Prevalence of asymptomatic bacteriuria among pre-school children in Nnewi, South-East Nigeria

Background: Early diagnosis and management of urinary tract infection (UTI) in young children reduces the risk of renal scarring and chronic renalinsufficiency. We determined the prevalence of asymptomatic bacteriuria(ASB) among pre-school children in Nnewi, South-East Nigeria.Methodology: This was a crosssectional survey involving apparently healthy nursery school children aged 3-5 years. A pre-tested, care-giver administered questionnaire was used to obtain information about the participants including age, sex, history of fever and antibiotic administration in the two weeks preceding the study. Following a clinical examination, a sample of mid-stream urine was collected from each participant for dipstick urinalysis, and urine microscopy and culture. ASB was defined as the presence of .105CFU/ml of urine in a participantwho had no symptoms of UTI.Results: Out of 792 children, 417 (52.3%) were females and 375 (47.4%) were males. The mean age of the children was 4.0 } 0.7 years. ASB was found in 31 children (4%). The prevalence of ASB in females (7.2%) was significantly higher than in males (0.5%), p<0.001. The highest prevalenceof ASB of 5.6% occurred in the 4-year-olds and the lowest of 2.0 %occurred in 5 year olds, p=0.09. The commonest bacterial isolates among the ASB cases were Staphlococcus aureus, 13 (40.6%); Streptococcus faecalis, 9 (28.1%) and Escherichia coli, 5 (15.6%). Conclusion: Asymptomatic bacteriuria is commoner in female preschoolchildren and S. aureus is the commonest bacterial isolate. Routine evaluation of female preschool children for bacteriuria is recommended.Key words: Asymptomatic bacteriuria, Pre-school children, Prevalenc

The performance of an Histidine rich protein-2 rapid diagnostic test (RDT) against the standard microscopy in the diagnosis of malaria parasitaemia among febrile under-five children at Nnewi

Background: Malaria remains a major cause of morbidity and mortality, thus there is need for quick, reliable inexpensive diagnostic tool to facilitate its prompt treatment especially in resource poor settings.Objectives: To compare the sensitivity of a locally available Histidinerich protein-2 based rapid diagnostic test (RDT) with the standard microscopy.Methods: This study was carried out to test the performance of an histidine rich protein -2 rapid diagnostic test (RDT) against the standard microscopy in the diagnosis of malaria among febrile under-five children attending Paediatric Clinic of NAUTH Nnewi. A total of 200 children under the age of five years were recruited for the study. Data on socio-demographic characteristics and symptoms were collected through an interviewer administered questionnaire. Blood sample was collected in EDTA bottle after observing universal precautions. All of them were tested with both Giemsa stained blood smear and Histidine rich protein-2 (HRP-2) rapid diagnostic test (RDT).Results: There were 118 males and 82 females, giving a male: female ratio of 1.44:1. Their ages ranged from 3-59 months and the average age was 27+17.49 months. Average number of days the subjects had fever before presentation were 3.78+1.95 days with a range of 1- 14 days. Body temperature ranged from 35.9-40.40C with average of 37.7+0.80C. Forty (20%) were positive by microscopy while 42 (21%) were positive by rapid diagnostic test. Twenty-percent of those positive by microscopy (n=8) were negative by RDT while 23.8% of those positive by RDT (n=10) were negative by microscopy. Using microscopy as a gold standard, the sensitivity of the RDT was 80%, the specificity was 93.8%. The positive and negative predictive values were 76.2% and 94.9% respectively.Conclusion: Based on these findings, the RDT demonstrated reasonable concordance with microscopy and was recommended for use at every level of healthcare in the diagnosis of malaria.Keywords: Malaria, RDT, Microscopy, under- five

Respiratory symptoms and ventilatory function tests in Nigerians with HIV infection

Background: The impact of the human immunodeficiency virus (HIV) infection on the respiratory system of Africans has been little studied. This study aimed to determine the pattern of respiratory symptoms and ventilatory functions in HIV infected Nigerians. Methods: In this cross sectional study, Respiratory symptoms frequency, Forced vital capacity (FVC), Forced expiratory volume in one second (FEV 1 ), FEV 1 /FVC ratio, Forced expiratory flow between 25% and 75% of FVC, were determined in 100 HIV positive subjects and compared with values in 100 HIV negative controls. Results: HIV positive patients had significantly more respiratory symptoms and lower ventilatory function tests values compared to the matched controls (p<0.05). HIV patients with at least one respiratory symptom and those with CD4 count less than 200cells/μl had lower ventilatory function values than their counterparts. 32% of the HIV patients had restrictive ventilatory functional impairment. (p<0.05). Using regression analysis, factors like HIV status, CD4 count and presence of respiratory symptoms were found to be associated with impairment in ventilatory functions. Conclusions: HIV infected patients had more frequent respiratory symptoms and lower ventilatory function values. Further lung function studies and CT scanning in HIV positive patients especially in those with respiratory symptoms are indicated