Knowledge, attitude and practices of HIV post exposure prophylaxis amongst health workers in Lagos University Teaching Hospital

Introduction: timely PEP after needle stick exposure to high risk body fluids can reduce the rate of  occupational transmission significantly. Ignorance of this may increase the risk of seroconversion to HIV for healthcare workers. This study was conducted with the aim of demonstrating the current level of knowledge and practise of healthcare workers as regards PEP. Methods: this was a cross-sectional study, pretested questionnaire were self administered to 372  health workers from various clinical specialties. The responses were collated and analyzed; results were presented in frequency tables. Results: this study revealed a high level of awareness among the  respondents as 83.3% were aware of  PEP. Despite the high level of awareness, respondents still have an inadequate knowledge about PEP, only  32% of the respondents could name at least two of the recommended drugs for PEP, only 54.0% of respondents knew when to commence PEP following occupational exposure to HIV. There was a low level of practice of PEP among the respondents as only 6.3% of respondents had PEP despite occurrence of needle stick injury. Conclusion: this study revealed a general low level use of PEP despite the average knowledge of PEP and the  favourable attitude towards HIV PEP amongst the respondents.Key words: Post exposure prophylaxis, human immunodeficiency virus, Health care worker

Seroprevalence of human T lymphotropic virus antibodies among healthy blood donors at a tertiary centre in Lagos, Nigeria

Introduction: Transmission of human T-lymphotropic viruses (HTLV) occurs from mother to child, by sexual contact and blood transfusion. Presently, in most centres in Nigeria, there is no routine  pre-transfusion screening for HTLV. The study aims to determine the prevalence of HTLV- 1 and HTLV-2 among healthy blood donors at a tertiary centre in Lagos.Methods: A cross-sectional study was carried out at the blood donor clinic of the Lagos State University Teaching Hospital (LASUTH), Ikeja. About 5mls of venous blood was collected from each subject into a  sterile plain bottle after obtaining subject's consent. The serum separated and stored at -200C. Sera were assayed for HTLV by an enzyme-linked immunoassay (ELISA) for the determination of antibodies to HTLV 1 and HTLV -2. Western blot confirmatory testing was done on reactive samples. All donors were also screened for HIV, HBsAg and HCV by rapid kits. Results: The seroprevalence of HTLV -1 by ELISA was 1.0% and 0.5% by Western Blot among blood donors. A total of 210 healthy blood donors were enrolled. Only 2 (1.0%) blood donors were repeatedly reactive with ELISA test. On confirmatory testing with Western Blot, 1 (0.5%) blood donor was positive for HTLV. All the healthy blood donors were negative for HIV, HbsAg and HCV. None of the 210 blood donors had been previously transfused; as such no association could be established between transfusion history and HTLV positivity among the blood donors. Conclusion: The seroprevalence of HTLV in this environment is low among healthy blood donors.Key words: Seroprevalence, HTLV, healthy blood donors, Nigeri

Prevalence of Priapism and Its Awareness amongst Male Homozygous Sickle Cell Patients in Lagos, Nigeria

Background. Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation. Impotence and infertility are major problems in male sickle cell disease patients, and priapism has been implicated as a cause of impotence and infertility. The aim of this study is to determine priapism prevalence and assess the knowledge of male homozygous male patients about it in Lagos, Nigeria. Methods. A cross-sectional study was conducted amongst male homozygous sickle cell disease patients of Lagos State University Teaching Hospital. Pretested questionnaires were distributed to determine the prevalence and assess their knowledge on priapism. Data were analyzed using SPSS version 16.0. Results. A total of 114 consenting subjects filled the questionnaires, 85 of 114 (74.6%) had not heard about priapism before this study. A total of 77 of 114 (67.5%) did not know that they are at risk of priapism. Whilst 84 of 114 (73.7%) were not aware that priapism is a complication of SCD. The majority, 94 of 114 (82.5%), were not aware that priapism could cause impotence. Conclusion. There is a need to create more awareness about this complication amongst sickle cell disease patients in order to stem the incidence of impotence and infertility amongst them

CD4 Count Pattern and Demographic Distribution of Treatment-Naïve HIV Patients in Lagos, Nigeria

Background. CD4 count measures the degree of immunosuppression in HIV-positive patients. It is also used in deciding when to commence therapy, in staging the disease, and in determining treatment failure. Using the CD4 count, this study aimed at determining the percentage of HIV-positives who require antiretroviral therapy at enrollment in an HIV treatment and care centre. Methods. The Baseline CD4 count, age and gender of 4,042 HAART-naïve patients, who registered between December 2006 and June 2010, at Lagos State University Teaching Hospital, Ikeja, were retrospectively studied. Data were analyzed using SPSS version 16.0 (Statistical Package for Social Sciences, Inc., Chicago, Ill). Results. Patients consisted of 2507 (62%) female and 1535 (38%) males. The mean age of males was years and that of females years. Overall, the mean CD4 count was of  cells/mm3. The mean CD4 count of males was  cells/mm3 and that of females cells/mm3. A total of 72.3% males, 64.3% females and 67.4% overall registered patients had CD4 count 500 cells/mm3 at registration. Conclusion. Females account for more than half of registered patients in HIV clinic and have a relatively higher CD4 count than males. About three-quarter of HIV positives require antiretroviral therapy at registration

Hemoglobin and Ferritin Concentrations in Subjects with Metabolic Syndrome

Background Metabolic syndrome (MetS), a clinical condition characterized by insulin resistance, glucose intolerance, dyslipidemia, hypertension, and obesity, has been linked with raised levels of serum ferritin (Sfr) concentrations. Objectives This study was carried out to compare hemoglobin (Hb) and Sfr concentrations in patients with MetS, regular donors and first-time donors. Materials and Methods A total of 102 subjects who were between 18 and 60 years were enrolled for the study. They were divided into three groups. The first group ( n = 20) was made up of 5 males and 15 females, all who met the criteria that define MetS. The second group ( n = 52; M = 34, F = 18) were regular donors, while the last group ( n = 30; M = 16, F = 14) were first-time donors or those who had not donated before. Following an overnight fast, 20 mL of venous blood was drawn from each subject. About 5 mL of this was put into sodium ethylenediaminetetraacetate (EDTA) specimen bottles for the full blood count parameters with Sysmex KX-21N hematology analyzer (made in Japan). The remaining 15 mL had serum separated for Sfr assay using enzyme-linked immunosorbent assay (ELISA) with a commercial assay kit manufactured by Teco Diagnostics. Results Significant difference was found in the mean Sfr concentration of subjects with MetS (163 ± 136.92 ng/mL) and regular donors (41.46 ± 40.33 ng/mL), P = 0.001. The mean Sfr concentrations of subjects with MetS (163 ± 136.92 ng/mL) were also higher than that of first-time donors (102.46 ± 80.26 ng/mL), but it was not statistically significant, P = 0.053. The Hb concentrations of the three groups were not significantly different. Conclusion Sfr concentrations of regular donors were lower than that of subjects with MetS and first-time donors. The difference between regular donors and subjects with MetS was statistically significant. However, there is no significant difference in the Hb concentrations in the three groups. MetS is not associated with anemia or hyperferritinemia

Prevalence of Priapism and Its Awareness amongst Male Homozygous Sickle Cell Patients in Lagos, Nigeria

Background. Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation. Impotence and infertility are major problems in male sickle cell disease patients, and priapism has been implicated as a cause of impotence and infertility. The aim of this study is to determine priapism prevalence and assess the knowledge of male homozygous male patients about it in Lagos, Nigeria. Methods. A cross-sectional study was conducted amongst male homozygous sickle cell disease patients of Lagos State University Teaching Hospital. Pretested questionnaires were distributed to determine the prevalence and assess their knowledge on priapism. Data were analyzed using SPSS version 16.0. Results. A total of 114 consenting subjects filled the questionnaires, 85 of 114 (74.6%) had not heard about priapism before this study. A total of 77 of 114 (67.5%) did not know that they are at risk of priapism. Whilst 84 of 114 (73.7%) were not aware that priapism is a complication of SCD. The majority, 94 of 114 (82.5%), were not aware that priapism could cause impotence. Conclusion. There is a need to create more awareness about this complication amongst sickle cell disease patients in order to stem the incidence of impotence and infertility amongst them. Background Sickle Cell Disease. Sickle cell disorder is a genetic abnormality involving haemoglobin and red cells. The glutamine on the 6th position of the chain is replaced with valine consequent on a single point mutation in which thymine replaces adenine on the deoxyribonucleic acid structure. Haemoglobin S resulting from the substitution causes polymerization of haemoglobin and red cell sickling on exposure to low-oxygen tension and unsickle on oxygenation. The sickled red cells obstruct blood vessels and impede free flow of blood of the affected vessel causing vascular congestion, oxygen deprivation, anaerobic glycolysis, lactic acidosis, and pain. This may be responsible for priapism, an acute complication of sickle cell disease. Priapism in Sickle Cell Disease. Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation Priapism is due to occlusion of the outflow vessels from the corpora cavernosa by sickled cells, consistent with significantly lower HbF levels in affected cases Priapism may be self limited, and of short duration usually lasting less than 3 hours. It may also be chronic and recurrent lasting more than 24 hours. Increased rate of impotence has been reported in sickle cell patients whose attacks lasted more than 24 hours Sexual intercourse has been implicated to precipitate attack amongst Jamaican. Others reported spontaneous attacks that wake the patient from sleep Many treatment modalities are available for priapism, these include the use of drugs, exchange blood transfusion and surgical intervention. Drugs like -adrenergic agonist which increase the contractile state of the trabecular/arterial meshwork and facilitate venous outflow from the corpora Adequate hydration and analgesia may dislodge the trapped sickled red cells, partial exchange blood transfusion to lower the HbS level to less than 30% has been tried Surgical interventions which is usually the last procedure for unresolved priapism involves aspiration and irrigation of the corpora cavernosa with saline Infertility is a major problem in male sickle cell disease patients reported by Abudu et al. in which they noted a lower testosterone levels in males compared with age-matched controls Methods This cross-sectional study to determine the prevalence and assess the knowledge of male sickle cell disease patients on Consenting participants were recruited consecutively into the study after obtaining the institution's ethics and research committee approval. Pretested questionnaires were distributed to them to determine the prevalence and assess their knowledge on priapism. The questionnaire was designed by the authors, adapted from previous related studies Statistical Assessment Data were analyzed using SPSS version 16.0 (Statistical Package for Social Sciences, Inc., Chicago, IL, USA). The descriptive data was given as mean ± standard deviation (SD). The Pearson chi-squared test was used to test for association between discrete variables. A value was considered to be statistically significant when <0.05. Result A total of 114 consenting subjects filled the questionnaires; the mean age was 21.97 ± 7.51, with a minimum of 14 years and maximum of 53 years. A total of 105 of 114 (92.1%) were single, while 9 of 114 (7.9%) were married. The majority, 65 of 114 (57%), had secondary education, 36 of 114 (31.6%) had tertiary education, 10 of 114 (8.8%) had primary education, while 3 of 114 (2.7%) had no education The A total of 23 of 45 (51.11%) did not get any treatment, 6 of 45 (13.33%) were admitted, and 8 of 45 (17.77%) were treated but not admitted. When asked about how many times they had episode of priapism, the majority, 11 of 45 (24.44%), had it twice followed by 9 of 45 (20%) once, 4 of 45 (8.8%) thrice, and 3 of 45 (6.66%) 5 times. When asked about precipitating factors, 17 of 45 (37.77%) had it after waking up from sleep followed by no known factors in 10 of 45 (22.22%), followed by 5 of 45 (11.11%) following bone pain crises, and 4 of 45 (8.88%) after sexual intercourse

Characterizing prostate cancer risk through multi-ancestry genome-wide discovery of 187 novel risk variants.

The transferability and clinical value of genetic risk scores (GRSs) across populations remain limited due to an imbalance in genetic studies across ancestrally diverse populations. Here we conducted a multi-ancestry genome-wide association study of 156,319 prostate cancer cases and 788,443 controls of European, African, Asian and Hispanic men, reflecting a 57% increase in the number of non-European cases over previous prostate cancer genome-wide association studies. We identified 187 novel risk variants for prostate cancer, increasing the total number of risk variants to 451. An externally replicated multi-ancestry GRS was associated with risk that ranged from 1.8 (per standard deviation) in African ancestry men to 2.2 in European ancestry men. The GRS was associated with a greater risk of aggressive versus non-aggressive disease in men of African ancestry (P = 0.03). Our study presents novel prostate cancer susceptibility loci and a GRS with effective risk stratification across ancestry groups