Edwardsiella ictaluri, an unusual cause of bacteraemia in a Nigerian child with acute bloody diarrhoea

Enteric septicaemia of catfish was first detected in 1976 as an economically significant disease associated with commercial catfish production. Initially, Edwardsiella ictaluri was a host specific pathogen of catfish species but has also been reported from other hosts other than the catfish such as the zebrafish. E. ictaluri has not been isolated in humans hence it is not a zoonotic infection. There has been no previous report of isolation of this organism in humans. This was a case report of a 5 year old boy who presented with fever, vomiting, passage of bloody stool of 6 days and abdominal pain of a day duration. In the case of this 5 year old boy who presented with features of dysentery, blood culture using BACTEC™ grew E. ictaluri. E. ictaluri may be a pathogen which can infect humans just like another closely related species, Edwardsiella tarda. Although, E. ictaluri has not been reported in humans, could this be the first case? Non availability of diagnostic technique appropriate for its diagnosis may explain the rare incidence of the organism in humans, hence many cases would have been treated without isolating the organism

Comparative Assessment of Some Rapid Diagnostic Test (RDT) Kits for Malaria Diagnosis in Ibadan, Nigeria

Background:  Deployment of sound diagnostic deliverables remains a crucial component of malaria control and prevention programme in Africa. This study aims to make a comparative assessment of the efficacy of three famous brands of rapid diagnostic kits (RDT) available in Nigerian market, with the traditional Giemsa staining (microscopic) method, in testing for malaria in endemic zones, also to provide relevant information and guidance to individuals, health care service providers, test kit manufacturers as well as health corporate organizations. Methods: Giemsa microscopy along with RDT kits (Acon, Paracheck and SD Bioline) were carried out on 525 patient samples presumed to present with acute uncomplicated malaria by clinical diagnosis. In addition, the total WBC count and haematocrit were conducted on the blood samples. Results: Out of the 525 samples recruited, three hundred (300) 57.1% were found positive by Giemsa microscopy. SD Bioline had a positivity rate of 260 (49.5%) while Acon and Paracheck trailed behind with 200 (38.1%) and 150 (28.6%) samples respectively. The sensitivity, specificity and efficiency of the three RDT kits were as follows: SD Bioline (86.3%, 99.6%, 92%); Paracheck (50%, 97.7%, 70.4%) and Acon (66.7%, 100%, 80.9%) respectively. Children within the age bracket 0-10 years had the highest malaria positivity rate (F=5.29; p< 0.05). 115 (38.3%) of children in this age group were positive for malaria with Mean PCV of 30.65 ± 0.52 compare to non-malaria control. The dominant malaria species was P. falciparum with 280 (93.3%) cases. However, an appreciable cases of P. falciparum & P. vivax 15 (5.0%) along with P. falciparum & P. malariae 5 (1.7%) co-infections were confirmed. It was also observed that the haematocrit value for individuals correlated inversely with the parasite density (r = -0.78; p< 0.05). Conclusion and Recommendation: Giemsa microscopy method still remains the gold standard for malaria diagnosis in limited resources endemic zones and recommends that imported RDT kits for malaria should be validated before use in developing countries. Keywords: Giemsa Microscopy; Rapid Diagnostic Kits; Parasite Density; Co-Infection; Malaria Contro

COVID‑19 at the Community Level: What are the Countermeasures?

Although several efforts have been implemented to prevent and control the coronavirus disease 2019 (COVID‑19) pandemic at the population level, varying outcomes have been reported in several quarters, despite the implementation of socio‑behavioral methods commonly at the population level to stop the human‑to‑human transmission. We did a narrative review of relevant articles of identified countermeasures at the population level, for curbing the COVID‑19 pandemic. The key fi ndings were evidence measures such as physical distancing, quarantine, isolation, screening, active case detection, and risk communication if properly implemented. Other countermeasures identified were air disinfection and lockdown restrictions. Air disinfection has a potentially harmful effect on humans, while lockdown restrictions have been counterproductive in many settings. In  conclusion, many of these public health measures are with peculiarities and needs to be contextualized to be effective in curbing the pandemic. Further research and regular assessments are needed on the countermeasures. Keywords: Coronavirus disease 2019, pandemic, prevention, severe acute respiratory syndrome coronavirus

Views of early career doctors on residency training and clinical practice in Nigeria: A qualitative report from charting study

In Nigeria, Early Career Doctors (ECDs) constitute a significant number of the doctor's health workforce and play a crucial role in health service delivery. However, there is a paucity of data concerning attitude, perception, and challenges in training and skill acquisition faced by ECDs undergoing residency training in Nigeria. This study is a component of Challenges of Residency training and early career doctors in Nigeria (CHARTING study) a multicentre and multidisciplinary study that explored the views of ECDs on residency training and clinical practice in Nigeria. Methods: Focus Group Discussions (FGD) were conducted among fourteen respondents, to address specific aspects of the residency training program and encourage respondents to express themselves about issues relevant to their personal experiences as regards the assessment of practice and proffer recommendations. Discussions were digitally recorded with an audio recorder. Audio-recordings was transcribed verbatim. Transcripts were analysed, and coding was done using NVivo 12 program. Results: All the study participants expressed various degrees of dissatisfaction and challenges such as lack of up to date knowledge, poor&contingent rewards, workload distribution, lack of mentorship, and unequipped facility during the residency training program. Majority of the study participants considered the program is currently skewed towards service delivery at the detriment of training and research. Conclusion: The study provided robust information on the knowledge of the trainees' perception of the residency training program in Nigeria as well as the challenges of residency training among ECDs as regards their experience and practice; it also proffered recommendations to mitigate the challenges. Keywords: Career, Internship, Postgraduate, Registrar, Trainee, Residency, Doctors, Dentist, Early Career Doctors, Nigeria, Education, Graduate Medical, Residenc

Review of COVID‑19 Vaccine

Coronavirus disease 2019 (COVID‑19) accounts for over 92 million confirmed cases worldwide, with over 2.06 million deaths. In the past year, more than 290 candidate vaccines have been tested; COVID‑19 vaccine  development was sped up, with shortened timeline, due to the urgent global need in the face of the pandemic. In addition, people with the highest risk of contracting the disease, such as health workers with a high risk of exposure, elderlies, and people with underlying comorbidities, were prioritized with vaccination rollout. The article narratively reviewed original and review articles available on PubMed and Google Scholar related to the theme to provide up‑to‑date information. The different templates developed and studied for COVID‑19 vaccines include the whole‑virus vaccine, viral vector vaccine, nucleic acid (deoxyribonucleic acid and ribonucleic acid), and protein subunit vaccine. Myths impede vaccine uptake in this part of the globe. Adopting these myths leads to sharing and spreading, which negatively impacts the prevention of COVID‑19 and vaccine uptake. Adverse event following immunizations (AEFIs) is classified based on severity, from minor to severe. The minor ones are common events that pose no potential health risks to the receiver of the vaccine. The type determines the safety profile, severity, and frequency of AEFIs observed with the vaccine administration. Overall, this pandemichas heightened the global level of threat awareness; it has also provided motivation to prepare for future  pandemics by developing new vaccines

Silver nanoparticle synthesis by Acalypha wilkesiana extract: phytochemical screening, characterization, influence of operational parameters, and preliminary antibacterial testing

© 2019, The Author(s). Introduction: The application of skin bleaching products to inhibit melanogenesis is a common practice within the African diaspora. Despite the adverse health effects of skin bleaching, rigorous studies investigating skin bleaching behavior among these populations in the United States are limited. In our P30 pilot study, we explored predictors of skin bleaching practice intensity among African and Afro-Caribbean women. Methods: In collaboration with our Community Engagement Core, we conducted a cross-sectional study to investigate the relationship between demographic and psychosocial predictors and skin-bleaching-related practice patterns among African and Afro-Caribbean women in New York City. Results: Among the 76 participants recruited, the median age at the initiation of skin bleaching was 19.5 (16–25) years, yielding a median duration of 13.5 (6–23) years. Although pregnant women were not actively recruited for the study, 13.2% (n = 10) of the participants used skin bleaching products while pregnant or possibly breastfeeding. Nativeness and education were associated with various components of skin bleaching practice intensity, including duration of skin bleaching, daily use of products, and bleaching of the entire body. Participants’ perceived skin-color-related quality of life was not associated with skin bleaching practice intensity. Conclusion: Skin bleaching is a habitual practice that likely requires culturally sensitive interventions to promote behavioral change. The existence of prenatal and postnatal exposure to mercury, hydroquinone, and other potentially harmful chemicals in skin bleaching products highlights an urgent need to explore the adverse effects of skin bleaching practices on birth outcomes and the growth and neurodevelopment of young babies

Anthrax outbreak: exploring its biological agents and public health implications

The (re)emergence of several infectious zoonoses underlines the need for the re-evaluation of the transmission patterns and key players responsible for effective inter-species transfer of diseases. Anthrax is caused by Bacillus anthracis, a zoonotic rod-shaped, Gram-positive, spore-forming bacterium that is highly fatal to both human and animal populations. B. anthracis is widespread across several regions of the world, including Africa, Asia, southern Europe, North and South America, and Australia, and it has a remarkably high attendant impact on the sustainability and profitability of livestock. The current trend in the global distribution of anthrax necessitates an urgent contextual understanding of the key drivers of the spread of B. anthracis in different parts of the world toward the end goal of an anthrax-free world. The understanding of the drivers is integral for the development of control and preventive measures, and also the development of agents such as therapeutics and vaccines against B. anthracis. This review presents a holistic description of the transmission pattern and epidemiology of B. anthracis, and updates on the diagnostic techniques and approaches available for the detection of B. anthracis. In addition, this review highlights plausible prevention and control strategies for the bacterium. This review further underscores the need for participatory epidemiology, hygiene, and safety protocols, the establishment of comprehensive surveillance systems, and global collaborative efforts toward vaccine development as critical steps in controlling anthrax

Challenges of residency training and early career doctors in Nigeria study (charting study): a protocol paper

Introduction: Early career doctors (ECDs) make up a significant proportion of the workforce of medical/dental practitioners in Nigeria. ECDs play pivotal roles in the Nigerian healthcare system. However, several factors affect ECDs in their career endeavours, ranging from poor remuneration to psychosocial problems (such as burn out, job dissatisfaction, etc.). While other countries have tried to investigate these factors and their impact, no national inquiry has been done yet in Nigeria. This demonstrates the critical need to conduct a nationally representativestudy exploring these factors, such as demographic, workplace and psychosocial factors, among ECDs in Nigeria. This article is a protocol paper for the challenges of residency training and early career doctors in Nigeria study; charting study to be conducted under the auspices of the Nigerian Association of Resident Doctors of Nigeria(NARD).Methods: The Charting Study would be a mixed study design, utilizing both qualitative and quantitative study designs and access data from structured questionnaire, focus group interview and secondary data available to the association.Conclusion: The outcome of this study will provide great insight into various issues affecting ECDs in Nigeria and make necessary recommendations.Keywords: Nigeria, early career doctors, junior doctors, physicians, dentists, workplace, psychosocial issue

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century