Seroprevalence of Hepatitis B Surface Antigen among patients attending Aminu Kano

Background: Hepatitis B virus infection has become a global public health problem. In Nigeria, several studies from different parts of the country have confirmed the endemicity of the infection. This study seeks examine the seroprevalence of Hepatitis B viral infection among patients attending Aminu Kano Teaching Hospital in Kano metropolis. Method: This is a retrospective study in which patients tested for hepatitis B virus using hepatitis B surface antigen (HBsAg) as a marker were reviewed over 3 years. A total of 6,395 patients comprising of 4,040 males and 2,355 females including adults and children were tested for HBsAg from January 2004 to December 2006. Over this period, 1,509 sera were tested in 2004, 2,322 in 2005 and 2,564 in 2006. Results: Among the 6,395 patients, 703(11.4%) comprising of 240 (10.2%) females and 490 (12.1%) males were positive for HBsAg. The highest prevalence was seen at the extremes of life in which 19.4% and 16.9% were seen among patients below 10years and above 50 years respectively. The yearly trend of HBV surface antigenemia was 220 (14.6%) in 2004, 235 (10.1%) in 2005 and 275 (10.7%) in 2006. Conclusion: We conclude that the prevalence of HBsAg among patients attending Aminu Kano Teaching Hospital, Kano is high and highest prevalence is seen at the extremes of life.Key Words: Hepatitis B, Hepatitis B surface antigen (HBsAg), Kano

An overview of the aetiologic agents of diarrhoea diseases in children: How far have we gone in management and control?

Diarrhoea disease is the second leading cause of death amongst Nigerian children  (after malaria) with a prevalence rate in Nigeria of 18.8% which is one of the worst in sub-Sahara Africa. A major contributor to childhood morbidity and mortality, causes  4 million deaths each year in under-fives with each child experiencing about 5 episodes of diarrhoea yearly. We review diarrhoea diseases in children with focus on infectious diarrhoea with the aim of looking at the progress made so far in its management and control. Diarrhoea can be classified into acute and chronic;  secretory, osmotic, inflammatory or due to impaired motility;  infectious and non-infectious. In developing countries, infections are the most common causes of acute watery diarrhoea in  children, whereas chronic diarrhoea results from  non-infectious causes like inherited metabolic disorders, sensitivity to gluten orneoplasm. Diagnosis includes a careful history from the patient, examination of stool sample and examination of faecal swab  samples where stool is not available. Diarrhoea in this age group is mostly of infectious origin and can be viral, bacterial, parasitic or fungi. Treatment in this environment is primarily supportive with oral or intravenous fluid and preventive measures include  domestic hygiene promotion, breast-feeding promotion, improved weaning practices, probiotic use, oral  rehydration therapy with additional L-glutamine, zinc supplementation and  vaccination against childhood infectious diseases like rotavirus, measles and cholera. An aluminmagnesium silicate, Smectite® has been found to be of potential benefit in the management of diarrhoea. Use of Rotavirus vaccines, probiotics and Smectite® is being advocated

Open comparative efficacy of some artemisinin-based combinations for treatment of acute uncomplicated plasmodium falciparum malaria in Ilorin Nigeria

Widespread resistance of Plasmodium falciparum to chloroquine and sulfadoxinepyrimethamine has prompted the federal government of Nigeria, in line with WHO recommendations to adopt artemisinin-based combinations as first-line treatment of acute uncomplicated Plasmodium falciparum malaria. We evaluated 3 artemisinin-based combinations available in the Nigerian market to determine their efficacy and tolerability. Adequate clinical and parasitological response (ACPR) was comparable between artemetherlumefantrine (A-L) and artesunate-amodiaquine (AS-AQ) groups (92.8% v 91.2%, p = 0.79), both combinations being significantly more efficacious than artesunate-sulfadoxinepyrimethamine (AS-SP) group (A-L v AS-SP 92.8% v 69%; p = 0.005); (AS-AQ v AS-SP 91.2% v 69%; p = 0.018). Drug-related adverse events were significantly higher among the AS-AQ group compared to other treatment combinations (p = 0.004). We conclude that A-L and ASAQ have high comparative cure rates among patients evaluated in ilorin, Nigeria. Tolerability concern should play an important consideration when prescribing AS-AQ especially among adult patients

Multiple antibiotic resistance iIndex of EscherichiaColi isolates in a tertiary hospital in south-west Nigeria

Background: The effectiveness of available antibiotics is reducing as  microorganisms device means of evading its effects, resulting in the development of superbugs. Pathogens previously susceptible are becoming resistant, and spreading beyond the hospital environment. This change is a major concern for infection control and prevention and a huge economic burden for health care. This study aims to determine the drug sensitivity pattern of E. coli isolated in a tertiary hospital labMethodology: Gram negative bacilli, lactose fermenter, motile, indole positive,  glucose fermenter, gas producing isolate were identified as E.coli. Antimicrobial susceptibility testing to commonly prescribed antibiotics was carried out using the modified Kirby Bauer method and reported with the Clinical and Laboratory Standard Institute Interpretative chart. Mulitiple Antibiotic Resistance index was calculated as number of antibiotics to which isolate is resistant divided by the total number of antibiotics against which isolate was tested.Result: Five hundred and twenty–seven isolates were identified, among which a high rate of resistance to cefuroxime (407), high rate of intermediate susceptibility to nalidixic acid (264) and high rate of sensitivity to ceftriaxone (388) was noted. Sixty percent of the isolates had an index 0.2. Of the 40% with Multiple Antibiotic Resistance index > 0.2, 61 % were from inpatient samples.Conclusion: The high Multiple Antibiotic Resistance index of the E. coli isolates indicates previous exposure to antibiotics and development of resistance to commonly prescribed antibiotics, hence, antimicrobial susceptibility testing is imperative in selecting therapeutic options. Attention also needs be paid to effective infection control and prevention to curb its spread among individuals