Predictors of Bovine TB Risk Behaviour amongst Meat Handlers in Nigeria: A Cross-Sectional Study Guided by the Health Belief Model

Bovine Tuberculosis (bTB) is still a serious public health threat in developing countries. The aim of this study is to determine the social and cognitive factors predicting one of the risk behaviours amongst meat handlers in Nigeria, namely, eating Fuku Elegusi. This is the practice of eating the visibly infected parts of the lung in-order to convince customers to buy meat. The study is guided by the health belief model (HBM).This is a cross-sectional study of 349 randomly selected meat handlers in Oko-Oba Abattoir, in Lagos State. Descriptive statistics and multiple logistic regression analysis were employed to determine perceptions and prevalence of risk behaviours and to identify predictors of eating Fuku Elegusi.Just over a quarter (28.1%) of the study participants knew that eating Fuku Elegusi could be a source of bTB in humans. The prevalence of eating Fuku Elegusi was found to be 22%. Across all knowledge indicators related to bTB, those who don't eat Fuku Elegusi exhibited better knowledge. Strong predictors of eating Fuku Elegusi were: being male (OR: 2.39, 95% CI: 1.10 to 5.19; p = 0.03), not knowing that eating Fuku Elegusi exposes to bTB (OR: 3.72, 95% CI: 1.69 to 8.22; p = 0.001), and the perception that one cannot sell meat without tasting it (perceived barrier) (OR: 1.35, 95% CI: 1.13 to 1.60; p = 0.001). Lower risk of eating Fuku Elegusi was predicted by perceived susceptibility to bTB due to another risk behaviour, namely, not washing hands after handling meat (OR: 0.78, 95% CI: 0.64 to 0.96; p-value = 0.021). Television and radio were the most acceptable media for TB prevention messages (78.5% and 75.6% respectively).Meat handlers in developing countries bear high risk to bTB owing to prevailing social and cognition determinants. Findings were largely consistent with the propositions of HBM

Factors associated with pastoral community knowledge and occurrence of mycobacterial infections in human-animal interface areas of Nakasongola and Mubende districts, Uganda

<p>Abstract</p> <p>Background</p> <p>Nontuberculous mycobacteria (NTM) are emerging opportunistic pathogens whose role in human and animal disease is increasingly being recognized. Major concerns are their role as opportunistic pathogens in HIV/AIDS infections. The role of open natural water sources as source and livestock/wildlife as reservoirs of infections to man are well documented. This presents a health challenge to the pastoral systems in Africa that rely mostly on open natural water sources to meet livestock and human needs. Recent study in the pastoral areas of Uganda showed infections with same genotypes of NTM in pastoralists and their livestock. The aim of this study was to determine the environmental, animal husbandry and socio-demographic factors associated with occurrence and the pastoral community knowledge of mycobacterial infections at the human-environment-livestock/wildlife interface (HELI) areas in pastoral ecosystems of Uganda.</p> <p>Methods</p> <p>Two hundred and fifty three (253) individuals were subjected to a questionnaire survey across the study districts of Nakasongola and Mubende. Data were analyzed using descriptive statistics and multivariable logistic regression analysis.</p> <p>Results</p> <p>Humans sharing of the water sources with wild animals from the forest compared to savannah ecosystem (OR = 3.3), the tribe of herding pastoral community (OR = 7.9), number of rooms present in household (3-5 vs. 1-2 rooms) (OR = 3.3) were the socio-demographic factors that influenced the level of knowledge on mycobacterial infections among the pastoral communities. Tribe (OR = 6.4), use of spring vs. stream water for domestic use (OR = 4.5), presence of sediments in household water receptacle (OR = 2.32), non separation of water containers for drinking and domestic use (OR = 2.46), sharing of drinking water sources with wild animals (OR = 2.1), duration of involvement of >5 yrs in cattle keeping (OR = 3.7) and distance of household to animal night shelters (>20 meters) (OR = 3.8) were significant socio-demographic factors associated with the risk of occurrence of mycobacterioses among the pastoral communities in Uganda.</p> <p>Conclusion</p> <p>The socio-demographic, environmental and household related factors influence the risk of occurrence as well as pastoralists' knowledge of mycobacterial infections in the pastoral households at the human-environment-livestock/wildlife pastoral interface areas of Uganda.</p

NOMA: A Preventable “Scourge” of African Children

Noma is a serious orofacial gangrene originating intraorally in the gingival-oral mucosa complex before spreading extraorally to produce a visibly destructive ulcer. Although cases of noma are now rarely reported in the developed countries, it is still prevalent among children in third world countries, notably in sub-Sahara Africa, where poverty, ignorance, malnutrition, and preventable childhood infections are still common. This review summarizes historical, epidemiological, management, and research updates on noma with suggestions for its prevention and ultimate global eradication. The global annual incidence remains high at about 140,000 cases, with a mortality rate exceeding 90% for untreated diseases. Where the patients survive, noma defects result in unsightly facial disfigurement, intense scarring, trismus, oral incompetence, and social alienation. Although the etiology has long been held to be infectious, a definitive causal role between microorganisms cited, and noma has been difficult to establish. The management of noma with active disease requires antibiotics followed by reconstructive surgery. Current research efforts are focused towards a comprehensive understanding of the epidemiology, and further elucidation of the microbiology and pathogenesis of noma

Factors that facilitate infant survival in a low socio-economic community in Lagos State, Nigeria

Infants are delicate, relying mostly on caregivers for their survival. Their survival is plagued by diseases, poverty, behavioural habits and cultural beliefs of the caregivers in the developing countries. For strategies to improve infant survival, the health seeking behaviour and home care practices of caregivers during infant illness episodes were studied. A total of 742 caregivers in 5 out of 11 health districts of Ajeromi/Ifelodun Local Government areas of Lagos State whose infants were ill four weeks preceding the survey were interviewed using a semi-structured questionnaire. Sixty-two (8.4%) of the interviewed lost their infants; 51.6% of children who died did so in hospitals, 35.5% at home and 12.9% at unspecified places. The notable causes of death were malaria (22.6%), acute respiratory infections (14.5%) and diarrhea (12.9%). Majority of the caregivers (60.0%) whose infants died did not seek external help until 24hrs or more after onset of illness signs. Infant's tendency to survive an illness episode was significantly dependent on full term delivery (

Comparison of dynabeads and capcellia methods with facscount for the estimation of CD4 T-lymphocyte levels in HIV/AIDS patients in Lagos, Nigeria

Objective: To compare the efficacy of the Capcellia assay and the Dynabeads technique against the FACScount technique in the estimation of CD4 T-lymphocytes within a Nigerian setting. Design: Prospective study.Setting: Urban area in Nigeria. Subjects: Ninety seven subjects (51 HIV seronegative and 46 HIV seropositive adults)seen in the blood banks and two out patient clinics in Lagos within the study period. Main Outcome Measures: Dynadeads technique with a higher correlation coefficient is a feasible alternative to the FACScount method. Results: There was an overall correlation coefficient of r = 0.75 for CD4 cell counts as determined by the Dynabeads technique in comparison with the FACScount method. Also, an overall correlation coefficient of r = 0.17 for CD4 cell counts as determined by the Capcellia technique against the FACScount method. Conclusion: Dynabeads technique is simple to carry out and cheaper in terms of demand for human expertise and infrastructural requirements than the FACScounts. Therefore, it was recommended for use in the laboratory for monitoring of ARV therapy in Nigeria and any other resource poor country. East African Medical Journal Vol. 83(4) 2006: 105-11

Changes in Serum Proteins and Creatinine levels in HIV Infected Nigerians

Immune dysregulation in terms of hypergammaglobulinaemia and hypogammaglobulinaemia was part of definition of immunodeficiency that characterized AIDS. This results in either raised level of total plasma/serum protein or low level of plasma/serum protein depending on which component of immune dysregulation predominates. This study examined the level of total serum proteins and globulins in HIV infected Nigerians. 64 patients with HIV infection and 10 apparently healthy subjects were recruited from 3 hospitals in Lagos Metropolis. They were examined for the presence of TB and malaria. Serum total protein, albumin and creatinine levels were determined using commercially available kits while the globulin level was computed. Level of immunodeficiency was also determined by CD4+ cell count, using the FACS count method. Data obtained from the patients were compared with values obtained from 10 healthy controls; using appropriate statistical tests on EPI-INFO V 6.0. Results showed that hypergammaglobulinaemia is the major immune dysregulation found with globulin level of 7.4g/d1 as compared with 2.9g/d1 in healthy control though it was not statistically significant. Total serum protein was also higher in HIV infected patients than the controls. The serum globulin was found to correlate negatively with CD4 cell count (r = -0.28, P = 0.0067). Serum creatinine appears not to differ significantly between control and infected patients although the creatinine levels has a positive correlation to plasma globulin levels (r = 0.45, p = 0.001). In conclusion hypergammaglobulinaemia was found to be common in HIV infected Nigerians. This was associated with raised level of plasma creatinine. KEY WORDS: Serum proteins, Creatinine, Albumin, Globulin and HIV Nigerian Journal of Health and Biomedical Sciences Vol.3(2) 2004: 69-7

COMPARATIVE STUDY ON SPECIFIC AND EARLY DETECTION OF PULMONARY MYCOBACTERIA COMPLEX USING SMEAR AND CULTURE METHOD AND SEROLOGICAL PATHOZYME EIA KITS

The objective of this study was to compare the sensitivity and specificity of smear and culture methods with rapid serological EIA myco kits manufactured by Omega diagnostics, for the early detection of Mycobacterium tuberculosis (MTB) complex. Sera from various categories of smear and culture results were compared with the result of 38KDa, 16KDa and purified protein for IgA, IgM and IgG antibodies with sensitivity of 4%, 24% and 76%, respectively and with specificity of100% for IgG in Smear and Culture Positive (S

The emerging threat of pre-extensively drug-resistant tuberculosis in West Africa: preparing for large-scale tuberculosis research and drug resistance surveillance

Background Drug-resistant tuberculosis (TB) is a global public health problem. Adequate management requires baseline drug-resistance prevalence data. In West Africa, due to a poor laboratory infrastructure and inadequate capacity, such data are scarce. Therefore, the true extent of drug-resistant TB was hitherto undetermined. In 2008, a new research network, the West African Network of Excellence for Tuberculosis, AIDS and Malaria (WANETAM), was founded, comprising nine study sites from eight West African countries (Burkina Faso, The Gambia, Ghana, Guinea-Bissau, Mali, Nigeria, Senegal and Togo). The goal was to establish Good Clinical Laboratory Practice (GCLP) principles and build capacity in standardised smear microscopy and mycobacterial culture across partnering laboratories to generate the first comprehensive West African drug-resistance data. Methods Following GCLP and laboratory training sessions, TB isolates were collected at sentinel referral sites between 2009–2013 and tested for first- and second-line drug resistance. Results From the analysis of 974 isolates, an unexpectedly high prevalence of multi-drug-resistant (MDR) strains was found in new (6 %) and retreatment patients (35 %) across all sentinel sites, with the highest prevalence amongst retreatment patients in Bamako, Mali (59 %) and the two Nigerian sites in Ibadan and Lagos (39 % and 66 %). In Lagos, MDR is already spreading actively amongst 32 % of new patients. Pre-extensively drug-resistant (pre-XDR) isolates are present in all sites, with Ghana showing the highest proportion (35 % of MDR). In Ghana and Togo, pre-XDR isolates are circulating amongst new patients. Conclusions West African drug-resistance prevalence poses a previously underestimated, yet serious public health threat, and our estimates obtained differ significantly from previous World Health Organisation (WHO) estimates. Therefore, our data are reshaping current concepts and are essential in informing WHO and public health strategists to implement urgently needed surveillance and control interventions in West Africa