Molecular diagnosis of MDR-TB using GenoType MTBDRplus 96 assay in Ibadan, Nigeria

Summary: Multidrug resistant Mycobacterium tuberculosis (MDR-TB) is of great public health importance worldwide. This three month laboratory- based study (1st September-30th November, 2011) was carried out at the TB laboratories of the University College Hospital, Ibadan, Nigeria to determine the magnitude of MDR-TB using molecular based GenoType MTBDRplus 96 assay. Two sputum samples were collected from each subject. These were processed using Ziehl -Neelsen (ZN) reagents. The sputa were cultured on Loewenstein-Jensen egg –based medium and incubated at 370C for eight weeks. Mycobacterium tuberculosis complex (MTBC) was confirmed by colonial morphology and repeat ZN staining. All the Acid-fast bacill (AFB) positive smears and culture positive isolates were tested for genetic identification and drug susceptibility testing (DST) using PCR- based GenoType MTBDRplus 96 assay (HAINs Lifesciences, GmbH, Nehren, Germany) according to manufacturers’ instructions. Of the 68 samples processed, 11 (16.2%) were AFB positive while six (8.8%) were positive for culture. Eleven (64.7%) out of the 17 samples tested for genetic identification were MTBC while six were Non Tuberculosis  Mycobacteria (NTM). All NTM were from AFB positive sputum while none was from culture positive isolates. Of the six culture isolates tested for DST, three (33.3%) were susceptible to isoniazid and rifampicin; one (16.7%) showed mono-resistance to isoniazid while two (30.0%) were resistant to the two drugs. This study shows that MDR-TB is present in Ibadan. There is a need to make DST diagnostic facilities more available and accessible in Nigeria.Keywords: Molecular diagnosis, MDR-TB, GenoType MTBDRplus 96assay, Ibadan, Nigeri

Anti-tuberculosis activities of the crude methanolic extract and purified fractions of the bulb of Crinum jagus

Summary: Tuberculosis (TB) is of great public health burden globally especially in developing countries of Africa and Asia . Current TB regimen involves multiple therapies and of long duration leading to poor patient adherence. There is also the challenge of multidrug resistant TB. Hence, there is a need for discovery of new anti- TB drugs. This study was designed to investigate the in –vitro activity of the crude methanolic extract and chromatographic fractions of the bulb of Crinum jagus against Mycobacterium tuberculosis isolates. The extracts were screened for anti- TB activity against three different M. tuberculosis isolates and a drug susceptible reference strain H37Rv using Lowenstein Jensen (L-J) medium and Middlebrook 7H10agar. The crude extract was prepared using soxhlet extraction apparatus while the purified fractions were obtained by column chromatography. The two media were inoculated with M. tuberculosis strains, after which the crude and purified extracts were added. After 4-6 weeks incubation, colony forming units were counted and percentage inhibition calculated. The crude extract and the purified fractions showed inhibitory activity on all the isolates tested including the reference strain. Fraction 3 showed the highest inhibitory percentage (86%) among the extracts. At a concentration of 1.0mg/ml, the percentage inhibition of fraction 3, rifampicin and isoniazid against M. tuberculosis strain 3 were 83%, 95% and 86% in L-J medium respectively while 86%, 96% and 89% were obtained respectively in Middle brook medium. Results showed that the crude methanolic extract and the purified fractions of the bulb of Crinum jagus exhibited anti-mycobacterial activity which is an indication of promising potential of this plant for the development of anti-tuberculosis agent.Keywords: Crinum jagus, Chromatographic fractions, Mycobacterium tuberculosis, In-vitr

Comparative Assessment between Provisional Sums in Private and Public Client Initiated Project in Nigeria

A project is an activity moderated and measured within its set cost, time and quality. Funding of projects is as important as the project itself. Most projects are either funded by taxpayer’s money (Public initiated projects) or from individual’s pockets (Private initiated projects). Abuja, the capital of Nigeria is still developing after more than 30 years of creation, as evident with the volume of construction projects on going within the city. Cost overrun in the Nigerian construction industry is fast becoming a very popular occurrence especially in Abuja. This paper aims to conduct a comparative assessment of provisional sums in public and private client initiated projects in Abuja in a view to proffer solutions to the plague of cost and time overrun in construction projects. 50 structured questionnaires were administered to property developers and only 36 were eventually retrieved and employed for data analysis. The data was analysed using Analysis of Variance (ANOVA) and frequency distribution table. Findings revealed that the one-way analysis of variance (ANOVA) between the two groups indicates that p<0.03 meaning that significant difference exist between the percentage differences of provisional sum in a private initiated project and public initiated project. It was also discovered that the Federal, State, and Local tiers of government are the biggest funders of public initiated projects while individuals; banks and churches are the biggest funders of private initiated projects. . The paper concluded that bureaucratic bottlenecks, corruption amongst other factors is responsible for fewer developers in public initiated projects. Government must reduce corruption, operational lapses and promote project continuity to reduce the number of abandoned projects and ensure qualitative delivery. Recommendations include that projects should be awarded and executed as soon as they are tendered to reduce the effect of inflation between tender time and project execution. Keywords: Provisional Sum, Private Initiated Project, Public Initiated Project, Cost, Funding

Clinicopathological analysis of histological variants of ameloblastoma in a suburban Nigerian population

BACKGROUND: This study was carried out to establish the relative incidence and provide clinico-pathologic information on the various histological types of ameloblastoma seen at the Obafemi Awolowo University Teaching Hospital complex, Ile-Ife in order to provide a baseline data which will be of significance to the pathologist and clinician. METHODS: Clinico-pathologic data on a total of 77 histologically diagnosed cases of ameloblastoma archieved at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife over a 15 year period were obtained and analysed descriptively. RESULTS: Follicular ameloblastoma was the most common histological type (50 cases, 64.9%), followed by plexiform ameloblastoma (10 cases, 13.0%). 4 (5.2%) cases of desmoplastic and 3 (3.9%) cases of acanthomatous ameloblastoma were seen while the basal cell variant accounted for 2 (2.6%) cases. Only 1 case of the unicystic type was seen. Some of the 77 cases presented as a mixture of two or more histological types. Ameloblastoma occurred over an age range of 11 to 70 years with a peak age incidence in the 3(rd )decade. CONCLUSION: This study provides a baseline data on variants of ameloblastoma as obtained in a suburban Nigerian population. Since variants of ameloblastoma differ in biologic behaviour, the data collected in this study provides clinicopathologic information which is of significance to the pathologist and clinician

Ameloblastic carcinoma: a clinicopathologic analysis of cases seen in a Nigerian Teaching Hospital and review of literature

Introduction: ameloblastic carcinoma is a rare malignant odontogenic neoplasm that exhibits histological features of ameloblastoma in combination with cytological atypia. It may arise de novo or secondarily through malignant de-differentiation of pre-existing ameloblastoma or odontogenic cyst. Secondary ameloblastic carcinomas often results from repeated surgical intervention, which is a mainstay of odontogenic tumor management in resource limited settings. To date, relatively few cases of ameloblastic carcinomas have been reported and many cases have been misdiagnosed as ameloblastoma. This is due to its wide range of clinicopathological feature which range from indolent to aggressive. It may present as an aggressive ulcerated mass or as a simple cystic lesion; hence, it often challenging to delineate from its benign counterpart, ameloblastoma. Methods: this study reviewed the clinicopathological data on 157 cases of odontogenic tumors diagnosed over a 10 years period from the pathology archive of the Oral Pathology Unit of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria. Results: of all these cases, we identified that 64.9% were Ameloblastomas, while 8.3% were ameloblastic carcinomas. Primary subtypes of ameloblastic carcinoma constituted 23.08%, while 69.23% of the cases were of the secondary subtype. We also found that the secondary subtype of ameloblastic carcinomas showed a higher mean duration value of 7.7 years. Most lesions were found in posterior mandible and presented with ulceration, perforation and ill-defined borders radiographically. Conclusion: this study is among the few that have documented higher frequency of secondary ameloblastic carcinoma in the scientific literature

Pericardial effusion in a patient with hyperthyroidism: A case report

Pericarditis and pericardial effusion are commonly associated with hypothyroidism. It is an uncommon association with hyperthyroidism. We present a case of pericarditis/pericardial effusion in a 28-year-old Nigerian lady with hyperthyroidism. There was resolution of the pericardial effusion with antithyroid  medications and steroid therapy. We recommend a high index of suspicion of this association in patients  with hyperthyroidism and/or Graves’ disease

Pattern of distribution of reactive localised hyperplasia of the oral cavity in patients at a tertiary health institution in Nigeria

Background: Reactive localized hyperplastic lesions of the oral cavity (RHLs) are relatively common peripheral lesions which present as a range of clinically similar lesions at dental centers. Diagnosis can be challenging if dentists are unfamiliar with their clinicopathological across various populations.Objective: This study reviews the pattern of distribution of RHLs of the oral mucosa in a hospital- the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife.Materials and methods: We reviewed 10 years data from the archives of the Department of Oral Maxillofacial Surgery and Oral Pathology, Obafemi Awolowo University, Nigeria. Information on RHLs were extracted and recorded on standardized data forms and analyzed using STATA.Results: The most common lesions were pyogenic granuloma (43.7%) and focal fibrous hyperplasia (39.7%), respectively. RHLs were found to be more frequent in women (66.7%) than men (33.3%). The most common locations of involvement was the gingivae (84.6%), and lesions were more common in the 9–29 year age group and the mean age was 37.7 (±21.1) years. The relationship between age group and reactive lesions was however not statistically significant.Conclusion:  The major benefit of this study is an improved knowledge of the frequency and distribution of oral reactive le- sions in sub-Saharan Africa which may be highly beneficial when establishing a diagnosis and treatment plan in clinical practice.Keywords: Focal fibrous hyperplasia, oral mucosa, peripheral giant cell granuloma, peripheral ossifying fibroma, pyogenic gran- uloma, reactive hyperplasia

Pattern of distribution of reactive localised hyperplasia of the oral cavity in patients at a tertiary health institution in Nigeria

Background: Reactive localized hyperplastic lesions of the oral cavity (RHLs) are relatively common peripheral lesions which present as a range of clinically similar lesions at dental centers. Diagnosis can be challenging if dentists are unfamiliar with their clinicopathological across various populations. Objective: This study reviews the pattern of distribution of RHLs of the oral mucosa in a hospital- the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife. Materials and methods: We reviewed 10 years data from the archives of the Department of Oral Maxillofacial Surgery and Oral Pathology, Obafemi Awolowo University, Nigeria. Information on RHLs were extracted and recorded on standardized data forms and analyzed using STATA. Results: The most common lesions were pyogenic granuloma (43.7%) and focal fibrous hyperplasia (39.7%), respectively. RHLs were found to be more frequent in women (66.7%) than men (33.3%). The most common locations of involvement was the gingivae (84.6%), and lesions were more common in the 9\u201329 year age group and the mean age was 37.7 (\ub121.1) years. The relationship between age group and reactive lesions was however not statistically significant. Conclusion: The major benefit of this study is an improved knowledge of the frequency and distribution of oral reactive lesions in sub-Saharan Africa which may be highly beneficial when establishing a diagnosis and treatment plan in clinical practice. DOI: https://dx.doi.org/10.4314/ahs.v19i1.45 Cite as: Soyele OO, Ladeji AM, Adebiyi KE, Adesina OM, Aborisade AO, Olatunji AS, et al. Pattern of distribution of reactive localised hyperplasia of the oral cavity in patients at a tertiary health institution in Nigeria. Afri Health Sci. 2019;19(1). 1687-1694. https://dx.doi. org/10.4314/ ahs. v19i1.4

A geographical analysis of ethnic distribution of jaw ameloblastoma in Nigerians

Introduction: Ameloblastoma is the most common odontogenic tumour in Nigeria. A definite geographic variation has been observed in the frequency of odontogenic tumors from different parts of the world. However, there is no study on the regional variations in Nigeria. Hence, this study was designed to document the ethnic and geographical distribution of jaw ameloblastoma in Nigeria.Methods: Archival data on ameloblastoma from 10 health facilities were obtained. Global Moran’s I detected geographic clustering in its distribution while Local Getis Ord indicated the location of ameloblastoma clusters. Chi-square tested associations between variables at 0.05 level of significance.Results: A total of 1,246 ameloblastoma cases were recorded in Nigeria. Besides substantial state variations, a South-North gradient was noticed in its distribution. Significant positive spatial autocorrelation was observed in the three major groups while ameloblas- toma hotspots were found in the SouthWestern and Northwestern Nigeria. The Igbos had a higher prevalence of ameloblastoma outside their home region than within.Conclusion: The study hypothesized that the geographical distribution of ameloblastoma in Nigeria is the result of all or one of the following:  the country’s tropical climate, migration patterns and health seeking behavior. Hopefully, these claims should lead to further enquiry on the underlying causes.Keywords: Ameloblastoma, ethnicity, spatial analysis, Nigeria

A geographical analysis of ethnic distribution of jaw ameloblastoma in Nigerians

Introduction: Ameloblastoma is the most common odontogenic tumour in Nigeria. A definite geographic variation has been observed in the frequency of odontogenic tumors from different parts of the world. However, there is no study on the regional variations in Nigeria. Hence, this study was designed to document the ethnic and geographical distribution of jaw ameloblastoma in Nigeria. Methods: Archival data on ameloblastoma from 10 health facilities were obtained. Global Moran\u2019s I detected geographic clustering in its distribution while Local Getis Ord indicated the location of ameloblastoma clusters. Chi-square tested associations between variables at 0.05 level of significance. Results: A total of 1,246 ameloblastoma cases were recorded in Nigeria. Besides substantial state variations, a South-North gradient was noticed in its distribution. Significant positive spatial autocorrelation was observed in the three major groups while ameloblastoma hotspots were found in the SouthWestern and Northwestern Nigeria. The Igbos had a higher prevalence of ameloblastoma outside their home region than within. Conclusion: The study hypothesized that the geographical distribution of ameloblastoma in Nigeria is the result of all or one of the following: the country\u2019s tropical climate, migration patterns and health seeking behavior. Hopefully, these claims should lead to further enquiry on the underlying causes. DOI: https://dx.doi.org/10.4314/ahs.v19i1.44 Cite as: Adisa AO, Osayomi T, Effiom OA, Kolude B, Lawal AO, Soyele OO, et al. A geographical analysis of ethnic distribution of jaw ameloblastoma in Nigerians. Afri Health Sci. 2019;19(1). 1677-1686. https://dx.doi.org/10.4314/ ahs. v19i1.4