Correlates of genital Chlamydial trachomatis infection in a cohort of infertile women in Ibadan, Nigeria

Background: Genital Chlamydial trachomatis infection, though often asymptomatic, is an established indirect causative agent of female infertility via its activities on the tubal physiology. Many risk factors are postulated for its acquisition and the main thrust of this study was to establish the organisms’ correlates among infertile women attending gynaecologic clinic in Ibadan.Methods: A systematic sampling technique was used on each selected day to recruit women who met the inclusion criteria into the study using a sampling frame of 2. Interviewer-administered questionnaires were used to obtain attributes considered as risk factors for acquiring genital Chlamydia trachomatis infection from 150 consenting infertile women between January and November 2015. These attributes included sexual history, social status, alcohol intake and past history of sexually transmitted infections (STIs). Blood samples and endocervical swabs were subsequently taken for detection of C. trachomatis infection using polymerase chain reaction (PCR). Data analysis was done using SPSS version 20.0.Results: The mean age of the respondents was 34.1±5.6 years and 7.30% were positive for C. trachomatis. Chlamydia trachomatis infection was significantly associated with past history of gonorrhoea, history of multiple sexual partners, husband that has other sexual partners and lifetime sexual partners greater than one.Conclusions: The prevalence of asymptomatic C. trachomatis among infertile women indicated the pathogen as a potential aetiologic agent of female infertility and supported the asymptomatic nature of the infection. The risk factors found to be associated with the organisms’ infection lend out further support to the sexual transmissibility of C. trachomatis

Human cytomegalovirus infection, viraemia and retinitis among people living with HIV/AIDS in Kano, North-Western Nigeria

Background: Human cytomegalovirus (HCMV) is a leading cause of opportunistic infection in HIV-infected patients. HCMV viraemia is an active infection marker and prelude to end-organ diseases (EODs), such as retinitis. The aim of the study was to assess the burden and associated factors of HCMV infection, viraemia and retinitis among HIV-infected patients in Nigeria.Methods: Comparative cross-sectional study of 160 HIV-infected adults, comprising 80 participants in each of <100/mm3 and ≥100 cells/mm3 CD4+ cell count groups, who attended HIV clinic at a tertiary hospital located in a major Nigerian city.  A questionnaire was used to collect data from eligible consenting participants and their case files. Sera from all participants were tested for anti-HCMV IgG using ELISA method, and plasma of seropositive participants were subjected to PCR for HCMV viraemia. Participants whose samples were HCMV viraemic were examined for HCMV retinitis using indirect ophthalmoscopy. Data was analyzed using Minitab vs 14.1.1PP.Results: All 160 participants tested positive for anti-HCMV IgG. HCMV viraemia was 14.4% (23 of 160) generally, but comparatively more among <100 CD4 cells/mm3 group (18.8%; 15 of 80) than in ≥100 cells/mm3 patient group (10%; 8 of 80). Only HCMV viraemic patients in <100 CD4 cells/mm3 group (20%; 3 of 15) were diagnosed with HCMV retinitis. WHO stage was associated with HCMV viraemia (χ2= 7.79, p=0.05) and HCMV retinitis (χ2= 4.60, p=0.03). The only predictor of HCMV retinitis was WHO staging I and II [aOR = 0.04, 95%CI (0.01- 0.52)].  Conclusions: Evidence of previous and active HCMV infection is prevalent among PLWHA in Nigeria with WHO staging being associated and a predictor of HCMV viraemia and retinitis, respectively

EPIDEMIOLOGY OF BACTERIA COLONIZATION AND ICU-ACQUIRED INFECTION IN A NIGERIAN TERTIARY HOSPITAL

Background: Health care associated infection (HCAI) or Hospital acquired infection is associated with significant morbidity, mortality and cost. The incidence is about 6% and disproportionately higher in critically ill patients who may have been immune-compromised with many invasive procedures already performed. Prevention of HCAI and appropriate management of patients in the intensive care unit (ICU) requires knowledge on the pattern of microbial colonization and infections. The aim of this preliminary study was to provide current data on the pattern of ICU acquired infections in our hospital. Patients and Methods: It was a cross sectional study of patients admitted into the ICU who were expected to stay longer than 48hrs between July 2011 and September 2012. Urine, blood, and tracheal aspirate were collected on days 1, 3 and 5 for microbiological studies. All patients involved in the study had urethral catheter in-situ and received mechanical ventilation in the ICU. Results: Fifty-nine patients were recruited into the study. The mean age of the patients was 30.08 + 19.9yr; while the reasons for admissions were respiratory failure (59.3%), cardiovascular instability, trauma and neurological diseases. About 30% of the samples taken from the study sites on arrival in the ICU had positive culture yields. Organisms cultured included Klebsiella oxytoca, Staphylococcus aureus, and Pseudomonas aeruginosa. The urinary tract had the highest number of isolated organisms- 9(60%), followed by equal number of isolated organisms-3(20%) in the blood and respiratory tract. Eleven (73.3%) of the organisms isolated were Gram-negative bacteria, and 4 (26.7%) were Gram-positive cocci. The commonest bacteria isolates were Staphylococcus aureus (4/26.7%) and Klebsiella oxytoca (4/ 26.7%). A total of 15 ICU- acquired infections were detected in 9 of 59 patients. Conclusion: The HCIA infection rate was 15%, and urinary tract infections (UTI) was the commonest hospital acquired infection in our ICU. Klebsiella oxytoca and Staphylococcus aureus were the commonest organisms

Oral, genital and anal human papillomavirus infections among female sex workers in Ibadan, Nigeria.

BACKGROUND: There are limited data on the epidemiology of HPV in different anatomical sites of female sex workers (FSW). We investigated the prevalence and concordance of cervical, vulval, oral and anal HPV among FSW in Ibadan, Nigeria. METHODS: FSWs aged 18-45 years were enrolled in a cross-sectional survey. After interview and clinical examination, samples were collected from mouth, cervix, vulva and anus. HPV genotyping was done with Anyplex II 28HPV assay. Multivariable analyses were performed to explore associated risk factors and concordance of HPV infections across sites. RESULTS: In total, 315 FSWs participated in the study with a mean age of 30-6.5 years. The prevalence of any HPV infection was 88% in the vulva, 84% in the cervix, 75% in the anus and 24% in the oral cavity. HPV 35 was the most prevalent and concordant high-risk type in the four sites. The risk factors for HPV infection by anatomic site varied. CONCLUSION: This large study showed a high prevalence and concordance of HPV infections of cervical, vulval, oral and anal HPV among FSWs in Nigeria. The potential to acquire and transmit HPV is high in this population, and we highlighted the urgency to protect young women through HPV vaccination

The prevalence of, and risk factors for, mycoplasma genitalium infection among infertile women in Ibadan: A cross-sectional study

Background: The association of mycoplasma genitalium (M. genitalium) with infertility has been documented. The infections are asymptomatic and difficult to diagnose. Understanding the associated risk factors will help in facilitating better screening measures for at-risk groups. Objective: The aim was to determine the prevalence of, and risk factors for, M. genitalium infection among infertile women in Ibadan. Materials and Methods: In this cross-sectional study, 402 women (267 infertile and 135 fertile) referred to 2 hospitals in Ibadan between March and November 2015 were enrolled. Information was obtained, using structured questionnaire, on sociodemographic and behavioral characteristics of the respondents while endocervical swabs were obtained for detection of M. genitalium. MgPa gene was diagnosed using the conventional Polymerase chain reaction. Bands corresponding to 495kb were documented as positive for M. genitalium. Results: Among the infertile women, 43 (16.1%) had evidence of M. genitalium infection as against 3 (2.2%) of women without infertility (p<0.001). Associated risk factors included having more than one lifetime sexual partner (OR=10.13, 95% CI: 3.76-33.97); husbands having other sexual partners (OR=12.88, 95% CI: 2.08-90.63); being a serial monogamist (OR=6, 95% CI: 4.35-8.27) and low socio-economic status (OR=2.80, 95% CI: 1.28-6.10). No relationship exists between the previous history of sexually transmitted infections and M. genitalium. Conclusion: The risk factors for M. genitalium infection are similar to those peculiar to other sexually transmitted infections. Its routine screening should be incorporated into the current protocol for microbiological evaluation of infertile women

Sero-Prevalence of HIV Infection Among Commercial Sex Workers in Ibadan, Nigeria

Context: Commercial sex workers (CSWs) are an important group for the transmission of human immunodeficiency virus (HIV) infection all over the world. In view of the upsurge in the prevalence of HIV in Nigeria, it is desirable to determine the magnitude of their contribution to the problem and how to incorporate them into control efforts. Objective: The main objective of this study was to determine the sero-prevalence of HIV infection among commercial sex workers (CSWs) in Ibadan, Nigeria. Study Design: This was a cross-sectional survey involving 169 CSWs that were randomly selected from 18 brothels in Ibadan and 136 other women without HIV-related symptoms who visited the Special Treatment Clinic, University College Hospital Ibadan who served as the control group. Results: Of the 169 CSWs investigated, 58 (34.3%) had HIV infection whilst only 3 (2.2%) of the control subjects were seropositive for HIV, a highly statistically significant difference (p < 0.000001). Vaginal candidiasis was the most common STD diagnosed in both CSWs and the control subjects. All the 13 CSWs that had scabies, 4 (36.4%) of those with genital warts and 19 (67.9%) of those with genital ulcers had HIV infection. Apart from HIV infection, the only condition that was markedly more prevalent among the CSWs was genital ulcer (16.6% vs 1.5%; p < 0.0001). Conclusion: These findings indicate a high seroprevalence of HIV among CSWs in Ibadan and the need to direct efforts to prevent them from spreading it further in the population. Key Words: HIV, Seroprevalence, Commercial Sex Workers. [Trop J Obstet Gynaecol, 2003, 20: 12-15

Concordance of genotype specific HPV infections across the four anatomic sites

Data for: "Oral, genital and anal human papillomavirus infections among female sex workers in Ibadan, Nigeria"

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