Oncogenic human papilloma virus infection among women attending the cytology clinic of a tertiary hospital in Lagos, South-West Nigeria

Background:Cervical cancer is the most common gynaecological cancer and a leading cause of cancer death in women in Nigeria. Persistence infection with high risk or oncogenic Human Papillomavirus (HPV) types is now known to be a necessary cause of cervical cancer.Methods:This study is a descriptive cross-sectional study carried out to determine the prevalence and distribution of oncogenic HPV infection among women seen at the cytology clinic of a tertiary hospital in Lagos South-west Nigeria and then identify the likely predisposing factors to this infection. Eligible women were selected by consecutive sampling method for the study. Pap smear and endocervical swab samples were collected from each participant. The endocervical swab samples were screened for HPV types 16, 16A, 31, 33 and 35 by the multiplex Polymerase Chain Reaction (PCR) using the specific primers for the HPV types.Results: Twenty-four (30.4%) of the 79 tested swab samples were positive for viral DNA of high risk HPV 16. There was a statistically significant difference in the mean ages of participants with positive cervical HPV and those without the infection respectively (34.8 ± 9.9 vs. 46.2 ± 10.1 years; P = 0.028). However, there were no significant differences found between the women with HPV positivity and those without with respect to marital status (P = 0.074), tribe (P = 1.009), religion (P = 0.681) and educational status (P = 0.552). Other identified risk factors that showed statistically significant differences for oncogenic HPV infection were age at sexual debut (P = 0.009), parity (P = 0.003), number of lifetime sexual partner(s) (P = 0.000), use of combined oral contraceptives (P = 0.044), HIV seropositivity (P = 0.000) and smoking (P = 0.033).Conclusion:Cumulative high risk HPV infection is high in Lagos, Nigeria. This thus support the need for routine and early screening of all identified high risk sexually active women for HPV infection in Nigeria, as well as emphasising further the importance of sex education for the girl child in schools and increased awareness for parents towards HPV vaccination for their generally healthy adolescent girls.

Perinatal outcome in anaemic pregnant women in South-Western Nigeria

Background: Anaemia in pregnancy is a global public health problem in most developing and developed countries with major consequences for human health as well as social and economic development. Fetuses of anaemic mothers are at risk of preterm deliveries, low birth weights, morbidity and perinatal mortality due to the impairment of oxygen delivery to placenta and foetus.Methods: This study was conducted at the antenatal clinic and labour ward complex of a teaching hospital in south-western Nigeria to determine the effect of anaemia in pregnancy on perinatal outcome. Eligible participants were enrolled for the study by consecutive sampling method. Relevant data were extracted from the case records of these eligible women and a structured interviewer administered questionnaire was used for the data collection.Results: There were statistically significant differences between anaemia and reduced gestational age at birth (P = 0.000), low one-minute (P = 0.000) and five-minute (P = 0.003) Apgar scores, reduced birth weight (P=0.005) and foetal death (P = 0.013). No significant difference was noted in the rate of neonatal admission in the two groups (P = 0.085).Conclusion: This study has thus highlighted the importance of considering maternal anaemia as an indicator of adverse perinatal outcomes. There is therefore, a need to counsel intending mothers and their partners about early antenatal booking, compliance with routine antenatal medications and prompt identification and treatment of anaemia in pregnancy, all as means of curtailing the overwhelming perinatal morbidity and mortality associated with the condition.

Preterm delivery and low maternal serum cholesterol level: any correlation?

Background: Preterm birth is a major challenge in perinatal health care with prematurity accounting for 40-60% of all perinatal deaths in Nigeria. The physiologic hypercholesterolaemia of later pregnancy suggests an adaptive function for pregnancy maintenance or fetal growth. Decreased levels of maternal total cholesterol and low-density lipoprotein cholesterol have been reported in association with preterm delivery.Methods: This was a prospective observational cohort study designed to assess whether low maternal serum cholesterol during early pregnancy is associated with preterm delivery in these women. Eligible participants were enrolled for the study at gestational age of 14 to 20 weeks over a period of 12 months. Blood samples were obtained to measure total serum cholesterol concentrations and the sera were then analyzed enzymatically by the Cholesterol Oxidase: p-Aminophenazone (CHOD PAP) method.Results: The study showed an incidence of 5.0% for preterm delivery in the low risk study patients. Preterm birth was 4.83-times more common with low total maternal cholesterol than with midrange total cholesterol (11.8% versus 2.2%, P = 0.024).Conclusions: We can infer from the study that the low maternal serum cholesterol (hypocholesterolaemia) is associated with preterm delivery. We can therefore recommend on this basis that the concept of an optimal range for maternal serum cholesterol during pregnancy may have merit and pregnant women should be encouraged to follow a healthy, balanced diet and ensure regular antenatal visit to their healthcare provider

The use of complementary and alternative medicine by 7427 Australian women with cyclic perimenstrual pain and discomfort: A cross-sectional study

© 2016 Fisher et al. Background: To assess the prevalence of cyclic perimenstrual pain and discomfort and to detail the pattern of complementary and alternative (CAM) use adopted by women for the treatment of these symptoms. Methods: Data from the 2012 national Australian Longitudinal Study of Women's Health (ALSWH) cross-sectional survey of 7427 women aged 34-39 years were analysed to estimate the prevalence of endometriosis, premenstrual syndrome (PMS), irregular or heavy periods and severe dysmenorrhoea and to examine the association between their symptoms and their visits to CAM practitioners as well as their use of CAM therapies and products in the previous 12 months. Results: The prevalence of endometriosis was 3.7 % and of the perimenstrual symptoms assessed, PMS was most prevalent at 41.2 % whilst irregular bleeding (22.2 %), heavy periods (29.8 %) and severe period pain (24.1 %) were reported at lower levels. Women with endometriosis were more likely than non-sufferers to have consulted with a massage therapist or acupuncturist and to have used vitamins/minerals, yoga/meditation or Chinese medicines (p < 0.05). PMS sufferers were more likely to consult with an osteopath, massage therapist, naturopath/herbalist or alternative health practitioner and to have used all forms of CAM therapies except Chinese medicines than women who had infrequent PMS (all p < 0.05). Women with irregular periods did not have different patterns of CAM use from non-sufferers and those with heavy periods did not favour any form of CAM but were less likely to visit a massage therapist or use yoga/meditation than non-sufferers (p < 0.05). For women with severe dysmenorrhoea there was no difference in their visits to CAM practitioners compared to non-sufferers but they were more likely to use aromatherapy oils (p < 0.05) and for more frequent dysmenorrhoea also herbal medicines, Chinese medicines and other alternative therapies compared to non-sufferers (all p < 0.05). Conclusions: There is a high prevalence of cyclic perimenstrual pain and discomfort amongst women in this age group. Women were using CAM differentially when they had specific symptoms of cyclic perimenstrual pain and discomfort. The use of CAM needs to be properly assessed to ensure their safe, effective use and to ascertain their significance as a treatment option enabling women with menstrual problems and their care providers to improve their quality of life

Nomenclature- and Database-Compatible Names for the Two Ebola Virus Variants that Emerged in Guinea and the Democratic Republic of the Congo in 2014

In 2014, Ebola virus (EBOV) was identified as the etiological agent of a large and still expanding outbreak of Ebola virus disease (EVD) in West Africa and a much more confined EVD outbreak in Middle Africa. Epidemiological and evolutionary analyses confirmed that all cases of both outbreaks are connected to a single introduction each of EBOV into human populations and that both outbreaks are not directly connected. Coding-complete genomic sequence analyses of isolates revealed that the two outbreaks were caused by two novel EBOV variants, and initial clinical observations suggest that neither of them should be considered strains. Here we present consensus decisions on naming for both variants (West Africa: “Makona”, Middle Africa: “Lomela”) and provide database-compatible full, shortened, and abbreviated names that are in line with recently established filovirus sub-species nomenclatures

Filovirus RefSeq Entries: Evaluation and Selection of Filovirus Type Variants, Type Sequences, and Names

Sequence determination of complete or coding-complete genomes of viruses is becoming common practice for supporting the work of epidemiologists, ecologists, virologists, and taxonomists. Sequencing duration and costs are rapidly decreasing, sequencing hardware is under modification for use by non-experts, and software is constantly being improved to simplify sequence data management and analysis. Thus, analysis of virus disease outbreaks on the molecular level is now feasible, including characterization of the evolution of individual virus populations in single patients over time. The increasing accumulation of sequencing data creates a management problem for the curators of commonly used sequence databases and an entry retrieval problem for end users. Therefore, utilizing the data to their fullest potential will require setting nomenclature and annotation standards for virus isolates and associated genomic sequences. The National Center for Biotechnology Information’s (NCBI’s) RefSeq is a non-redundant, curated database for reference (or type) nucleotide sequence records that supplies source data to numerous other databases. Building on recently proposed templates for filovirus variant naming [ ()////-], we report consensus decisions from a majority of past and currently active filovirus experts on the eight filovirus type variants and isolates to be represented in RefSeq, their final designations, and their associated sequences

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

Prevalence of the Hepatitis B “e” Antigen in Nigerian Patients with Chronic Liver Disease

Background: In Chronic Hepatitis B liver disease [CHB] the presence of the “e” antigen [HBeAg] is thought to be associated with active virus replication and increased risk of severe liver disease. Its absence is thought to characterize inactive disease associated with suppressed viral replication, normal liver enzymes, and improved clinical outcomes. Methodology: 163 patients with a clinical, ultrasound and/or histological evidence of liver cirrhosis or HCC were evaluated. The hepatitis B virus antigens [HBsAg and HBeAg] and serum alanine aminotransferase [ALT] were determined as an indicator of chronic HBV infection, active viral replication and underlying hepatic inflammation respectively. Results: 84/163 [52%] were GBsAg positive of which [10/84] 11.9% were HBeAg positive. Significant ALT elevation was seen in most patients with liver cirrhosis and HCC and was seen in both “e” antigen positive [80%] and negative [60%] patients [p=0.2]. Conclusion: Chronic hepatitis B liver disease [CHB] associated with “e” negative HBV infection appears to be the predominant presentation of liver cirrhosis and hepatocellular carcinoma. Contrary to common expectations, HBeAg negative infections are associated with severe ongoing hepatic inflammation and cause severe liver disease comparable with HB e positive disease. NQJHM Vol. 14 (1) 2004: pp. 1-

Clinical Evaluation of Ocular Antiviral Effect of Garcinia Kolanut Water Extract in Epidemic Haemorrhagic Keratoconjunctivitis in Lagos

Background: The claim of an Octogenarian on Garcinia kolanuts crude water extract on his open angle glaucoma has opened up a series of researchers into the native nuts as to their pharmocotherapeutic properties. Some of these have been reported as pressure lowering effects on laboratory animals and as antibacterials and antifungal on common microorganisms affecting human eyes in in-vitro research studies. Garcinia Kola nuts are fruits to tropical vegetation and are common to all dialects, tribes and natives of West Africa. Epidemic haemorrhagic Karatoconjunctivetis (EHKC, Apollo) and Epidemic keratoconjunctivitis (EKC) occur yearly in Nigeria in the dry and dusty climates from adenovirus serotypes, 8,11,19 and 37 even though over 50 serotypes have been identified. No specific anti-adenoviral agent has been identified globally. Conventional management is mainly symptomatic and this involves the use of artificial tears, analgesics and corticosteroids with caution in the severe cases. Critical awareness and preventive measures are usually applied. These infections are highly contagious and the serotypes can survive in many environments and remain infectious on many surfaces for up to 35 days. Materials and Methods: This prospective study was planned specifically for the dry and dusty period when epidemics usually occur and EKC and EHKC, on volunteering patients. All patients were examined, diagnosed and treated. Garcinia kolanut water extract was aseptically extracted and stored in 10ml bottles at the Pharmaceutical Department of the College of Medicine University of Lagos (CMUL) and were given to patients under this study. All volunteering patients seen, examined and diagnosed as having acute epidemic conjunctivitis and or haemorrhagic ketatoconjunctivitis were human subjects in this study. Symptoms and signs of infections were monitored pre and post instillations with Garcinia Kolanuts water extract at the Guinness Eye Center of the Lagos University Teaching Hospital (GEC/LUTH). They were all treated with only Garcinia kolanut water extract. Clinical photographs were also taken pre and post treatment with extracts. Statistical evaluation was done. Result: Three Hundred and fifty (350) patients volunteered and were seen and diagnosed as suffering from EHKC and EKC. They all used only the sterile Garcinia kolanut water extract as drops for their ocular complaints. Table 1 shows the demographic data. This study show that as early as 2 hours, most patients remarked that they got relief from most of their ocular symptoms while within 6 hours of installations most patients confirmed this relief. Clinically ocular discharges, watering and redness were definitely improved. There was no gender or age significance. Statistically P>0.5 is significant while the effects of Garcinia Kolanut extract on pre and during instillations of symptoms and signs of ocular manifestations of the viral infections were compared. There was a marked relief both subjectively and objectively showing antimicrobial properties of the extract. Conclusion: This study has further broadened our understanding of the phamakotherapeutic activities of Garcinia kolanut extract. The effectiveness of this extract to quickly bring resolutions to the ocular symptoms and signs of the patient is noticeable and encourage. Since no specific anti-adenoviral agent is presently in existence globally, this may serve as a breakthrough in the management of these viral infections. Conclusive viral studies on the conjunctival swabs from these patients will soon be published. NQJHM Vol. 14 (3&4) 2004: pp. 270-27