Toxoplasma Gondii Infection in HIV/AIDS: Prevalence and Risk Factors

BACKGROUND: Toxoplasmosis is an infection caused by the protozoan Toxoplasma gondii. It is common in severely immunecompromisedpersons.OBJECTIVE: To determine the seroprevalence of T. gondii infection and the risk factors associated with the infection and to investigate the association between T. gondii infection and CD4 cell count.METHODS: Sera collected from 242 HIV positive HAART- naive patients were tested for T. gondii specific immunoglobulin G antibodies. Information was obtained using a structured questionnaire. Baseline CD4 cell counts were obtained from patients case files. Data was managed using SPSS version 20 software and Microsoft Excel worksheet.RESULTS: One hundred and sixty eight (69.4%) subjects were females while 74(30.6%) were males. One hundred (41.3%) of study participants were Toxoplasma IgG antibody positive. Thirty two(32) HIV positive pregnant women were among this group studied with 12( 37.5%) being Toxo IgG antibody positive. Toxoplasma seropositivity was higher in females (42.8%) than in males (39.2%), P= 0.60. CD4 cell count level of < 200 was negatively associated with Toxoplasma seropositivity than CD4 count . 200 by logistic regression (OR= 0.6; 95% CI 0.3- 1.0). Living in proximity with cat was positively associated with T. gondii infection (P= 0.01).CONCLUSION: T. gondii infection is common in pregnant women indicating greater probability of congenital transmission of T. gondii. This could form a basis for recommending intensifying health education and prophylactic treatment for all HIV positive pregnant women. Measures should be taken to prevent stray cats from entering homes.Keywords: Toxoplasma gondii , IgG, Seroprevalence, HIV positive, CD4 cells

Acanthus montanus: An experimental evaluation of the antimicrobial, anti-inflammatory and immunological properties of a traditional remedy for furuncles

<p>Abstract</p> <p>Background</p> <p><it>Acanthus montanus </it>(Nees) T. Anderson (Acanthaceae) is a shrub widespread in Africa, the Balkans, Romania, Greece and Eastern Mediterranean. It is used in African traditional medicine for the treatment of urogenital infections, urethral pain, endometritis, urinary disease, cystitis, leucorrhoea, aches and pains. In southeastern Nigeria, the root is popular and acclaimed highly effective in the treatment of furuncles. This study was undertaken to experimentally evaluate the antimicrobial and anti-inflammatory properties of the root extract as well as its effect on phagocytosis and specific cell-mediated immune response which may underlie the usefulness of the roots in treatment of furuncles.</p> <p>Methods</p> <p>The aqueous root extract (obtained by hot water maceration of the root powder) was studied for effects on the growth of clinically isolated strains of <it>Pseudomonas aeruginosa </it>and <it>Staphylococcus aureus</it>. The anti-inflammatory activity was investigated using acute topical edema of the mouse ear induced by xylene, acute paw edema induced by agar in rats, formaldehyde arthritis in rats, vascular permeability induced by acetic acid in mice and heat- and hypotonicity-induced haemolysis of ox red blood cells (RBCs). Also evaluated were the effects on <it>in vivo </it>leukocyte migration induced by agar, phagocytic activity of macrophages on <it>Candida albicans </it>and specific cell-mediated immune responses (delayed type hypersensitivity reaction (DTHR) induced by sheep red blood cell (SRBC)). The acute toxicity and lethality (LD₅₀) in mice and phytochemical constituents of the extract were also determined.</p> <p>Results</p> <p>The extract moderately inhibited the growth of the test organisms and significantly (<it>P </it>< 0.05) inhibited (57%) topical acute edema in the mouse ear. It significantly (<it>P </it>< 0.05) suppressed the development of acute edema of the rat paw in a non-dose-related manner and was not effective in inhibiting the global edematous response to formaldehyde arthritis. It also inhibited vascular permeability induced by acetic acid in mice and the haemolysis of ox RBCs induced by heat- and hypotonicity. The extract increased total leukocyte and neutrophil counts and caused a significant (<it>P </it>< 0.05) dose-related increase in the total number of macrophages at the 800 mg/kg dose. On phagocytic activity, the extract evoked a significant (<it>P </it>< 0.05) increase in the number of macrophages with ingested <it>C. albicans </it>at 800 mg/kg dose, and significantly (<it>P </it>< 0.05) inhibited DTHR in a dose-related manner. Phytochemical tests on the extract revealed an abundant presence of alkaloids and carbohydrates while saponins, glycosides, and terpenoids occurred in trace amounts. Acute toxicity test established an oral and intraperitoneal LD₅₀greater than 5,000 mg/kg.</p> <p>Conclusion</p> <p>The effectiveness of the root of <it>A. montanus </it>in the treatment of furuncles may largely derive from mobilization of leukocytes to the site of the infection and activation of phagocytic activity as well as suppression of exacerbated immune responses by its constituents. Antimicrobial and anti-inflammatory activities are likely contributory mechanisms. Phytochemical constituents such as alkaloids and carbohydrates may be responsible for these pharmacological activities.</p

Topical‑intracameral anesthesia in manual small incision cataract surgery: A pilot study in a Tertiary Eye Care Center in Africa

Background: Cataract remains a leading cause of blindness worldwide. Manual small incision cataract surgery (MSICS) is currently practiced as the technique of choice in Sub‑Saharan Africa to reduce the backlog of cataract blindness. Optimal pain control during surgery remains a challenge to cataract surgeons.Aim: To evaluate the efficacy and safety profile of the use of aqueous topical/intracameral anesthesia in MSICS.Materials and Methods: In this hospital‑based case series, consecutive patients presenting at the eye clinic with operable cataract and willing to have surgery were enrolled. Baseline sociodemographics (age, sex, and occupation), type of cataract by morphology, pain perception, and surgeons experience were recorded. Descriptive and comparative statistical analyses were performed. A P &lt; 0.05 was considered statistically significant.Results: The surgeries were performed on 30 eyes of 16 (53.3%) males, and 14 (46.7%) females (sex ratio, 1:0.9) who were aged 60.3 ± 16.32 standard deviation (SD) (95% confidence interval [CI] of mean; 53.94–66.13) (range; 20–98 years). Using the visual analog scale, the mean pain score was 2.7 SD ± 2.215 (1.87–3.53 95% CI). There was no correlation between degree of pain perception and gender (P = 0.806) or age (P = 0.388). Patient’s cooperation was excellent in 22 (73.3%) of patients. Intraoperative complications occurred in 3 (10%) of patients.Conclusion: The mean pain score in this study is low. There is no correlation between perception of pain with gender or age. Surgeons experience is excellent in most of the cases. This method of anesthesia in MSCIS is adequate for patient’s comfort and safe cataract surgery.Key words: Anesthesia, cataract surgery, intracameral, topica

Perception and Practice of Periodic Medical Checkup by Traders in South East Nigeria

BACKGROUND Periodic medical checkup helps improve life expectancy. Traders are a major economically active population in south eastern Nigeria and are expected to benefit from periodic medical checkup. A good knowledge and understanding of the prevailing health knowledge, attitude and preventive health behaviour of these traders is essential for creating population-specific health programs. OBJECTIVES To determine the knowledge, attitude and practice of periodic medical checkup by traders in South east Nigeria, as well as the influence of age, gender and educational status on its practice in this group. METHODS: A questionnaire- based descriptive study carried out among traders in Nnewi, South east Nigeria, who were selected randomly between September and October 2010. A total of 323 traders responded, 252 males (78.0%) and 71(22.0%)females. Themeanagewas 31.9± 10 years and the ages ranged from15 to 65 years withmajority(49.2%) between 20-29 years. Majority (61.0%) had secondary school education and 1.2% had post secondary school education. About 74.9% were aware of periodic medical checkup; all females and 67.9% of males. Major source of information was through friends (61.2%), then mass media(18.2%). The commonest known type of medical checkup was general examination (60.7%), then blood pressure measurement (55.4%). About 63.8% feel everybody needs medical checkup. Most (85.5%) feel medical checkups can improve their work efficiency. Only 29.4% of males and 39.4% of females practice periodic medical checkup. Age, gender and educational status were found not to affect practice of periodic medical checkup significantly. CONCLUSION: This study revealed a high level of awareness of periodic medical checkup, but a very low level of practice among this group. Effort should be made by health agencies to educate traders on the various types of medical check up, their indications and benefits as well as its practice encouraged. Keywords: Periodic medical checkup, traders,Nigeria