T-Lymphocyte Subsets in Apparently Healthy Nigerian Children

Population studies showed that there are differences in T-lymphocytes subpopulation of normal children in different regions, and reference values in an area might be different from another. This study compared the values in our population with CDC and WHO reference values. Blood samples from 279 healthy, HIV-negative children <12 years of age were analysed for complete blood count, CD3+, CD4+, CD8+ counts and percentages. Except for CD8%, mean values for all parameters measured significantly decreased with age. CD4+ counts were higher in females than males, P < .05. Using the WHO criteria, 15.9% of subjects had low total lymphocyte count and 20.6% had low CD4 count. Children <3 years had median CD4% lower than WHO normal values. Our median CD4+ counts correlated with CDC values. Values used by WHO in infants are higher than ours. We suggest that our children be assessed using CDC reference values which correlate with ours

Hepatitis C Virus Antibodies Among Blood Donors in Jos, Nigeria

Background: Hepatitis C virus (HCV) is one of the hepatitis agents known to be transmitted through blood and blood products. Hepatitis C virus has been implicated as a major cause of chronic liver disease and hepatocellular carcinoma worldwide. This study was, therefore, undertaken with the objective of determining the sero-prevalence of HCV antibodies among blood donors in the central city of Jos, Nigeria. Method: A total of two hundred blood donors were recruited from three hospitals within Jos metropolis. Sera from all subjects were tested for Hepatitis C virus antibodies using a second generation enzyme linked immunosorbent assay (ELISA). Results: Ninety five percent (95%)of the blood donors were males and most of them were aged between 21 and 50years. Twelve (6.0%)of the blood donors were anti-HCV seropositive and all of them males. Conclusion: There is an urgent need to introduce routine screening of blood donors for Hepatitis C virus markers in centers where this is not currently been practiced. This will reduce the risk of transfusion-associated hepatitis C infection and its complications in Nigeria

Heme Mediated STAT3 Activation in Severe Malaria

The mortality of severe malaria [cerebral malaria (CM), severe malaria anemia (SMA), acute lung injury (ALI) and acute respiratory distress syndrome (ARDS)] remains high despite the availability associated with adequate treatments. Recent studies in our laboratory and others have revealed a hitherto unknown correlation between chemokine CXCL10/CXCR3, Heme/HO-1 and STAT3 and cerebral malaria severity and mortality. Although Heme/HO-1 and CXCL10/CXCR3 interactions are directly involved in the pathogenesis of CM and fatal disease, the mechanism dictating how Heme/HO-1 and CXCL10/CXCR3 are expressed and regulated under these conditions is still unknown. We therefore tested the hypothesis that these factors share common signaling pathways and may be mutually regulated.We first clarified the roles of Heme/HO-1, CXCL10/CXCR3 and STAT3 in CM pathogenesis utilizing a well established experimental cerebral malaria mouse (ECM, P. berghei ANKA) model. Then, we further determined the mechanisms how STAT3 regulates HO-1 and CXCL10 as well as mutual regulation among them in CRL-2581, a murine endothelial cell line.The results demonstrate that (1) STAT3 is activated by P. berghei ANKA (PBA) infection in vivo and Heme in vitro. (2) Heme up-regulates HO-1 and CXCL10 production through STAT3 pathway, and regulates CXCL10 at the transcriptional level in vitro. (3) HO-1 transcription is positively regulated by CXCL10. (4) HO-1 regulates STAT3 signaling.Our data indicate that Heme/HO-1, CXCL10/CXCR3 and STAT3 molecules as well as related signaling pathways play very important roles in the pathogenesis of severe malaria. We conclude that these factors are mutually regulated and provide new opportunities to develop potential novel therapeutic targets that could be used to supplement traditional prophylactics and treatments for malaria and improve clinical outcomes while reducing malaria mortality. Our ultimate goal is to develop novel therapies targeting Heme or CXCL10-related biological signaling molecules associated with development of fatal malaria

The evolving SARS-CoV-2 epidemic in Africa: insights from rapidly expanding genomic surveillance

Investment in SARS-CoV-2 sequencing in Africa over the past year has led to a major increase in the number of sequences generated, now exceeding 100,000 genomes, used to track the pandemic on the continent. Our results show an increase in the number of African countries able to sequence domestically, and highlight that local sequencing enables faster turnaround time and more regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and shed light on the distinct dispersal dynamics of Variants of Concern, particularly Alpha, Beta, Delta, and Omicron, on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve, while the continent faces many emerging and re-emerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Neonatal sepsis and mortality in low-income and middle-income countries from a facility-based birth cohort: an international multisite prospective observational study

Background Neonatal sepsis is a primary cause of neonatal mortality and is an urgent global health concern, especially within low-income and middle-income countries (LMICs), where 99% of global neonatal mortality occurs. The aims of this study were to determine the incidence and associations with neonatal sepsis and all-cause mortality in facility-born neonates in LMICs. Methods The Burden of Antibiotic Resistance in Neonates from Developing Societies (BARNARDS) study recruited mothers and their neonates into a prospective observational cohort study across 12 clinical sites from Bangladesh, Ethiopia, India, Pakistan, Nigeria, Rwanda, and South Africa. Data for sepsis-associated factors in the four domains of health care, maternal, birth and neonatal, and living environment were collected for all mothers and neonates enrolled. Primary outcomes were clinically suspected sepsis, laboratory-confirmed sepsis, and all-cause mortality in neonates during the first 60 days of life. Incidence proportion of livebirths for clinically suspected sepsis and laboratory-confirmed sepsis and incidence rate per 1000 neonate-days for all-cause mortality were calculated. Modified Poisson regression was used to investigate factors associated with neonatal sepsis and parametric survival models for factors associated with all-cause mortality. Findings Between Nov 12, 2015 and Feb 1, 2018, 29 483 mothers and 30 557 neonates were enrolled. The incidence of clinically suspected sepsis was 166·0 (95% CI 97·69–234·24) per 1000 livebirths, laboratory-confirmed sepsis was 46·9 (19·04–74·79) per 1000 livebirths, and all-cause mortality was 0·83 (0·37–2·00) per 1000 neonate-days. Maternal hypertension, previous maternal hospitalisation within 12 months, average or higher monthly household income, ward size (>11 beds), ward type (neonatal), living in a rural environment, preterm birth, perinatal asphyxia, and multiple births were associated with an increased risk of clinically suspected sepsis, laboratory-confirmed sepsis, and all-cause mortality. The majority (881 [72·5%] of 1215) of laboratory-confirmed sepsis cases occurred within the first 3 days of life. Interpretation Findings from this study highlight the substantial proportion of neonates who develop neonatal sepsis, and the high mortality rates among neonates with sepsis in LMICs. More efficient and effective identification of neonatal sepsis is needed to target interventions to reduce its incidence and subsequent mortality in LMICs. Funding Bill & Melinda Gates Foundation

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Attenuation of salt-induced hypertension by aqueous calyx extract of Hibiscus Sabdariffa

The aqueous calyx extract of Hibiscus Sabdariffa (HS) has a folk reputation as an antihypertensive agent. On account of its antioxidant properties and probably high K+ concentration, we hypothesized that HS may attenuate the development of salt-induced hypertension. Sprague-Dawley rats (n=8 each) were treated for 12 weeks as follows: control (normal diet + water), salt-loaded (8% salt diet + water), HS (normal diet + 6mg/ml HS), salt+HS (8% salt diet + 6mg/ml HS) and furosemide (normal diet+ 0.25mg/Kg furosemide). Their blood pressure and heart rates were measured and responses to noradrenalin and acetylcholine (0.01mg/kg respectively) were estimated. The cationic concentration of 6mg/ml HS was determined. The Na+ and K+ concentrations of 6mg/ml HS were 3.6 and 840mmol/l respectively. The mean arterial pressure (MAP±SEM; mmHg) of salt loaded rats (184.6±29.8) was significantly higher than control (113.2±3.0; P<0.05), HS (90.0±7.4; P<0.001) salt+HS (119.4±8.9; P<0.05) and furosemide (94.9±11.5; P<0.01). The MAP of salt+HS and control rats did not differ significantly and the effect of HS was comparable to furosemide. The pressor response to noradrenalin or vasodilator response to acetylcholine remained similar in all groups. These results suggest that HS attenuated the development of salt-induced hypertension and this attenuation may be associated with its high K+ content or high potassium: sodium ratio and not with altered pressor/depressor response to noradrenalin or acetylcholine. Also the effects of HS and furosemide on blood pressure are comparable

Attenuation of salt-induced hypertension by aqueous calyx extract of Hibiscus sabdariffa

Summary: The aqueous calyx extract of Hibiscus sabdariffa (HS) has a folk reputation as an antihypertensive agent. On account of its antioxidant properties and probably high K+ concentration, we hypothesized that HS may attenuate the development of salt-induced hypertension. Sprague-Dawley rats (n=8 each) were treated for 12 weeks as follows: control (normal diet + water), salt-loaded (8% salt diet + water), HS (normal diet + 6mg/ml HS), salt+HS (8% salt diet + 6mg/ml HS) and furosemide (normal diet+ 0.25mg/Kg furosemide). Their blood pressure and heart rates were measured and responses to noradrenalin and acetylcholine (0.01mg/kg respectively) were estimated. The cationic concentration of 6mg/ml HS was determined. The Na+ and K+ concentrations of 6mg/ml HS were 3.6 and 840mmol/l respectively. The mean arterial pressure  (MAP±SEM; mmHg) of salt loaded rats (184.6±29.8) was significantly higher than control (113.2±3.0; P&lt;0.05), HS (90.0±7.4; P&lt;0.001) salt+HS (119.4±8.9; P&lt;0.05) and furosemide (94.9±11.5; P&lt;0.01). The MAP of salt+HS and control rats did not differ significantly and the effect of HS was comparable to furosemide. The pressor response to noradrenalin or vasodilator response to acetylcholine remained similar in all groups. These results suggest that HS attenuated the development of salt-induced  hypertension and this attenuation may be associated with its high K+ content or high potassium: sodium ratio and not with altered  pressor/depressor response to noradrenalin or acetylcholine. Also the effects of HS and furosemide on blood pressure are comparable.Keywords: Hibiscus sabdariffa calyx, salt-induced hypertension, anti-hypertensive effect, High dietary K+, K+:Na

Community-perceived benefits of ivermectin treatment in Northeastern Nigeria

A 3-step approach involving focus group discussion, structured interviews and informal conversations with key individuals was used to investigate community usage and perceived benefits of ivermectin in nine Nigerian villages participating in a WHO-sponsored investigation of community-directed treatment with ivermectin (CDTI). Only 27% of 284 persons interviewed had received treatment. An under-estimation of the district's ivermectin needs led to inadequate supply of ivermectin to the communities, which was cited as the main reason (65%) for non-treatment. All those treated (N=76) were further interviewed using questionnaires. Worm expulsion (80%) and blindness prevention (68%) were the most frequently stated benefits. Other perceived benefits were an increase in vitality (68%), sexual drive and performance (29%). The sudden relief from a heavy burden of worms, which had built up over a long period, may have indirect effect on all aspects of an individual's health and account for the diverse experiences. The feeling of vitality, good appetite and general health following ivermectin treatment is an animating experience to many communities. Health planners face the challenge of preparing communities for fewer 'sensational' experiences and preventing a possible feeling of disappointment that may result from frequent usage.Ivermectin Perception Onchocerciasis Nigeria