Gaps in the implementation of COVID-19 mitigation measures could lead to development of new strains of antimicrobial resistant pathogens: Nigerian perspective

The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is a new virus that is responsible for COVID-19, a disease that complicate health conditions and results in death. The total diversion of attention of government and health care workers (HCW's) to prevent the escalation of the pandemic disease has placed a great barrier to diagnosis and treatment of other illnesses that share common symptoms with COVID-19, and that has consequently enabled the endemic practice of self-antimicrobial medication to increase in the country. Development of secondary infections in COVID-19 and in other conditions, caused by antibiotic resistant pathogens are what could make them more deadly now or in the future. The mitigation strategies adopted in Nigeria and its States, which include enforcing social distancing, partial or total lockdown, and restricting access to health care facilities for non COVID-19 patients, have further increased the demand of antimicrobial agents from unauthorized outlets in communities for inappropriate use. A cross-sectional survey of 162 randomly selected individuals that visited medical stores and 170 medical store owners to evaluates the level of self-medication with five oral broad spectrum antibiotics and antimalaria during the lockdown revealed an increase (68.5%) in practice of self-medication with at least one of the antimicrobial and emergence of new misususers. Blind treatment of symptoms of malaria and common cold without diagnosis and health care consultation was nearly 100%. Irrational use of sanitizers, disinfectants and other cidal agents that can fuel antimicrobial resistance has drastically increased in Nigeria. Exposure of microorganisms in the environment without caution to large volume of fumigants is increasing on daily basis. We strongly recommend that while mitigating SARS-CoV-2 virus spread, efficacious and feasible technological, social, economic and behavioral interventions that will also control the evolution and spread antimicrobial resistant microorganisms should be applied

Influence of socialization of widows and married women on academic performance of women in women centres in Bauchi state, Nigeria

Introduction: Women education have lately become the concerns of most stakeholders especially the states governments in north-western states of Nigeria, education is a basic human right and has been recognized as such, sociologists attribute the manifest function of education include transmission of culture, creation of common identity, section and screen of talents and promotion of personal growth and development. Purpose: The study focus on the Influence of socialization of widows and married women on academic performance of women in women centres in Bauchi state, Nigeria. Methodology: The survey design was used for the study. The study population is 802. A sample of 265 women was drawn from widow and married students of Women Centre Jama’are, Azare, Misau and Ningi in Bauchi State from the population with the aid of Krejcie and Morgan (1970) table for determining sample size. Research instrument titled Academic Performance Test (APT) was used for data collection which was adjudged to possess content validity by teachers in secondary schools that mark WAEC and NECO in Bauchi State with a reliability ‘r’ index of 0.68 for Mathematics and 0.76 for English language. Result: Findings revealed that: there is no significant difference between academic performance of widow and married students of Women Centre Jama’are, Azare, Misau and Ningi in Bauchi State. Also Widows and married women relate better when they have acquaint themselves with the environment and are ready to acquire knowledge.  Recommendation: It was recommended that parents and husbands should encourage their daughters and wives to go back to continuing education centre for their education

Educational services and socio-economic status of internally displaced persons in Maiduguri, Nigeria: Implications for sociology of education

Introduction: Internally Displaced Persons (IDPs) are people who involuntary migrate from their homes due to armed conflict or drought and disasters in such critical situations that the relocation of an affected population becomes inevitable. They are scourged by poverty and hunger, diseases, neglect and feelings of alienation, among others. Purpose: The study focused on effects of the Boko Haram insurgency on educational needs, educational services, and socio-economic interventions by the various NGOs and governmental actors involved in humanitarian assistance, coordinated by the National Emergency Management Agency (NEMA) and State Emergency Management Agency (SEMA)on the basis camp in Bakasi, Dalori and Farm center IDPs of Borno state, Nigeria. Methodology: The survey design was used for the study. A descriptive study using pre-test and post-test treatment with a stratified sampling technique was used to select three (3) IDPs camps (IDPCs). The Hypotheses were tested using ANOVA was used to test the hypothesis. A total of 435 questionnaires were administered to the respondents, out of which 395 (Bakasi 116, Farm Centre 75, and Dalori 244) questionnaires were dully completed. Result: The study reveals that socio-economic and educational services of the respondents and educational facilities on the basis of the camp had not differed. Recommendation: Educational provisions should be made available where the children of the IDPs will be hosted and skills acquisition programmes to cater to skill development in different areas to enhance their economic status. There should effective synergy between security forces, Government, civil society NGOs, locals and internationals in order to build confidence and trust

Anaemia: A Useful Indicator of Neglected Disease Burden and Control

The authors argue that one way of evaluating the effectiveness of an intervention aimed at controlling neglected tropical diseases would be to assess its impact on anemia prevalence

Diagnosis of malaria and typhoid fevers using basic tools: a comparative analysis of a retrospective data with a prospective evaluation in an endemic setting

Malaria and typhoid fever are among important and endemic diseases in the tropical countries such as Nigeria. Diagnosis of most cases of malaria/typhoid co-infections are based on clinical suspicion alone or unreliable diagnostic tools leading to poor or misdiagnosis. A retrospective analysis was conducted on the positivity rate for malaria parasite and typhoid fever among patients who attended the Bayero University, Kano (BUK) Health Clinic from January to December 2013. A prospective study was also carried out on 200 febrile patients and 80 apparently healthy subjects (controls) with the view to determine the diagnostic profiles of malaria and /or typhoid fever co-infection using standard protocols (microscopy, rapid diagnostic test (RDT) for malaria parasite (MP), Widal test, stool and blood cultures for typhoid fever). Both test and control subjects were evaluated for the presence or otherwise of the malaria and /or typhoid aetiologic agents. Results obtained from the retrospective study for the period January to December 2013 indicated that, of the 2362 tests conducted, 318 (13.5%) were positive for MP using RDT and 722 (30.6%) were positive for typhoid fever using Widal test. Co-infection rate obtained was 89 (3.8%). Of the 200 subjects evaluated for the prospective study however, 42 (21%) and 34 (17%) were positive for MP using microscopic technique and RDT respectively. Microscopy was established to be more sensitive than RDT. Eighty nine (45%) were Widal positive. The culture method for typhoid fever diagnosis was negative. Co-infection rate stood at 17 (8.5%). No association however was found between the two disease conditions (p=0.6032). Significant proportion of the patients 86 (43%) were neither positive for malaria nor for typhoid fevers. Three isolates of non-typhoid salmonella specie and three other bacterial isolates were recovered from the stool and blood samples of the patients respectively. Baseline titre value for Widal test at BUK community was established as 160 and above for O antibodies to S. typhi, hence the criterion employed in the prospective evaluation. Laboratory evidence of malaria and typhoid co-infection rate at a titre of ≥160 was 8.5% using microscopy and 7% using RDT. The use of RDT is simple and easy, but has less sensitivity, thus may leave some patients with malaria un-detected. Based on the results of these findings, vis a vis the proportion of individuals negative for both malaria and typhoid fevers, clinicians should revisit causes of febrile illnesses other than malaria or typhoid and hence the need to include other tests for the detection of other causes.Keywords: Malaria diagnosis, Typhoid fever, RDT, Widal test, Co-infections, Nigeri

Applications of Molecular Diagnostic Techniques for Infectious Diseases

Diagnosis is concerned with identifying the cause of a disease or precise and consistent outcomes that are results of direct or indirect actions, reactions and interactions between the cause of a disease and the host. That outcome, if accurate, would help the clinician in disease management, or the epidemiologist in identifying trends of diseases or the administrator in policy and decision making. Traditionally, infectious disease diagnosis involves identifying the causative agents of infectious diseases through the direct examination, culture and often immunological tests on clinical specimens. The traditional diagnostic  techniques have varied sensitivities and specificities which influence their choice and applicability in a particular setting for the diagnosis of infectious diseases. However, the limitations of many traditional techniques particularly low specificity and long turnaround time often necessitate initiation of treatment before results are made available. Molecular diagnostic techniques involve a variety of techniques that explore the use of nucleic acid molecules for the identification of a particular pathogenic organism. These techniques include nucleic acid-based typing system, nucleic acid analysis without amplification, polymerase chain reaction (PCR) and other nucleic acid amplification techniques. Applications of molecular detection methods for infectious diseases have resolved many of the problems of the traditional diagnostic techniques, due to their exquisite sensitivity and specificity that allow the accurate and timely detection of very small numbers of organisms. This paper examines the principles and applications of molecular biology techniques in the identification of the causative agents of  infectious  diseases either in a routine setting or as research tools.Keywords: Infectious diseases, Molecular diagnosis, Polymerase Chain Reactio

Malaria and Hepatitis B co-infection in patients with febrile illnesses attending general outpatient unit of the Murtala Muhammed Specialist Hospital, Kano, Northwest Nigeria

Malaria and Hepatitis B Virus (HBV) infections are co-endemic throughout much of the tropical and sub-Saharan Africa and both present major threat to public health. A study on the prevalence of HBV and Malaria co-infection was carried out on 200 patients presenting with fever at the General Outpatient Department (GOPD) of the Murtala Muhammed Specialist Hospital (MMSH), Kano using Gold Standard microscopy and rapid diagnostic test (RDT). The effect of mono and co-infection on hematological parameters was also investigated. Fifty one (25.5%) out of the 200 patients studied were Malaria  positive. Females had higher prevalence rate(18%) of Malaria infection than males with 7.5%. Age group 15-24 had the highest Malaria prevalence (11%) followed by age group 25-34 with 6.5%. Higher mean  parasite density (1,200/ìl) was recorded among subjects with monoinfection of Malaria than mean parasite density (518/ìl) obtained among the co-infected. Mean parasite density was higher in female than male subjects. Thirteen (6.5%) subjects were HBV positive. Males had higher rate of infection with 4.5% prevalence than females with 2.0%. Nine individuals representing 4.5% of the total population had  co-infection with higher prevalence (3%) among the males. Age groups 25-34 were observed to have high co-infection rate of 1.5% and the least prevalence was observed among the age group 15-24 with 0.5%  prevalence for both males and females. Hematological evaluation carried out on all the categories of  subjects shows significant difference in mean values of PCV (P=0.041), Hb (P=0.018) between the  co-infection group and those with malaria infection and control groups. However, no significant difference (P>0.05) was observed in the values of WBC, PLT and Red cell indices among the co-infected and other test group. It was concluded that co-infection with the two ailments had no profound effect on hematologic parameters.Keywords: Co-Infection, Hepatitis B, Kano, Malaria, MMSH, Prevalenc

Integration of external quality assessment for microscopic diagnosis of malaria and tuberculosis : feasibility in Kano State, Nigeria

Background: Tuberculosis (TB) and malaria are endemic and are major public health burdens in Nigeria. Sputum smear microscopy for AFB and malaria microscopy are important for laboratory diagnosis and management of TB and malaria respectively. The \Vorld Health Organization has recommended the integration of malaria microscopy Quality Assessment (QA) with that of other microscopically diagnosed diseases, but there is no published evidence about the feasibility of implementing this policy in a resource poor setting in sub-Saharan Africa. Hypothesis: It is feasible to develop a model Quality Assessment (QA) system for malaria microscopy built on the existing TB microscopy QA system, in the context ofthe Nigerian health system. Objectives: To assess the feasibility oflinking malaria microscopy quality assessment into the existing AFB microscopy quality assessment system in Kano, Nigeria. Materials and methods: Five TB microscopy centres were selected for implementing the integrated TB and malaria microscopy QA scheme in the state. A model system was designed based on the Lot Quality Assurance System for selecting and blinded rechecking ofTB and malaria slides from these laboratories. Supervision and evaluation was conducted at 3 monthly intervals for 24 months. Results: Microscopy tests made up 21% of the laboratory tests conducted in one year in Kano state. The proportion of malaria and AFB microscopy among the microscopy tests was 35.1% and 27.2% respectively. To implement the model the five laboratories selected for implementing TB and malaria microscopy quality assessments had at least one microscope and two microscopists covering both TB and malaria. Full integration of the QA for TB and malaria microscopy was achieved in two laboratories, and partial integration in two other laboratories. The system improved the quality of TB and malaria microscopy results, particularly specificity. The average specificity of TB microscopy from the five laboratories increased from 80% to 97.9% and for the two laboratories in which malaria microscopy QA was fully integrated it increased from 76.0% and 66.7% to 100%. The average specificity of malaria microscopy from the two laboratories increased from 77.8% to 80.0%. On average, the concordance rate of TB microscopy results increased from 81% at baseline to 91.0% at the final assessment. For malaria microscopy the concordance rate increased from 69.2% at the baseline, to 83.3% at the final assessment in . one laboratory, but decreased from 100% to 83.3% in the other laboratory due to 16.7% false positive results. Increases in the concordant TB and malaria microscopy results were positively associated with the ability of the laboratories to prepare and stain the TB and malaria slides. There was a decreased false positivity and false negativity rates of TB microscopy results in all the five laboratories. Conclusions: It is feasible to integrate the QA system for TB and malaria microscopy and the assessment improved the quality of both services. However, a lot of advocacy is needed to engage all the relevant stakeholders and the integrated system needs testing out in different settings in order to be able to develop sound recommendations to guide the complex scaling up process

Comparing Haemozoin count and Parasitaemia in the Prognosis of severe Plasmodium Falciparum Malaria in Children and non-immune adults in Kano-Nigeria

This study compared the value of pigment containing leucocytes (neutrophils and monocytes) counts and the malaria parasite density in the prognosis of severe malaria on four hundred and twenty (420) patients with clinical evidence of severe malaria in Kano-Nigeria. Three clinical groups comprising patients with impaired consciousness, patients with cerebral malaria and those with severe anaemia were identified. Samples were analysed for Malaria parasitemia and pigment count Giemsa’s thick and Leishman’s thin film respectively. Patients with impaired consciousness (n=217) recorded the highest malaria pigment count of 342.86 (±177.34) monocytes pigments/microliter. The highest parasite count of 234,962 (±264.5) per microliter was recorded among the cerebral malaria group. Patients with severe malaria and anaemia had the least neutrophils pigment and parasite counts of 219.0 (±140.96)/microliter and 212,232(±12.61)/microliter respectively. A linear relationship between the malaria parasite count and the Intraneutrophilic malaria pigment count in severe malaria was demonstrated. Pigment count proved a higher prognostic value in severe malaria compared to Parasitaemia.Keywords: Haemozoin, Plasmodium falciparum, Parasitaemia, Malari

Prevalence and Risk Factors of High Risk Human Papillomavirus Infections among Women Attending Gynaecology Clinics in Kano, Northern Nigeria

Cervical cancer is the most common female cancer in northern Nigeria, yet the pattern of infection with human papillomavirus, the principal aetiologic agent is unknown. This was a preliminary study conducted in two referral hospitals in order to establish base-line data on the prevalence and risk factors for the infection in Kano state, Nigeria. Fifty (50) randomly selected women aged 18 years and above were recruited from gynaecology clinics in Murtala Muhammad Specialist Hospital and Aminu Kano teaching Hospital. Relevant sexual and socio-demographic information were obtained from each subject using a questionnaire. Exfoliated cervical cells were harvested and processed using Polymerase Chain Reaction to identify the DNAs of high-risk HPV types 16 and 18. The prevalence rate of HPV infection was 76% [(38/50) at 95% CI=61.8-86.9] with 60.5% (23/38) having co-infections with both HPV type 16 and 18. Risk factors of the infection include low literacy level; living in rural settlements; low parity; early menarche (<15 years of age); early onset of first sexual intercourse (≤16 years of age) and multiple sexual partners. There was however, no statistically significant association between oral contraceptive usage and acquisition of the infections. Findings of this study suggest a high prevalence of HPV types 16 and 18 among women attending gynaecology clinic in Kano and thus called for more elaborate community based study in order to establish the magnitude of the problem from wider perspective.Keywords: Human Papillomavirus; Prevalence; Risk Factors, Northern Nigeri