Prevalence of Cryptosporidiosis among HIV/AIDS infected individuals attending gambo Sawaba General Hospital, Zaria

Background: Diarrhea remains one of the most important health problems globally and a leading cause of morbidity and mortality among immune compromised individuals. It accounts for over 50 million deaths (in all ages) world-wide and ranks 3rd among diseases responsible for human mortality globally. Aim: This study was aimed at determining the prevalence of cryptosporidiosis in patients who presented with diarrhea attending Gambo Sawaba General Hospital Zaria, Kaduna State, Nigeria. Methods: The study was cross-sectional study in which a total of 110 diarrheic stool samples were processed using formol ether Concentration Techniques and Stained for oocysts of Cryptosporidium species using modified ZN staining method while direct sample was screened for other enteric parasites. Results: The overall prevalence rate of cryptosporidium oocyst in the diarrhetic HIV/AIDS patient was 10%. Other parasites isolated were Ascaris lumbricoides 3.6% and Entamoeba histolytica 4.6%. Cryptosporidium infection was associated with those who defecate in pit latrine with a prevalence of 9.1% at (P=0.476) and those who drank well water without boiling with a prevalence of 7.2% at (P=0.419). There was no statistical difference between Cryptosporidium infection and those who eat undercooked food with a prevalence of 6.4% at (P=0.680). The oocysts were detected more frequently in female with 6.3% than male participants with 3.6% prevalence and patients between age group of 25-54 years were most affected with a prevalence of 2.7%. Conclusion: A prevalence of 10% of cases among this study group is high, hence should be considered in planning interventions aimed at optimizing management of HIV/AIDS and other immune-suppressed patients

Isolation, Characterization and Heavy Metals Tolerance Indices of Indigenous Fungal Flora from a Tannery located at Challawa Industrial Estate of Kano State, Nigeria

Seven fungal species (Aspergillus niger, Aspergillus versicolor, Aspergillus flavus, Aspergillus fumigatus, Rhizomucor pusillus, Trichophyton equinum and Rhizopus oryzae) were isolated from the tannery effluent collected at a tannery industry located at Challawa industrial estate of Kano State, Nigeria. Aspergillus niger had the highest percentage occurrence frequency of 36% (31) while Trichophyton equinum had the least percentage occurrence frequency of 4% (5). Consequently, Aspergillus niger recorded the highest mean tolerance indices of 1.175, 0.830, 0.580, 0.780 and 0.630 while Rhizomucor pusillus had the least of the tolerance indices of 0.675, 0.375, 0.346, 0.450 and 0.255 for chromium, cadmium, manganese and lead respectively. Accordingly, furthermore the minimum inhibitory concentration (MIC) and biomass yield of the seven tested fungi isolates cultured in the presence of the five heavy metals used in this study showed different level of growth pattern. Hence the high resistant potentials and tolerance to the selected heavy metals exhibited by the fungal species isolated in this study is an indication that indigenous fungal floral isolated from tannery effluent if properly harnessed may offer a feasible solution to the serious environmental pollution problems associated with the presence of heavy metals in tannery effluent

EVALUATION OF HYPOGLYCAEMIC, HYPOLIPIDAEMIC AND NON TOXIC EFFECT OF HYDRO-METHANOLIC EXTRACTS OF ZIZIPHUS MAURITIANA, ZIZIPHUS SPINA CHRISTI FRUIT AND GLIBENCLAMIDE ON ALLOXAN INDUCED DIABETIC RATS

The use of plant products in the management of diabetes has gained ground in pharmacotherapy. It becomes imperative to evaluate the antidiabetic effects of fruit extracts of Ziziphus mauritiana (HMZM), Ziziphus spina christi (HMZS) and Glibenclamide on blood glucose, total protein, albumin and lipid profile in alloxan induced diabetic rats. 68 albino rats weighing 70 - 130g were used in this study. 26 rats were used for acute toxicities of Ziziphus mauritiana and Ziziphus spina christi. 42 rats of 7 groups of 6 rats each were used to test antidiabetic effects of Ziziphus mauritiana and Ziziphus spina christi plant extracts. Group 1 served as the negative control, groups 2-7 were intraperitoneally administered 360mg/kg of alloxan in normal saline respectively. Group 2 served as positive control, groups 3 and 4; 5 and 6 were respectively administered daily dose of 200 and 400mg/kg of HMZM and HMZS, group 7 was administered 0.21mg/kg of glibenclamide. Results showed Ziziphus mauritiana and Ziziphus spina christi non toxic at dose of 5000mg/kg. 48 hours after alloxan administration, blood glucose levels were found to be significantly higher (P<0.05) in groups 2-7 compared to group 1, thus confirming induction of diabetes. In groups 3-7, on 7th and 14th days of administration of extracts and Glibenclamide, there was a significantly lower (p<0.05) serum glucose, triacylglycerol, High density Lipoprotein, Low density lipoprotein and significantly higher (P > 0.05) serum level of total protein and albumin compared to group 2. The results obtained showed a significantly lower (P < 0.05) serum level of glucose. The effects of HMZMand HMZS fruit extracts on blood glucose, total protein, albumin and lipid profile was dose dependent. Conclusively, this study has demonstrated the antidiabetic effects of HMZM and HMZS with HMZS having a more pronounced effect on Blood glucose and lipid profile. Keywords: Antidiabetic, Blood glucose, lipid profile, Glibenclamide, Ziziphus mauritiana, Ziziphus spina Christi

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

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

Comparative Infectivity and Pathogenicity of Kano and Sokoto (Northern Nigeria) Isolates of Trypanosoma Evansi in Rabbits

The present study was aimed at comparing the infectivity and pathogenicity of two isolates of Trypanosoma evansi in experimentally infected rabbits. Three groups each of five crossbred rabbits, two of which were challenged with approximately 2 x 106 T evansi of the Kano (KT) and Sokoto (ST) isolates, respectively, while the third group was the uninfected control (UC). The rabbits were monitored for parasitaemia, rectal temperature, clinical signs and changes in the packed cell volume (PCV), total leukocyte count and total plasma protein during the course of the infection. Impression smears of the brain, liver, lungs, heart, spleen, kidney, adrenal gland, bone marrow and aqueous humour were made, stained with Giemsa and examined for the presence of trypanosomes. The result revealed that all the infected rabbits developed intermittent fever and parasitaemia, with mean pre-patent periods of 3.6±1.8 and 7.8±3.1 days for the KT and ST groups, respectively. There was a decrease in mean PCV of the infected groups compared with the control. The KT group had the lowest PCV throughout the study compared with the ST and UC groups. There was a significant inverse correlation (r = -0.7262, P &lt; 0.05) between parasitaemia and the PCV in the KT group, but not in the ST group (r = -0.6070, P &gt; 0.05). Leukocytosis was higher in the ST group compared with the KT group all through the study, and was significantly higher (P &lt; 0.05) at days 11 and 18 post infection. Trypanosomes were observed in 56% of the organ impression smears from the KT group as against 11% in the ST isolate. Both isolates were infective to the rabbits, but the KT isolate appears to be more virulent than the ST isolate.Keywords: Trypanosoma evansi isolates, pathogenicity, rabbits, Northern Nigeri

Antifungal activity of Andrographis paniculata extracts and active principles against skin pathogenic fungal strains in vitro

Context: Andrographis paniculata Nees. (Acanthaceae) is an annual herbaceous plant widely cultivated in southern Asia, China, and Europe. It is used in the treatment of skin infections in India, China, and Malaysia by folk medicine practitioners. Objective: Antifungal activity of the whole plant extracts and isolation of active principles from A. paniculata were investigated. Materials and methods: Dichloromethane (DCM) and methanol (MEOH) extracts of A. paniculata whole plant were screened for their antifungal potential using broth microdilution method in vitro against seven pathogenic fungal species responsible for skin infections. Active principles were detected through bioguided assays and isolated using chromatography techniques. Structures of compounds were elucidated through spectroscopy techniques and comparisons were made with previously reported data for similar compounds. Results: DCM extract revealed lowest minimum inhibitory concentration (MIC) value (100 μg/mL) against Microsporum canis, Candida albicans, and Candida tropicalis, whereas MEOH extract revealed lowest MIC (150 μg/mL) against C. tropicalis and Aspergillus niger. DCM extract showed lowest minimum fungicidal concentration (MFC) value (250 μg/mL) against M. canis, C. albicans, C. tropicalis and A. niger, whereas MEOH extract showed lowest MFC (250 μg/mL) against Trichophyton mentagrophytes, Trichophyton rubrum, M. canis, C. albicans, C. tropicalis and A. niger. Bioassay guided isolation from DCM and MEOH extract afforded 3-O-β-d-glucosyl-14-deoxyandrographiside, 14-deoxyandrographolide, and 14-deoxy-11,12-didehydroandrographolide as antifungal compounds. The lowest MIC (50 μg/mL) and MFC (50 μg/mL) was exerted by 14-deoxyandrographolide on M. canis. Discussion and conclusion: This is first report on the isolation of antifungal substances through bioassay-guided assay from A. paniculata. Our finding justifies the use of A. paniculata in folk medicines for the treatment of fungal skin infections

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios