Asymptomatic Intestinal Parasitic Infestations among Children Under Five Years in Selected Communities in the Ho Municipality, Ghana.

BACKGROUND: The study investigated intestinal parasitic infestations (IPIs) and possible risk factors associated with asymptomatic children under five (5) years in five (5) selected communities in the Ho Municipality. METHODS: The study design was cross- sectional, with a simple random sampling technique involving 150 asymptomatic children under 5 years from 5 selected communities (Klave, Hoe, Freetown, Dave and Godokpe) in the Ho Municipality. A questionnaire was used to obtain socio-demographics and other relevant parameters. Direct wet preparation, formol-ether concentration and Modified ZN staining techniques were used for the identification of intestinal parasites from participants' stool samples. The Fisher's exact test and binary logistic regression analysis were used to determine the difference in IPIs proportions and assess the risk factors associated with IPIs respectively. RESULTS: The overall IPIs cases was 14% (21/150). Cryptosporidium spp was most predominant [5.3% (8/150)], followed by Entamoeba spp [3.3% (5/150)], Cyclospora cayetenensis [2.7% (4/150)], Ascaris lumbricoides [1.3% (2/150)], Giardia lamblia [0.7% (1/150)] and Strongyloides stercoralis [0.7% (1/150)]. Children in rural communities (23.4%) recorded significantly higher case rate compared to those in urban communities (9.8%0), (p=0.04). Lower educational attainment of mother [OR=0.55, 95% CI (0.37 - 0.83), p-value = 0.015] and residence in rural communities [OR = 0.53, 95% CI (0.33-0.88)], p-value = 0.025] were significantly associated with IPIs. CONCLUSION: Asymptomatic IPIs are quite prevalent among children under 5 years in the Ho Municipality. The study thus recommends active sensitization programs for parents/guardians on preventive measures and school health programs should be instituted in rural communities.

Diagnostic utility of QuantiFERON-TB gold in-tube in active pulmonary Tuberculosis in Nigeria.

BACKGROUND: The high positive responses obtained in active TB indicate that IGRAs may be useful in diagnosing active TB. This study aimed at evaluating the usefulness of Quantifer on-TB Gold-in Tube test (QFT-IT) in the diagnosis of active TB among Nigerians. METHODS: This study prospectively enrolled sputum smear positive TB cases and healthy disease free controls. Basic demographic and clinical data were collected using a structured questionnaire. Venous blood was collected into the QTF-IT tubes, incubated for 16-24 hours, serum harvested and stored at -200C till analysed in a batch. Tuberculin skin test (TST) was also done using 5TU and read within 48-72 hours. The performances of QFT-IT and TST among the cases and controls were compared. RESULTS: Sixty one TB cases and 41 controls were enrolled. The mean (SD) age of the TB cases was higher than the controls, 35.14+4.3 yrs v 27.8 + 2.1, p<0.001. Forty three (70.5%), 13 (21.3%) and 5 (8.2%) of the cases had a positive, negative and indeterminate QFT-IT results respectively compared with 14 (34.1%), 25 (61%), and 2 (4.9%) of the controls respectively, p values <0.001, 0.005 and 0.05 respectively. Fifty eight(95%) and 29(70.7%) of the TB cases and controls had a positive TST result respectively while 3 (5%) and 12( 29.3%) of the TB cases and controls had a negative TST result respectively, p values 0.003 each .QFT-IT had a sensitivity of 76% (95% CI 61.8 -85.2%) while the sensitivity of TST was 96.6% (95% CI 88.5 -98.3%), p = 0.07. The specificity of QFT-IT was 63.7% (95% CI 46-76%) and 30% (95% CI 20- 56%) for TST, p =0.001. Positive Likelihood ratio was 1.7 (95% CI 1.06-2.85) for QFT-IT and 1.4 (95%CI 1.06-1.8) for TST, p =0.002. Among the cases, both TST and QFT-IT were positive in 43(70.5%) and both negative in 1 (1.6%), and overall test .agreement was 77.7% (Kappa =0.13; p= 0.07). Female sex and higher total lymphocytes count were significantly associated with a positive QFT results. CONCLUSION: IGRA has a higher specificity and positive likelihood ratio in TB cases. Our findings indicate that QFT-IT may be a good adjunct tool to diagnose TB disease.

A new TB vaccine, MVA85A, induces durable antigen-specific responses 14 months after vaccination in African infants.

This study aimed to evaluate the durability of the immunogenicity of MVA85A beyond infancy. Participants in an immunogenicity study of MVA85A administered at age of 4 months had additional evaluation 14 months after initial vaccination for IFN-γ ELISPOT responses to Ag85A peptide and ESAT6/CFP-10 and tuberculin skin test (TST). 112 children participated in this study. The anthropometry, biochemical and haematological safety profile were similar between the MVA85A recipients and controls. MVA85A recipients still had significantly higher immune responses to Ag85A compared to the controls. The majority of these children had negative responses to the TST as well as the ESAT6/CFP-10 antigens. In summary, MVA85A-vaccinated children had a persistently higher Ag85A immune response 14 months following vaccination than controls. All the children had negligible evidence of latent infection with M. tuberculosis (Mtb), suggesting that deploying a prophylactic vaccine against Mtb infection at this age could still be effective in this setting.