Comparison of Rapid Diagnostic Tests and Microscopy for Malaria

Presumptive treatment of malaria results in significant overuse of antimalarials. This study compared the diagnostic accuracy of Histidine Rich Protein II and plasmodium lactate dehydrogenase (pLDH)-based Rapid Kits( RDTs)and using expert microscopy as the gold standard for the detection of falciparum and non-falciparum in 200 individuals suffering from fever episodes over a period 8months in a malaria-endemic area in Osogbo, Osun State. 99(44.5%) of these patients were microscopically parasitaemic with three Plasmodium species identified expect P.ovale. 25 (12.5%) of the study population had temperature < 37.50C at the time of presentation in the clinic among which 16 (64% ) were parasitaemic. Furthermore, 148 (74%) of the study population had fever episode of which 65(44%) were positive for malaria. The sensitivity and specificity of pLDH (Pf) were 84.7% and  78.3% respectively and HRP-2 were 72.7% and 90.9% respectively. Both had high detection (94.7%) at parasite density ≥ 10,000 parasite/`l of blood. Microscopy still remains the ‘Gold Standard’ since both are not 95% sensitive and cannot determine parasites quantification.Keywords: Plasmodium, Microscopy, Rapid Kits, Osogbo, Nigeria, LAUTECH Le traitement présomptif de paludisme résulte de l’usage abusif considérable des antipaludiques. Cette étude a pour but de comparer l’efficacité de diagnostic de l'histidine RichProtein II et de test de diagnostic rapide (TDR) à base de kits plasmodium lactate déshydrogénase (pLDH) et en utilisant la microscopie experte comme «gold standard» pour la détection de P. falciparum et non-falciparum chez 200 personnes souffrant d'épisodes de fièvre sur une période de huit mois dans une région où le paludisme est endémique dans Osogbo, l'Etat d'Osun. 99 (44,5%) de ces patients étaient parasitémiques à la microscopie à trois espèces de Plasmodiumidentifiées différentes de P. ovaleattendu. 25 (12,5%) de la population étudiée avait une température <37,5°C au moment de leur arrivée à la clinique parmi lesquels, 16 (64%) étaient parasitémiques. En outre, 148 (74%) de la population d’étude avait un épisode de fièvre dont 65 (44%) étaient positifs pour le paludisme. La sensibilité et la spécificité de pLDH (Pf) étaient respectivement de 84,7% et 78,3% et celles de HRP-2 étaient respectivement de 72,7% et 90,9%. Tous les deux tests avaient une bonne détection (94,7%) à densité parasitaire ≥ 10000 parasite/ul de sang. La microscopie reste le «Gold Standard» puisque les deux autres tests ne sont pas sensibles à 95% et ne peut pas déterminer la quantité parasitaire.Mots clés: Plasmodium, microscopie, kits de test rapide, Osogbo, Nigeria, LAUTECHArticle in English

Histological and biochemical markers of the liver of male Wistar rats on oral administration of nevirapine suspension

Background: Mechanism of action of nevirapine in the prophylaxis treatment and treatment of HIV-1 may involve elevations in levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and other biomarkers of liver function. This study presents the hepatotoxic effect of nevirapine suspension using animal model.Methods: A total number of 15 male Wister rats were fed normal chow and antiretroviral drug (Nevirapine) for a period of six weeks. The liver organ of the rats were obtained and subjected to histological procedures and biochemical analysis using enzyme assay obtained from Randox Laboratories Limited, Antrim United Kingdom (BT294QY).Results: The wistar rats showed no significant mean body weight difference when compared with the control group. However there was significant difference in the mean values of AST (77.77±3.03) and ALT (89.37±3.19) of the treated rats. Nevirapine treated rats showed significant difference in AST, ALT, and ALP in the single (77.77± 3.03, 31.80±1.73, 43.81 ±1.54) and double (89.37±3.19, 33.38±2.01, 34.64 ±1.02) doses when compared with the controls (75.14 ±2.00, 29.16±0.17, 45.44 ±1.85) respectively. Mild vascular congestion, infiltration of sinusoids by inflammatory cells, and haemorrhage were induced by nevirapine as compared with the control group showing normal vessels without congestion, normal sinusoids appearing normal without infiltration.Conclusion: The liver histology of the rats fed with Nevirapine suspension showed diffused hepatocellular necrosis. Routine check of the drug effect is important as it provides effective life management of HIV infected individuals.Keywords: Nevirapine, Wister rat, Hepatotoxicity, Liver, Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP

Transfusion transmissible viral infections among potential blood donors in Ibadan, Nigeria

It is evident that proper screening procedures prior blood transfusion is a cost-effective approach for prevention and control of transfusion-transmissible infections (TTIs). Also, it has been documented that sub-standard test kits are mostly used in resource limited settings for transfusion related diagnosis. However, the role of such practice in epidemiology of transfusion transmissible viral infections in a tertiary health care facility would give an insight to the rates of blood transfusion associated viral transmission in the community at large. Therefore, the study was designed to determine the prevalence of Human Immunodeficiency Virus (HIV), Hepatitis B and Hepatitis C viruses among blood donors in a tertiary hospital where quality diagnostic procedures are considered prior recruitment of donors. Post ethical approval, counselled and consenting 507(M= 426; F=81) aged 19 to 68 years (Median age:39) potential blood donors were recruited and tested for HIV, HBsAg and anti-HCV using commercial ELISA testkit in strict compliance with the manufacturer’sprocedures. Overall results show rates of 2.0%, 5.9% and 1.4% for HIV, HBsAg and HCV respectively. Also, highest prevalence rates were recorded among age group 26 to 35 years as 2.6%, 7.2% and 2.1% for HIV, HBV and HCV respectively. Furthermore, higher prevalences rates were noted among unmarried individuals as 2.6%, 6.8% and 2.1% for HIV, HBV and HCV respectively.Key words: Transfusion Transmissible Infections, HIV, Hepatitis B, Hepatitis C, Blood Donors, University College Hospital (UCH), ELISA

Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Background: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods: Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. Findings: In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. Interpretation: Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. Funding: Bill & Melinda Gates Foundation

Methylobacterium Genome Sequences: A Reference Blueprint to Investigate Microbial Metabolism of C1 Compounds from Natural and Industrial Sources

Methylotrophy describes the ability of organisms to grow on reduced organic compounds without carbon-carbon bonds. The genomes of two pink-pigmented facultative methylotrophic bacteria of the Alpha-proteobacterial genus Methylobacterium, the reference species Methylobacterium extorquens strain AM1 and the dichloromethane-degrading strain DM4, were compared. Methodology/Principal Findings The 6.88 Mb genome of strain AM1 comprises a 5.51 Mb chromosome, a 1.26 Mb megaplasmid and three plasmids, while the 6.12 Mb genome of strain DM4 features a 5.94 Mb chromosome and two plasmids. The chromosomes are highly syntenic and share a large majority of genes, while plasmids are mostly strain-specific, with the exception of a 130 kb region of the strain AM1 megaplasmid which is syntenic to a chromosomal region of strain DM4. Both genomes contain large sets of insertion elements, many of them strain-specific, suggesting an important potential for genomic plasticity. Most of the genomic determinants associated with methylotrophy are nearly identical, with two exceptions that illustrate the metabolic and genomic versatility of Methylobacterium. A 126 kb dichloromethane utilization (dcm) gene cluster is essential for the ability of strain DM4 to use DCM as the sole carbon and energy source for growth and is unique to strain DM4. The methylamine utilization (mau) gene cluster is only found in strain AM1, indicating that strain DM4 employs an alternative system for growth with methylamine. The dcm and mau clusters represent two of the chromosomal genomic islands (AM1: 28; DM4: 17) that were defined. The mau cluster is flanked by mobile elements, but the dcm cluster disrupts a gene annotated as chelatase and for which we propose the name “island integration determinant” (iid).Conclusion/Significance These two genome sequences provide a platform for intra- and interspecies genomic comparisons in the genus Methylobacterium, and for investigations of the adaptive mechanisms which allow bacterial lineages to acquire methylotrophic lifestyles.Organismic and Evolutionary Biolog

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Heavy metal concentration in selected fish species from Eleyele reservoir Ibadan Oyo State South-western Nigeria

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