INCIDENCE OF RIFAMPICIN-RESISTANCE PRESUMPTIVE M. TUBERCULOSIS CASES AMONG OUTPATIENTS IN KEBBI STATE, NIGERIA

Background: The present study determined the incidence of rifampicin resistance M. tuberculosis among outpatients at the General Hospital Yauri, Kebbi State, Nigeria. Materials and Methods: The study is a cross-sectional study conducted from February 2018 to October 2019. Sociodemographic data were collected from hospital registration books. Rifampicin resistance M. tuberculosis was detected using GeneXpert Model GX-IV following manufacturers' instruction. Descriptive statistics and logistic regression were computed using SPSS version 20. The results were presented as odds ratios with associated 95% confidence intervals, and P-value at 0.05. Result: Of the 837 samples, 65.8% (551/837) were males, and 34.2% (286/837) females, 11.4% (95/837) HIV-seropositive. M. tuberculosis was detected in 15.5% (130/837), of which 116/130 (89.23%) were males and 14/130 (10.77%) females. M. tuberculosis­-HIV coinfection was detected in 9.47% (9/95) of HIV positive. Rifampicin resistance was observed in 1.3% (11/837), 7.7% (10/130) in M. tuberculosis patients and 1.05% (1/94) in HIV seropositive. In logistic regression, the odds ratio for having a rifampicin-resistant M. tuberculosis was 0.49 (0.15-1.54) for > 30 years; taking <30 years as the reference value, 1.02 (1.00-1.03) for male; taking female as the reference value, and 0.78 (0.09-6.15) for HIV positive, taking negative as the reference value. Conclusion: This study reported the current incidence rate of rifampicin-resistant M. tuberculosis at the General Hospital Yelwa Yauri, Kebbi State, Nigeria, among presumptive TB patients. Patients diagnosed with rifampicin-resistant M. tuberculosis were predominantly male adults. Thus, frequent screening is vital for surveillance and reduces the risk of transmission and spread of M. tuberculosis&nbsp

Antigenic evolution of dengue virus in Malaysia / Mohammed Bashar Danlami

Neutralization escape mutant has played an important role in antigenic evolution of various virus-causing diseases. DENV, the causative agent of dengue has been shown to escape antibody neutralization, thereby causing an epidemic outbreak. The pattern through which DENV escape neutralization that leads to antigenic evolution, however, has not been thoroughly investigated in hyper endemic countries. It is hypothesized that, the highly susceptible DENV demonstrates a clear pattern of antigenic evolution from being minor strains (less frequent during an outbreak) to dominant strains (very frequent during an outbreak). This suggests that the minor strains may act as a springboard for the emergence of more virulent dominant strains by acquiring some characteristics of the minor strains. Hence, the overall objective of the present study is to provide an insight into the antigenic evolution of DENV-1 and DENV-2 in Malaysia. To investigate this possibility, the present study used truncated DENV-1 and DENV-2 recombinant E, cloned and expressed on phage M13 g3p attachment protein. Using site-directed mutagenesis, six single mutations were engineered separately onto the respective recombinant E gene. Effects of these mutations on binding to insects and mammalian cells were determined in vitro. The polyclonal antibodies generated against these recombinant proteins in BALB/c mice were used in microneutralization and Foci Reduction Neutralization Test to evaluate neutralizing antibody determinant associated with antigenic evolution. Serial propagation in vitro was adopted to handpick the neutralization escape mutant in the sub-neutralizing antibody concentration. To evaluate potential host where the selection occurs, the escape mutant were adapted to mimic mosquito and human cycle in vitro. Finding from the present study shows that two mutations (E272 and E390) on DENV-1 E were demonstrated to affect binding of the recombinant proteins to C6/36 mosquito and Vero cells. Polyclonal antibodies generated against recombinant E272 and E390 proteins exhibited decreased binding to DENV-1 virion. The polyclonal antibodies reduced the number of DENV-1 foci formed up to four-folds for the five endemic DENV-1 strains (GIa, GIb, GIc, GII and GIII) tested. Two DENV-1 isolates likely to escape neutralization were identified; D1.10245 (GII) and D1.11177 (GIb). In DENV-2, mutations on E52, E164 and E393 were demonstrated to affect binding of the recombinant proteins to C6/36 mosquito and Vero cells. Polyclonal antibodies generated in mice against recombinant E52, E164 and E176 exhibited decreased binding to DENV-2 (Asian 1 strain) and E164 and E335 on one of the Cosmopolitan strain. The polyclonal antibodies against E52, E71, E335 and E393 reduced the number of foci formed up to four-folds for Cosmopolitan DENV-2 strains tested. The E52 and E71 substitutions select isolates likely to escape neutralization in both Cosmopolitan strain (D2.14245 and D2.1877347) and Asian 1 strain (D2.16041). Evidence from the present study show that the neutralization escape strains from DENV-1 and DENV-2 alternating between two different hosts adapts differently. The observed difference in DENV-1 and DENV-2 on C6/36 and Vero cells was evident in the variation in amino acid residues on E. Of these 6 mutations engineered on DENV-1 and DENV-2 recombinant E, substitution on EDI/EDII junction are likely to facilitates antigenic evolution of DENV-1 (E272) and DENV-2 (E52 and E71) in Malaysia. Overall, the study identified dominant DENV-1 and DENV-2 strains expected to evolve in Malaysian natural population in the future. The antigenic determinants involved were identified. The result of the study directly underlines the effects of these mutations on naturally emerging DENV-1 and DENV-2 in Malaysian population and its implications on dengue affliction and vaccines design

Closing the antimicrobial stewardship gap - a call for LMICs to embrace the global antimicrobial stewardship accreditation scheme

Abstract The escalating challenge of antimicrobial resistance (AMR) poses a considerable concern for global health, particularly impacting low- and middle-income countries (LMICs). This article highlights the critical importance of tackling AMR in LMICs by adopting the Global Antimicrobial Stewardship Accreditation Scheme (GAMSAS). GAMSAS is portrayed as a holistic and sustainable strategy for antimicrobial stewardship, extending beyond accreditation to include educational programs, capacity enhancement, improved surveillance, and support for AMS policy research. While acknowledging the global uptake of the scheme, the article highlights its preliminary phase of adoption in LMICs, particularly in high-AMR burden regions like Sub-Saharan Africa. The piece stresses the imperative for LMICs to integrate GAMSAS, underscoring its significance in optimizing antimicrobial usage and patient health outcomes. It advocates for an all-encompassing approach that leverages international cooperation and sustained financial backing, crucial for the effective deployment and enduring success of antimicrobial stewardship efforts in these key areas

Pulmonary mycoses among pulmonary tuberculosis in Kebbi State North Western Nigeria

Abstract Background Pathogenic fungi are the source of the fungal illness known as pulmonary mycosis. The prevalence of pulmonary mycoses among patients with pulmonary tuberculosis is continuously rising, despite improvements in the disease’s diagnosis, treatment, and management. Three hundred clinically confirmed patients with pulmonary tuberculosis were recruited for this study. Sputum samples were collected and analyzed to detect M. tuberculosis using the GeneXpert machine. Fungal elements were determined using microscopy, culture, and fungal biochemical analysis. Fungal isolates were confirmed using nested PCR with the internal transcribed sequence region of the ribosomal cistron of the fungal species. Results Of the 300 sputum samples analyzed, 50 (16.7%) patients had pulmonary tuberculosis. Fungi pathogens were found in 142 patients (47.3%), with 99/142 (71.2%) primary infections, and 40/139 (29.5%) secondary infections. Among the secondary infections, 33 (11%) were fungi coinfections with rifampicin-sensitive MTB coinfections, while 7 (2.3%) were fungi co-infected with rifampicin-resistant MTB. Candida albican was the most common fungus isolate, accounting for 44 (31.7%), while non-Candidal albicans accounted for only 2 (1.4%). Of the 99 species responsible for primary infection, 33 (23.7%) were Blastomyces precursors, 30 (21.6%) were Candida species, and 21 (15.1%) were Aspergillus fumigatus. The fungal pathogen with the highest frequency of secondary infection was Candida species 14 (10.1%), followed by Aspergillus fumigatus 11 (7.9%), then Blastomyces precursors, and then 09 (6.5%). Conclusion In conclusion, this study determined the prevalence rate of fungal pathogens among pulmonary tuberculosis patients. The most dominant species observed were Blastomyces species, which are seldom reported in Africa and Nigeria. The two others were Aspergillus and Candida species. The study showed that a high percentage of cases of this species, responsible for pulmonary mycosis, were misdiagnosed and treated as pulmonary tuberculosis. Thus, there is a need for improved surveillance and accurate diagnosis of pulmonary infections for proper treatment

Performance of Fly Ash-Based Inorganic Polymer Mortar with Petroleum Sludge Ash

Petroleum sludge is a waste product resulting from petroleum industries and it is a major source of environmental pollution. Therefore, developing strategies aimed at reducing its environmental impact and enhance cleaner production are crucial for environmental mortar. Response surface methodology (RSM) was used in designing the experimental work. The variables considered were the amount of petroleum sludge ash (PSA) in weight percent and the ratio of sodium silicate to sodium hydroxide, while the concentration of sodium hydroxide was kept constant in the production of geopolymer mortar cured at a temperature of 60 °C for 20 h. The effects of PSA on density, compressive strength, flexural strength, water absorption, drying shrinkage, morphology, and pore size distribution were investigated. The addition of PSA in the mortar enhanced the mechanical properties significantly at an early age and 28 days of curing. Thus, PSA could be used as a precursor material in the production of geopolymer mortar for green construction sustainability. This study aimed to investigate the influence of PSA in geopolymer mortar