Physician use of updated anti-virus software in a tertiary Nigerian hospital

While physicians are becoming increasingly dependent on computers and the internet, highly lethal malware continue to be loaded into cyberspace. We sought to assess the proportion of physicians with updated anti-virus software in Jos University Teaching Hospital Nigeria and to determine perceived barriers to getting updates. We used a pre-tested semi-structured selfadministered questionnaire to conduct a cross-sectional survey among 118 physicians. The mean age (±SD) of subjects was 34(±4) years, with 94 male and 24 female physicians. Forty-two (36.5%) of 115 physicians with anti-virus software used an updated program (95%CI: 27, 45). The top-three antivirus software were: McAfee 40(33.9%), AVG 37(31.4%) and Norton 17(14.4%). Common infections were: Trojan horse 22 (29.7%), Brontok worm 8(10.8%), and Ravmonlog.exe 5(6.8%). Internet browsing with a firewall was an independent determinant for use of updated anti-virus software [OR 4.3, 95%CI, 1.86, 10.02; P< 0.001]. Busy schedule, 40(33.9%) and lack of credit card 39(33.1%) were perceived barriers to updating antivirus software. The use of regularly updated anti-virus software is sub-optimal among physicians implying vulnerability to computer viruses. Physicians should be careful with flash drives and should avoid being victims of the raging arms race between malware producers and anti-virus software developers.Keywords: Anti-virus software; Computer security; Updates; Physicians; Nigeri

Frequency of Cryptococcal Meningitis in HIV-1 Infected Patients in North Central Nigeria

Background: Cryptococcal meningitis (CM) is the most common severe life threatening fungal infection in AIDS patients. It is an important cause of morbidity and mortality. There is paucity of data on the prevalence of CM in Nigeria. We aimed to determine the frequency of CM, the clinical presentation and immunological profile.Methods: A cross sectional study was carried out at the Jos University Teaching Hospital (JUTH), A total of 100 HIV-1 infected patients suspected of having meningitis or meningoencephalitis were subjected to cerebrospinal fluid (CSF) analysis (including Indian ink preparation and fungal culture by conventional methods) and CD4 count was determined using flow cytometry (count bit Y-R 1004 Partec Muster Germany).Results: The freguency of CM was 36% in our cohort. The commonest clinical presentation included headache (100.0%), neck stiffness (77.8%), fever (72.0%), vomiting (55.6%), personality changes (55.6%), photophobia (27.8%) and convulsions (27.8%). The mean duration of symptoms was 24 &plusmn;22 days with a median of 17 days. The mean CD4 count was 89&plusmn;60 cells/mm3 with a median of 82 cells/mm3.Conclusion: The high prevalence of CM and the associated severe immunosuppression underscores the importance of early diagnosis of HIV infection which may reduce the incidence of CM. There is the urgent need for access to Amphotericin B and fluconazole in resource constrained settings in addition to a wide access to HAART.Key words: Cryptococcal meningitis, HIV, North central Nigeri