Current Trends In The Laboratory Diagnosis Of Tuberculosis

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Continuing Medical Education: Closing The Gap Between Medical Research And Practice

Continuing medical education (CME) has long been recognized as the key to updating and maintaining the knowledge and skill of health professionals.CME activities are well advocated, accepted and regulated in the developed world with sanctions for non-participation. In developing countries, including West Africa subregion, CME activities are less effective and no practical enforcement to compel individual’s participation. This review examined the importance, scope and regulation of CME activities and identified the barriers to effective CME in developing countries to include lack of motivation, time, finance and lack of access to CME facilities occasioned by underdevelopment in information and communication technology (ICT) and know-how. It is concluded with practical suggestions that; health professionals should embrace CME as a moral and ethical obligation; health organizations and institutions should provide incentives, adequate funding and protected time for CME activities; professional and regulatory bodies should enforce participation and impose sanctions if need be, as the way forward

Lassa virus persistence in body fluids after recovery from acute Lassa fever: a 2-year interim analysis of a prospective longitudinal cohort study

Background: There is anecdotal evidence for Lassa virus persistence in body fluids. We investigated various body fluids after recovery from acute Lassa fever and describe the dynamics of Lassa virus RNA load in seminal fluid. The primary objective of this study was to quantitatively describe virus persistence and clearance and assess the infectivity of seminal fluid. Methodology: In this prospective, longitudinal, cohort study, we collected plasma, urine, saliva, lacrimal, vaginal and seminal fluids from Lassa fever survivors at Irrua Specialist Teaching Hospital in Edo State, Nigeria. Inclusion criteria for participants were RT-PCR-confirmed Lassa fever diagnosis and age 18 years and above. Samples were taken at discharge from hospital (month 0) and at months 0·5, 1, 3, 6, 9, 12, 18, and 24 after discharge. Lassa virus RNA was detected using real-time RT-PCR. Infectivity was tested in cell culture and immunosuppressed mice. We used a linear mixed-effect model to analyse the dynamics of virus persistence in seminal fluid over time. Results: Between Jan 31, 2018, and Dec 11, 2019, 165 participants were enrolled in the study, of whom 159 were eligible for analysis (49 women and 110 men). Low amounts of Lassa virus RNA were detected at month 0 in plasma (45%, n=49/110), urine (34%, 37/110), saliva (5%, 5/110), lacrimal fluid (9%, 10/110), and vaginal fluid (21%, n=7/33 female participants). Virus RNA was cleared from these body fluids by month 3. However, 35 (80%) of 44 male participants had viral RNA in seminal fluid at month 0 with a median cycle threshold of 26·5. Lassa virus RNA remained detectable up to month 12 in seminal fluid. Biostatistical modelling estimated a clearance rate of 1·19 log₁₀ viral RNA copies per month and predicted that 50% of male survivors remain Lassa virus RNA-positive in seminal fluid for 83 days after hospital discharge, and 10% remain positive in seminal fluid for 193 days after discharge. Viral RNA persistence in seminal fluid for 3 months or more was associated with higher viraemia (p=0·006), more severe disease (p=0·0075), and longer hospitalisation during the acute phase of Lassa fever (p=0·0014). Infectious virus was isolated from 48 (52%) of 93 virus RNA-positive seminal fluid samples collected between month 0 and 12. Conclusion: Lassa virus RNA is shed in various body fluids after recovery from acute disease. The persistence of infectious virus in seminal fluid implies a risk of sexual transmission of Lassa fever

Prevalence and Impact of Socio-Economic/Enviromental Factors on Soil-Transmitted Helminth Infection in Children Attending Clinic in a Tertiary Hospital in Benin City, Nigeria

Children are important risk group for soil-transmitted helminths (STH). Hence, this study was undertaken to determine the impact of mothers’ educational status, the method of fecal disposal and source of water supply on the prevalence of STH infection. Four hundred and ninety six children, aged 1-15 years, who presented at the Children Out-patient Clinic of the University of Benin Teaching Hospital (UBTH) were screened for STH in their stool, using methods of wet preparation and Stoll's technique for detection and counting of helminthes eggs. A semi-structured, researcher administered questionnaire was used to collect information on socio demographics of mother/care giver, history of de-worming, source of water supply, and method of fecal disposal. The overall prevalence of STH infections was 9.5%, corresponding to 6.9% of Ascaris lumbricoides, 2.4% of hookworm and 0.2% of Trichuris trichiuria. Infection with hookworm was of highest intensity. Age group 6 - 10 had the highest prevalence of STH. Mother/caregivers level of education, method of faecal disposal and source of water supply, all significantly influenced the prevalence of STH infection. There is need for a coordinated, multi-sectarian and multidisciplinary strategy that integrates periodic deworming, health education and environmental sanitation for effective control.Keywords: Soil-transmitted helminths; Prevalence; Children; Benin City

Age and sex prevalence of infectious dermatoses among primary school children in a rural South-Eastern Nigerian community

Introduction: Various dermatoses, due to their morbidity characteristics, have been shown to negatively impact on learning. The most epidemiologically important seem to be the infectious types because of their transmissibility and amenability to simple school-health measures. The aim of this study was to assess the prevalence and sex/age correlates of infectious dermatoses in a rural South-eastern Nigerian community.Methods: The pupils were proportionately recruited from the three primary schools based on school population. Stratified simple random samplingmethod was adopted and a table of random numbers was used to select required pupils from each arm. Clinical and laboratory examination wasdone to establish diagnoses of infectious skin disease. Data collected were analyzed using SPSS version 16. Results: The 400 pupils consisted of 153 males and 247 females. Age range was between 6 and 12 years. The prevalence of infectious  dermatoses was 72.3%. The five most prevalent clinical forms of infectious dermatoses, in order of decreasing prevalence, were tinea capitis (35.2%), scabies (10.5%), tinea corporis (5.8%), tinea pedis (5.5%), and impetigo (5.0%). More cases, generally, occurred among males than females  (80.4% vs 67.2%)); while some specific clinical types, pediculosis and seborrheic dermatitis, exhibited predilection for females. Pyodermas and scabies were significantly more prevalent in the 7-9 age-group; while tinea capitis, tinea corporis, seborrheic dermatitis and pediculosis were more associated with .10 age-group.Conclusion: Infectious dermatoses were highly prevalent in the surveyed population. Many of the clinical types exhibited sex- and age-specificity

Emergence and spread of two SARS-CoV-2 variants of interest in Nigeria.

Identifying the dissemination patterns and impacts of a virus of economic or health importance during a pandemic is crucial, as it informs the public on policies for containment in order to reduce the spread of the virus. In this study, we integrated genomic and travel data to investigate the emergence and spread of the SARS-CoV-2 B.1.1.318 and B.1.525 (Eta) variants of interest in Nigeria and the wider Africa region. By integrating travel data and phylogeographic reconstructions, we find that these two variants that arose during the second wave in Nigeria emerged from within Africa, with the B.1.525 from Nigeria, and then spread to other parts of the world. Data from this study show how regional connectivity of Nigeria drove the spread of these variants of interest to surrounding countries and those connected by air-traffic. Our findings demonstrate the power of genomic analysis when combined with mobility and epidemiological data to identify the drivers of transmission, as bidirectional transmission within and between African nations are grossly underestimated as seen in our import risk index estimates

Inadequate Information in Laboratory Test Requisition in a Tertiary Hospital in Benin City, Nigeria

Aim: Laboratory investigations are important aspect of patient management and inadequate information or errors arising from the process of filling out laboratory Request Forms can impact significantly on the quality of laboratory result and ultimately on patient care.Objectives: This study examined the pattern of deficiencies in the laboratory test requisition by doctors at the University of Benin Teaching Hospital, Benin City, Nigeria, with a view to suggesting strategies of reducing error rates in laboratory test requisition. Materials and Method: The study generated data through retrospective examination of a total of 3072 laboratory request forms submitted to the medical microbiology laboratory over a period of three months. The various deficiencies in terms of missing or incomplete information on patient’s identity, clinical details, identity of doctor, and information on specimen submitted were recorded from each request form. The data generated were subjected to statistical computation using SPSS version 16, while applying descriptive statistics for analysis.Results: A total of 3072 request forms were evaluated, 2995 (97.5%) had one or more deficiency in terms of missing or incorrectly stated information. A total of 1786 (48.1%) of the request form had one or more incomplete or missing information in respect of patient identity. One thousand six hundred and ninety nine (55.3%) of the forms had error in relation to clinical information. The identity of the doctor requesting the test was missing or incomplete on 883 (28.8%) of the forms. Majority of the request forms 2957 (96.3%) had no complete information about the specimen submitted to the laboratory. Conclusion: This study demonstrated that overall, the error rate in laboratory test requisition by doctors is very high in our environment. There is need therefore to adopt practical strategies and policies to reduce this trend. Key words: Information, laboratory, requisition, Hospital, Benin City

Incidence and risk of primary cytomegalovirus infection among pregnant women in Benin City Nigeria

Background: Primary cytomegalovirus infection in pregnancy remains a leading cause of congenital hearing loss and mental retardation worldwide. Most women acquired CMV infection horizontally from their infected children or younger children who were cross- infected at school or day care facilities. Over 90% of infected women are asymptomatic and serological screening of all pregnant women is still not universally acceptable. Objectives: the aim of this study was to determine the incidence and risk of primary CMV infection among urban women in Benin City, Nigeria. Materials and Methods: Using a descriptive cross-sectional design, blood samples were collected from 800 pregnant women attending antenatal clinic at the University of Benin Teaching Hospital, and were analyzed for CMV-specific IgG and IgM antibodies using ELISA technique. Women with IgM positive results were further evaluated for primary CMV infection using IgG avidity test. Risk factors were identified using a structured questionnaire administered by the researchers. Information sought in the questionnaire included; age, occupation, husband’s occupation, marital status, gestational age, number of children, history of blood transfusion, HIV-status and child-care practices such as use of nursery/daycare services.Results: The overall prevalence of CMV infection was 97.0%. Ninety two percent had previous infection, 3.0% had recurrent infection (reactivation or re-infection), 2.0% had primary infection and 3.0% were seronegative. There was a significant relationship between primary infection and social class, parity and child-care practice. Conclusion: The incidence of primary CMV infection and the proportion of seronegative pregnant women at risk in our environment is a compelling reason for the introduction of CMV health education and voluntary routine screening for pregnant women as part of antenatal care to reduce the burden of congenital CMV infection.Keywords: Primary CMV Infection, Pregnancy, Risk factors, Nigeria

Research efforts to control highly pathogenic arenaviruses: A summary of the progress and gaps

Significant progress has been made in the past 10 years in unraveling the molecular biology of highly pathogenic arenaviruses that are endemic in several West African countries (Lassa fever virus) and in some regions of South America (Argentine and Bolivian hemorrhagic fever viruses). While this has resulted in proof-of-concept studies of novel vaccine candidates in non-human primates and in the discovery of several novel antiviral small molecule drug candidates, none of them has been tested in the clinic to date. The recent Ebola outbreak in West Africa has demonstrated very clearly that there is an urgent need to develop the prophylactic and therapeutic armamentarium against viral hemorrhagic fever viruses as part of a global preparedness for future epidemics. As it pertains to this goal, the present article summarizes the current knowledge of highly pathogenic arenaviruses and identifies opportunities for translational research.Fil: Kerber, R.. Bernhard Nocht Institute for Tropical Medicine; AlemaniaFil: Reindl, S.. Bernhard Nocht Institute for Tropical Medicine; AlemaniaFil: Romanowski, Victor. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Biotecnología y Biología Molecular. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Biotecnología y Biología Molecular; ArgentinaFil: Gomez, Ricardo Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Biotecnología y Biología Molecular. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Biotecnología y Biología Molecular; ArgentinaFil: Ogbaini Emovon, E.. Irrua Specialist Teaching Hospital; NigeriaFil: Günther, S.. Bernhard Nocht Institute for Tropical Medicine; AlemaniaFil: ter Meulen, J.. Philipps University Marburg; Alemani