Treatment Outcomes among Human Immunodeficiency Virus and Tuberculosis Co-Infected Pregnant Women in Resource Poor Settings of South-western Nigeria

The complex interactions between Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) infections may be magnified, in the presence of another potentially stressful condition like pregnancy. Though co-infection among pregnant women is rare, treatment outcomes may depend on accessibility to comprehensive treatment modalities. The objective of this study is to determine treatment outcomes among pregnant HIV and TB co-infected pregnant women in Lagos, South-western Nigeria. This retrospective, analytical study was carried out among ninety four (94) eligible pregnant women co-infected with HIV and TB at selected health-care facilities in Lagos state between January, 2008 and December, 2009. A standard checklist for data collection was used and analysis was carried out using the EPI info software. Mean age of respondents was 30.8 (±3.9) years. Sixteen (17.1%) TB cases were clinically diagnosed for tuberculosis. Among tuberculosis cases identified through sputum microscopy, 60(63.8%) were acid fast bacilli (AFB) positive and 21(22.3%) were identified in the first trimester. The mean percentage adherence to anti-retroviral drugs was 95.9% (±5.3). None of the participant smoked cigarette. Seventy three {73 (77.7%)} had contact with TB infected or suspected person in the last three months. Treatment outcome in mother showed that 74(78.7%) were cured, 8(8.5%) relapsed while 12 (12.8%) had treatment failures. Among the babies, 83(88.3%) were born alive. Women with both poor adherence (<90%) and with positive TB contact, but neither factor alone, were half-fold less likely to be cured compared with women with both good adherence (>95%) and no TB contact (OR=0.59, CI=0.45-0.95 and p=0.014). Cure rate was substantially lower in this study. This calls for extra strategies such as routine TB screening in antenatal clinics, strict adherence to national guidelines in the treatment of HIV/TB co-infections, focused antenatal care and comprehensive Prevention of Mother to Child Transmission (PMTCT) care and treatment

Prevalence of hypertension in the rural adult population of Osun State, southwestern Nigeria

EO Asekun-Olarinmoye,1 PO Akinwusi,2 WO Adebimpe,1 MA Isawumi,3 MB Hassan,3 OA Olowe,4 OB Makanjuola,4 CO Alebiosu,2 TA Adewole51Department of Community Medicine, 2Department of Medicine, 3Department of Surgery, 4Department of Microbiology, 5Department of Chemical Pathology, College of Health Sciences, Osun State University, Osogbo, Osun State, NigeriaBackground: The purpose of this study was to determine the prevalence of hypertension in two rural communities of Osun State, Nigeria.Methods: A consenting adult population of the Alajue and Obokun rural communities in southwestern Nigeria that presented for the screening exercise participated in this community-based cross-sectional descriptive study. Two hundred and fifty-nine respondents aged older than 18 years completed a standardized, pretested, structured questionnaire as part of activities celebrating World Kidney Day and World Glaucoma Day in 2011. Anthropometric data and blood pressure were recorded, and the data were analyzed using the Statistical Package for Social Sciences version 17.Results: The mean age of the respondents was 49.7 &plusmn; 1.6 years, 100 (38.6%) were males, 84 (32.4%) were farmers, and 111 (42.9%) were traders. The prevalence of hypertension was 13.16% (present in 34 respondents). Seventeen (6.6%) had isolated systolic hypertension, while 11 (4.2%) had isolated diastolic hypertension. Two hundred and thirty-six (91.1%) undertook daily exercise lasting at least 30 minutes and 48 (18.5%) had ever taken antihypertensive drugs on a regular basis. Four respondents (1.6%) claimed a family history of hypertension. The average body mass index (BMI) among respondents was 23.4 &plusmn; 4.9 kg/m2, 51 (19.6%) had a BMI of 25.0&ndash;29.9, and 30 (11.5%) had a BMI &ge; 30. A significant association existed between age older than 40 years and having hypertension (P < 0.05), while no relationship existed between age and BMI or between gender and hypertension (P > 0.05). Rates of older age and high BMI were significantly higher among hypertensives than among normotensives. Respondents with BMI < 25 had at least a three times greater likelihood of developing hypertension than those with BMI < 25 (odds ratio 2.9, 95% confidence interval 0.007&ndash;0.056, P = 0.011).Conclusion: The prevalence of hypertension is high in this study population and we recommend scaling up primary prevention efforts to reduce this in Nigerian communities.Keywords: prevalence, hypertension, anthropometry, body mass index, rural communit

Assessment of Ethical and Other Professional Standards in Private Medical Laboratories; Osun State Experience.

Compliance of 21 private medical laboratories in Osun State with ethical and other professional was assessed by the authors' pre and post inspection by the Medical Laboratory Science Council of Nigeria (MLSCN). Laboratory environment, personnel, equipment and adherence to Standard Operating Procedures (SOPs) were used as indicators and the results obtained were compared. Thirteen (62 %) was found to have conformed to environmental specifications before the MLSCN's inspection. This rose to 84% and 89% a month and 6 months post MLSCN inspection respectively. Ten (48%) had the right personnel before the Council's inspection followed by 74% which dropped to 72% six months later. Fifteen (67%) laboratories had prerequisite equipment in use before the Council's inspection and this rose to 84% and 89% a month and 6 months later, respectively. Adherence to SOPs was observed to have risen from 76% baseline to 95% a month after; the value dropped to 89% 6 months after the Council's inspection. Follow-up assessment by volunteer members of the Association of Medical Laboratory Scientists of Nigeria noted a sustained improvement of professional standards in private medical laboratories till 6 months after MLSCN inspection. It is recommended that competent volunteers be engaged by the MLSCN and other stakeholders within and outside the country to continually monitor the sustenance of acceptable standards of practice by medical laboratories.Keywords: Ethics, private medical laboratory, service

Asymptomatic bacteriuria among elderly and middle-aged rural community-dwellers in South-Western Nigeria

OA Olowe,1 OB Makanjuola,1 KO Olabiyi,1 PO Akinwusi,2 CO Alebiosu,2 MA Isawumi,3 MB Hassan,3 EO Asekun-Olarinmoye,4 WO Adebimpe,4 TA Adewole5 1Department of Medical Microbiology and Parasitology, 2Department of Medicine, 3Department of Ophthalmology, 4Department of Community Medicine, 5Department of Biochemistry, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria Abstract: Asymptomatic bacteriuria in elderly individuals has been well described in institutionalized settings, but to a lesser extent in the community. The purpose of this study was to determine the pathogens responsible for asymptomatic bacteriuria in elderly and middle-aged individuals in Alajue-Ede, South-Western Nigeria, and to identify any associated factors. Mid-stream urine samples were collected from apparently healthy elderly and middle-aged volunteers who were participating in community health screening. Samples were processed and bacterial isolates were identified following standard procedures. In total, 128 volunteers (48 men, 76 women) participated in the study. Twenty-eight (22.6%) urinary pathogens were isolated, comprising Klebsiella species in five (17.9%), Pseudomonas aeruginosa in one (3.6%), Escherichia coli in 19 (67.9%), and Proteus species in three (10.7%) cases. Women were identified as being at higher risk of asymptomatic bacteriuria, and the prevalence also increased with increasing age in men. The elderly in this community have a high prevalence of asymptomatic bacteriuria, and screening for comorbid medical conditions may be of benefit. Keywords: asymptomatic bacteriuria, urinary pathogens, elderly, urinary tract infectio

Methods for identifying Neisseria meningitidis carriers: a multi-center study in the African meningitis belt.

OBJECTIVE: Detection of meningococcal carriers is key to understanding the epidemiology of Neisseria meningitidis, yet no gold standard has been established. Here, we directly compare two methods for collecting pharyngeal swabs to identify meningococcal carriers. METHODS: We conducted cross-sectional surveys of schoolchildren at multiple sites in Africa to compare swabbing the posterior pharynx behind the uvula (U) to swabbing the posterior pharynx behind the uvula plus one tonsil (T). Swabs were cultured immediately and analyzed using molecular methods. RESULTS: One thousand and six paired swab samples collected from schoolchildren in four countries were analyzed. Prevalence of meningococcal carriage was 6.9% (95% CI: 5.4-8.6%) based on the results from both swabs, but the observed prevalence was lower based on one swab type alone. Prevalence based on the T swab or the U swab alone was similar (5.2% (95% CI: 3.8-6.7%) versus 4.9% (95% CI: 3.6-6.4%) respectively (p=0.6)). The concordance between the two methods was 96.3% and the kappa was 0.61 (95% CI: 0.50-0.73), indicating good agreement. CONCLUSIONS: These two commonly used methods for collecting pharyngeal swabs provide consistent estimates of the prevalence of carriage, but both methods misclassified carriers to some degree, leading to underestimates of the prevalence