Parallel and overlapping Human Immunodeficiency Virus, Hepatitis B and C virus Infections among pregnant women in the Federal Capital Territory, Abuja, Nigeria

Background: Risk factors that are associated with HIV infection are also associated with HBV and HCV infections in sub-Saharan Africa. The HIV-infected pregnant cohort represents a unique population and infection with the hepatitis virus is considered a public health problem worldwide. Objective: The purpose of this study was to evaluate the prevalence of Human Immunodeficiency Virus, Hepatitis B and C virus parallel and overlapping infections among pregnant women attending antenatal clinics in Federal Capital Territory (FCT), Abuja. Method: Five hundred (500) blood samples were collected from three district hospitals in the FCT and tested at Wuse General Hospital, Abuja for the presence of antibodies to HIV and Hepatitis C virus, and HBsAg by ELISA technique in accordance with the manufacturer’s instructions. HIV seropositive sera were confirmed by Western blot. Result: Of the 500 pregnant women, those detected with HIV antibodies, HBsAg and anti-HCV antibodies were 42 (8.4%), 19 (3.8%) and 8 (1.6%) respectively. The overall seroprevalence of HIV and HBV or HCV co-infection was 9.5% while 7.1% and 2.4% HIV positive pregnant women were specifically co-infected with HBV and HCV respectively. Those within the age bracket of 15-20 years had the highest prevalence of HIV (13.4%), HBV (5.1%) and HCV (1.9%) infections. Among the occupation characteristics of the women, those of them involved in trading recorded the highest prevalence of HIV (60.6%), HBV (30.3) and HCV (6.1%). HIV was higher among the married women than the singles ((8.6% vs 6.5%); with HBV infection the reverse was the case (3.0% vs 9.8%) while HCV was same for both groups. History of blood transfusion did not reflect a higher rate of HIV and HBV (1.4% vs 9.6%; 2.8% vs 4.0% respectively) unlike HCV infection with 0.5% recorded only among those that had transfusion experience. Conclusion: When monitoring the risk of hepatotoxicity to antiretroviral drugs among these group of patients caution should be maintained. Moreover, evidence of parallel and overlapping HIV, HBsAg and HCV infections among this cohort should motivate inclusion of HBV and HCV among the diseases of surveillance in the national sentinel survey in order to ascertain the bigger picture of these infections in Nigeria

The Impact of Immunization Control Activities on Measles Outbreaks in Akwa Ibom State, South-South, Nigeria

Background: The increase of vaccination rates means that fewer children will be vulnerable to vaccine preventable diseases such as measles, which will invariably result in a drop in the infant mortality and morbidity rates. Objective: To assess the impact of the implementation of measles reduction strategies from 2006 to 2008 using the quarterly national program for immunization (NPI) in Akwa Ibom state, Nigeria. Method: Following informed consent, individuals presenting with febrile rash illnesses were routinely bled and tested for measles specific IgM using commercially available ELISA kit-MV-ELISA (Enzygnost; Behring Diagnostics, Marburg, Germany) in accordance with the manufacturer’s instructions. Results: A total of four hundred and four individuals comprising of 216 vaccinated and 188 unvaccinated, presenting with febrile rash illness were screened for measles specific IgM antibodies as indication of active infection between January 2006 and December 2008 out of which 122 (30.2%) had detectable levels of measles antibodies. Among the vaccinated and unvaccinated groups, 32 (14.8%) and 90 (47.9%) respectively were detected with measles IgM antibodies. The highest and lowest antibody levels were detected in 2006 (vaccinated: 54.7%; unvaccinated: 78.4%) and 2008 (vaccinated: 1.2%; unvaccinated: 12%) respectively. The distribution of measles burden by year show an overall decline in prevalence from 70% in 2006, 8.9% in 2007 to 3.7% in 2008. While, children under the age of 5 similarly had a decline in measles incidence of 73.3%, 10.7% and 3.3% respectively. Sex distribution of infection within the 3-year period shows that more females (37.4%) than males (21.2%) expressed measles IgM antibodies, and active infection was detected more in the rural (31.4%) than urban area (27.7%). However, findings indicate a tremendous decline in active infection in the rural areas from 67% in 2006 to 0% in 2008, and in the urban areas from 78% in 2006 to 9.3% in 2008 among both vaccinated and unvaccinated groups. A highly significant reduction in measles infection was observed more among males than females (P=0.009). Infection distribution by location did not show any significant difference (P=0.65) even though more individuals in the rural areas were noted with active infection. Conclusion: The study shows a highly significant reduction in measles burden among vaccinated individuals (P=0.0001) and invariably increases protective coverage of measles vaccination most especially among children under 5 years of age (P=0.0066) in the state. Findings justify effort by government and WHO in carrying immunization campaigns in children, 5-years and below irrespective of vaccination status and experience

Growth Response of Explants of Irvingia Gabonensis (O'rorke, Baill) to In Vitro Treatment

Growth response of explants of Irvingia gabonensis to in vitro treatment was investigated using full, half and one quarter strength mineral components based on Murashige and Skoog medium. Plant growth regulator (kinetin-Kin) with concentration levels of 0, 1, 2, 3, 4 and 5mg/l were used for shoots initiation, while axillary formed shoots were rooted in various concentration levels of 0, 1, 2, 3, 4 and 5mg/l of indole butyric acid (IBA). One quarter strength growth medium containing 3mg/l kinetin, which supported the highest growth performance was used to study the effect of explant source and number of leaf primordia on shoot initiation of the species. Shoot length of axillary bud explant significantly (P<0.05) increased in one quarter strength medium than those of half and full strength media. Axillary bud explants with 1-2 leaf primordia gave optimum response in terms of regeneration frequency and coefficient of velocity of bud burst. High regeneration frequency and coefficient of velocity of bud burst with low percentage contamination were recorded by seedling and stump sprout explants. This study suggests that axillary bud explants of Irvingia gabonensis can respond to in vitro treatment under optimum culture conditions

Beliefs And Practice Concerning Pregnancy Delivery And Puerperium In Rural Akwa Ibom State

Focus group discussions involving 100 rural women in five communities of Akwa Ibom State, Nigeria were carried out over a six-month period. The aim was to determine if the beliefs and practices of our rural dwellers are such that contribute to maternal morbidity. The discussions revealed that the participants had a shallow knowledge of the causes of complications in pregnancy. Complications were largely attributed to spirits and other harmless events. Reducing physically demanding activities in pregnancy was ascribed to laziness and sexual intercourse was largely to be avoided. There was no food taboos specific to pregnancy, but food restrictions were described. Antenatal and intrapartum care by spiritual and traditional midwives was considered superior to orthodox care. Practices by the midwives include turning a baby in an abnormal lie, massaging the vagina with oil in labour; conducting delivery without gloves, pulling on the cord, manually removing or squeezing out the placenta if delivery is not spontaneous. Management of complications involves divinations, use of herbs and other concoctions, anointing oil, prayers and fasting. Puerperal seclusion practiced to varying degrees and maybe beneficial. Most beliefs and practices of our rural women are potential contributors to maternal morbidity. A few are harmless or even beneficial. Public enlightenment and education of our rural dwellers while incorporating the harmless/beneficial practices into modern obstetric care services will help reduce maternal morbidity. KEYWORDS: Pregnancy, Beliefs and Practice

Morphometric Study Of The Teratogenic Effect Of Artesunate On The Central Nervous System Of The Wistar Rat Foetus

The teratogenic influence of maternal administration of artesunate on the morphometry of foetal nervous system was studied. Twenty virgin female Wistar rats weighing between 200g and 230g were used for this study. The animals were divided into 4 groups of 5 rats each. Each group was kept in a separate plastic cage. The rats were fed with commercial rat feed and tap water ad libitum throughout the experimental period. The females were caged overnight with sexually mature male rats of the same strain. The presence of sperm (tailed structures) in the vagina smears obtained the following morning confirmed coitus and the sperm positive day was designated as day zero of pregnancy. Oral doses of 0.2mg/kg, 0.4mg/kg and 0.8mg/kg body weight of artesunate were administered to pregnant rats in 3 of the groups respectively from the 7th to the 11th day of gestation. The fourth group of rats was used as the control which received 2.0ml/kg body weight of distilled water on the same days. Results show that the high dose group rats demonstrated significant (

Human amniotic fluid glycoproteins expressing sialyl Lewis carbohydrate antigens stimulate progesterone production in human trophoblasts in vitro

Background: Progesterone is thought to mediate immune modulator effects by regulating uterine responsiveness. The aim of the study was to clarify the effect of transferrin and glycodelin A (former name PP14) as sialyl Lewis X-expressing glycoproteins on the release of progesterone by trophoblast cells in vitro. Methods: Cytotrophoblast cells were prepared from human term placentas by standard dispersion of villous tissue followed by a Percoll gradient centrifugation step. Trophoblasts were incubated with varying concentrations (50-300 mug/ml) of human amniotic fluid- and serum-transferrin as well as with glycodelin A. Culture supernatants were assayed for progesterone, human chorionic gonadotropin (hCG) and cortisol by enzyme immunometric methods. Results: The release of progesterone is increased in amniotic fluid transferrin- and glycodelin A-treated trophoblast cell cultures compared to untreated trophoblast cells. There is no relation between transferrin and the hCG or cortisol production of trophoblast cells. Conclusion: The results suggest that sialyl Lewis carbohydrate antigen-expressing amniotic fluid glycoproteins modulate the endocrine function of trophoblasts in culture by upregulating progesterone production. Copyright (C) 2004 S. Karger AG, Basel

Seasonal influenza risk in hospital healthcare workers is more strongly associated with household than occupational exposures: results from a prospective cohort study in Berlin, Germany, 2006/07

Background: Influenza immunisation for healthcare workers is encouraged to protect their often vulnerable patients but also due to a perceived higher risk for influenza. We aimed to compare the risk of influenza infection in healthcare workers in acute hospital care with that in non-healthcare workers over the same season. Methods: We conducted a prospective, multicentre cohort study during the 2006/07 influenza season in Berlin, Germany. Recruited participants gave serum samples before and after the season, and completed questionnaires to determine their relevant exposures and possible confounding factors. The main outcome measure was serologically confirmed influenza infection (SCII), defined as a fourfold or greater rise in haemagglutination inhibition antibody titres to a circulating strain of influenza (with post-season titre at least 1:40). Weekly mobile phone text messages were used to prompt participants to report respiratory illnesses during the influenza season. A logistic regression model was used to assess the influence of potential risk factors. Results: We recruited 250 hospital healthcare workers (mean age 35.7 years) and 486 non-healthcare workers (mean age 39.2 years) from administrative centres, blood donors and colleges. Overall SCII attack rate was 10.6%. Being a healthcare worker was not a risk factor for SCII (relative risk 1.1, p=0.70). The final multivariate model had three significant factors: living with children (odds ratio [OR] 3.7, p=0.005), immunization (OR 0.50, p=0.02), and - among persons living in households without children - ownership of a car (OR 3.0, p=0.02). Living with three or more children (OR 13.8,

Are Metastases from Metastases Clinical Relevant? Computer Modelling of Cancer Spread in a Case of Hepatocellular Carcinoma

Background: Metastasis formation remains an enigmatic process and one of the main questions recently asked is whether metastases are able to generate further metastases. Different models have been proposed to answer this question; however, their clinical significance remains unclear. Therefore a computer model was developed that permits comparison of the different models quantitatively with clinical data and that additionally predicts the outcome of treatment interventions. Methods: The computer model is based on discrete events simulation approach. On the basis of a case from an untreated patient with hepatocellular carcinoma and its multiple metastases in the liver, it was evaluated whether metastases are able to metastasise and in particular if late disseminated tumour cells are still capable to form metastases. Additionally, the resection of the primary tumour was simulated. The simulation results were compared with clinical data. Results: The simulation results reveal that the number of metastases varies significantly between scenarios where metastases metastasise and scenarios where they do not. In contrast, the total tumour mass is nearly unaffected by the two different modes of metastasis formation. Furthermore, the results provide evidence that metastasis formation is an early event and that late disseminated tumour cells are still capable of forming metastases. Simulations also allow estimating how the resection of the primary tumour delays the patient’s death. Conclusion: The simulation results indicate that for this particular case of a hepatocellular carcinoma late metastases, i.e.

The role of facemasks and hand hygiene in the prevention of influenza transmission in households: results from a cluster randomised trial; Berlin, Germany, 2009-2011

Background: Previous controlled studies on the effect of non-pharmaceutical interventions (NPI) - namely the use of facemasks and intensified hand hygiene - in preventing household transmission of influenza have not produced definitive results. We aimed to investigate efficacy, acceptability, and tolerability of NPI in households with influenza index patients. Methods: We conducted a cluster randomized controlled trial during the pandemic season 2009/10 and the ensuing influenza season 2010/11. We included households with an influenza positive index case in the absence of further respiratory illness within the preceding 14 days. Study arms were wearing a facemask and practicing intensified hand hygiene (MH group), wearing facemasks only (M group) and none of the two (control group). Main outcome measure was laboratory confirmed influenza infection in a household contact. We used daily questionnaires to examine adherence and tolerability of the interventions. Results: We recruited 84 households (30 control, 26 M and 28 MH households) with 82, 69 and 67 household contacts, respectively. In 2009/10 all 41 index cases had a influenza A (H1N1) pdm09 infection, in 2010/11 24 had an A (H1N1) pdm09 and 20 had a B infection. The total secondary attack rate was 16% (35/218). In intention-totreat analysis there was no statistically significant effect of the M and MH interventions on secondary infections. When analysing only households where intervention was implemented within 36 h after symptom onset of the index case, secondary infection in the pooled M and MH groups was significantly lower compared to the control group (adjusted odds ratio 0.16, 95% CI, 0.03-0.92). In a per-protocol analysis odds ratios were significantly reduced among participants of the M group (adjusted odds ratio, 0.30, 95% CI, 0.10-0.94). With the exception of MH index cases in 2010/11 adherence was good for adults and children, contacts and index cases. Conclusions: Results suggest that household transmission of influenza can be reduced by the use of NPI, such as facemasks and intensified hand hygiene, when implemented early and used diligently. Concerns about acceptability and tolerability of the interventions should not be a reason against their recommendation