Chlamydia and Vaginitis in Sexually Active Females: Classical Identification Methods for Effective Control

Laboratory diagnosis of Chlamydia and vaginitis in sexually active females has been limited by unavailability of a sequential method/rapid technique for simple diagnosis. Six hundred (600) adult females from hotel/brothel, Sexually Transmitted Infections (STIs) Clinic, Obstetrics/Gynaecology Clinic, Family Planning Clinic and Healthy controls were investigated for Chlamydia, Candida, trichomoniasis and bacterial vaginosis (BV). This was done using microscopy: wet mount, stained vaginal secretion and stained smear after culture. Results showed that there were 72% infections in the female groups. The brothel and STI group had infection in the range (70-86%). Chlamydial infection was highest in the STI group while Candida infection was highest in the healthy (control) females. Bacterial vaginosis was distributed in all groups. As p-value increased, f-value increased indicating constant co-infection of Candida and BV in Chlamydia positive females. Microscopy by direct detection from sample and stained smear after culture were in the range: 56-86%. Direct microscopy for BV was 78.5% and stained smear after culture, 57.1%. Sensitivity and specificity of the techniques showed that detection of Chlamydia was less sensitive by direct microscopy of sample but sensitivity and specificity of stained smear after culture were high. Immunoassay (32.2%) was also less sensitive. Sensitivity and specificity of wet mount microscopy for Candida, Trichomoniasis and BV were in the range 62.5 – 80% and 62.5-97.8% respectively. Wet mount has high sensitivity and specificity for detecting agents of vaginitis and may be useful for routine use and for diagnosis where disease is absent, thus, making identification more cost effective

The Use of Helicobacter Pylori Stool Antigen Test for the Diagnosis of Helicobacter Pylori in Lagos, Nigeria

Objectives: This study was carried out to screen the use of Helicobacter pylori stool antigen (HpSA) tests for diagnosis and monitoring of H pylori in Nigeria. Methods: Seven hundred and forty participants were enrolled after informed consent was obtained, while 83 came back for a post-eradication test. The stool samples were taken from the patients at endoscopy and tested for HpSA. Results: The proportion of patients that were positive at the pretest, 520 (70.3%) was significantly higher (Fisher’s exact p = 0.001) than those positive at the post-test, 44 (53%). There was a significant difference (F = 4.106, p = 0.043) between the mean age of those that came for the pretest (40.0 ± 14.5 years) and those that came for the post-test, 43.6 ± 11.6 years. More males than females had the tendency to come back for a post-eradication test. Conclusion: Although potential bias was introduced during this study, HpSA using monoclonal antibody could still be used for diagnosis and monitoring of H pylori in Nigeria. Keywords: Helicobacter pylori, stool antigen test "El uso del test de Antígeno en Heces para el Diagnóstico de la Infección por Helicobacter pylori en Lagos, Nigeria" RESUMEN Objetivos: Este estudio se llevó a cabo con el propósito de examinar el uso del test de antígeno en heces (HpSA) para el diagnóstico y monitoreo de Helicobacter pylori en Nigeria Método: Tras obtener su consentimiento informado, se enrolaron ciento cuarenta participantes, mientras que 83 regresaron para un test de post-erradicación. Las muestras de heces fueron tomadas de pacientes en endoscopia e investigadas en busca de HpSA. Resultados: La proporción de pacientes que resultaron positivos en el test previo, 520 (70.3%) fue significativamente mayor (Test exacto de Fisher p = 0.001) que la de los que resultaron positivos en el test posterior, 44(53%). Hubo una diferencia significativa (F = 4.106, p = 0.043) entre la edad promedio de los que vinieron al test previo (40.0 ± 14.5 años) y la de aquellos que vinieron al test posterior, 43.6 ± 11.6 años. Más varones que hembras mostraron tendencia a regresar al test de post-erradicación. Conclusión: Aunque un sesgo potencial fue introducido en este estudio, HpSA con anticuerpos monoclonales podría todavía usarse para el diagnóstico y monitoreo de H pylori en Nigeria. Palabras claves: Helicobacter pylori, prueba de antígeno en hece