Serum ferritin and HCV infection on Nigerian patients with primary liver cell carcinoma

No Abstract. African Journal of Clinical and Experimental Microbiology Vol. 7(3) 2006: 149-15

Diagnostic accuracy of rapid urease test for the diagnosis of Helicobacter pylori gastic biopsies in Nigerian with dyspepsia

Background: The strong association of Helicobacter pylori (H. pylori) with dyspepsia has caused a major paradigm shift in patients’ management. It has been observed that histology is usually employed as the routine test for the diagnosing H. pylori in centres where  Oesophagogastroduodenoscopy (OGD) is available in Nigeria. Because of the drawbacks attendant to the use of histology, in terms of cost effectiveness and technical expertise, it is necessary to evaluate the diagnostic accuracy of a simpler alternative for ease of management of patients with dyspepsia.Objective: This study evaluated the diagnostic accuracy of rapid urease test (RUT) in the diagnosis of Helicobacter pylori (H. pylori) in patients with dyspepsia.Methods: Eighty-six consecutive adult patients with dyspeptic symptoms presenting for endoscopy were recruited after giving informed consent. Gastric antral biopsies were collected at endoscopy for RUT and histology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of RUT was calculated using histology as the referencestandard. Results: Of the 86 subjects, there were 39 (45.3%) males and 47(54.7%) females. The mean age was 49.19±13.75 years. The age range was 23 to 85 years. The sensitivity, specificity, PPV, NPV of RUT was 93.33%, 75.6 %, 80.76 %, and 91.17 % respectively.Conclusion: RUT is accurate for the diagnosis of H. pylori infection. Its use will serve as a good alternative to histology in management of patients with dyspepsia in resource poor environments, except in patients who need histology for reasons other than H. Pylori diagnosis.Key words: Dyspepsia, Helicobacter pylori, Rapid Urease test, Histology

Hepatitis B immunization at the University College Hospital, Ibadan: an eight year review of vaccine administration records

Vaccination of health care workers (HCWs) against hepatitis (HBV) infection is highly necessary in Nigeria where the infection occurs in hperendemic proportions. We hereby determine the trends in the administration of HBV vaccine at the University College Hospital (UCH), Ibadan, Nigeria. The study reviewed the records for the administration of vaccine against HBV at the Staff Medical Services Department of UCH, Ibadan, Nigeria, from 1994 to 2001. A total of 1,437 subjects consisting of 686 (47.7%) males and 751 (52.3 %) females were vaccinated against HBV from 1994 to 2001. They were aged 16 to 64 years and consisted of 356 students (24.8%) and 1081 healthcare workers (HCWs) (75.2%) which comprised Doctors (30.9%), Dentists (1.9%), Paramedics (19.6%), Non-medics (14.6%) and subjects with undisclosed occupational category ((10.7%). About 11% to 100% of the subjects had annual prescreening for HBsAg sero-negativity from 1996 to 2001 but none had post vaccination assay of anti-HBs titre. All the subjects received 1st dose of 0, 1, 2 accelerated HBV vaccination schedule while on annual basis, 16.7% to 91.8% of the subjects received the 3rd dose of the vaccine. Despite the proportional participation of the different occupational groups was highest among the doctors and dentists but lowest among the paramedics, only 59.7% of all the vaccinees had three dose(s) of the vaccine during the 8 year period. In conclusion, although the HBV vaccination programme had shortcomings, it is an established practice at UCH, Ibadan and efforts should be made to improve on its prevailing standard.Keywords: Immunization, HBV, Healthcare Workers, Nigerians, UCH, Ibadan

Correlation of Serum Anti-Helicobacter pylori Immunoglobulin A (IGA) with Histological Parameters of Chronic Gastritis in Ibadan, Nigeria

Background: The seroprevalence of anti-H. pylori IgA antibodies has been reported to vary among populations and in relation to strains of Helicobacter pylori bacterium. However, there has been conflicting reports on the association between IgA serological status and the histological variables of chronic gastritis. This study was therefore conducted to clarify this relationship.Method : Using an ELISA based commercial kit, anti-H. pylori IgA antibodytests were performed on 65 dyspeptic patients and 65 age- and  ex-matched controls. The gastric biopsies of these patients were also examined histologically for the degrees of inflammation, activity, intestinal metaplasia and atrophy. The CagA status of the patients had been determined previously.Results: There was an anti-H. pylori IgA antibody prevalence of 67.7% in dyspeptics and 56.9% in non-dyspeptic individuals. No correlations were observed between serum H. pylori IgA antibody and the graded parameters of chronic gastritis in dyspeptic patients, although twice more patients withmild gastric inflammation were found among IgA positive than among IgA negative patients. However, a statistically significant relationship was established between serum IgA positivity and the CagA status of the patients (p = 0.028).Conclusion: The seroprevalence of anti-H. pylori IgA antibody is high inour environment. Serum IgA status may be associated with milder degreesof gastritis in our patients but a larger cohort of patients is needed to confirm this. There seems to be a good agreement between serum IgA and CagA statuses among dyspeptic patients

Prevalence of Helicobacter pylori among Nigerian patients with dyspepsia in Ibadan

Introduction: Determination of the true prevalence of Helicobacter pylori (H. pylori) is difficult in a hyper-endemic area like Nigeria with use of serological tests because of their low discriminatory power between previous and current infections. The use of biopsy based methods will go a long way to mitigate this problem. We investigated the prevalence of H. pylori in dyspeptic patients and its relationship with gastroduodenal pathologies using gastric biopsy histology and rapid urease test. Methods: Eighty-six consecutive adult patients with dyspepsia underwent upper gastrointestinal endoscopy using forward-viewing endoscopes. Antral biopsy specimens were collected for histology and rapid urease test. Diagnosis of H. pylori infection was made if both or either of the tests was positive. Results: Of the 86 subjects, there were 39 (45.3%) males and 47(54.7%) females. The age range was 23 to 85 years with a mean of 49.19±13.75 years. Diagnosis of H. pylori was made in 55(64%) patients. Gastritis was the commonest endoscopic finding (60.5%), serious gastroduodenal pathology (gastric ulcer, duodenal ulcer and gastric cancer) were documented in only 12 (14%) patients. Thirty three (63.5%) of the 55 patients with gastritis had H. pylori infection while 7(58.3%) of the 12 patients with serious gastroduodenal lesions had the infection. Thirteen (72.2%) of the 18 patients that had normal endoscopic findings were H.pylori positive. Conclusion: The prevalence of H. pylori among dyspeptics using biopsy based methods is high in the South-Western part of Nigeria. It is therefore important to test and treat H. pylori among Nigerians with dyspepsia

Serum Hepatitis C virus and hepatitis B surface antigenaemia in Nigerian patients with acute Icteric hepatitis

Acute hepatitis is common in Nigeria and hepatitis B virus (HBV) infection has been a major aetiological factor. However, the role of Hepatitis C virus (HCV) infection is yet undetermined. Forty-five consecutive Nigerian patients with acute Icteric hepatitis (AIH) attending the Medical Clinic of the University College Hospital, Ibadan, Nigeria and 45 healthy adult Nigerians (controls) were studied for evidence of infection with both viruses. Questionnaire on risk procedures, which predispose to acquisition of both HBV and HCV infections were administered to the patients. Blood samples were collected from all the subjects and tested for antibody to HCV (anti-HCV) and Hepatitis B surface Antigen (HbsAg) using the second generation enzyme Linked Immunoassay (Monolisa -R, Sansofi, Pasteur; France). Anti-HCV was detected in 21(47%) and 17(38%) of the patients and controls respectively. The corresponding prevalence of HbsAg were 38(84%) and 11(24%), p<0.001. Hepatitis b virus infection was found to occur more than HCV infection in the patients with AIH but similar among the controls. Combined HBV and HCV infection occurred more frequently among the patients (42.1%) than in the control (11%); (<0.001). Although there was no significant difference in the HCV infection between the two groups, isolated HCV infection is commoner in the control than in the patients with AIH, (p<0.001). Similarly, single HCV infection is commoner than lone HBV infection among the control, p<0.05. In summary, this study shows that while both HBV and HCV infections are common in Nigeria, AIH may be more associated with HBV than HCV in the country