Gastrointestinal stromal tumor of the anal wall in a Nigerian

Documented reports of gastrointestinal stromal tumors (GIST) are relatively few in the sub-Saharan continent. The body of evidence points towards anal wall involvement being a rarity indeed. In this article we document a 61 year old Nigerian man who presented with bleeding per rectum and in whom the histological features (including immunohistochemistry) of the biopsied anal lesion was GIST.Key words: Gastrointestinal stromal tumors (GIST), anal wall, immunohistochemistry, Nigeri

A modified anthrax toxin-based enzyme-linked immunospot assay reveals robust T cell responses in symptomatic and asymptomatic Ebola virus exposed individuals

Background Ebola virus (EBOV) caused more than 11,000 deaths during the 2013–2016 epidemic in West Africa without approved vaccines or immunotherapeutics. Despite its high lethality in some individuals, EBOV infection can produce little to no symptoms in others. A better understanding of the immune responses in individuals who experienced minimally symptomatic and asymptomatic infection could aid the development of more effective vaccines and antivirals against EBOV and related filoviruses. Methodology/Principle findings Between August and November 2017, blood samples were collected from 19 study participants in Lagos, Nigeria, including 3 Ebola virus disease (EVD) survivors, 10 individuals with documented close contact with symptomatic EVD patients, and 6 control healthcare workers for a cross-sectional serosurvey and T cell analysis. The Lagos samples, as well as archived serum collected from healthy individuals living in surrounding areas of the 1976 Democratic Republic of Congo (DRC) epidemic, were tested for EBOV IgG using commercial enzyme-linked immunosorbent assays (ELISAs) and Western blots. We detected antibodies in 3 out of 3 Lagos survivors and identified 2 seropositive individuals not known to have ever been infected. Of the DRC samples tested, we detected antibodies in 9 out of 71 (12.7%). To characterize the T cell responses in the Lagos samples, we developed an anthrax toxin-based enzyme-linked immunospot (ELISPOT) assay. The seropositive asymptomatic individuals had T cell responses against EBOV nucleoprotein, matrix protein, and glycoprotein 1 that were stronger in magnitude compared to the survivors. Conclusion/Significance Our data provide further evidence of EBOV exposure in individuals without EVD-like illness and, for the first time, demonstrate that these individuals have T cell responses that are stronger in magnitude compared to severe cases. These findings suggest that T cell immunity may protect against severe EVD, which has important implications for vaccine development

Antimicrobial stewardship programmes in healthcare facilities in Lagos State, Nigeria: a needs assessment

ABSTRACT: Objectives: Optimising antibiotic use in healthcare settings through antimicrobial stewardship programmes (ASPs) is critical to effectively treat infections, protect patients from harms caused by unnecessary antibiotic use, and combat antimicrobial resistance. This needs assessment was designed to provide the current status of ASPs in healthcare facilities in Lagos State and identify gaps for future interventions. Methods: A descriptive cross-sectional survey was conducted using a self-administered questionnaire to ascertain the extent and nature of ongoing ASPs among selected healthcare facilities and identify gaps for future interventional studies. Results: Of 32 questionnaires distributed, 25 (78%) were completed and returned from three tertiary, six secondary, eleven primary and five private healthcare facilities. The mean years of practice of respondents was 13.96 ± 7.8 years (2–31 years). Six facilities (24%) had a team responsible for ASP operating at varying degrees of capacity, while five (20%) had a formal ASP. All six facilities with an antimicrobial stewardship (AMS) team had a medical doctor as the team lead, and 5 (20%) also had a pharmacist involved in implementation efforts. Routine pre-authorisation for specific antibiotic was performed in six facilities (24%), four of which monitor pre-authorisation interventions. Only two facilities (8%) performed prospective audit and feedback for specific antibiotic agents. Private healthcare facilities were more likely to have information technology (IT) capability to support the needs of AMS activities. Conclusion: This study revealed minimal ASP activities in healthcare facilities in Lagos State and highlighted possibilities of leveraging on available IT resources for a co-ordinated AMS strategy

Serology results, 1976 Democratic Republic of Congo.

<p>Serology results, 1976 Democratic Republic of Congo.</p

Detection of EBOV antibodies, 1976 Democratic Republic of Congo.

<p>(A) Representative image of reactive LFn-EBOV-GP and LFn-EBOV-sGP Western blot analysis in 9 sera collected in surrounding areas of the 1976 Ebola virus outbreak in the Democratic Republic of Congo. +, positive control. Molecular size marker units are kDa. EVD, Ebola virus disease.</p

qRT-PCR, antigen ELISA, and serology results, Lagos, Nigeria.

<p>qRT-PCR, antigen ELISA, and serology results, Lagos, Nigeria.</p

Ex vivo CD8+ and CD4+ cellular reactivity to EBOV LFn fusion proteins, Lagos, Nigeria.

<p>CD8+ and CD4+ cells from the EVD survivors and documented EVD contacts were treated with the LFn-EBOV fusion proteins and the IFN-γ+ and TNF-α+ responses were detected by LFn ELISPOT ex vivo experiments. Individual and mean CD8+ IFN-γ+ (A) and TNF-α+ (B) and CD4+ IFN-γ+ (C) and TNF-α+ (D) responses are shown. Dotted lines represent the cut-off value. Control HCWs, control healthcare workers. *, p<0.05.</p

Detection of EBOV antibodies, Lagos, Nigeria.

<p>(A) Sera samples from 3 EVD survivors, 10 documented EVD contacts, and 6 control HCWs were subjected to LFn-EBOV-GP1 and LFn-EBOV-sGP Western blot analysis. +, positive control. Molecular size marker units are kDa. EVD, Ebola virus disease. Control HCWs, control healthcare workers.</p

Cellular immune responses, Lagos, Nigeria.

<p>PBMC samples from the EVD survivors, documented EVD contacts, and control HCWs were treated with the LFn-EBOV fusion proteins and the IFN-γ+ and TNF-α+ cellular responses were detected by LFn ELISPOT ex vivo experiments. Representative image of IFN-γ (A) and TNF-α (B) cellular responses when stimulated with the LFn-Ebola virus fusion proteins. NP, LFn-EBOV-NP. VP40, LFn-EBOV-VP40. GP1, LFn-EBOV-GP1. LFn, negative control. PHA, phytohemaglutanin, positive control.</p

Ex vivo cellular reactivity to EBOV LFn fusion proteins, Lagos, Nigeria.

<p>PBMC samples from the EVD survivors and documented EVD contacts were treated with the LFn-EBOV fusion proteins and the IFN-γ+ and TNF-α+ cellular responses were detected by LFn ELISPOT ex vivo experiments. Average magnitude of convalescent IFN-γ (A) and TNF-α (B) responses are shown. Dotted lines represent the cut-off value. Control HCWs, control healthcare workers. *, p < 0.05.</p