Prevalence and incidence of asymptomatic bacteriuria among nigerian children and adolescents with type 1 diabetes mellitus

Background: It is commonly believed that patients with diabetes mellitus are at increased risk of urinary tract infection than non-diabetic patients.Objective: To determine the prevalence and incidence of asymptomatic bacteriuria (ASB) among children and adolescents with type 1 diabetes mellitus and compare the result with that of their non-diabetic peers.Methods: Bacteriuria was screened for in 34 patients (17 with type 1 diabetes mellitus and 17 with non-diabetic endocrine disorders) at their regular follow-up visits to our Paediatric Endocrine Clinic, using clean midstream freshly voided urine specimens collected every three months for 12 months from each of the 34 children and adolescents and cultured. The sub­jects were matched for age and sex. The results of the culture of each urine specimen (four for each patient) were recorded and analyzed at the end of the study period.Results: Among the 34 patients screened, only two (one, 5.9%, out of 17 diabetic and one, 5.9%, out of 17 non-diabetic) had asymptomatic bacteriuria and the urine culture of each of them yielded a growth of Escherichia coli sensitive to gentamycin. The duration of diabetes in the girl with ASB was 7 years. She had a poor glycaemic control and some psychosocial chal­lenges. Her pubertal maturation was delayed (Tanner Stage II at the age of 15 years and has not attained menarche). She weighed 29 Kg, with BMI of 16.0 kg/m2. In addition, she had vaginal candidiasis for which she was appropriately treated, using ketoconazole. The other patient with ASB was a 7-year-old girl with precocious puberty due to congenital adrenal hyperplasia diagnosed at the age of 18 months. The two patients with ASB did not progress to symptomatic bacteriuria after a follow-up period of one year.Conclusion: The prevalence and incidence of asymptomatic bacteriuria in diabetic children and adolescents do not differ from those of their non-diabetic counterparts

Elevated high-sensitivity C-reactive protein among apparently healthy adults with concomitant prediabetes and latent tuberculosis infection in Nigeria

Background: The increasing prevalence and convergence of type 2 diabetes mellitus (DM) and active tuberculosis (TB) comorbidity, especially in adults in the lower-and middle-income countries, demand new approaches to control the ‘syndemic’. Consequently, we set out to investigate the possibility of early detection of prediabetes mellitus and/or latent tuberculosis infection using novel method.Methods: This was a case-control study of 105 adults classified into 4 groups: Healthy Community Controls (HCC, n=30); Prediabetes mellitus (PDM, n=25); Latent Tuberculosis Infection (LTBI, n=23); Individuals with Prediabetes mellitus+Latent Tuberculosis Infection (PDM+LTBI, n=27). Sera collected were assayed for high-sensitivity C-reactive protein (hs-CRP) using the ultra-sensitive Human high sensitivity C-reactive protein ELISA Kit (Melsin Medical Co., Ltd, China). Other ancillary tests and measurements done include Erythrocyte Sedimentation Rate, serum Glycated-hemoglobin (HbA1c), Interferon-gamma (INF-ϒ) and Waist circumference.Results: A total of 88 (83.8%) of the enrolled participants had full complement of results and were included in the analysis of four study groups: HCC (n=25), PDM (n=21), LTBI (n=19) and PDM+ LTBI (n=23). With respect to the serum biomarkers, isolated PDM and LTBI cases recorded significantly higher HbA1c (%) and INF-ϒ positivity respectively. Predictors of PDM+LTBI show statistically significant higher tertile (T3), representing elevated hs-CRP levels, (OR=6.50, 95% CI=4.83-22.39, p=0.0037).Conclusions: This study revealed that persons harboring the two associated asymptomatic conditions, PDM + LTBI have higher inflammatory state detectable by assaying the biomarker, hs-CRP, which could be used for ‘one-time bi-directional targeted screening’ for PDM in LTBI and vice versa

Indiscriminate handling of rodents and some cultural practices: their possible role in the spread Lassa virus (LV) in Edo State, Nigeria

Background: The traditional healer/spiritualist is consulted for various services ranging from treatment of diseases to the procurement of charms/placement of curses/and or lifting. Speculations are rife that rodents which may include species of Mastomysare used by traditional doctors in Edo state, Nigeria for the preparation of a charm used to place a curse on another person. The rodent, Mastomysnatalensis is known to cause a fatal viral haemorrhagic fever, Lassa fever and this disease is endemic this state. Sporadic outbreaks have been reported.Aim: To explore the knowledge of study participants on rodents as vector of lassa fever virus and its use for the making of charms by traditional native doctors. Also to find out the perceived measures that will be effective in convincing all those who handle the rodent indiscriminately on the dangers inherent in the practice including contracting Lassa fever (LF) and spreading the Lassa virus (LV).Design: A cross sectional studyMethod: The study tool was a questionnaire designed to examine the knowledge about the rodent as the vector for the LV, the reason for the choice of rodents and its use for the preparation of a charm, why the curse is placed on individuals and measures perceived to be effective in the enlightenment of every one of the dangers of handling the rodent.Result: Two hundred and forty-one volunteers participated in the study. One hundred and twenty-four were males and 117, females aged between less thantwenty and sixty years and above. Seventy-two (29.9%) were aware that the rodent is of utility in the preparation of a charm to place a curse and a significantly higher level of awareness was associated with lower levels of education (P<0.001). Forty-six (63.9%) of those who were aware that the rodent is used to make a charm say it is common knowledge, 20(27.8%) attested to the fact that they got to know from friends and 6(8.3%) said they heard of it from neighbors. Some of the reasons volunteered to warrant the curse include jealousy, envy instinctive hatred etc. The rodent is said to be available on sale in some open markets in Benin City, Edo state in Southern Nigeria.Conclusion: Indiscriminate handling of rodents which may include species of Mastomysraises substantial concern regarding potential risk of rodent-borne zoonoses particularly the spread of LV and; also negate control efforts against the spread of LF in Edo State. Control programs designed carefully to effectively implement enlightenment campaign without transgressing the culture and customs of the people is advocated. This will have to be with the full cooperation and participation of relevant stakeholders.Key words: rodents,hunting,charms, rodent-borne zoonosis