Active transmission of Trypanosoma brucei gambiense Dutton, 1902 sleeping sickness in Abraka, Delta State, Nigeria

Active surveillance of Human African trypanosomiasis (HAT) or sleeping sickness was undertaken in 3 agrarian villages in Ethiope East Local Government Area of Delta State, Nigeria. Card Agglutination Trypanosomiasis Test (CATT) was used qualitatively for mass screening with undiluted fresh whole blood (WB) and quantitatively for diagnosis in serum dilution tests. Thereafter, palpation for enlarged cervical lymph gland (ECLG) was followed by parasitological examination of aspirate using wet film, haematocrit centrifugation technique (HCT) and mini-anion exchange centrifugation technique (mAECT). Only one confirmed case of sleeping sickness was diagnosed out of the 491 samples screened. The results showed 43 (9.8%) serological positive cases in WB/ CATT test. 12 (27.9%) suspected cases that reacted at &lt1/4 titre in serum dilution test were highly suspected serological positive but parasitological negative cases. The study indicates that there is ongoing active transmission of Gambian type sleeping sickness in Abraka focus of Nigeria. The highly suspected cases will be followed up. Many cases might have gone undetected and more villages within the same focus were not covered. Moreover, a large-scale multi-disciplinary disease surveillance, vector and animal reservoir studies are required to determine the true situation of HAT in this focus. KEY-WORDS: Transmission, Gambian Trypanosomiasis, Screening, Blood, Serum, Diagnosis

Comparison of Mycobacterium tuberculosis drug susceptibility using solid and liquid culture in Nigeria.

BACKGROUND: This study compares Mycobacterium tuberculosis culture isolation and drug sensitivity testing (DST) using solid (LJ) and liquid (BACTEC-MGIT-960) media in Nigeria. METHODS: This was a cross sectional survey of adults attending reference centres in Abuja, Ibadan and Nnewi with a new diagnosis of pulmonary tuberculosis (TB) or having failed the first-line TB treatment. Patients were requested to provide three sputum specimens for smear-microscopy and culture on LJ and BACTEC-MGIT-960. Positive cultures underwent DST for streptomycin, isoniazid, rifampicin and ethambutol. RESULTS: 527 specimens were cultured. 428 (81%) were positive with BACTEC-MGIT-960, 59 (11%) negative, 36 (7%) contaminated and 4 (1%) had non-tuberculosis mycobacteria (NTM). 411 (78%) LJ cultures were positive, 89 (17%) negative, 22 (4%) contaminated and 5 (1%) had NTM. The mean (SD) detection time was 11 (6) and 30 (11) days for BACTEC-MGIT-960 and LJ. DST patterns were compared in the 389 concordant positive BACTEC-MGIT-960 and LJ cultures. Rifampicin and isoniazid DST patterns were similar. Streptomycin resistance was detected more frequently with LJ than BACTEC-MGIT-960 and ethambutol resistance was detected more frequently with BACTEC-MGIT-960 than LJ, but differences were not statistically significant. MDR-TB was detected in 27 cases by LJ and 25 by BACTEC-MGIT-960 and using both methods detected 29 cases. CONCLUSIONS: There was a substantial degree of agreement between the two methods. However using the two in tandem increased the number of culture-positive patients and those with MDR-TB. The choice of culture method should depend on local availability, cost and test performance characteristics

Early versus late rehabilitation for stroke survivors: A prospective study

The aim of this study was to examine the optimum time of rehabilitation initiation after stroke in terms of disabilities, mobility and fall risk assessment. Data were collected prospectively at seven tertiary level health care centers in Bangladesh during the 36 months period from 2013 to 2016. All respondents were divided into four groups based on the initiation of rehabilitation as: a) 0-24 hours, b) 25-72 hours, c) 4-7 days and d) 8-60 days. Results show that significant improvement on stroke recovery, disabilities reduction, improvement in mobility restriction and reduction of fall risks in all the four groups but more improvement was observed in 0-24 hour’s group during follow-up after 3 and 12 weeks. On multinomial logistic regression analysis, the independent factors shows the mobility restriction and fall risk were more in the younger patients, male gender, married, hemorrhagic lesion and bilateral stroke

A Molecular Epidemiological and Genetic Diversity Study of Tuberculosis in Ibadan, Nnewi and Abuja, Nigeria

Background Nigeria has the tenth highest burden of tuberculosis (TB) among the 22 TB high-burden countries in the world. This study describes the biodiversity and epidemiology of drug-susceptible and drug-resistant TB in Ibadan, Nnewi and Abuja, using 409 DNAs extracted from culture positive TB isolates. Methodology/Principal Findings DNAs extracted from clinical isolates of Mycobacterium tuberculosis complex were studied by spoligotyping and 24 VNTR typing. The Cameroon clade (CAM) was predominant followed by the M. africanum (West African 1) and T (mainly T2) clades. By using a smooth definition of clusters, 32 likely epi-linked clusters related to the Cameroon genotype family and 15 likely epi-linked clusters related to other “modern” genotypes were detected. Eight clusters concerned M. africanum West African 1. The recent transmission rate of TB was 38%. This large study shows that the recent transmission of TB in Nigeria is high, without major regional differences, with MDR-TB clusters. Improvement in the TB control programme is imperative to address the TB control problem in Nigeria

Susceptibility Assessment of Methicillin-Resistant Strains to Extract

Many plant-derived compounds have been used to treat microbial infections. Staphylococcus aureus a common cause of many organ infections, has generated increasing concern due to its resistance to antibacterial drugs. This work was carried out to explore the susceptibility of 6 strains (LN872136, LN872137, LN871238, LN871239, LN872140, and LN871241) of methicillin-resistant Staphylococcus aureus to aqueous extract of Lepidium sativum seeds in vitro. Various concentrations (5-20 mg/mL) were used to evaluate the effect of the extract on bacteria growth via the assessment of the microbial biomass and the inhibition zone (IZ). The results showed that the plant extract at 15 or 20 mg/mL, significantly decreased the the biomass of S aureus strains after 24 or 48 hours exposure period. Staphylococcus aureus (LN871241) showed the largest IZ at 20 mg/mL and documented by scanning electron microscope. The current work may suggest that L sativum seed extract can be candidate as a promising antimicrobial agent to treat infection with methicillin-resistant S aureus