Fertility knowledge, care seeking behavioral pattern and attitudes of infertile men in Lagos, Nigeria

Background: The objective was to study the extent of infertility knowledge, attitude and care seeking behavioral pattern of infertile men in Lagos.Methods: A cross sectional study was carried out using questionnaire between 2009 and 2014. Adult males who were clinically infertile, visiting the clinics for the first time and consented were studied. Descriptive statistics were used for the analysis.Results: Only 226 men, mean age 38±5.8 years participated. Up to 20.8% had sired a child for between >1 but 3 times (mean coitus 2.3±0.9 times) weekly. Only 11.1% knew about male-female factor infertility. Up to 42.9% knew about fertility and the sign of female ovulation and 38.1% correctly defined clinical infertility. Up to 40.3% switched treatment for competency of the new places and exorbitant price by 22.1%. Sixty-six (29.2%) made the first visit to a proper care place within a period >1 but 3 years. Majority (50 %) sought to know the causes of infertility, 14.6% how to improve fertility and 6.6% the reality of male infertility.Conclusions: Majority of the participants sought inappropriate help and delayed in seeking appropriate care. Poor collaboration and referral system observed. There is need for edification of both care providers and seekers to be ethical in their actions. Infertility care cost intervention is needed

Accessory gene regulators and virulence genes associated with the pathogenicity of Staphylococcus aureus from clinical and community settings in Lagos, Nigeria

Staphylococcus aureus is a prominent pathogen that causes serious community and hospital-acquired infections globally. Its pathogenicity is attributed to a variety of secreted and cell surface associated proteins that are modulated by the quorum-sensing accessory gene regulator (agr) system. In this study, we investigated the presence of toxin genes and agr involved with S. aureus from clinical samples and apparently healthy individuals. Unequivocal identification of the isolates was obtained with the Vitek 2 system. We screened 70 clinical (CL) and 22 community (C) S. aureus strains for the methicillin resistance (mecA) gene, agr and superantigens (SAg) (enterotoxins and toxic shock syndrome toxin-1) using PCR techniques. A total of 12 clinical isolates were classified as methicillin-resistant S. aureus (MRSA); 89 isolates belonged to one of the four agr groups (agr1-4), and 3 isolates were non-typeable. Of the agr groups, agr1 was the most prominent and mostly consisted of isolates from pus/wounds. The methicillin-susceptible S. aureus (MSSA) isolates were distributed within the four agr groups while MRSA strains were restricted to agr1 and agr3. The most common enterotoxin gene, sei, was likewise more prevalent in MSSA strains than in MRSA strains, where sea predominated. The co-existence of two or more enterotoxins was confirmed in 40% of the isolates. sea occurred through all the agr groups except agr3 and sei was not found in agr1 and agr4. The toxic shock toxin (tst) gene was detected in six MSSA. These findings suggest that MSSA may cause more lethal infections than MRSA because of the increased frequency of toxic genotypes seen in MSSA strains. Significance: • Isolates in the agr1,3 groups had more SAg toxin genes, whereas isolates in the agr4 groups possessed more tst genes. • The MSSA isolates contained higher proportions of virulence genes than MRSA. • The clinical implications of this discovery include that MSSA may cause more lethal infections than MRSA due to the greater number of toxigenic genotypes discovered