Prostaglandin levels and semen quality in male partners of infertile couples in Ile-Ife, Nigeria

Objective: To provide data on semen prostaglandins in Nigerian men and relate this to fertility potential as provided by semen analysis results.Design: Prospective studySetting: Infertility Clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, NigeriaSubjects: All male partners of infertile couples who reported for male factor test at the clinic and agreed to be part of the study by completing informed consent forms.Results: The study revealed a high percentage of men with sub-normal semen .Range of PGF2a in the subjects was 0.15-11.05ƒÊg/ml with a mean of 2.77} 0.23 ƒÊg/ml while that of PGE was 21.8- 652.0 ƒÊg/mlwith a mean of 248.79} 13.88 ƒÊg/ml. Among men with normal semen profile, mean PGF2a and PGE levels are 2.1} 0.32 ƒÊg/ml and 325.1} 28.3 ƒÊg/ml respectively while that in semen of men with subnormal semen are 3.0} 0.28 ƒÊg/ml and 225.1 } 15.1ƒÊg/ml respectively. Despite the wide range of PG values in all the groups, significant differences(P<0.05) were found to exist between the PG values of men in the normal and sub normal semen groups. Significant differences were also found when theywere grouped according to sperm count alone. However, differences observed when in the grouping according to other individual semen characteristics are not significant.Conclusion: The wide range of PG values obtained in all the groups make it difficult to make far reaching conclusions as to the relationship between PG levels and semen quality. Further research is desirable in establishing the role of PGs in sperm function

Prostaglandin levels and semen quality in male partners of infertile couples in Ile-Ife, Nigeria

The study revealed a high percentage of men with sub-normal semen .Range of PGF2á in the subjects was 0.15-11.05µg/ml with a mean of 2.77± 0.23 µg/ml while that of PGE was 21.8- 652.0 µg/ml with a mean of 248.79± 13.88 µg/ml. Among men with normal semen profile, mean PGF2á and PGE levels are 2.1± 0.32 µg/ml and 325.1± 28.3 µg/ml respectively while that in semen of men with subnormal semen are 3.0± 0.28 µg/ml and 225.1 ± 15.1µg/ml respectively. Despite the wide range of PG values in all the groups, significant differences(P<0.05) were found to exist between the PG values of men in the normal and sub normal semen groups. Significant differences were also found when they were grouped according to sperm count alone. However, differences observed when in the grouping according to other individual semen characteristics are not significant. Conclusion: The wide range of PG values obtained in all the groups make it difficult to make far reaching conclusions as to the relationship between PG levels and semen quality. Further research is desirable in establishing the role of PGs in sperm function

Cross-sectional study of antioxidant status in normotensive and hypertensive pregnancy

Objectives: The study measured the concentrations of antioxidants in women during pregnancy and the Post Partum Period (PPP) with a view to investigating their role in the aetiology of pregnancy induced hypertension (PIH). Study Design: Informed consent was obtained from 105 women who were divided into three groups: 15 age and parity matched normotensive non-pregnant (control group), 45 normotensive and 45 hypertensive pregnant women. The two groups of pregnant women were divided into three groups of 15 each and studied in the second and third trimesters and PPP respectively. Venous blood was obtained from all the participants for measurements of some antioxidants (uric acid, albumin, catalase and vitamin C). Data were analyzed using descriptive and inferential statistical methods. Results: The results show that the mean concentrations of catalase, albumin, vitamin C and uric acid for the control were 3.1 ± 0.18 µ/l, 46.6 ± 6.6 g/l, 0.38 ± 0.01 mg/dl and 0.16 ± 0.03 mmol/l respectively. The mean concentration of all antioxidants except uric acid were significantly lower during pregnancy when compared with controls (t= 2.06; p<0.01). In the normotensive group of pregnant women, vitamin C was the only antioxidant that showed significant higher concentration when the second trimester concentration and third trimester concentration were compared (t=2.06; p<0.05). Uric acid levels were significantly higher (t=2.06; p<0.05) and nd rd catalase and vitamin C levels were significantly lower in the hypertensive group during the 2 and 3 trimesters (t=2.06; p<0.05). There was a tendency for all antioxidant concentrations to return to normal values during the PPPin the normotensive group; however in the hypertensive group, uric acid levels remained significantly higher (t=2.06; p<0.05). Conclusion: In conclusion this study showed that pregnancy generally reduced the concentration of antioxidants but vitamin C levels were higher in late pregnancy of normotensive women. Therefore higher levels of vitamin C may protect against PIH

Perspectives of TB survivors and policymakers on post-TB disability

Background: An international multistakeholder participatory workshop was hosted in the Gambia, West Africa, in November 2021. Objectives: To explore the experiences, challenges and recommendations of workshop participants on health and wellbeing after TB treatment. Methods: An exploratory, descriptive, qualitative approach was used for data collection through facilitator-guided group discussions. Workshop participants included adolescent and adult TB survivors, and representatives of TB advocacy groups and the policy sector. Discussions were audio-recorded and transcribed verbatim, and the data were analysed using a deductive thematic approach. Results: Overall, 38 participants (22 women) from six West African countries participated in the workshop, comprising 33 TB survivors and advocacy group representatives and 5 participants from the policy sector. Although some TB survivors noted improved ability to carry out physical activities, others continued to experience detrimental effects on their family life, social interactions, physical health and ongoing stigma. Policymakers emphasised the lack of data and clear guidelines on post-TB disability. Conclusions: Some TB survivors continue to suffer detrimental effects of the illness even after treatment completion. However, available data on post-TB disability is inadequate to support policy adoption. Therefore, there is an urgent need for increased advocacy, awareness and research to bridge knowledge gaps

Isoniazid preventive treatment among child contacts of adults with smear-positive tuberculosis in The Gambia.

Setting: Greater Banjul area of The Gambia. Objectives: To evaluate uptake, adherence and completion of treatment among tuberculosis (TB) exposed children in The Gambia when isoniazid preventive treatment (IPT) is delivered at home Design: Child (age <5 years) contacts of adults with smear-positive TB were prospectively enrolled. Following symptom screening, tuberculin skin testing and clinical evaluation where indicated, those without disease were placed on daily isoniazid, provided monthly at home. Adherence was assessed by pill counts and IsoScreen™ urine test. Results: Of 404 contacts aged <5 years, 368 (91.1%) were offered IPT. Of the 328 (89.4%) for whom consent was received and who commenced IPT, 18 (5.5%) dropped out and 310 (94.5%) remained on IPT to the end of the 6-month regimen. Altogether, 255/328 children (77.7%, 95%CI 73.2-82.2) completed all 6 months, with good adherence. The IsoScreen test was positive in 85.3% (435/510) of all tests among those defined as having good adherence by pill count and in 16% (8/50) of those defined as having poor adherence (P < 0.001). A cascade of care analysis showed an overall completion rate with good adherence of 61% for all child contacts. Conclusion: Home-delivered IPT among child contacts of adults with smear-positive TB in The Gambia achieved verifiable high uptake and adherence rates. System rather than patient factors are likely to determine the success of IPT at national level

ISOLATION, CHARACTERIZATION AND IMMUNOCHEMICAL STUDIES ON FIBROUS PROTEINS FROM COWRY SHELL (CYPRAEA MONETA, LINNAEUS)

Background: Biomaterials are non-drug substances used to treat, enhance or replace functions of body tissues or organs. Natural sources of biomaterials have recently become the focus of several research activities. Cowry shell constitutes one of the most promising natural sources of biomaterials because of its chemical stability, biodegradability and biocompatibility in the body. However, its applications may be limited due to immunogenic and toxic responses that may occur following implantation, hence this study. Materials and Methods: Crude fibrous protein extracted with citrate buffer from pulverised cowry shells (Cypraea moneta (L)), was resolved into two components (CSP1 and CSP2) by gel filtration. Immunological studies were performed with antisera obtained from rabbits by double immunodiffusion and immunoelectrophoresis techniques. Mice treated with the proteins were observed for signs of toxicity and their liver, kidney, lungs and spleen were processed histologically. Results: The native molecular weight of CSP1 and CSP2 determined by gel filtration were 91kDa and 33kDa respectively. CSP1 and CSP2 displayed single bands on SDS-PAGE with subunit molecular weight values of 19kDa and 19.5kDa respectively. Antisera obtained from rabbits immunised with the crude citrate buffer extracts precipitated the antigen in double immunodiffusion tests. Histopathological examinations revealed a dose-dependent damaging effect of the shell proteins on liver, kidney, lung and spleen tissues of the treated mice. Conclusion: This study showed that cowry shells contain fibrous proteins which are immunogenic and toxic in mice at relatively high concentrations, causing visible organ damage without concurrent physical manifestations

Risk Factors for Pre-Treatment Mortality among HIV-Infected Children in Rural Zambia: A Cohort Study

Many HIV-infected children in sub-Saharan Africa enter care at a late stage of disease. As preparation of the child and family for antiretroviral therapy (ART) can take several clinic visits, some children die prior to ART initiation. This study was undertaken to determine mortality rates and clinical predictors of mortality during the period prior to ART initiation.A prospective cohort study of HIV-infected treatment-naïve children was conducted between September 2007 and September 2010 at the HIV clinic at Macha Hospital in rural Southern Province, Zambia. HIV-infected children younger than 16 years of age who were treatment-naïve at study enrollment were eligible for analysis. Mortality rates prior to ART initiation were calculated and risk factors for mortality were evaluated.351 children were included in the study, of whom 210 (59.8%) were eligible for ART at study enrollment. Among children ineligible for ART at enrollment, 6 children died (mortality rate: 0.33; 95% CI:0.15, 0.74). Among children eligible at enrollment, 21 children died before initiation of ART and their mortality rate (2.73 per 100 person-years; 95% CI:1.78, 4.18) was significantly higher than among children ineligible for ART (incidence rate ratio: 8.20; 95% CI:3.20, 24.83). In both groups, mortality was highest in the first three months of follow-up. Factors associated with mortality included younger age, anemia and lower weight-for-age z-score at study enrollment.These results underscore the need to increase efforts to identify HIV-infected children at an earlier age and stage of disease progression so they can enroll in HIV care and treatment programs prior to becoming eligible for ART and these deaths can be prevented

Performance of metabonomic serum analysis for diagnostics in paediatric tuberculosis

We applied a metabonomic strategy to identify host biomarkers in serum to diagnose paediatric tuberculosis (TB) disease. 112 symptomatic children with presumptive TB were recruited in The Gambia and classified as bacteriologically-confirmed TB, clinically diagnosed TB, or other diseases. Sera were analysed using 1H nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS). Multivariate data analysis was used to distinguish patients with TB from other diseases. Diagnostic accuracy was evaluated using Receiver Operating Characteristic (ROC) curves. Model performance was tested in a validation cohort of 36 children from the UK. Data acquired using 1H NMR demonstrated a sensitivity, specificity and Area Under the Curve (AUC) of 69% (95% confidence interval [CI], 56–73%), 83% (95% CI, 73–93%), and 0.78 respectively, and correctly classified 20% of the validation cohort from the UK. The most discriminatory MS data showed a sensitivity of 67% (95% CI, 60–71%), specificity of 86% (95% CI, 75–93%) and an AUC of 0.78, correctly classifying 83% of the validation cohort. Amongst children with presumptive TB, metabolic profiling of sera distinguished bacteriologically-confirmed and clinical TB from other diseases. This novel approach yielded a diagnostic performance for paediatric TB comparable to that of Xpert MTB/RIF and interferon gamma release assays

Diagnosis of paediatric TB using Xpert® MTB/RIF Ultra on fresh respiratory samples.

OBJECTIVE: To evaluate the diagnostic accuracy of Xpert® MTB/RIF Ultra (Ultra) on fresh respiratory samples for the diagnosis of pulmonary TB (PTB) in children.METHODS: Between July 2017 and December 2019, children with presumed TB were prospectively enrolled at clinical sites in three African countries. Children were assessed using history, physical examination and chest X-ray. Sputum or gastric aspirate samples were analysed using Ultra and culture. The diagnostic accuracy of Ultra was calculated against culture as the reference standard.RESULTS: In total, 547children were included. The median age was 4.7 years, 77 (14.1%) were HIV infected and 77 (14.1%) had bacteriologically confirmed TB. Ultra detected an additional 20 cases in the group of children with negative culture results. The sensitivity of Ultra was 66.3% (95% CI 47-82), and the specificity was 95.4% (95% CI 89-99) when assessed against culture as the reference standard.CONCLUSION: Despite the improved performance of Ultra as compared to Xpert as was previously reported, its sensitivity remains sub-optimal for the detection of TB in children. Ultra detected additional 20 cases which otherwise could not have been detected by culture alone, suggesting that the latter is an imperfect reference standard