Antibody response to routine measles vaccination among a population of Nigerian children and evaluation of vaccine potency

Background: Despite a global decline in mortality and morbidity from measles in the last decade, outbreaks continue to occur in some parts of the world including Nigeria.Objective: To determine antibody response to routine measles vaccinationin Nigerian children and evaluate vaccine potency.Methods: A prospective study of 234 children selected from 3 health centres in an urban area of Lagos, Nigeria. Blood was obtained before and 8-12 weeks after routine vaccination with Edmonston-Zagreb strain of measles vaccine. Antibodies were detected using the measles antibody neutralization test. Reconstituted vaccines samples were analysed forpotency on monolayers of Vero slam cells in 96-well tissue culture plates.Results: Twenty seven(11.5%) had pre-vaccination antibodies. Seroconversion rate among the 195 who returned for postvaccinationsampling was 69.2%: It was however 74.2% in children with no pre-vaccination antibodies compared to 17.6% in those with antibodies. (p<0.05). Only six (50%) of the measles vaccine vials were potent. Seroconversion rate among subjects vaccinated from potent vials was 74.3% compared with 42.9% in those vaccinated from non-potent vials (p = 0.006).Conclusion: Seroconversion to measles vaccination in our environmentis sub-optimal, partly attributable to low vaccine potency. Improvement of vaccine handling processes and booster doses of the vaccine are recommended

Herpes simplex encephalitis

No Abstract

Frequency of relapse among Nigerian children with steroid‑sensitive nephrotic syndrome

Background: The clinical course of steroid‑sensitive nephrotic syndrome (SSNS) among Nigerian children has rarely been reported; this makes prognostication difficult.Objectives: The objective was to determine the frequency of relapses including frequent relapses (FR) and steroid‑dependence (SD) in a cohort of Nigerian children with SSNS. A secondary objective was to identify clinical and demographic factors associated with relapse in these children.Methods: Medical records of children with SSNS in a Tertiary Hospital in Nigeria were reviewed. Children with onset of nephrotic syndrome (NS) at age <1‑year, follow‑up period <12 months and secondary causes of NS were excluded. The relapse status of each child was determined in the 1st and 2nd year after diagnosis and the proportions with no relapse, FR and SD were calculated.Results: Fifty children (68% males; median [range] age at onset of NS 4.8 [1.1–14.9] years) were followed‑up for 31.1 (12.1–79.8) months. In the 1st and 2nd year of follow‑up, 23 (46%) and 24 (70.6%) children experienced relapse, respectively. In the 1st‑year, 0% and 10% had FR and SD while in the 2nd year 2.9% and 11.8% had FR and SD, respectively. Age at onset of NS, gender, time to first remission, serum creatinine or presence of hypertension or microscopic hematuria was not associated with 1st or 2nd year relapse.Conclusion: About half and two‑thirds of children with NS in our center experience relapse in the 1st and 2nd year of follow–up, respectively; much fewer proportions experienced FR and SD in these periods. None of the commonly reported demographic and clinical factors was associated with NS relapse.Key words: Frequent relapses, prednisolone, steroid‑dependenc

Blood pressure to height ratio as a screening tool for prehypertension and hypertension in adolescents

Background: Current methods of detection of childhood hypertension are cumbersome and contribute to under‑diagnosis hence, the need to generate simpler diagnostic tools. The blood pressure to height ratio has recently been proposed as a novel screening tool for prehypertension and hypertension in some populations. We evaluated its applicability in our environment.Materials and Methods: The weights, heights, and blood pressure measurements of 2364 apparently healthy adolescents were determined. Sex‑specific systolic and diastolic blood pressure to height ratios (SBPHR) and (DBPHR) were calculated, and their ability to detect prehypertension and hypertension was determined using receiver operating curves. Discriminatory ability was measured by the area under the curve (AUC) and optimal cutoff points along the curve were determined. P < 0.05 was considered statistically significant.Results: The SBPHR and DBPHR were similar across all age groups and sexes. The AUC of SBPHR and DBPHR for diagnosing prehypertension and hypertension by sex was >0.95 for both diastolic and systolic hypertension in both sexes. It ranged between 0.803 and 0.922 for prehypertension and 0.954–0.978 for hypertension indicating higher accuracy for hypertension. Sensitivity was higher for systolic and diastolic hypertension (90–98%) compared with prehypertension (87–98%). Specificity was lower than sensitivity across all categories of hypertension and prehypertension (0.64–0.88%) though higher for hypertension (0.75–0.88) compared with prehypertension (0.64–0.75).Conclusion: BPHR is a useful screening tool for prehypertension and hypertension in black adolescents. Accuracy increased with higher degrees of hypertension.Keywords: Adolescents, blood pressure, height, hypertensio

Effector CD8 T cell immunity in microsporidial infection: a lone defense mechanism

Microsporidia are a group of pathogens, which can pose severe risks to the immunocompromised population such as HIV infected individuals. The expertise to diagnose these pathogens is limited and therefore their prevalence is believed to be much higher than what is currently known. In a mouse model of infections, it has been reported that CD8 T cells are the primary effector cells responsible for protecting the infected host. As the infection is acquired via per-oral route, CD8 T cells in the gut compartment apparently act as a first line of defense against the pathogens. Thus, generation of a robust CD8 T cell response that exhibits polyfunctional ability is critical for host survival. In this review, we describe the effector CD8 T cells generated during microsporidial infection and underline the factors that may be essential for the elicitation of protective immunity against this understudied but significant pathogen. Overall, this review will highlight the necessity for a better understanding of the development of the CD8 T cell response in gut associated lymphoid tissue (GALT) and provide some insights into therapies that may be used to restore defective CD8 T cell functionality in an immunocompromised situation