Hepatitis Delta Virus in Patients Referred for Malaria Parasite Test in Ile-Ife, Nigeria

Hepatitis delta virus (HDV) infection is considered the most severe form of human viral hepatitis. The infection only occurs in the presence of a concomitant hepatitis B virus (HBV) and leads to severe liver disease that includes fulminant liver failure and rapid progression to cirrhosis, as well as increased risk of hepatocellular carcinoma (HCC). Diverse data exist on HBsAg carrier rates, but not much is known about the rates of HDV co-infection in cases of HBV infections in Nigeria. More so, HDV has not been detected in people with unknown HBV status or people who had no clinical evidence of liver disease in Nigeria. We therefore determined the prevalence of HBV and HBV/HDV co-infection in patients without clinical evidence of liver disease referred for malaria parasites test from two health institutions in Ile-Ife, Nigeria, using one step HBsAg diagnostic kit (Nova Diagnostic®, USA) and HDV IgM and IgG ELISA kit (Dia.Pro, Italy). Of the 275 patients tested, 38 (13.8 %) were HBsAg positive and 12 (31.6%) of them had antibody to HDV, hence HBV/HDV prevalence in the study population was 4.4 % (12/275). The result of this study shows a significant HBV/HDV prevalence in the study population, and the need for public enlightenment to further improve management. There is also the need to consider HDV screening in patients with no clinical evidence of liver disease. Keywords: HDV, Hepatitis B, co-infection,, ELISA, Nigeri

Hepatitis B Core IgM antibody (anti-HBcIgM) among hepatitis B Surface antigen (HBsAg) negative blood donors in Nigeria

<p>Abstract</p> <p>Background</p> <p>Transfusion associated Hepatitis B virus (TAHBV) continues to be a major problem despite mandatory screening for Hepatitis B surface Antigen (HBsAg). Presence of HBsAg is the common method for detecting hepatitis B infection. Unfortunately, this marker is not detected during the window period of the infection. Nigeria being a developing country cannot afford DNA testing of all collected units of blood which serve as the only possibility of achieving zero risk of transfusion associated HBV. Five different serological makers of hepatitis B virus (HBV) infection were therefore assessed to evaluate the reliability of using HBsAg marker alone in diagnosis of HBV infection among blood donors and to detect the serological evidence of the infection at the window period. This will preclude the possibility of transmitting hepatitis B through transfusion of Hepatitis B surface antigen (HBsAg) negative blood in Nigeria.</p> <p>Methods</p> <p>Between July and August 2009, 92 blood donors were enrolled for the study. The prevalence of 5 different markers of Hepatitis B virus infection was detected using Enzyme Linked Immunosorbent Assay (ELISA). Demographic factors were assessed during the study.</p> <p>Results</p> <p>HBsAg and its antibody (anti-HBs) was detected in 18 (19.6%) and 14(15.2%) of the 92 blood donors respectively. Anti-HBc IgM was found in 12(13.0%) of the 92 blood donors while Hepatitis B envelope antigen (HBeAg) and its antibody (anti-HBe) were detected in 4(8.9%) and 12(26.7%) respectively from 45 donors sampled. HBeAg is a marker of high infectivity and appears after HBsAg. At least one serological marker was detected in 30(32.6%) of the blood donors. Five (5.4%) of the 92 donors had anti-HBc IgM as the only serological evidence of hepatitis B virus infection.</p> <p>Conclusions</p> <p>The result of this study shows that five donors have anti-HBcIgM as the only serological evidence of HBV infection. Inclusion of anti-HBcIgM in routine screening of blood donors in Nigeria should be encouraged. This is the first study to assess anti-HBcIgM in the country.</p

High Prevalence of Anti-HCV Antibodies Among Pregnant Women in Southwestern Nigeria

Hepatitis C virus (HCV) is the most common cause of cirrhosis, hepatocellular carcinoma and liver transplantation. While universal screening for other blood-borne viruses (BBVs) such as HIV and HBV among pregnant women is recommended in Nigeria, no such recommendation exist for HCV in the country. Despite recently developed direct-acting antiviral agents (DAAs) to cure HCV at high rates and at very high cost, the absence of an HCV vaccine or approved therapy during pregnancy makes prevention of vertical transmission impossible at the moment. Using a commercially available enzyme linked immunoassay technique, prevalence of antibodies to hepatitis C virus (anti-HCV) was determined among pregnant women attending antenatal clinics in Southwestern Nigeria. Of the 273 serum samples obtained from the pregnant women 9.5% was positive for anti-HCV antibody. There were differences in anti-HCV prevalence by age and locality. Results of the study confirm endemicity of HCV among pregnant women in the country, consequently, we advocate free screening, among other essential measures for HCV intervention in Nigeria. Keywords: HCV, Hepatitis, Pregnant women, Seroprevalence, ELISA, Nigeri

Detection of Q129H Immune Escape Mutation in Apparently Healthy Hepatitis B Virus Carriers in Southwestern Nigeria

As the global effort to eradicate hepatitis B continues, immune escape mutations (IEMs) and drug resistance mutations (DRMs) affecting its diagnosis, treatment, and prevention are compromising this goal. However, knowledge about the prevalence and circulation of these mutations in Nigeria is scarce. Serum samples (n = 199) from apparently healthy prospective blood donors, pregnant women, and individuals presenting with fever in southwestern Nigeria were analyzed for the presence of IEMs and DRMs by means of nested PCR in the HBV S (HBs) and HBV polymerase (Pol) genes, followed by phylogenetic and mutational analyses. In total, 25.1% (n = 50/199) of samples were positive for HBV, as measured by PCR. In 41 samples (20.6%), both fragments could be amplified, whereas the HBs gene and the Pol gene fragment alone were detected in 0.5% (n = 1/199) and 4% (n = 8/199) of samples, respectively. Sequences were successfully obtained for all 42 HBs gene fragments but for only 31/49 Pol gene fragments (totaling 73 sequences from 44 individuals). All sequences were identified as HBV genotype E. IEMs were present in 18.2% (n = 8/44) of the sequences of HBV-positive individuals with available sequences. IEM Q129H was detected in eight out of the 44 (18.2%) HBV isolates sequenced in this study; however, no DRMs were observed. This study confirms the circulation of HBV IEMs and reports the presence of Q129H IEM for the first time in Nigeria. Intensified research on the dynamics of IEM is necessary in order to enhance the elimination of HBV.Peer Reviewe

Rotavirus and bacterial diarrhoea among children in Ile-Ife, Nigeria: Burden, risk factors and seasonality.

BackgroundDiarrhoea is a leading cause of death among under-five children globally, with sub-Saharan Africa alone accounting for 1/3 episodes yearly. Viruses, bacteria and parasites may cause diarrhoea. Rotavirus is the most common viral aetiology of diarrhoea in children less than five years globally. In Nigeria, there is scarce data on the prevalence/importance, burden, clinical/risk factors and seasonality of rotavirus and bacteria and this study aims to determine the role of rotavirus and bacteria on diarrhoea cases in children less than five years in Ile-Ife, Nigeria.MethodsSocio-demographic data, environmental/risk factors and diarrhoiec stool samples were collected from children less than five years presenting with acute diarrhoea. Rotavirus was identified using ELISA. Bacteria pathogens were detected using cultural technique and typed using PCR. Diarrhoeagenic E. coli (DEC) isolates were subjected to antimicrobial susceptibility testing. Pathogen positive and negative samples were compared in terms of gender, age-group, seasonal distribution, and clinical/risk factors using chi-square with two-tailed significance. SPSS version 20.0.1 for Windows was used for statistical analysis.ResultsAt least one pathogen was detected from 63 (60.6%) children having gastroenteritis while 28 (44.4%) had multiple infections. Rotavirus was the most detected pathogen. Prevalence of rotavirus mono-infection was 22%, multiple infection with bacteria was 45%. Mono-infection prevalence of DEC, Shigella spp., and Salmonella spp. were 5.8% (6/104), 5.8% (6/104), and 2.9% (3/104) and co-infection with RVA were 23.1% (24/104), 21.2% (22/104) and 10.6% (11/104) respectively. All rotaviral infections were observed in the dry season. The pathotypes of DEC detected were STEC and EAEC. Parent earnings and mid-upper arm circumference measurement have statistical correlation with diarrhoea (p = 0.034; 0.035 respectively).ConclusionIn this study, rotavirus was more prevalent than bacteria and occurred only in the dry season. Among bacteria aetiologies, DEC was the most common detected. Differences in seasonal peaks of rotavirus and DEC could be employed in diarrhoea management in Nigeria and other tropical countries to ensure optimal limited resources usage in preventing diarrhoea transmission and reducing indiscriminate use of antibiotics

Molecular epidemiology of hepatitis D virus circulating in Southwestern Nigeria

Background: Hepatitis B virus (HBV) and hepatitis D virus (HDV) infections are major public health problems in sub-Saharan Africa. Whereas it is known that HBV infection is endemic in Nigeria, there is only little data about HDV prevalence available. Here, we assessed the HDV seroprevalence and determined the HDV and HBV genotypes distribution among HBsAg positive individuals in Southwestern Nigeria. Methods: This cross-sectional study involved 188 serum samples from HBsAg positive outpatients recruited at four tertiary hospitals in Southwestern Nigeria. Anti-HDV antibodies were detected by ELISA while HDV-RNA was detected by RT-PCR. Sequencing followed by phylogenetic analyses and HBV genotype-specific PCR were used to characterize HDV and HBV genotypes, respectively. Results: Out of 188 HBsAg positive serum samples, 17 (9 %) showed detectable HDV-RNA. Anti-HDV antibodies test was possible from 103 samples and were observed in 4.9 % (5/103) patients. There was no significant difference in HDV prevalence between four main cities across the country. 64.7 % of HDV-RNA positive samples were from males and 35.3 % from females (P

The study of asymptomatic Plasmodium falciparum in humans infectedwith immunodeficiency virus in Ile-Ife, Nigeria

The study of the prevalence of asymptomatic Plasmodium falciparum in humans infected with immunodeficiency virus (HIV) was carried out in Ile-Ife, Osun State Nigeria. The aim of the study is to determine the prevalence of asymptomatic infection P.falciparum in HIV positive individuals and correlate it to age Parasitaemia and CD4 T cell count. Out of ninety three (93) HIV positive patients that participated in the study, 53 (58.8%) were females while 40 (41.4%) were males; 48 (52.4%) females and 35 (33.8%) males were positive for asymptomatic P. falciparum given a total number of 83 (86.6%). Twenty non-HIV patients were used as control samples: 9 (45%) were males and 11 (55%) were females. With 3.0 (33.3%) males and 5 (45.45%) females were positive with insignificant value of mean Parasitaemia of 125.0µl of blood. Age group 31-40 had the highest positive rate of 26 (32.2%) and age group 11-20 and above 60 had the least of positive rate. The correlation between age and both CD4 T cell count and Parasitaemia showed levels of significance less than 0.01 (P&lt;0.01) while the correlation between CD4 T cell and count and Parasitaemia showed no significant correlation, having P-value of P&gt;0.05. Comparing the males mean age, CD4 T cell count and Parasitaemia with that of females there was no level of significance P-value being greater than 0.05 (P&gt;0.05) each. In conclusion, the study showed that in asymptomatic Plasmodium falciparum, almost all the tested samples were positive which could be as a result of depletion in the immune level, hence there is need to always screen for Plasmodium falciparum whether in asymptomatic or symptomatic patients. The CD4 T cells count from the study can not be used for the detection or determination of the presence of malaria infection in HIV positive patients. The best method for malaria identification so far is still the staining method. There should not be discrimination when sampling the patient when investigations on HIV and malaria are to be carried out when both are infected

Rotavirus Surveillance in Urban and Rural Areas of Niger, April 2010–March 2012

To access this article, click on "Additional Links".Knowledge of rotavirus epidemiology is necessary to make informed decisions about vaccine introduction and to evaluate vaccine impact. During April 2010–March 2012, rotavirus surveillance was conducted among 9,745 children <5 years of age in 14 hospitals/health centers in Niger, where rotavirus vaccine has not been introduced. Study participants had acute watery diarrhea and moderate to severe dehydration, and 20% of the children were enrolled in a nutrition program. Of the 9,745 children, 30.6% were rotavirus positive. Genotyping of a subset of positive samples showed a variety of genotypes during the first year, although G2P[4] predominated. G12 genotypes, including G12P[8], which has emerged as a predominant strain in western Africa, represented >80% of isolates during the second year. Hospitalization and death rates and severe dehydration among rotavirus case-patients did not differ during the 2 years. The emergence of G12P[8] warrants close attention to the characteristics of associated epidemics and possible prevention measures