Seroprevalence of Hepatitis C Virus Infection in Nigerians with Type 2 Diabetes Mellitus

Background: Several studies have suggested a strong epidemiologic association between Diabetes Mellitus (DM) and Hepatitis C Virus (HCV) infection in some populations. However, the reasons why chronic HCV infection is prevalent in DM remain unknown. Our aims were to determine the prevalence of HCV infection in a population of Nigerian diabetics compared with the general population as well as assess the influence of sex and age on HCV infection in the same diabetic population. Design and Methods: A total of 115 diabetic patients were compared with 2,301 blood donors matched by recognized risk factors to acquire HCV infection. Serologic testing for anti HCV was done using a commercial enzyme-linked immunosorbent assay (ELISA) kits. Results: Sixty (60) type 2 diabetic patients were males while fifty-five (55) were females. Their mean age was 55.4 ± 9 years and mean blood glucose level was 8.5mmol/l. One subject tested positive for HCV infection. The control group consisted of 2,031 adults recruited from the blood donor\'s clinic. Forty five of them (2.2%) tested positive for HCV. Conclusion: Our preliminary results suggest a low sero-prevalence of HCV infection among our patients with type 2 diabetes. Presently, routine screening for HCV infection in persons with diabetes may not be necessary. Keywords: HCV infection, type 2 diabetes mellitus Nigerian Journal of Clinical Practice Vol. 11 (3) 2008: pp. 199-20

Self-medication with antibiotics for the treatment of menstrual symptoms in southwest Nigeria: a cross-sectional study

Background: Self-medication with antibiotics is an important factor contributing to the development of bacterial antibiotic resistance. The purpose of this study was to evaluate the prevalence of self-medication with antibiotics for the treatment of menstrual symptoms among university women in Southwest Nigeria. Methods: A cross-sectional survey was administered to female undergraduate and graduate students (n = 706) at four universities in Southwest Nigeria in 2008. The universities were selected by convenience and the study samples within each university were randomly selected cluster samples. The survey was self-administered and included questions pertaining to menstrual symptoms, analgesic and antibiotic use patterns, and demographics. Data were analyzed using descriptive statistics and logistic regression. Results: The response rate was 95.4%. Eighty-six percent (95% CI: 83-88%) of participants experienced menstrual symptoms, and 39% (95% CI: 36-43%) reported using analgesics to treat them. Overall, 24% (95% CI: 21-27%) of participants reported self-medicated use of antibiotics to treat the following menstrual symptoms: cramps, bloating, heavy bleeding, headaches, pimples/acne, moodiness, tender breasts, backache, joint and muscle pain. Factors associated with this usage were: lower levels of education (Odds Ratio (OR): 2.8, 95% CI: 1.1-7.1, p-value: 0.03); nonscience major (OR: 1.58, 95% CI: 1.03-2.50, p-value: 0.04); usage of analgesics (OR: 3.17, 95% CI: 2.07-4.86, p-value: <0.001); and mild to extreme heavy bleeding (OR: 1.64, 95% CI: 1.01-2.67, p-value: 0.05) and pimples/acne (OR: 1.57, 95% CI: 0.98-2.54, p-value: 0.06). Ampicillin, tetracycline, ciprofloxacin and metronidazole were used to treat the most symptoms. Doctors or nurses (6%, 95% CI: 4-7%), friends (6%, 95% CI: 4-7%) and family members (7%, 95% CI: 5-8%) were most likely to recommend the use of antibiotics for menstrual symptoms, while these drugs were most often obtained from local chemists or pharmacists (10.2%, 95% CI: 8-12%). Conclusions: This is the first formal study to report that approximately 1 out of 4 university women surveyed in Southwest Nigeria self-medicate with antibiotics to treat menstrual symptoms. This practice could provide monthly, low-dose exposures to antibiotics among users. Further studies are necessary to evaluate the impacts of selfmedication on student health

Antibiotic Susceptibility Pattern and Beta-Lactamase Production of Strains of Campylobacter Species Isolated in Ile-Ife, Nigeria

Nigerian Journal of Biomedical Sciences Vol.3(2) 2004: The study was to determine the antibiotic susceptibility patterns and beta-lactamase production of Campylobacter jejuni/coli isolates obtained from stool specimens from children with diarrhoea at the Obafemi Awolowo University Teaching Hospital Complex (O.A.U.T.H.C.), Ile-Ife. Thirty strains of Campylabacter jejuni/coli were isolated from children with diarrhoea in the clinical laboratory of the department of Medical Microbiology and Parasitology of O.A.U.T.H.C. The antimicrobial susceptibility test was carried out according to the method described by Bauer et al, 1966. All isolates were tested for evidence of beta-lactamase activity by the starch paper technique (Odugbemi et al 1977). All isolates tested were sensitive to erythromycin, gentamicin, tetracycline and ciprofloxacin whereas only one strain was sensitive to cotrimoxazole. None of the isolates produced beta-lactamase. In this environment, the clinical use of erythromycin, tetracycline, gentamicin and ciprofloxacin is recommended for the treatment of Campylobacter enteritis. KEY WORDS: Campylobacter jejuni/coli; beta-lactamase; antibiotics; susceptibility. Nigerian Journal of Biomedical Sciences Vol.3(2) 2004: 61-6

Sexually transmitted infections in Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria: A decade of clinic experience

Sexually transmitted infections (STIs) remain cosmopolitan in all societies of the world and in some cases assume epidemic proportions. These infections are common infectious diseases nowadays, with an annual incidence of more than 200 million cases a year. Venereal pathogens continue to increase in number and the spectrum of pathogens has limitless elasticity. While genital discharge and ulceration are common presenting symptoms, unusual findings on examination and investigation are not uncommon. We assessed our clinic experiences during the first ten years in an STI clinic. Salient findings are that 85% of all patients seen have an STI. The breakdown of infections revealed that Candida albicans was the most common venereal pathogen accounting for 24% while Neisseria gonorrhoeae accounted for about 18.0%. Sarcoptes scabiei and Phthirus pubis causing scabies and pediculosis accounted for 1.8% and 0.3% respectively. As commonly established, the age bracket 19 to 39 years was clearly the age group in which sexually transmitted infections were mostly diagnosed. In a control programme, this age group should be targeted, while there is the need to continue to stimulate awareness of both the general public and health workers at all levels on the problems of sexually transmitted infections, the scourge of all ages. Key Words: Sexually transmitted infections, venereal pathogens, clinic experience, control awareness Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 64-6

Campylobacter Antimicrobial Drug Resistance among Humans in Ilorin, Nigeria.

Background: Though Campylobacter enteritis is a self-limiting disease, antimicrobial agents are recommended for extraintestinal infections and for treating immunocompromised persons. Erythromycin and ciprofloxacin are drugs of choice. The rate of resistance to these drugs is increasing in both developed and developing countries thus compromising their use in therapy. Continued surveillance of resistance pattern is necessary to guide rational use of antimicrobial agents in therapy when such are indicated. Objective: This study aims at determining the resistance of Campylobacter jejuni/coli to common antimicrobial agents. Methods: Campylobacter jejuni/coli recovered from cases of childhood diarrhoea in Ilorin, Nigeria were studied. All the organisms were isolated by standard techniques using the Butzler-type medium and they were preserved in 15% glycerol cryopreserve medium. The in-vitro antibiotic susceptibility testing for all organisms was performed by employing the Kirby- Bauer disc diffusion method. Production of beta-lactamase by the isolates was determined by the starch paper technique. Results: High level resistance to cotrimoxazole, ceftriaxone, and ampicillin were 96%, 84% and 68% respectively. On the other hand none of the isolates had any evidence of resistance to erythromycin and ciprofloxacin. Only one of the 25 isolates tested produced beta-lactamase. Conclusion: Campylobacter jejuni/coli are susceptible to firstline dugs, ery thromycin and ciprofloxacin. However high level resistance to other agents portends a possibility of transfer of acquired resistance and the need for continuous surveillance of resistance pattern Keywords: Campylobacter enteritis, Antimicrobial agents, Resistance, Surveillance. Nigerian Medical Journal Vol. 48 (3) 2007: pp. 75-7

Campylobacter enteritis in Ilorin, Nigeria

No Abstract

Asymptomatic bacteriuria in patients with diabetes mellitus in Ile-Iffe, South-West Nigeria

No Abstract. East African Medical Journal Vol. 85 (1) 2008 pp. 18-2

Bacteriology And Antimicrobial Suceptibility Profile Of Agents Of Orofacial Infections In Nigerians

A prospective study to determine the pattern of microorganisms seen in orofacial infections as well as investigating the antimicrobial susceptibility profile of the isolates was undertaken. Specimens were obtained aseptically from 25 patients presenting with orofacial infections at the Department of Oral Surgery and Pathology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. The specimens were transported in an anaerobically pre-reduced transport medium for processing in the laboratory. Isolation and identification were done employing standard bacteriological techniques. Antimicrobial susceptibility testing was performed by the disc diffusion method. All the 25 clinical samples obtained yielded growth of bacteria. Anaerobes were cultured from 24 (96%) specimens while 1 specimen yielded only aerobic isolates. Altogether, 44 bacterial isolates were obtained and 40 (91%) were anaerobes. Most of these anaerobes were Gram-negative rods and Gram-positive cocci. About 75-100% of the anaerobes were susceptible to commonly available antibiotics. Strikingly, sulphonamides demonstrated the weakest in-vitro activity against all isolates. The study revealed again the polymicrobial nature of orofacial infections as well as the predominance of anaerobes in the aetiology of these infections. Erythromycin and penicillin should be considered as frontline drugs in the treatment of mild orofacial infections while drugs like ciprofloxacin and clindamycin can be reserved for more severe and resistant infections. Afr. J. Clin. Exper. Microbiol. 2004; 5 (3): 272-27

Fluoroquinolone-Resistant Enteric Bacteria in Sub-Saharan Africa: Clones, Implications and Research Needs

Fluoroquinolones came into widespread use in African countries in the early 2000s, after patents for the first generation of these drugs expired. By that time, quinolone antibacterial agents had been used intensively worldwide and resistant lineages of many bacterial species had evolved. We sought to understand which Gram negative enteric pandemic lineages have been reported from Africa, as well as the nature and transmission of any indigenous resistant clones. A systematic review of articles indexed in the Medline and AJOL literature databases was conducted. We report on the findings of 43 eligible studies documenting local or pandemic fluoroquinolone-resistant enteric clones in sub-Sahara African countries. Most reports are of invasive non-typhoidal Salmonella and Escherichia coli lineages and there have been three reports of cholera outbreaks caused by fluoroquinolone-resistant Vibrio cholerae O1. Fluoroquinolone-resistant clones have also been reported from commensals and animal isolates but there are few data for non-Enterobacteriaceae and almost none for difficult-to-culture Campylobacter spp. Fluoroquinolone-resistant lineages identified in African countries were universally resistant to multiple other classes of antibacterial agents. Although as many as 972 non-duplicate articles refer to fluoroquinolone resistance in enteric bacteria from Africa, most do not report on subtypes and therefore information on the epidemiology of fluoroquinolone-resistant clones is available from only a handful of countries in the subcontinent. When resistance is reported, resistance mechanisms and lineage information is rarely investigated. Insufficient attention has been given to molecular and sequence-based methods necessary for identifying and tracking resistant clones in Africa and more research is needed in this area