Assessment of the validity of rapid diagnostic test kits available in the Nigerian market for Mycobacterium tuberculosis

Tuberculosis (TB) is an infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Early diagnosis is important in TB disease control. The use of rapid diagnostic test (RDT) kits drastically reduces the time required for reaching clinical diagnosis and this has been successful in diagnosis of HIV, syphilis and more recently malaria to mention a few. What is the case for RDTs for diagnosis of tuberculosis? Thus, the aim of this study is to evaluate and compare the performances of results produced by different rapid diagnostic test strips available in the Nigerian market for TB. A total of one hundred and eighty-four (184) subjects aged between 12-68 years were recruited for the study. These were referred from the chest clinic with a high index of suspicion of TB. Sputum samples were collected for AFB detection using the Ziehl-Neelsen and Auramine-phenol staining techniques. Blood samples were collected for serology tests using five (5) different rapid diagnostic test kits from different manufacturers, HIV status determination and evaluation of the haematological parameters we carried out. As a result, there were significant differences in the results obtained between AFB tests and serological methods with P<0.01 in all cases. The sensitivity and specificity respectively of the five different kits were 28.6% and 32.0% (Nova), 19.5% and 29.2% (Fistech), 9.1% and 27.1% (Diaspot), 12.4% and 27.7% (Abcon) and 12.4% and 27.7% (Global).finally, findings from this study show that these rapid serological tests are poor in diagnosing tuberculosis and cannot be recommended for use in this environment.© 2015 International Formulae Group. All rights reserved.Keywords: Tuberculosis, rapid diagnostic tests, acid fast bacill

Serum iron markers in HIV and HIV-malaria infected participants residing in malaria endemic area of South-Eastern Nigeria

HIV and malaria co-infections affect iron status. The present study was designed to determine the collective predictive power of some iron markers in HIV infected and malaria co-infected participants. For thisstudy, 101 participants were randomly recruited from indivividuals requesting for HIV screening. The participants were grouped as ‘asymptomatic HIV participants (n=36); asymptomatic HIV-malaria co-infected participants (n=19); symptomatic HIV participants (n=16) and HIV uninfected control participants (n=30). Blood analysis were performed for HIV infection, malaria infection, haemoglobin (g/dl), CD4 + T cell count(/mm3), albumin (g/l), iron (ug/dl), UIBC (ug/dl), TIBC (ug/dl) and percent transferrin saturation (TS%). The analysis of variance (ANOVA) showed that the blood concentrations of haemoglobin (f=4.805,

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Variations in the leukocyte and cytokine profiles between placental and maternal circulation in pregnancy-associated malaria

Okezie Caleb Okamgba,1 Martin O Ifeanyichukwu,1 Ayodele O Ilesanmi,2 Lawrence N Chigbu3 1Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikwe University, Nnewi Campus, Nnewi, Anambra State, 2Department of Medical Laboratory Science, Kwara State University, Malete, Kwara State, 3Department of Microbiology, College of Medicine, Abia State University, Uturu, Abia State, Nigeria Background: Activation of immune cells by malaria infection induces the secretion of cytokines and the synthesis of other inflammatory mediators. This study compared the cytokine levels and leukocyte count between malaria-infected peripheral and placental blood of pregnant women before delivery and postpartum. The cytokines assessed include interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin-4 (IL-4), interleukin-6 (IL-6) and interleukin-10 (IL-10). Materials and methods: The subjects comprised 144 malaria-infected pregnant women and 60 malaria-infected women at post-partum stage (for placental blood collection). Others were 60 malaria-uninfected pregnant women and 40 malaria-uninfected women at postpartum stage (for placental blood collection). Forty malaria-infected and 40 malaria-uninfected nonpregnant women served as control subjects. The test groups were asymptomatic, and the control groups were apparently healthy subjects. All were aged between 17 and 44 years. Ethical approval for the study was obtained at Abia State University Teaching Hospital and Living Word Mission Hospital, Aba. Informed consent was obtained from the participants. Blood samples were aseptically collected initially from the maternal peripheral circulation and from the placenta on delivery, and tested for HIV and malaria using standard methods. IFN-γ, TNF-α, IL-4, IL-6 and IL-10 were measured by enzyme-linked immunosorbent assay technique. Kruskal–Wallis test was used for comparison of the groups. Results: IFN-γ was significantly higher in the peripheral than in placental blood (P=0.001). IL-4 and IL-10 were significantly lower in the peripheral than in placental blood (P=0.001 and P=0.004, respectively). The total leukocytes, neutrophils and lymphocyte counts were significantly higher in the placenta than in peripheral blood (P=0.001), and the mixed differential count was significantly higher in the placenta than in peripheral blood (P=0.012). Conclusion: This study has shown that the cytokine levels and leukocyte counts may differ between the peripheral and placental blood of the same women. Therefore, measurement of parameters in the peripheral circulation may not always reflect the levels in the placental blood for the assessment of immune cellular response at the materno–fetal interface. Keywords: malaria parasite density, cytokines, peripheral blood, placental blood, leukocyt

CD4 counts in HIV positive subjects before and during antiretroviral therapy

No Abstract.Journal of Biomedical Investigation Vol. 5 (2) 2007 pp. 66-6

Prevalence and intensity of malaria among HIV seropositive patients in Nnewi, Anambra state

No Abstract

CD4+ T-cells count in HIV-malaria co-infection in adult population in Nnewi, South Eastern Nigeria

The study was designed to evaluate CD4+ T-cells count in subjects with HIV-malaria co-infection in Nnewi, South Eastern Nigeria and to assess the effects any changes in CD4+ counts has on the prevalence andor severity of both illness. Two hundred and eighty-five participants aged between 16 and 72 years were recruited for the study and grouped as symptomatic HIV subjects, asymptomatic HIV subjects, HIV/AIDSsubjects on ART (Antiretroviral Therapy) and HIV-seronegative subjects. HIV and malaria parasite screening, CD4+ T-cell count and parasite density were determined using standard laboratory methods. The result showed that the prevalence of malaria infection was 75% in symptomatic HIV, 46.7% in asymptomatic HIV and 59.6% in HIV/AIDS subjects on ART respectively as opposed to 26.9% observed in the control (