Factors influencing compliance in patients with tuberculosis on directly observed therapy at Ile-Ife, Nigeria

Background: Increased morbidity and mortality of tuberculosis have been blamed on neglect of the human dimension of tuberculosis control. One of such factors included in human dimension is non-compliance, a behavioural parameter, which has led to the emergence of multi-drug resistant tuberculosis, and poor treatment outcome.Objective: To explore the impact of directly observed therapy (DOT) on compliance and the factors influencing it.Design: A retrospective study.Setting: Chest clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.Methods: Directly observed therapy (DOT) was employed. Records of the socio-demographic characteristics, treatment categories, complications developed, results of investigations, level of compliance and treatment outcome for the patients were kept. The data for thepatients seen between May 1996 and April 1997 were retrieved and analysed. Those that complied were compared with those that did not comply.Results: One hundred and ninety nine patients comprising ninety one males and 108 females, were seen during the period .They were mostly between the ages of 16 years and 45 years(mean ± SD = 31.7±14.98). One hundred and fifty eight (73%) complied and all of themwere cured. The only factor that significantly influenced rate of compliance was proximity to the chest clinic.Conclusion: DOT improves the rate of compliance. No socio-demographic factors considered significantly influenced the rate of compliance under DOT, and as such they are not reliablepredictive factors. Locating chest units in the existing primary health care facilities will improve the rate of compliance with antituberculosis therapy. More attention should be paid to behavioural aspect of tuberculosis control

Seroprevalence of IgG anti- T. Gondii antibody among HIV-infected patients in Maiduguri, north eastern Nigeria.

Background: Toxoplasma gondii infection is one of the commonest opportunistic infections in HIV-infected patients, with the fatal consequences of toxoplasmic encephalitis particularly in advanced disease. However, data regarding T.gondii infection in the setting of HIV/AIDS are scant in Nigeria. Objective: To determine the seroprevalence of T.gondii amongst HIV-infected patients as well as to determine the correlation between anti-T.gondii IgG titre and the CD4+ cell count/HIV-1 RNA viral load. Method: A cross sectional study in which a total of 190 subjects were involved i.e. 110 newly diagnosed HAART naïve HIV-positive patients and 80 apparently healthy HIV-negative age- and-sex matched controls that were selected by simple random sampling method. Results: The age range of the study population was 20-64 years. The mean ages of male subjects for both HIV-positives and controls were 37.52 ±8.20 years and 35.79 ±12.31years, respectively, (p= 0.462). On the other hand, the mean ages of female subjects for both HIV-positives and controls were 29.90 ±6.98 years and 32.30 ±10.29 years, respectively, (p=0.149). Twenty one subjects (19.1%) among HIV-positives and 1 (1.25%) HIV-negative tested positive for anti-T.gondii IgG, respectively, (p= 0.000). The prevalence rate ration of anti-T. gondii IgG of HIV positives compared to HIVnegatives was 15.28. Significant proportion of anti-T.gondii positive subjects presented with AIDS defining illnesses compared with their anti-T.gondii negative counterparts. Conclusion:The study has shown that anti-T.gondii IgG is about 15 times more prevalent among HIV positive patients compared to controls. Routine screening for T.gondii IgG anti-body is therefore recommended for all HIV-infected subjects at the facility as well as commencement of chemoprophylaxis against Toxoplasmic encephalitis in HIV-infected patients with CD4+ cell count of <100 cells/ml

Limited emergence of resistance to integrase strand transfer inhibitors (INSTIs) in ART-experienced participants failing dolutegravir-based antiretroviral therapy: a cross-sectional analysis of a Northeast Nigerian cohort

Background Due to the high prevalence of resistance to NNRTI-based ART since 2018, consolidated recommendations from the WHO have indicated dolutegravir as the preferred drug of choice for HIV treatment globally. There is a paucity of resistance outcome data from HIV-1 non-B subtypes circulating across West Africa. Aims We characterized the mutational profiles of persons living with HIV from a cross-sectional cohort in North-East Nigeria failing a dolutegravir-based ART regimen. Methods WGS of plasma samples collected from 61 HIV-1-infected participants following virological failure of dolutegravir-based ART were sequenced using the Illumina platform. Sequencing was successfully completed for samples from 55 participants. Following quality control, 33 full genomes were analysed from participants with a median age of 40 years and median time on ART of 9 years. HIV-1 subtyping was performed using SNAPPy. Results Most participants had mutational profiles reflective of exposure to previous first- and second-line ART regimens comprised NRTIs and NNRTIs. More than half of participants had one or more drug resistance-associated mutations (DRMs) affecting susceptibility to NRTIs (17/33; 52%) and NNRTIs (24/33; 73%). Almost a quarter of participants (8/33; 24.4%) had one or more DRMs affecting tenofovir susceptibility. Only one participant, infected with HIV-1 subtype G, had evidence of DRMs affecting dolutegravir susceptibility—this was characterized by the T66A, G118R, E138K and R263K mutations. Conclusions This study found a low prevalence of resistance to dolutegravir; the data are therefore supportive of the continual rollout of dolutegravir as the primary first-line regimen for ART-naive participants and the preferred switch to second-line ART across the region. However, population-level, longer-term data collection on dolutegravir outcomes are required to further guide implementation and policy action across the region

Review Article: Malaria Vaccine: The Pros and Cons

Background: Malaria is an important parasitic disease of humans caused by infection with a parasite of the genus Plasmodium and transmitted by female anopheles. Infection caused by P. falciparum is the most serious of all the other species (P. ovale, P. vivax and P. malariae) especially in terms of morbidity and mortality hence the reason why most of the research has been focussed on this species. The disease affects up to about 40 per cent of the world's population with around 300-500 million people currently infected and mainly in the tropics. It has a high morbidity and mortality especially in resource-poor tropical and subtropical regions with an economic fall of about US$ 12 billion annually in Africa alone. relevant literatures were reviewed from medical journals, library search and internet source. Other relevant websites like PATH, Malaria Vaccine Initiative and Global Fund were also visited to source for information. The key words employed were: malaria, vaccine, anopheles mosquito, insecticide treated bed-nets, pyrethroids and Plasmodium. several studies have underscored the need to develop an effective human malaria vaccine for the control and possible eradication of malaria across the globe with the view to reduce the morbidity and mortality associated with the disease, improve on the social and economic losses and also protect those at risk. It is very obvious that the need for effective human malaria vaccine is not only to serve those living in malaria endemic regions but also the non-immune travellers especially those travelling to malaria endemic areas; this would offer cost effective means of preventing the disease, reducing the morbidity and mortality associated with it in addition to closing the gap left by other control measures. It is very obvious that there is no single control measure known to be effective in the control of malaria, hence the need for combination of more than one method with the aim of achieving synergy in the total control and possible eradication of the disease. It suffices to say that despite the use of combination of more than one method (e.g. drugs treating patients, breaking the life cycle of the vector mosquito using larvicides, clearing swamps and other mosquito breeding sites), no much progress was made towards achieving this goal, hence the renewed interest especially with regards to vaccine development.Key words: malaria, vaccine, anopheles mosquito, insecticide treated bed-nets, pyrethroids and plasmodiu

Factors influencing compliance in patients with tuberculosis on directly observed therapy at Ile-Ife, Nigeria

Background: Increased morbidity and mortality of tuberculosis have been blamed on neglect of the human dimension of tuberculosis control. One of such factors included in human dimension is non-compliance, a behavioural parameter, which has led to the emergence of multi-drug resistant tuberculosis, and poor treatment outcome

Knowledge, perception and impact of COVID-19 on practice of doctors in an insurgency affected area

Objective: This study aimed to assess the knowledge, perception and impact of COVID-19 on doctors practising in an insurgency-afflicted Borno State, North-Eastern Nigeria.Method: A cross-sectional study conducted using pretested Google forms questionnaire. Data were analysed using SPSS version 25. A multidimensional score with cut-off of ≥8 was used to rate doctors’ level of knowledge and a p-value of <0.05 was considered significant.Results: One hundred and thirty-nine (139) doctors (mean ± SD age: 34.7 ± 6.1years, 96 (69.1%) males) completed the survey. Eighty-five (61.2%) were not aware of the origin of SARS-COV-2. Only 42 (30.2%) and 19 (13.7%) knew about the commonest mode of transmission and the earliest symptom of COVID-19, respectively. Few (23.7%) understood why children have milder disease. Only 44 (31.7%) doctors had a score of ≥8. Majority (133, 95.7%) observed standard measures to curb COVID-19 transmission in their practice. Only 38 (27.3%) had medical journals and other academic arenas as their predominant source of information. All attested that COVID-19 has profoundly affected their practice; 85% suspended academic activities. Majority (94.2%) perceived that COVID -19 would be worse in IDP camps and 54 (38.8%) believed that insurgency could limit COVID-19 patients from accessing care. Most (116, 83.4%) participant anticipated a change in their practice after the pandemic.Conclusion: There is a dearth of information on COVID-19 among doctors practising in an insurgency affected area. The pandemic has significantly changed their medical practice now and will possibly affect their future views about modes of practice during a pandemi

Semantic Image Retrieval with Feature Space Rankings

Learning to hash is receiving increasing research attention due to its effectiveness in addressing the large-scale similarity search problem. Most of the existing hashing algorithms are focused on learning hash functions in the form of numeric quantization of some projected feature space. In this work, we propose a novel hash learning method that encodes features\u27 relative ordering instead of quantizing their numeric values in a set of low-dimensional ranking subspaces. We formulate the ranking-based hash learning problem as the optimization of a continuous probabilistic error function using softmax approximation and present an efficient learning algorithm to solve the problem. As a generalization of Winner-Take-All (WTA) hashing, the proposed algorithm naturally enjoys the numeric stability benefits of rank correlation measures while being optimized to achieve high precision with very compact code. Additionally, the proposed method can also be easily extended to nonlinear kernel spaces to discover ranking structures that can not be revealed in linear subspaces. We demonstrate through extensive experiments that the proposed method can achive competitive performances as compared to a number of state-of-The-Art hashing methods