Telemarketing and Consumer protection in Nigeria: A Case for the Domestication of the U.S. Telephone Consumer Protection Act, (TCPA, 1991)

The Resolution of telecommunications regulatory issues that affect consumer protection with a view to adopting world best practices for enhanced Consumer Protection calls for a case by case review and appraisal of such topical and vexed issues that affect consumer protection in the telecommunications subsector. Consumer Protection issues in telecommunications revolves around matters of poor services, billing cost, lack of network, drop calls, telemarketing, unsolicited adverts etc. The problems of telemarketing and unsolicited advertisements have been endemic enough to attract criticism and calls for a legal framework to regulate or check the trend. In the USA, the issue of telemarketing and unsolicited adverts has since been addressed by the enactment of the U.S Telephone Consumer Protection Act, 1991. This work seeks to address the issues of telemarketing unsolicited advertisements in the telecommunications regulatory framework with a view to improving consumer satisfaction in the sector. A case for the domestication of the U.S.A experience is been made by an analysis of the USA TCPA, 1991, showing its relevance, shortcomings and grey areas and amendments for application in Nigeria. It is opined that the U.S TCPA 1991, when domesticated in Nigeria mutatis mutandis will cure the viral virus of unsolicited adverts in the Nigerian telecommunications regulatory environment. Keywords: consumer protection, U.S Telephone Consumer Protection Act, 1991, Telecommunications, Advertisement, Regulatory, customers, Lotteries, The Telemarketing Industry, Global Systems of Mobile Telecommunications (GSM), Value Added Services (VAS), National Coordinator of Wireless Application Service Providers of Nigeria (WASPAN), The Nigerian Communications Commission, Federal Communications Commission (FCC), Consumers Protection Council (CPC), Nigerian Communications Commissions (NCC)

Intelligence Gathering Imperative: A Tool for Successful Security Outfits’ Operation

This study examines the recent security challenges Nigerians and non-Nigerians encounters in their daily existence to eke a living. These threats are orchestrated by the activities of one of the deadliest terrorist group in the world (Boko Haram), and herdsmen notorious killers, armed banditry, cow rustling by rustlers, incessant kidnapping especially students in schools and unsuspecting Nigerians and non-Nigerians alike; which has made Nigeria federating states unsafe for any meaningful socio-economic development to thrive. To achieve this, two objectives were stated to include, underscore the overarching relevance of intelligent gathering in preventing crime and understand the elaborateness of intelligence gathering that can be utilized to mitigate crimes outcomes. The study found that intelligence gathering is the disconnect that has precipitated this state of affairs in Nigeria. Equally responsible is the people’s loyalty which is first and foremost skewed to ethnoreligious and political considerations instead of the country. It was recommended among other appeals to include: The National Intelligence Agency (NIA) of Nigeria which is the coordinating security agency should be properly funded and personnel trained in modern intelligence gathering techniques, the unnecessary bickering, in-fighting for superiority between and among security agencies in Nigeria should be discouraged because this itself is a big challenge in security equation of Nigeria; and serious effort should be made to stop the politicization of security intelligence gathering matters based on tribe, ethnic group, religious and political affiliations

Deciphering the growth behaviour of Mycobacterium africanum.

BACKGROUND: Human tuberculosis (TB) in West Africa is not only caused by M. tuberculosis but also by bacteria of the two lineages of M. africanum. For instance, in The Gambia, 40% of TB is due to infections with M. africanum West African 2. This bacterial lineage is associated with HIV infection, reduced ESAT-6 immunogenicity and slower progression to active disease. Although these characteristics suggest an attenuated phenotype of M. africanum, no underlying mechanism has been described. From the first descriptions of M. africanum in the literature in 1969, the time to a positive culture of M. africanum on solid medium was known to be longer than the time to a positive culture of M. tuberculosis. However, the delayed growth of M. africanum, which may correlate with the less virulent phenotype in the human host, has not previously been studied in detail. METHODOLOGY/PRINCIPAL FINDINGS: We compared the growth rates of M. tuberculosis and M. africanum isolates from The Gambia in two liquid culture systems. M. africanum grows significantly slower than M. tuberculosis, not only when grown directly from sputa, but also in growth experiments under defined laboratory conditions. We also sequenced four M. africanum isolates and compared their whole genomes with the published M. tuberculosis H37Rv genome. M. africanum strains have several non-synonymous SNPs or frameshift mutations in genes that were previously associated with growth-attenuation. M. africanum strains also have a higher mutation frequency in genes crucial for transport of sulphur, ions and lipids/fatty acids across the cell membrane into the bacterial cell. Surprisingly, 5 of 7 operons, recently described as essential for intracellular survival of H37Rv in the host macrophage, showed at least one non-synonymously mutated gene in M. africanum. CONCLUSIONS/SIGNIFICANCE: The altered growth behaviour of M. africanum might indicate a different survival strategy within host cells

Evaluation of the Kudoh method for mycobacterial culture: Gambia experience

AbstractObjective/backgroundTo evaluate the Kudoh swab method for improving laboratory diagnosis of tuberculosis (TB) in Gambia.MethodsA total of 75 sputa (50 smear positive and 25 smear negative) were examined. Sputum samples were collected from leftover routine samples from the Medical Research Council Unit, Gambia TB Diagnostic Laboratory. The samples were processed using the standard N-acetyl-l-cysteine-NaOH (NALC-NaOH) methods currently used and Kudoh swab method. These were cultured on standard Lowenstein Jensen (LJ) and Modified Ogawa media, respectively, and incubated aerobically at 36±1°C for mycobacterial growth. To determine if the decontamination and culture methods compared could equally detect the Mycobacterium tuberculosis complex (MTBC) highly commonly isolated in Gambia, spoligotyping was done.ResultsIn total, 72% (54/75) of MTBC were recovered by both LJ and Modified Ogawa methods. The LJ method recovered 52% (39/75) and Modified Ogawa recovered 56% (42/75) of the MTBC, respectively. Spoligotyping showed Euro-American 35% (19/54), Indo-Oceanic 35% (19/54), Mycobacterium africanum (West African type 2) 26% (14/54), Beijing 2% (1/54), and M. africanum (West African type 1) 2% (1/54).ConclusionThe Kudoh method is simpler and cheaper than the NALC-NaOH method. There was no significant difference in recovery between the methods. The Kudoh method is ideal in overburdened TB laboratories with poor resources in developing countries. The predominant lineages were Euro-American and Indo-Oceanic, followed by M. africanum (West African type 2)

A cross-sectional study of tuberculosis drug resistance among previously treated patients in a tertiary hospital in Accra, Ghana: public health implications of standardized regimens.

BACKGROUND: Mycobacterium tuberculosis drug resistance is a major challenge to the use of standardized regimens for tuberculosis (TB) therapy, especially among previously treated patients. We aimed to investigate the frequency and pattern of drug resistance among previously treated patients with smear-positive pulmonary tuberculosis at the Korle-Bu Teaching Hospital Chest Clinic, Accra. METHODS: This was a cross-sectional survey of mycobacterial isolates from previously treated patients referred to the Chest Clinic Laboratory between October 2010 and October 2013. The Bactec MGIT 960 system for mycobactrerial culture and drug sensitivity testing (DST) was used for sputum culture of AFB smear-positive patients with relapse, treatment failure, failure of smear conversion, or default. Descriptive statistics were used to summarize patient characteristics, and frequency and patterns of drug resistance. RESULTS: A total of 112 isolates were studied out of 155 from previously treated patients. Twenty contaminated (12.9%) and 23 non-viable isolates (14.8%) were excluded. Of the 112 studied isolates, 53 (47.3%) were pan-sensitive to all first-line drugs tested Any resistance (mono and poly resistance) to isoniazid was found in 44 isolates (39.3%) and any resistance to streptomycin in 43 (38.4%). Thirty-one (27.7%) were MDR-TB. Eleven (35.5%) out of 31 MDR-TB isolates were pre-XDR. MDR-TB isolates were more likely than non-MDR isolates to have streptomycin and ethambutol resistance. CONCLUSIONS: The main findings of this study were the high prevalence of MDR-TB and streptomycin resistance among previously treated TB patients, as well as a high prevalence of pre-XDR-TB among the MDR-TB patients, which suggest that first-line and second-line DST is essential to aid the design of effective regimens for these groups of patients in Ghana

Whole-genome sequencing illuminates the evolution and spread of multidrug-resistant tuberculosis in Southwest Nigeria.

Nigeria has an emerging problem with multidrug-resistant tuberculosis (MDR-TB). Whole-genome sequencing was used to understand the epidemiology of tuberculosis and genetics of multi-drug resistance among patients from two tertiary referral centers in Southwest Nigeria. In line with previous molecular epidemiology studies, most isolates of Mycobacterium tuberculosis from this dataset belonged to the Cameroon clade within the Euro-American lineage. Phylogenetic analysis showed this clade was undergoing clonal expansion in this region, and suggests that it was involved in community transmission of sensitive and multidrug-resistant tuberculosis. Five patients enrolled for retreatment were infected with pre-extensively drug resistant (pre-XDR) due to fluoroquinolone resistance in isolates from the Cameroon clade. In all five cases resistance was conferred through a mutation in the gyrA gene. In some patients, genomic changes occurred in bacterial isolates during the course of treatment that potentially led to decreased drug susceptibility. We conclude that inter-patient transmission of resistant isolates, principally from the Cameroon clade, contributes to the spread of MDR-TB in this setting, underscoring the urgent need to curb the spread of multi-drug resistance in this region

Evolution of Mycobacterium tuberculosis complex lineages and their role in an emerging threat of multidrug resistant tuberculosis in Bamako, Mali

In recent years Bamako has been faced with an emerging threat from multidrug resistant TB (MDR-TB). Whole genome sequence analysis was performed on a subset of 76 isolates from a total of 208 isolates recovered from tuberculosis patients in Bamako, Mali between 2006 and 2012. Among the 76 patients, 61(80.3%) new cases and 15(19.7%) retreatment cases, 12 (16%) were infected by MDR-TB. The dominant lineage was the Euro-American lineage, Lineage 4. Within Lineage 4, the Cameroon genotype was the most prevalent genotype (n = 20, 26%), followed by the Ghana genotype (n = 16, 21%). A sub-clade of the Cameroon genotype, which emerged ~22 years ago was likely to be involved in community transmission. A sub-clade of the Ghana genotype that arose approximately 30 years ago was an important cause of MDR-TB in Bamako. The Ghana genotype isolates appeared more likely to be MDR than other genotypes after controlling for treatment history. We identified a clade of four related Beijing isolates that included one MDR-TB isolate. It is a major concern to find the Cameroon and Ghana genotypes involved in community transmission and MDR-TB respectively. The presence of the Beijing genotype in Bamako remains worrying, given its high transmissibility and virulence

Implementing health worker training on sepsis in South Eastern Nigeria using innovative digital strategies: an interventional study

Background: Sepsis is a leading cause of morbidity and mortality especially in low- and middle-income countries such as Nigeria. Training of health workers using digital platforms may improve knowledge and lead to better patient outcomes. Objectives: To assess the effectiveness of a digital health educational module on sepsis in improving the knowledge of medical doctors in Cross River State Nigeria on the diagnosis and management of patients presenting with sepsis. Design: Quasi-experimental analytical study. Methods:: We developed and deployed a sepsis module through an innovative application (Sepsis tutorial app) to doctors in Calabar, Nigeria. We assessed quantitative pre- and post-intervention knowledge scores for those completing the tutorial on sepsis between both assessments. A user satisfaction survey evaluated the content of the tutorial and the usability of the app. Results:: One hundred and two doctors completed the course. There were more males than females (58.8% versus 41.2%). Over half (52%) were junior doctors, a minority were general practitioners and house officers (3% and 5%, respectively), and 72.6% had practiced for periods ranging from 1 to 15 years post-qualification. Gender and age appeared to have no significant association with pre- and post-test scores. The oldest age group (61–70) had the lowest mean pre- and post-test scores, while general practitioners had higher mean pre- and post-test scores than other cadres. The majority (95%) of participants recorded higher post-test than pre-test scores with a significant overall increase in mean scores (25.5 ± 14.7%, p < 0.0001). Participants were satisfied with the content and multimodal delivery of the material and found the app usable. Conclusion:: Digital training using context-responsive platforms is feasible and may be used to close the critical knowledge gap required to respond effectively to medical emergencies such as sepsis in low- to middle-income settings

Second-line anti-tuberculosis drug resistance testing in Ghana identifies the first extensively drug-resistant tuberculosis case

Background: Drug resistance surveillance is crucial for tuberculosis (TB) control. Therefore, our goal was to determine the prevalence of second-line anti-TB drug resistance among diverse primary drug-resistant Mycobacterium tuberculosis complex (MTBC) isolates in Ghana. Materials and methods: One hundred and seventeen MTBC isolates with varying first-line drug resistance were analyzed. Additional resistance to second-line anti-TB drugs (streptomycin [STR], amikacin [AMK] and moxifloxacin [MOX]) was profiled using the Etest and GenoType MTBDRsl version 2.0. Genes associated with resistance to AMK and MOX (gyrA, gyrB, eis, rrs, tap, whiB7 and tlyA) were then analyzed for mutation. Results: Thirty-seven (31.9%) isolates had minimum inhibitory concentration (MIC) values ≥2 µg/mL against STR while 12 (10.3%) isolates had MIC values ≥1 µg/mL for AMK. Only one multidrug-resistant (MDR) isolate (Isolate ID: TB/Nm 919) had an MIC value of ≥0.125 µg/mL for MOX (MIC = 3 µg/mL). This isolate also had the highest MIC value for AMK (MIC = 16 µg/mL) and was confirmed as resistant to AMK and MOX by the line probe assay GenoType MTBDRsl version 2.0. Mutations associated with the resistance were: gyrA (G88C) and rrs (A514C and A1401G). Conclusion: Our findings suggest the need to include routine second-line anti-TB drug susceptibility testing of MDR/rifampicin-resistant isolates in our diagnostic algorithm

Immunogenicity of antigens from the TbD1 region present in M. africanum and missing from "modern" M. tuberculosis: a cross- sectional study

<p>Abstract</p> <p>Background</p> <p>Currently available tools cannot be used to distinguish between sub-species of the <it>M. tuberculosis </it>complex causing latent tuberculosis (TB) infection. <it>M. africanum </it>causes up to half of TB in West- Africa and its relatively lower progression to disease suggests the presence of a large reservoir of latent infection relative to <it>M. tuberculosis</it>.</p> <p>Methods</p> <p>We assessed the immunogenicity of the TbD1 region, present in <it>M. africanum </it>and absent from "modern" <it>M. tuberculosis</it>, in an ELISPOT assay using cells from confirmed <it>M. africanum </it>or <it>M. tuberculosis </it>infected TB patients without HIV infection in the Gambia.</p> <p>Results</p> <p>Antigens from the TbD1 region induced IFNγ responses in only 35% patients and did not discriminate between patients infected with <it>M. africanum </it>vs. <it>M. tuberculosis</it>, while PPD induced universally high responses.</p> <p>Conclusions</p> <p>Further studies will need to assess other antigens unique to <it>M. africanum </it>that may induce discriminatory immune responses.</p