Assessment of risk factors associated with HTLV-1/-2 infection among people living with HIV/ AIDS in Bauchi State, Nigeria

Introduction: Human T-cell lymphotropic virus (HTLV) is associated with shorter survival of HIV co-infected persons due to masked immunosuppression. Since both retroviruses share similar routes of transmission, there is a need to determine risk factors associated with these pathogens. This study aimed to assess the risk factors associated with HTLV-1/-2 and HIV co-infected among persons attending a secondary hospital in Ningi, Bauchi State, Nigeria. Methods: Blood samples were collected from 182 HIV infected persons and analysed for anti- HTLV-1/2 IgM and IgG antibodies using commercial Enzyme-Linked Immunosorbent Assay (ELISA) kits. Interviewer-based questionnaire were used to collate sociodemographic and risk factor data of the subjects and clinical history were obtained from participants’ medical records. Results: The seroprevalence of anti-HTLV-1/-2 IgM and IgG were 9.9% and 19.8%, respectively. Out of the 80 ART-naïve, 25 (31.3%) were IgM seropositive. Out of 102 ART-experienced, 11 (10.8%) were anti-HTLV-1/-2 IgM positive. There was a significant association between ART status and seroprevalence of anti-HTLV-1/-2 IgM (p=0.009). However, there was no significance association between seroprevalence of HTLV IgM and gender of the subjects (p=0.06). There was a significant association between the seroprevalence of anti-HTLV-1/-2 IgG and education level of subjects (p=0.039). However, no association between anti-HTLV-1/-2 IgG and other sociodemographic variables studied (p˃ 0.05). History of injury from sharp objects (aOR: 5.3, p<0.0001) and consistent protective sexual practice (aOR: 2.27, p=0.033) were associated with seroprevalence of anti-HTLV-1/-2 IgM. Discussion: High seroprevalence of HTLV-1/-2 and HIV co-infection was reported. ART status, protective sexual intercourse and injuries with sharp objects were identified risk factors of coinfection. It’s recommended to consider HTLV screening for all HIV infected persons and vice versa

Antibacterial Activity of Vanillic Acid against Staphylococcus aureus, Salmonella typhi, and Proteus mirabilis

Aim. This study investigated the efficacy of vanillic acid against selected pathogenic bacteria obtained from clinical samples. Method. The antibacterial efficacy of vanillic acid against selected pathogenic bacteria collected from clinical samples was studied using a broth macrodilution method. The minimum inhibitory concentration was determined by treating each isolate with increasing amounts of vanillic acid ranging from 150 to 2000 µg/ml. Results. The lowest inhibitory concentrations found were 600 µg/ml for Staphylococcus aureus, Proteus mirabilis, and Salmonella Typhi, and the time-kill susceptibility test also demonstrated a significant reduction in viable cells of the bacterial isolates investigated in this study. The findings of this study confirmed the antimicrobial effect of vanillic acid on bacterial growth and its activity against Staphylococcus aureus, Proteus mirabilis, and Salmonella Typhi. Conclusion. Vanillic acid may provide a solution for alternate therapeutic choices for diseases caused by Staphylococcus aureus, Proteus mirabilis, and Salmonella Typhi

Time-Series Analysis of Malaria Cases Among Suspected Febrile Patients Attending a Peri-Rural Health Centre Between February 2020- January 2021

Sub-Saharan Africa has a high rate of malaria-related morbidity and death, with Nigeria accounting for a substantial proportion of these cases owing to its malarious nature. Most Nigerians live in environments that encourage the development of mosquito vectors that are responsible for malaria transmission. This study aimed to determine the prevalence of malaria in the peri-urban areas. A time-series analysis was performed on 1,141 people with suspected febrile illness who visited a peri-urban health center over the course of a year (February 2020 – January 2021). Each person who presented to the hospital and was tested for malaria was included in the study. The 12-month study reported an overall prevalence of 24% (p0.05). A total of 273 individuals were found to be seropositive, with males (162) having a higher prevalence than females (111). Cases of seropositivity have been reported in all age groups. This study concluded that malaria remains a public health concern in the country, particularly in areas favorable for mosquito vector reproduction. Consequently, elimination approaches should be strengthened to safeguard people, particularly in vulnerable regions

PHYTOTHERAPEUTIC POTENTIAL OF HERBAL SUPPLEMENTS FOR COVID-19

The current Coronavirus Disease-19 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) has reportedly posed a significant threat to the global public health institution systems. The treatment has been supportive and not effective. Coupled with the lack of vaccine interventions, the search for effective therapeutic alternatives is still on. Herbal supplements have been used in the treatment of viral diseases for years and could serve as an alternative for COVID-19 therapy if the combinations are known and tested. Recent studies have proved that certain herbal supplements have exhibited antiviral activity against similar coronaviruses. Besides, molecular docking studies further proved the efficacy of the antiviral activity of the herbal supplements against SARS-CoV-2. However, there is still a need for in-vitro and in-vivo studies of the antiviral activity of these herbal supplements against SARS-CoV-2. Nevertheless, these herbal supplements have a high therapeutic potential for COVID-19 therapy. This study reveals the chemical composition of herbal supplements to come up with findings that can redefine research and development, risk analysis, and containment of the novel coronavirus disease

The Interplay Between Epigenetics, Vector Competence and Vaccine Immunodynamics as a Possible Explanation for Recent Yellow Fever Resurgence in Nigeria

Background: Yellow fever virus (YFV), a member of the genus Flaviviridae is the causative agent of YFD. The virus is classified as single-stranded RNA which is mostly transmitted by mosquitoes identified by Walter Reed in the year 1900 as Aedes aegypti [4]. In the past, Nigeria had been facing asporadic outbreaks of Yellow fever (YF), which began with the populous Northern region of the country. Aedes species of mosquitoes mainly transmit yellow fever virus (YFV) and vaccination is the only effective means of preventing it.Objectives: This article presents a critical review and literature updates on the vector biology, YF vaccine immunodynamics and epigenetics of YFV, with the aim to understand the interplay of these factors in the re-emergence of YF and risk assessment of living or traveling to YF endemic areas. (in the year 2016-2018)Methodology: The live, attenuated viral strain of the 17D vaccine was administered to tourists and inhabitants of endemic regions of Africa (Figure: 2) and South America. Those eligible for the vaccine were usually given through routes of administration either by single subcutaneous or intramuscular injection. The vaccine (17D-204 strain) could be given either to infants (pediatric dosage) above 9 months or adults (adult dosage) using one dose of subcutaneous injection (≥4.74 log10 plaque-forming units/0.5mL) not later than 10 days to regional migrationConclusion: Vectorial migration, jungle-to-urban spillover, immunization failure (especially in persons with chronic immune-mediated inflammatory diseases) and perhaps, genetic modification of YFV could be reasons for the resurgence of YF in the country. The single dose of the vaccine was usually sufficient to confer prolonged immunity against the infection but booster doses were often required based on endemic state of certain countries' Medical Laboratory Staff who frequently work on wild-type yellow fever virus. Based on regular exposure to this virus on routine basis, the neutralizing antibody titers against the virus are usually assessed every ten years to determine the necessity for booster doses of the 17D vaccine. Irrespective of the knowledge of neutralizing antibody titers for the virus, vaccination every 10 years is recommended especially for individuals frequently exposed to the virRecommendations: Increase vaccination coverage. Include YF vaccine in childhood vaccination programs. Make effort to maintain and control future outbreaks. Keywords: Vaccination, Genetics, Yellow Fever, Re-emergenc

Humoral immunological kinetics of severe acute respiratory syndrome coronavirus 2 infection and diagnostic performance of serological assays for coronavirus disease 2019: an analysis of global reports

As the coronavirus disease 2019 (COVID-19) pandemic continues to rise and second waves are reported in some countries, serological test kits and strips are being considered to scale up an adequate laboratory response. This study provides an update on the kinetics of humoral immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and performance characteristics of serological protocols (lateral flow assay [LFA], chemiluminescence immunoassay [CLIA] and ELISA) used for evaluations of recent and past SARS-CoV-2 infection. A thorough and comprehensive review of suitable and eligible full-text articles was performed on PubMed, Scopus, Web of Science, Wordometer and medRxiv from 10 January to 16 July 2020. These articles were searched using the Medical Subject Headings terms 'COVID-19', 'Serological assay', 'Laboratory Diagnosis', 'Performance characteristics', 'POCT', 'LFA', 'CLIA', 'ELISA' and 'SARS-CoV-2'. Data from original research articles on SARS-CoV-2 antibody detection >= second day postinfection were included in this study. In total, there were 7938 published articles on humoral immune response and laboratory diagnosis of COVID-19. Of these, 74 were included in this study. The detection, peak and decline period of blood anti-SARS-CoV-2 IgM, IgG and total antibodies for point-of-care testing (POCT), ELISA and CLIA vary widely. The most promising of these assays for POCT detected anti-SARS-CoV-2 at day 3 postinfection and peaked on the 15th day; ELISA products detected anti-SARS-CoV-2 IgM and IgG at days 2 and 6 then peaked on the eighth day; and the most promising CLIA product detected anti-SARS-CoV-2 at day 1 and peaked on the 30th day. The most promising LFA, ELISA and CLIA that had the best performance characteristics were those targeting total SARS-CoV-2 antibodies followed by those targeting anti-SARS-CoV-2 IgG then IgM. Essentially, the CLIA-based SARS-CoV-2 tests had the best performance characteristics, followed by ELISA then POCT. Given the varied performance characteristics of all the serological assays, there is a need to continuously improve their detection thresholds, as well as to monitor and re-evaluate their performances to assure their significance and applicability for COVID-19 clinical and epidemiological purposes

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Human Immunodeficiency Virus Resistance Testing Technologies and Their Applicability in Resource-Limited Settings of Africa

There has been tremendous breakthrough in the development of technologies and protocols for counselling, testing, and surveillance of resistant human immunodeficiency virus strains for efficient prognosis and clinical management aimed at improving the quality of life of infected persons. However, we have not arrived at a point where services rendered using these technologies can be made affordable and accessible to resource-limited settings. There are several technologies for monitoring antiretroviral resistance, each with unique merits and demerits. In this study, we review the strengths and limitations of prospective and affordable technologies with emphasis on those that could be used in resource-limited settings