Prevalence of Cryptosporidiosis in diarrhoeal stools of children under-five years seen in Ahmadu Bello University Teaching Hospital Zaria, Nigeria

Introduction: Human cryptosporidiosis is a zoonotic disease and is increasingly recognized as a major public health problem. It is associated with significant effects on growth, physical and cognitive functions and excess mortality especially among children.Aim: To determine the prevalence of Cryptosporidium oocyst excretion in children less than 5years with diarrhoea in ABUTH Zaria.Methods: Children aged 0 to 59 months managed in paediatrics wards of ABUTH for diarrhoea were studied between July 2008 and June 2009. Stool specimens obtained from these subjects were analysed for Cryptosporidium oocysts using the modified ZN staining technique.Results: A total of 185 children were enrolled. There were 78 (42.2%) boys and 107(57.8%) girls. A total of 33 children studied excreted oocysts in their stools, giving a prevalence of Cryptosporidium oocysts of 17.8%. Thehighest rate (21.7%) was observed in children aged between 13 and 36 months, and no oocysts were observed in stools of neonates. Oocyst excretion was observed to be commoner in the rainy season.Conclusion: Cryptosporidium is a common cause of diarrhoea among under-five children in our environment. It was commoner after infancy and in the rainy season. Recommendation: Routine screening for  Cryptosporidium should be part of evaluation of diarrhoeal illness especially in children beyond the neonatal age group.Key words: Cryptosporidiosis; diarrhoea; under-five; childre

Epidemiology of Hepatitis B and Hepatitis C Virus infections among HIV counseling and testing clients in Jos, North central Nigeria

Hepatitis B and hepatitis C virus infection are common in Nigeria; where they are a major cause of both acute and chronic liver disease, as well as hepatocellular cancer. Persons at risk of acquisition of Human Immunodeficiency Virus (HIV) infection are also at risk of acquisition of infection with Hepatitis B virus (HBV) and Hepatitis C virus (HCV). We set out to determine the epidemiology of HBV and HCV infection among HIV Counseling and Testing (HCT) clients at the Jos University Teaching Hospital (JUTH), Nigeria.This was a cross-sectional study conducted at the HCT unit of the AIDS Prevention Initiative in Nigeria (APIN) Jos University Teaching Hospital (JUTH), Jos, Nigeria between November, 2012 and April 2013.Subjects were recruited consecutively at the HCT unit of APIN JUTH. Included were subjects 18 years of age and above, antiretroviral (ARV) drug naive, who accepted and signed the consent form.Clients who declined to sign the consent form were excluded. The study involved collecting demographic data, exposure to risk factors and laboratory determination of HBV and HCV sero-prevalence in the subjects using Enzyme Linked Immunoassay (ELISA) and Polymerase chain reaction (PCR) assay methods.Chi-squared test was used to determine significance of association between categorical variables.One hundred and thirty two (56.9%) were females, 100 (43.1%) were males. Thirty six (15.5%) tested positive for HBsAg by ELISA, 31 (13.4%) were confirmed positive by DNA PCR. Nine (3.9%) tested positive by ELISA to HCV antibody, 7 (3.0%) were confirmed positive by RNA PCR. Co-infection rate of HIV / HBV was 5.2%. Infection was more common among those younger than 36 years in the case of HBV and those older than 36 years in the case of HCV.We concluded the prevalence of HBV infection was high. Study was limited by the cross sectional design

Prevalence of multi-drug resistance (MDR) Pseudomonas aeruginosa isolates in surgical units of Ahmadu Bello University teaching Hospital, Zaria, Nigeria: An indication for effective control measures

Background: Multiple antibiotic resistance in bacteria populations is currently one of the greatest challenges to the effective management of infections. Constant bacteriological monitoring of pathogens in the hospital in general and specialized units is necessary to provide accurate data on the prevalence and antibiotic resistance pattern of specific pathogens. Method: All clinical samples from the surgical units of ABUTH, Zaria over a 24-month period were processed and Pseudomonas aeruginosa isolates characterized and identified using standard microbiological procedures. The antibiotic susceptibility of isolates and a standard strain to ceftazidime, amikacin, gentamicin, imipenem, ciprofloxacin and perfloxacin was determined by the disk diffusion method. Results: A total of 1,452 clinical specimens were processed and 878 pathogenic bacteria isolated within the study period. There were 92 Pseudomonas aeruginosa isolates, giving a prevalence level of 10.5%. Most of the isolates were from urine (51.1%) and wounds (41.3%). A total of 18/92 (19.6%) of the isolates were resistant to three or more of the antibiotics tested, with the most prevalent resistance pattern being ceftazidime+gentamicin+perfloxacin+ofloxacin (27.8%). Conclusion: There is need for instituting an antimicrobial resistance surveillance system that provides clinicians with up-to-date data on the prevalence and resistance pattern of commonly encountered pathogens like Pseudomonas aeruginosa. Key Words: Psuedomonas aeruginosa, drug resistance, surgical units Annals of African Medicine Vol.3(1 ) 2004: 13-1

ANTIBIOTIC SUSCEPTIBILITY PATTERN AND MULTIPLE ANTIBIOTIC RESISTANCE INDEX OF PSEUDOMONAS AERUGINOSA URINE ISOLATES FROM A UNIVERSITY TEACHING HOSPITAL

Urine samples submitted to the Medical Microbiology diagnostic laboratory of the Ahmadu Bello University Teaching Hospital, Zaria, were routinely screened for Pseudomonas aeruginosa over a three-month period with 13/150 (8.67%) of the pathogenic bacteria isolated positively identified. All the isolates were resistant to the cheap, commonly available antibiotics; rifampicin, ampicillin/cloxacillin, erythromycin, chloramphenicol and ampicillin but were uniformly susceptible to ciprofloxacin. The high prevalence of multidrug resistance indicates a serious need for broad-based, local antimicrobial resistance surveillance for continuous tracking of antibiotic resistance trends among all clinically relevant isolates and introduction of effective interventions to reduce multidrug resistance in such pathogens. Key Words: Pseudomonas aeruginosa, antibiotic susceptibility, multiple antibiotic resistance, urinary tract infection Afr. J. Clin. Exper. Microbiol. 2004; 5(2): 198 – 202

Pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria

Background: Asymptomatic bacteruria in pregnancy is a common condition affecting pregnant women because of both anatomical and physiological changes in pregnancy. This condition appears to be commoner in people living with HIV because of the added immunosuppression caused by the virus. Aim: The study was to identify the pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria. Methods: This was a prospective cross sectional study among symptom-free HIV positive pregnant women attending the prevention of mother to child transmission of HIV (PMTCT) antenatal clinic in Zaria, Nigeria between 1st March and 31st August 2011. A structured, closeended questionnaire was administered and mid-stream urine samples were obtained and processed within 2 hours of collection in the laboratory. Results: A total of 220 consenting, asymptomatic, HIV positive pregnant women were screened for bacteriuria out of the 240 eligible women who were approached to participate in the study. Sixteen (16) women were positive for significant bacteriuria, giving a prevalence of 7.3%. A total of six (6) different isolates were isolated with Staphylococcus aureus (8) making 50%, E. coli (4) 18.8%, Klebsiella spp (2) 12.5%, Streptococcus spp (2) 12.5% and Proteus spp (1) 6.2%. All the isolated organisms were sensitive to gentamycin, cefuroxime, ceftazidime, ciprofloxacin and nitrofurantoin. Conclusion: This study found Staphylococcus aureus as the most common organism isolated in the urine of asymptomatic patients with HIV infection in pregnancy. The isolated organisms were sensitive to gentamycin, cefuroxime, ceftazidime, ciprofloxaxin and nitrofurantoin. Key words: HIV, Asymptomatic bacteriuria, Microbial isolates, mid-stream urine, immunosuppressio

A standardised Phase III clinical trial framework to assess therapeutic interventions for Lassa fever

Background Only one recommendation currently exists for the treatment of Lassa fever (LF), which is ribavirin administered in conjunction with supportive care. This recommendation is primarily based on evidence generated from a single clinical trial that was conducted more than 30 years ago–the methodology and results of which have recently come under scrutiny. The requirement for novel therapeutics and reassessment of ribavirin is therefore urgent. However, a significant amount of work now needs to be undertaken to ensure that future trials for LF can be conducted consistently and reliably to facilitate the efficient generation of evidence. Methodology We convened a consultation group to establish the position of clinicians and researchers on the core components of future trials. A Core Eligibility Criteria (CEC), Core Case Definition (CCD), Core Outcome Set (COS) and Core Data Variables (CDV) were developed through the process of a multi-stakeholder consultation that took place using a modified-Delphi methodology. Results A consensus position was achieved for each aspect of the framework, which accounts for the inclusion of pregnant women and children in future LF clinical trials. The framework consists of 8 core criteria, as well as additional considerations for trial protocols. Conclusions This project represents the first step towards delineating the clinical development pathway for new Lassa fever therapeutics, following a period of 40 years without advancement. Future planned projects will bolster the work initiated here to continue the advancement of LF clinical research through a regionally-centred, collaborative methodology, with the aim of delineating a clear pathway through which LF clinical trials can progress efficiently and ensure sustainable investments are made in research capacity at a regional level