Sero-prevalence study of parasitic infections among HIV positive and Negative patients in Lagos, Nigeria

Background: Diseases caused by opportunistic pathogens are the major clinical signs of HIV infected and AIDS patients with parasitic infection being part of the common causes of morbidity and mortality.Objectives: This was a cross-sectional study to determine the sero prevalence of serum antibodies to three parasitic infections namely Entamoeba histolytica, Schistosoma sp. and Toxoplasma gondii, which are opportunistic infections among HIV/AIDS patients.Methods: One thousand and eighty patients that attended three healthcare institutions in Lagos were recruited for the study through convenience sampling method. Venous blood was collected from the recruited patients and screened for HIV infection as well as the presence of serum antibodies to three parasitic infections. All positive sera samples were confirmed for HIV infection.Result: The results revealed that 65/1080 (6%) of the recruited patients were HIV sero-positive. In addition, 5/65 (7.7%) of the HIV positive patients had E. histolytica co-infection, 1/65 (1.5%) had Schistosoma sp. co-infection while 2/65 (3.1%) had T. gondii co infection. The results also indicated that the proportion of patients with E. histolytica was significantly higher among HIV sero-positive patients than the sero-negative patients (P = 0.031).Conclusion: The study showed the opportunistic potential of the three parasitic infections among HIV/AIDS patients in the study area.Keywords: HIV, AIDS, Seropositive, Seronegative, Toxoplasma gondii, Entamoeba histolytica, Schistosoma haematobiu

The roles, Challenges and institutionalization of institutional review boards

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Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD) and Uncomplicated Plasmodium Falciparum In Lagos

The protective role of Glucose-6-Phosphate deficiency (G6PD) in malaria has been an issue of considerable contention in malariology and population genetics. Most reports have proposed that heterozygous females have malaria resistance similar to or greater than hemizygous males. In view of this controversy, this study was undertaken to evaluate the protective role of G6PD in malaria using RANDOX (G6PD) quantitative technique backed up with questionnaire to highlight the frequency of self-reported malaria episodes by patients attending health facilities in Lagos. Malaria diagnosis was done using standard microscopy technique. A total of 100 blood samples slide positive for P.falciparum were used in the study with 66 symptomatic patients (Group A) and 34 asymptomatic (group B). The mean parasite density (MPD) was 613.34 + 1291.6 parasite/μL of blood ranging from 45 to 11,970 parasites/μL of blood. There were variations in G6PD activity (μ/g Hb). Patients with low or deficient G6PD (n = 28) had an MPD of 415.57 + 297.07 parasites/μL of blood. Those with normal G6PD activity (n = 71) had an MPD of 697.86 + 1516.92 parasites/μ/L of blood. This result demonstrated that patients with low G6PD activity had lower MPD which could possibly be protective though the difference was not statistically significant (F =0.539; P = 0.539). In addition, the relationship between G6PD activity (U/g Hb) and frequency of malaria occurrence showed a significant association for Group A (

Knowledge, attitude and practice of the trainee seafarers to HIV/AIDS and STIs at Apapa Seaport, Lagos

The epidemic of human immunodeficiency virus (HIV) in Nigeria is being fuelled by ignorance and other Sexually Transmitted Infections (STIs). Little is known about HIV-risk related sexual behavior of the Nigerian sailors. This study describes the baseline knowledge, attitude and practice of the trainee sailors to HIV. Ninety four (83.2%) of the 113 trainee interviewed consented to participate in voluntary counseling and confidential testing (VCT) programme. Each trainee completed an anonymous self- administered questionnaire and was tested for syphilis, trichomoniasis and HIV. Seventy one (75.5%) of the respondents were between ages 21-25 years. Twenty three (25%) did not believe that having sex with commercial sex workers puts them at high risk of HIV while eighteen (19.1%) did not believe that condoms were protective. Only ten (10.6%) practiced abstinence while three were homosexual. Despite all these, sixty three (67%) believed that they were at little or no risk of HIV, prevalence of which was found to be 5.3% among them. Seventy one (75.5%), fifteen (16%), twenty (21%) and (20.2% of respondents believed that genital ulcers, gonorrhea, syphilis and HIV respectively were not sexually transmitted. Trichomoniasis and syphilis were found in two (2.1%) and one (1.1%) respondents respectively. Female sex (P=0.002) and trichomoniasis (P=0.017) were found to significantly influence HIV infection. There was a high level of ignorance about HIV and STIs among respondents. This was further highlighted by the high rate of high-risk behaviors. Therefore, sustained educational programs and promotion of condoms are recommended to address this problem. African Journal of Clinical Experimental Microbiology Vol. 8 (2) 2007: pp. 94-10

Patient satisfaction with radioiodine treatment and telephone follow-up for the management of thyrotoxicosis

Waiel A Bashari, Rebecca L Coates, Shahbaz Nazir, Naomi E Riddel, Oluwaseyi O Lawanson, Ahmed M Mohamed, Samson O Oyibo Department of Diabetes and Endocrinology, Peterborough City Hospital, Peterborough, UK Background and objective: Patient satisfaction is of paramount importance when delivering a patient-centered service. Our hospital has been a center for the use of radioiodine to treat thyrotoxicosis for several years, but we began carrying out patient satisfaction surveys and implementing changes after 2008. The aim of the project reported here was to assess patient satisfaction with our radioiodine treatment and telephone follow-up service, and to compare results with our previous surveys.Patients and methods: Anonymous patient satisfaction questionnaires were sent to all patients who received radioiodine treatment for thyrotoxicosis between January 2012 and December 2013. Patients were asked to answer four questions concerning informed consenting, treatment, and telephone follow-up using a four-point Likert scale, and post back the questionnaires. A suggestion box was included for comments and suggestions for improvement.Results: A total of 56 questionnaires were posted out (to 44 females and 12 males) and 34 questionnaires were returned (60.8% response rate). Between 94% and 100% of the responders, depending on the question asked, were satisfied with the service they received. Patients also put useful comments and suggestions in the suggestion box provided.Conclusion: Patients with thyrotoxicosis were satisfied with our radioiodine treatment and telephone follow-up service. This survey has revealed areas for service improvement, and highlights the importance of patient satisfaction when assessing a patient-centered service. Keywords: service improvement, patient-centered service, patient satisfaction survey, informed consentin

Malaria and HIV co-infection and their effect on haemoglobin levels from three healthcare institutions in Lagos, southwest Nigeria

Background: Malaria and human immunodeficiency virus (HIV) are two major infections with enormous public health consequence. Together, they are endemic in many developing countries with anaemia being the most frequent haematological consequence of the infections.Objective: To determine the prevalence of malaria and HIV co-infection as well as anaemia among selected patients from three health-care institutions in Lagos, Nigeria.Methods: A cross-sectional study of 1080 patients was carried out to  determine the prevalence of malaria and HIV coinfection as well as anaemia. Blood sera from each of the patients were screened for malaria parasites, HIV-1 and HIV-2 using Giemsa stain, Cambridge Biotech  Recombigen HIV-1/HIV-2 rapid device, respectively while haemoglobin estimation was performed using cyanmethemoglobin method.Results: Our data showed that the total number of malaria infected  patients were significantly higher in HIV sero-positive patients 47.7% (31/65) when compared with their HIV sero-negative counterparts 25.8% (262/1015) P = 0.047. The result also revealed that 25.8% (8/31) of the patients co-infected with malaria and HIV had anaemia as compared to 11.1% (29/262) infected with malaria alone. Multivariable logistic  regression analysis showed that patients with dual infection of malaria and HIV were twice likely to be anaemic than those infected with malaria alone [adjusted OR 2.4, 95% CI, 1.3 to 2.7, P = 0.014].Conclusion: Our data indicated a higher prevalence of malaria in HIV infected patients and also revealed that patients coinfected with malaria and HIV were more likely to be anaemic.Keywords: Malaria, malaria and HIV co-infection, anaemia, parasite densit

Human African trypanosomes: challenges posed to the human immune system.

Human infection by either Trypanosoma brucei gambiense (Tbg) or Trypanosoma brucei rhodesiense (Tbr) and the establishment of disease is made possible by the intermittent switching of their variant surfaceglycoprotein (VSG) and expression of serum resistance associated (SRA) protein (by Tbr) which nullifies the lytic action of the normal human serum. The ability to switch expression from one VSG to the other is recognized to be the major mechanism that permits the parasite to evade the otherwise efficient host antibody, hence preventing parasite elimination and allowing the establishment of a chronic infection. These changes were reported to: disable the host’s capacity to mount a protective anti-parasite antibody response and prevent the development of effective B-cell memory against encountered variant antigenic parasite types (VATs). Both B cell-mediated antibody response and the Th1 cell responses leading to the production of interferon-gamma (IFN-ϒ) are required for maximum host resistance to trypanosomes, with IFN-ϒ acting to induce macrophage trypanolytic and trypanostatic activities. High levels of both tumor necrosis factor alpha (TNFα) and interleukin 10 (IL-10) have been associated with trypanosomal infection. Trypanosomal genetics (including the parasite’s intrinsic characteristics), human immune response polymorphisms and geographical locations are important elements that describe the severity or mildness of HAT. As the parasite devices ways to evade thehuman immune system, and in the absence of a suitable vaccine, surveillance, prompt diagnosis and treatment with available drugs and vector control efforts will go along way in reducing the incidence of HAT.Keywords: African trypanosomes, Variant surface glycoprotein, Serum resistance associated (SRA) protein, Trypanosomal genetic polymorphisms, Immune response polymorphism

A guide to the Simulium damnosum complex (Diptera: Simuliidae) in Nigeria, with a cytotaxonomic key for the identification of the sibling species.

<title/> Although approximately 40% of all the people blinded by Onchocerca volvulus are Nigerians, almost nothing was known about the various cytospecies of the blackfly vectors present in Nigeria until 1981. The activation of the Nigerian National Onchocerciasis Control Programme in 1986 (and that programme's initiation of mass distributions of ivermectin in 1991) provided a significant stimulus to understand the biology of the Nigerian vectors but the exploration of any possible differences between the cytospecies has been hampered by a lack of accessible taxonomic information. This review attempts to satisfy that need. There are nine different cytoforms reliably recorded from Nigeria (Simulium damnosum s.s. Nile form, S. damnosum s.s. Volta form, S. sirbanum Sirba form, S. sirbanum Sudanense form, S. soubrense Beffa form, S. squamosum A, S. squamosum B, S. squamosum C and S. yahense typical form), and three more are known from surrounding countries and might be reasonably expected to occur in Nigeria. All of these cytospecies are presumed to be vectors, although there have been almost no identifications of the vectors of O. volvulus in Nigeria. The biogeographical distribution of the cytoforms is broadly similar to that known in other parts of West Africa (although many of the cytoforms remain insufficiently studied). The physico-chemical hydrology of the Nigerian breeding sites of the cytospecies does not, however, correspond to that seen elsewhere in West Africa, and it is not clear whether this might be related to differences in the cytoforms. An illustrated cytotaxonomic key is presented to facilitate and encourage future studies