predictive models using nested cross-validation and sequential backward feature selection (SBFS), with 80% of the dataset randomly selected for training and optimisation and the remaining 20% for testing the models. Outcomes were classified as Pf-positive or Pf-negative, corresponding to the presence or absence of malaria, respectively. RESULTS: Among the three machine learning models examined, the penalised logistic regression model had the best area under the receiver operating characteristic curve for the training set (AUC = 84%; 95% confidence interval [CI]: 75-93%) and test set (AUC = 83%; 95% CI: 63-100%). Increased odds of malaria were associated with higher body weight (adjusted odds ratio (AOR) = 4.50, 95% CI: 2.27 to 8.01, p < 0.0001). Even though the association between the odds of having malaria and body temperature was not significant, patients with high body temperature had higher odds of testing positive for the Pf antigen than those who did not have high body temperature (AOR = 1.40, 95% CI: 0.99 to 1.91, p = 0.068). In addition, patients who had bushes in their surroundings (AOR = 2.60, 95% CI: 1.30 to 4.66, p = 0.006) or experienced fever (AOR = 2.10, 95% CI: 0.88 to 4.24, p = 0.099), headache (AOR = 2.07; 95% CI: 0.95 to 3.95, p = 0.068), muscle pain (AOR = 1.49; 95% CI: 0.66 to 3.39, p = 0.333), and vomiting (AOR = 2.32; 95% CI: 0.85 to 6.82, p = 0.097) were more likely to experience malaria. In contrast, decreased odds of malaria were associated with age (AOR = 0.62, 95% CI: 0.41 to 0.90, p = 0.012) and BMI (AOR = 0.47, 95% CI: 0.26 to 0.80, p = 0.006). CONCLUSION: Newly developed routinely collected baseline sociodemographic, environmental, and clinical features to predict Pf antigen positivity may be a valuable tool for clinical decision-making.

Prevalence of enteric parasitic infections among people living with HIV in Abeokuta, Nigeria.

INTRODUCTION: Enteric parasitic infections have been increasingly recognized as etiology of life-threatening chronic diarrhea in PLWHA in sub-Saharan Africa. This study investigated the prevalence and burden of intestinal parasitic infection among PLWHA in Abeokuta, southwest Nigeria. METHODS: Freshly passed stool samples were collected from PLWHA. Detection of Cryptosporidium spp and Microsporidium spp was carried out with Kinyoun's stain and Weber's Chromotrope-based stain respectively. Investigation of other intestinal parasites was done using the direct saline preparation and formol-ether concentration methods. CD4+ T cell count was measured using Partec flow cytometry technique. RESULTS: A total of 231 (males: females 96:135; mean age 31.81±11.40 years) PLWHA were recruited into the study, among whom 84 (36.4%) were infected with at least one intestinal parasites. Fifty two (22.5%) individuals were positive for Cryptosporidium spp and a significant association between Cryptosporidium sppand diarrhea was observed (p=0.006). Seven (3.0%) were positive for Microsporidium spp. Helminths recovered included Ascaris lumbricoides (20.8%), hookworm (6.5%), Strongyloides stercoralis (4.3%), Trichuris trichiura (5.6%) and Taenia spp. (5.6%). Cryptosporidium spp, Microsporidium spp and S. stercoralis were significantly associated with CD4+ count ≥ 200 cells/mm3 (p<0.05). Cryptosporidium sppand A. lumbricoides were significantly observed among patients that are anti-retroviral therapy (ART) naive. CONCLUSION: High prevalence of opportunistic parasitic infection was significantly correlated with diarrhea, low CD4+ count and ART naïve individuals in the study. These findings re-emphasize the need for early diagnosis of opportunistic parasites and appropriate intervention among PLWHA.

Prevalence and associated factors of Plasmodium falciparum and soil transmitted helminth infections among pregnant women in Osun state, Nigeria.

BACKGROUND: Plasmodium falciparum and soil transmitted helminth (STHs) infection are widespread in sub-Sahara Africa, where co-infection is also common. This study assessed the prevalence of these infections and their risk factors among pregnant women in Osogbo, Nigeria. METHODS: A total of 200 pregnant women attending the antenatal clinic were recruited. Plasmodium falciparum was detected using thick and thin film methods, while formol ether concentration method was used for STHs detection. A questionnaire was used to investigate the possible risk factors associated with acquisition of malaria and helminth infections. RESULTS: The prevalence of P. falciparum, STHs and their co-infection was 29.5%, 12% and 5% respectively. P. falciparum, STHs and P. falciparum + STHs co-infection was significantly higher in primigravidae (52.5% vs 58.3% vs 80%) than in secongravidae (18.6% vs 25.0% vs 20%) and multigravidae (28.8% vs 16.7% vs 0%) (p=0.02). Prevalence associated factors identified for P. falciparum was age (p=0.0001) while gravidity (p=0.02) was identified for P. falciparum + STHs co-infection. CONCLUSION: High prevalence of P. falciparum and helminth infections was observed among the pregnant women with primigravidae being the most susceptible to co-infection. There is an urgent need to implement an effective malaria and STHs preventive method for this high risk population.

Efficacy of praziquantel in the treatment of Schistosoma haematobium infection among school-age children in rural communities of Abeokuta, Nigeria.

BACKGROUND: Chemotherapy with praziquantel (PZQ) has been the cornerstone of schistosomiasis control over the last two decades. Being the only available drug for the treatment of over 200 million people worldwide, continuous monitoring of PZQ efficacy under the pressure of widespread use is therefore advocated. METHODS: The efficacy of taking two doses of oral PZQ for the treatment of Schistosoma haematobium was examined among school children in Nigeria. Urine specimens were collected from 350 school children and examined using the filtration technique. Blood was collected for packed cell volume (PCV) estimation, and the weight and height of each child were estimated. S. haematobium egg positive pupils were treated with two oral doses of PZQ at 40 mg/kg with a four-week interval in between. Drug efficacy was determined based on the egg reduction rate (ERR). RESULTS: Among 350 school children, 245 (70.0%) - of which 132 were males and 113 were females, with an age range of 4 to 15 years - were diagnosed with S. haematobium. All the 245 infected children received a single oral dose of 40 mg/kg PZQ twice with a four-week interval in between and were followed up for 12 weeks. At four, eight and twelve weeks post treatment, the ERR was 57.1%, 77.6% and 100%, respectively. The ERR was significantly higher among the children with a light infection compared to those with a heavy infection. One hundred and twenty-one children were egg negative at four weeks post treatment, among which 1 (6.3) and 120 (52.4%) had heavy and light infections, respectively. Following the second round of treatment, the cure rate at eight weeks and twelve weeks was 85.3% and 100%, respectively. CONCLUSION: This study demonstrated the efficacy of taking two doses of oral PZQ for the treatment of urinary schistosomiasis among school children in Nigeria.

Prevalence of Plasmodium falciparum Parasitaemia and Its Correlation with Haematological Parameters among HIV-Positive Individuals in Nigeria.

Malaria and HIV are the two most important health challenges of our time. Haematologic abnormalities are features in Plasmodium falciparum infection, and anaemia is a well-known outcome. The prevalence and haematological impact of P. falciparum parasitaemia were determined among HIV-infected individuals in Nigeria. Parasite detection was carried out using microscopy and Polymerase Chain Reaction (PCR). Haemoglobin concentration was determined using an automated machine while CD4+ T-cells count was analyzed using flow cytometer. Thirty-seven (18.5%) out of the 200 HIV individuals enrolled had malaria parasites detected in their blood. All the positive cases were detected by PCR while only 20 (10%) were detected by thick blood microscopy. The mean haemoglobin concentration and packed cell volume (PCV) of HIV individuals with malaria parasitaemia were lower compared to those without malaria parasitaemia but the difference was not statistically significant. Also no significant difference was observed in malaria positivity in respect to sex and mean CD4+ cell count. The study highlights the effects of P. falciparum parasitaemia on the haematologic and immune components of HIV individuals.

Assessment of Clinical Diagnosis, Microscopy, Rapid Diagnostic Tests, and Polymerase Chain Reaction in the Diagnosis of Plasmodium falciparum in Nigeria.

This study compares the performance of clinical diagnosis and three laboratory diagnostic methods (thick film microscopy (TFM), rapid diagnostic test (RDT), and polymerase chain reaction (PCR)) for the diagnosis of Plasmodium falciparum in Nigeria. Using clinical criteria, 217 children were recruited into the study out of which 106 (48.8%) were positive by TFM, 84 (38.7%) by RDT, and 125 (57.6%) by PCR. Using a composite reference method generated from the three diagnostic methods, 71 (32.7%) patients were found to be truly infected and 90 (41.5%) truly uninfected, while 56 (25.8%) were misidentified as infected or noninfected. When each of the 3 diagnostic methods was compared with the composite reference, PCR had sensitivity of 97.3%, specificity of 62.5%, positive predictive value (PPV) of 56.8%, and negative predictive value (NPV) of 97.8%; microscopy had sensitivity of 77.2%, specificity of 72%, PPV of 66.9%, and NPV of 81.1%, while RDT had sensitivity of 62.3%, specificity of 87.4%, PPV of 67.7%, and NPV of 84.5%. PCR test performed best among the three methods followed by TFM and RDT in that order. The result of this study shows that clinical diagnosis cannot be relied upon for accurate diagnosis of P. falciparum in endemic areas.