Improvised bubble continuous positive airway pressure (BCPAP) device at the National Hospital Abuja gives immediate improvement in respiratory rate and oxygenation in neonates with respiratory distress

Background: Prematurity accounts for 25% of Neonatal mortality in Nigeria and Respiratory Distress Syndrome is responsible for half of these deaths. Introducing continuous positive airway pressure for the treatment of RDS in Nigeria where health care financing is predominantly out-of-pocket is quite challenging. It was hypothesized that applying the principle of under-water-seal pressure generation could convert a simple oxygen delivery system into an effective Bubble CPAP device.Objectives: To provide evidence in support of the immediate clinical effectiveness of the NHBCPAP device.Design/Methods: At the neonatal unit of the National Hospital Abuja, we assembled a circuit of tubing connecting a gas source (oxygen concentrator or cylinder) through an interface (nasal prongs) to the baby and this was further connected through an expiratory tube to an under-waterseal bottle to generate CPAP. The device is activated by turning on the oxygen source. The device was applied to preterm babies with RDS as well as some term babies with respiratory distress admitted into the neonatal intensive care units. Respiratory rate, SPO2 and other signs of respiratory distress were monitored before and at 1 hour, 6 hours and 12 hours after the application.Results: Forty eight newborn babies with respiratory distress were treated with the device out of whom twenty three (48%) were very low birth weight with respiratory distress syndrome. The mean respiratory rate dropped from 64.5 (19.2)/min before commencement of CPAP to 59.5(11.6)/min, 56.6 (10.5), and 56.6(10.7) at 1, 6 and 12 hours respectively, p<0.05. The corresponding values for SPO2 were 84.5(14) before and 95.9 (5.3), 95.9(6.5) and 96.9(6.4) at 1, 6 and 12 hours respectively, p<0.05. The respiratory changes were however less marked among very low birth weight babies.Conclusion: The simplified customized device produces clinical responses similar to those reported for the conventional CPAP devices

Clinical presentation of congenital malaria at the Lagos University Teaching Hospital

No Abstract

Customized bubble continuous positive airway pressure (BCPAP) device at the National Hospital Abuja for the treatment of respiratory distress syndrome (RDS)

Using the principle of under-water-seal pressure, we assembled a circuit to produce an effective Bubble Continuous Positive Airway Pressure device at theNational Hospital. The device is reasonably inexpensive and is suitable for use at secondary and tertiary health institutions for the care of the preterm infant with RDS

Congenital malaria with atypical presentation: A case report from low transmission area in India

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Isolation of Monoclonal Antibodies with Predetermined Conformational Epitope Specificity

Existing technologies allow isolating antigen-specific monoclonal antibodies (mAbs) from B cells. We devised a direct approach to isolate mAbs with predetermined conformational epitope specificity, using epitope mimetics (mimotopes) that reflect the three-dimensional structure of given antigen subdomains. We performed differential biopanning using bacteriophages encoding random peptide libraries and polyclonal antibodies (Abs) that had been affinity-purified with either native or denatured antigen. This strategy yielded conformational mimotopes. We then generated mimotope-fluorescent protein fusions, which were used as baits to isolate single memory B cells from rhesus monkeys (RMs). To amplify RM immunoglobulin variable regions, we developed RM-specific PCR primers and generated chimeric simian-human mAbs with predicted epitope specificity. We established proof-of-concept of our strategy by isolating mAbs targeting the conformational V3 loop crown of HIV Env; the new mAbs cross-neutralized viruses of different clades. The novel technology allows isolating mAbs from RMs or other hosts given experimental immunogens or infectious agents

Congenital malaria in Urabá, Colombia

<p>Abstract</p> <p>Background</p> <p>Congenital malaria has been considered a rare event; however, recent reports have shown frequencies ranging from 3% to 54.2% among newborns of mothers who had suffered malaria during pregnancy. There are only a few references concerning the epidemiological impact of this entity in Latin-America and Colombia.</p> <p>Objective</p> <p>The aim of the study was to measure the prevalence of congenital malaria in an endemic Colombian region and to determine some of its characteristics.</p> <p>Methods</p> <p>A prospective, descriptive study was carried out in the mothers who suffered malaria during pregnancy and their newborns. Neonates were clinically evaluated at birth and screened for <it>Plasmodium spp</it>. infection by thick smear from the umbilical cord and peripheral blood, and followed-up weekly during the first 21 days of postnatal life through clinical examinations and thick smears.</p> <p>Results</p> <p>116 newborns were included in the study and 80 umbilical cord samples were obtained. Five cases of congenital infection were identified (four caused by <it>P. vivax </it>and one by <it>P. falciparum</it>), two in umbilical cord blood and three in newborn peripheral blood. One case was diagnosed at birth and the others during follow-up. Prevalence of congenital infection was 4.3%. One of the infected newborns was severely ill, while the others were asymptomatic and apparently healthy. The mothers of the newborns with congenital malaria had been diagnosed with malaria in the last trimester of pregnancy or during delivery, and also presented placental infection.</p> <p>Conclusions</p> <p>Congenital malaria may be a frequent event in newborns of mothers who have suffered malaria during pregnancy in Colombia. An association was found between congenital malaria and the diagnosis of malaria in the mother during the last trimester of pregnancy or during delivery, and the presence of placental infection.</p

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Clinical pattern and perinatal outcome of major congenital malformations seen at Aminu Kano Teaching Hospital Kano, Nigeria

Aims/Objective: To look at the rate of congenital malformation in the Kano area of Nigeria against the background of socioeconomic depression and high consanguinity.Methodology: A retrospective review of obvious major congenital malformations in both inborn and out born neonates admitted into the special care baby unit over a seven-year period at the Aminu Kano Teaching Hospital was done.Results: Congenital malformations accounted for 6% of the total number of admissions into the unit. There was a slight male preponderance and the mean maternal age was 24.5 years. Gastrointestinal, central nervous system and unclassified malformations were the commonest. The gastrointestinal system had the highest case fatality rate. Majority of the central nervous system cases were referred because of non-availability of a neurosurgeon. Conclusion: Prenatal diagnosis and early postnatal diagnosis will improve the outcome of babies with congenital malformations, as the intervention waiting time will be reduced. There is a need to develop a medical genetics research centre in the country. Sahel Medical Journal Vol. 9(1) 2006: 23-2

Comparative study of expansive and non-expansive soils stabilized with lime and Rice Husk Ash (RHA)

by Kaling Taki and P. Bhattachary