Evaluation of CD4+ T Cells in HIV Patients Presenting with Malaria at the University of Ilorin Teaching Hospital Nigeria

CD4 count is an important immunological marker of disease progression in HIV seropositive patients. This study was carried out to determine the effect of malaria or fever of unknown origin on the population of CD4+ T lymphocytes of HIV seropositive patients attending the highly active antiretroviral therapy (HAART) clinic of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. 36 subjects were selected for this study. Ongoing history of fever was used as a case definition for malaria and malaria was confirmed from microscopic examination of thick and thin film of blood sample obtained from the patients during presentation with fever. The CD4 count was evaluated during presentation of fever and post-fever using flow cytometry. There was significant decrease in CD4 count of the patients. However, upon classifying the patients into 2 groups - those that returned to the clinic after a week and those that returned after a month - a significant increase in CD4 count was noticed in the group that returned after a week, while a significant decrease was noticed in the group that returned after a month (at p value of 95%). Further classification of the patients based on presence of malaria parasite, and body temperature resulted in varying effects on CD4 count post-fever (in the general group, 27 were positive for malaria parasites. Of these 27, there was an increase in CD4 count in 9 (33.3%). However in the group that returned after a week, all 6 (100%) that were positive for malaria parasites showed increase in CD4 count. Five (26.3%) of the 19 patients that had body temperature within the range of 35.5-37.4^o^C showed an increase in CD4 count, while 7 (41.2%) the 17 patients that had body temperature of 37.5^o^C and above showed an increase in CD4 count. The results led to the conclusion that while some components of the immune response to malaria could strengthen the immune system of HIV seropositive patients by increasing their CD4 count, other components will suppress their immunity by decreasing their CD4 count, accelerating the progression to AIDS

Prevalence and Characterization of Salmonella Isolates from Poultry Farms in Ilorin, Nigeria

Poultry birds are very important source of essential proteins in developing countries, but also play an important role in transmission of Salmonella to human and nonhuman. Exposure to this pathogen also occurs through use of poultry droppings as manure for crop and vegetable production. This study investigated prevalence of Salmonella in feces of poultry farms in Ilorin, Nigeria. Salmonella isolated were further characterized by molecular method. Fecal samples were cultured in pre-enrichment medium, Selenite F medium and finally sub-cultured on Salmonella-Shigella agar. None lactose fermenting colonies with black center were picked for presumptive identification using biochemical tests and confirmed by serological test by method previously described. Molecular characterization was carried out using 16S rRNA gene sequencing following standard procedure. Out of 170 samples collected and examined, 8 (4.7%) gave biochemical characteristics that resembled Salmonella, but only 6 (3.5%) were confirmed as Salmonella by polyvalent antisera. Molecular characterization revealed that serovars isolated were Salmonella Enteritidis 3 (1.8%) and Salmonella Paratyphi 3 (1.8%). Phylogenetic tree constructed by neighbor-joining method as derived from analysis of the 16S rRNA gene sequences showed close relationship to Salmonella Paratyphi strain FB0015 16S ribosoma RNA gene partial sequence to our Salmonella Paratyphi isolates. The detection of 3.5% prevalence rate of Salmonella serovar from feces of laying poultry birds my serve as potential source of transmission of this pathogen to human through chicken meat, egg or use of poultry dropping as manure in crop or vegetable production

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Comparative alteration in atherogenic indices and hypocholesteremic effect of palm oil and palm oil mill effluent in normal albino rats

The comparative hypocholesteremic effect of feeding palm oil and palm oil mill effluent (POME) was investigated in male albino rats. Diets were prepared and designed to contain 50% of energy as carbohydrate, 35% as fat, and 15% as protein. Groups of six rats were each fed one of these diets, while a group was fed pelletized mouse chow which served as the control. Feeding on palm oil and POME led to a significant increase (p < 0.05) in serum total cholesterol, triglyceride, and vLDL. Feeding on POME led to significant increase (p < 0.05) in cholesterol, triglyceride and LDL levels in brain tissues. Increased hepatic LDL level was also observed in POME fed rats. Except for hepatic triglyceride and tissues HDL level, a rather reduced level of the studied lipids was observed in the serum and tissues of palm oil fed rats compared to POME. These results indicate the protective potentials of palm oil against cardiovascular disease, as well as hyperlipidemia that characterize obesity and hypertension; as compared to its effluent

Biochar, poultry manure and NPK fertilizer: sole and combine application effects on soil properties and ginger (Zingiber officinale Roscoe) performance in a tropical Alfisol

Biochar has a low chemical composition and is recalcitrant to degradation. For good soil fertility and nutrient use efficiency of crops it becomes imperative that addition of a fast releasing nutrient source to biochar be sought. Therefore, studies were conducted in 2017 and 2018 to evaluate the effects of biochar with poultry manure (PM) and NPK fertilizer on soil properties, growth and yield of ginger. Treatments evaluated were: biochar applied alone at 15 t ha-1 , PM applied alone at 15 t ha-1, NPK fertilizer applied alone at 200 kg ha-1, biochar applied at 15 t ha-1 with poultry manure applied at 15 t ha-1 (B+PM), biochar applied at 15 t ha-1 with NPK fertilizer applied at 200 kg ha-1 (B+NPK) and a control with no amendment whatsoever. The experimental design was a randomized complete block design with three replications. Biochar, PM, NPK fertilizer alone or B+PM and B+NPK improved soil physical and chemical properties, growth and yield of ginger compared to no amendment (control). NPK fertilizer did not improve soil physical properties nor increased pH, OM, Ca and Mg significantly. B+PM and B+NPK improved soil physical and chemical properties, growth and ginger yield compared to their sole forms. Although B+PM had better soil physical properties, B+NPK increased yield and growth of ginger compared to B+PM. B+NPK increased the yield of ginger by 12.2% and 10.6% in 2017 and 2018, respectively compared with B+PM. B+NPK also increased the yield of ginger by 49.2% and 50.3% in 2017 and 2018, respectively compared to biochar alone. This was related to high presence of nutrients in B+NPK especially N and K which are important for ginger rhizome formation