Screening of Rodents from Rural Communities of Lagos and Ogun State Nigeria of Lassa Virus RNA

Background: In recent times, there has been an increase in the number of Lassa fever cases resulting from the several episodes of Lassa fever epidemics ravaging Nigeria and other West African countries. The presence of Lassa virus in rodents other than the major reservoir (Mastomys natalensis) has been a public health concern as to the actual burden of the disease. It is therefore of a public health necessity to explore the LASV RNA habouring potential of several species of rodents in endemic as well as non-endemic areas for proper prevention of emergence of outbreaks in non-endemic areas. Objectives: The aim of this study was to detect the presence of LASV RNA in different species of rodents in Ikorodu, Lagos state and Abeokuta, Ogun state. Methods: A total of ninety one (91) rodents were captured from Ikorodu, Lagos State (61 rodents) and Abeokuta, Ogun State (30 rodents), euthanized, bled, and plasma obtained for the detection of LASV RNA by Reverse Transcriptase Polymerase Chain Reaction. Results: A total of 91 rodents consisting of 77 Rattus rattus and 14 Crocidura spp. The S segment of LASV RNA was not in any of the 91 rodents’ plasma samples. Conclusion: The rodents captured within the rural communities of Ikorodu, Lagos State and Abeokuta, Ogun State were found not to habour the LASV RNA. This study is limited by the relatively small sample size. Similar studies should be encouraged both in endemic and non-endemic areas in order to understand the actual burden of Lassa fever as well as put into check future epidemics.

Seroprevalence of parvovirus B19 antibodies and evidence of viremia among Nigerian patients with sickle cell anemia

Clinical, biochemical and molecular evidence for the sickle cell anemia （SCA） crisis in Nigerian patients arising from parvovirus b19 infection remains inadequate. This study determined the prevalence and correlates of antiparvovirus b19 antibodies in a population of SCA patients and non-SCA healthy controls in Lagos, Nigeria. In this prospective cross-sectional study, we enrolled 73 confirmed SCA patients from 5 district hospitals in Lagos and 81 sex and age-matched non-SCA healthy controls. Serum sample from each study participant was screened for anti-parvovirus b19 by ELISA and PCR techniques. Standard biomedical assays were also done. Anti-parvovirus b19 IgM and IgG antibodies were detected in 22 （14.3%） and 97 （62.9%） of the 154 sera screened, 13 （17.8%） and 45 （61.6%） in SCA patients; 9 （11.1%） and 52 （64.2%） in non-SCA controls. The overall seronegativity rate was 19.5%. Parvovirus B19 DNA was found in 2 （11.1%） of the 18 IgM seropositive SCA serum samples screened. On the whole, parvovirus b19 infection was more commonly asymptomatic in non-SCA controls but caused significant elevation in liver enzymes in infected SCA patients （P 〈 0.05）. The risk of acute parvovirus b19 infection increased 65 times during unsteady state among the SCA patients. Although no deaths of infected patients were recorded during the study, age below 12 years, hospitalization and overcrowded environment were risk factors for infection. We conclude that parvovirus b19 is common in SCA patients, incurring greater susceptibility to infections.

Assessment of co-segregated TLR4 genotypes among Nigerian children with asymptomatic and clinical malaria

Objective: To assess the occurrence and pattern of Toll-like receptor 4(TLR4) cosegregated genotypes among children with Plasmodium falciparum malaria in Nigeria.Methods: In this case-control study, a total of 79 Plasmodium falciparum infected children aged 2–7 years and 105 age-matched uninfected controls of Yoruba descents in Lagos were studied. The extracted DNA samples were used for TLR4 genotyping at codons 299(Asp > Gly) and 399(Thr > Ile) by PCR-restriction fragment length polymorphism. Malaria infection was diagnosed by blood smear microscopy and infected children were stratified into asymptomatic, uncomplicated and severe malaria sub-groups.Malnutrition was determined by measuring the mid upper arm circumference and anemia was defined as hemoglobin < 11 g/dL.Results: The proportions of children with acute malnutrition and severe anemia were12.0% and 3.2%, respectively. Parasitemia and malnutrition were not correlated and four distinct patterns of TLR4 genotypes were found in the study population: Asp299Asp/Thr399Thr(90.2%), Asp299Gly/Thr399Thr(4.3%), Gly299Gly/Thr399Thr(3.8%) and Asp299Gly/Thr399Ile(1.6%). These genotypes did not differ significantly(P > 0.05) in frequency between infected and non-infected children. However, low and high occurrences of the TLR4 Asp299Asp/Thr399 Thr and Asp299Gly/Thr399 Thr genotypes were observed in the severe malaria subgroup.Conclusions: This study reveals a protective role for TLR4 Asp299Gly/Thr399 Ile and Asp299Asp/Thr399 Thr genotypes against severe malaria in Nigerian children.

HIV-Infection Reduction-Rates in Patients, on Antiretroviral Efficacy-Trial of a Nigerian Broad-Spectrum Antiviral Medicine (Antivirt^®)

In verifying antiretroviral efficacy of a Nigerian broad spectrum antiviral medicine (Antivirt®), the Nigerian Institute of Medical Research certified it safe by toxicological test on laboratory animals, before commencing treatment of three HIV/AIDS patients whose viral loads varied widely (millions, hundreds of thousands and thousands). To overcome errors associated with such wide differences in subject-classes, percentages of viral load-reductions were calculated instead of comparing their viral loads. After first month of the Antivirt®-treatment, means of ranked viral loads of the patients significantly (P ≤ 0.05) increased from 10.00 ± 7.21 to 11.30 ± 5.51 (-41.03% infection-reduction rate) instead of reducing. From second month of the trial, their viral loads started to reduce, continuously, so that their infection-reduction rates have been increasing from that -41.03%, to -38.22% in the second month;23.98% in the third month;31.76% in the fourth month and 64.12% after the fifth month.

HPV prevalent types in a cohort of sexually active Nigerian women:implications for vaccination programmes

Background:The human papillomavirus virus(HPV)is very common with over 150 strains and at least 42 acquired by sexual contact.It is a public health concern among women the world over,with an estimated prevalence of 11.7%globally,and 24%in Sub-Saharan Africa.There are five common HPV types;HPV16,HPV18,HPV52,HPV31,and HPV58.Cervical cancer affects women globally,with estimated 570,000 new cases in 2018.Nearly 90%of the 311,000 deaths worldwide in that year occurred in low-and middle-income countries.Objective:To estimate the prevalence of HPV among sexually active women in Lagos,Nigeria;and to determine the most common HPV type among that category.Methods:A descriptive cross-sectional study design was implemented,with 198 women in total enrolled for the study.Sexually active women from various health facilities in Lagos were screened by obtaining cervical tissue,stirred into PCR cell media,and assayed for HPV genotypes using the Roche COBAS®4800 System.Results:Age of the women ranged from 18 to 65 years(mean 34.6±6.4),with the majority(56.4%)between 25-34 years;65%were married and 63%had a secondary education.Age at first penile-vaginal contact ranged from 9 to 38 years(mean 20.4±3.9).Sixty-five percent of women stated total lifetime sexual partners of between 2 and 4(mean 2.9±2.5).The prevalence of high-risk HPV was 40.4%(95%CI:40.1 to 40.7)and breakdown of types obtained were;HPV16,2.5%(95%CI:2.22 to 2.78);HPV18,3.5%(95%CI:3.22 to 3.78);other high risk(OHR)HPV,28.3%(95%CI:28 to 28.6);HPV16&OHR HPV,1.5%(95%CI:1.22 to 1.78);HPV18&OHR HPV,4.1%(95%CI:3.82 to 4.38);HPV16,18&OHR HPV,0.5%(95%CI:0.221 to 0.779).HPV negative and inconclusive results were 58.1%and 1.5%respectively.Conclusion:Prevalence of OHR HPV is high among Nigerian women.This informs the pattern of HPV existing in the African region,and may aid future efforts at eradicating the virus.The findings are further contributive evidence to the initiative to eliminate cervical cancer as a public health challenge in Nigeria.

Review of the prevalence,diagnostics,and containment measures of the current mpox outbreak

Monkeypox(mpox),is a disease from the Poxviridae family that can cause several serious medical issues.This mini-review sought to analyze the existing literature regarding the current mpox outbreak with a focus on the prevalence,diagnostics,and containment measures.Mpox cases have been reported to World Health Organization(WHO)from 85 Member States in all six WHO regions during the period of January 1,2022,through August 3,2022.Standardized or optimized guidelines for the clinical care of patients with mpox are limited,particularly in low-resource settings.In an effort to achieve guidance and meet standards,special attention should be paid to this outbreak in order to eradicate such a rare infectious disease by analyzing prevention and control measures.Patient outcomes may also be poor,and their illnesses may last for a long time.The spectrum of clinical symptoms,including complications and sequelae,as well as aspects of the illness may be indicators of sickness severity and complications;therefore,its clinical presentation must be better understood to improve containment measures.In addition,it is important to create and evaluate a standard of care that takes a variety of parameters into account,including antiviral,immune therapies,and clinical metrics that are particular to mpox.The global emergence of mpox has presented new challenges for public health and has called for further investigation into its epidemiological profile across international contexts.

Performance Evaluation of Real Time Polymerase Reaction Assay (SCODA) for Detection of SARS-CoV-2

In order to robustly detect and quantify gene expression from small amounts of RNA, amplification of the gene transcript is necessary. Real Time PCR is useful for detection and quantification of genetic constitution of pathogens. This technique amplifies a tiny DNA target million or billion times in such a way that it can be easily studied by scientists. Availability of highly sensitive and specific assay for the detection of SARS-Cov-2 and easy accessibility of such was necessary for early diagnosis and effective management of COVID-19 infection. The aim of this study was to evaluate the performance characteristic of SCODA. Validation of SCODA was performed using synthesized standards and clinical samples previously tested using a commercially approved COVID-19 RT-qPCR detection kit (LifeRiver). The assay showed a linearity of 98.2% on the ORF1ab target and 99.8% on the N-gene target. The sensitivity and specificity were both 100%. Analysis for the LoD95 produced 74.04 (CI: 25 - 1000) cp/μl on ORF1ab gene and 1.119 (CI: 1 - 1) cp/μl on N-gene target with a precision of CV ≤ 3%. SCODA showed high comparable performance in comparison with LifeRiver and other commercial COVID-19 RT-qPCR test kits.

Detections of mefA, ermB, and mphA Macrolides Resistant Genes in Bacteria Isolated from Covid-19 Patients from Selected Health Facilities in Ibadan, Nigeria

Background: COVID-19 is a disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Epidemiological data indicated that bacterial complications in COVID-19 would decrease clearance rate of the infecting agent and increase mortality rate. Macrolides such as Azithromycin are usually administered to COVID-19 patients as palliative treatments. Currently, a considerable number of bacterial strains have developed resistance to various antibiotics, especially macrolides. Resistance is reported to be due to possession of mefA, ermB, and mphA genes by Gram positive and Gram negative bacteria. Therefore, this study determined antibiotic resistance patterns and identify mefA, ermB and mphA macrolide-resistant genes in bacterial pathogens isolated from COVID-19 cases in Ibadan, Nigeria. Methods: 400 Nasopharyngeal samples were collected from symptomatic cases before antibiotic medication;structured questionnaires were administered to collect socio-demographic data of participants. Samples were cultured on Blood, Chocolate, MacConkey and Mannitol salt agar at 37°C for 48 hrs. Bacterial identification was performed using VITEK 2.0 ID cards and API 20E for Gram positive and negative bacteria respectively. Antibiotic Susceptibility Testing was performed using Kirby Bauer disc diffusion methods and VITEK 2.0 AST card kits. DNA of multidrug resistant bacterial isolates was extracted;resistant genes were determined using a polymerase chain reaction with specific primers. Amplified genes were detected using agarose gel electrophoresis. Results: 240 (60%) had bacterial growth and 97 (22.2%) yielded no growth. From the 240 bacterial isolates, 38 (15.83%) were multi-drug resistant including resistance to macrolides (Azithromycin) 20 (52.63%) of which were positive for either mefA or ermB, and none (0.0%) possess mphA gene;14 (36.8%) isolates had mefA gene, 10 (26.3%) isolates carried ermB gene. Conclusion: Multi-drug bacterial resistance including macrolides and quinolones was detected. Only mefA and ermB genes were detected in the bacterial isolates, especially in Gram positive organisms. The detection of mefA and ermB genes in the MDR bacterial isolates raised concern on the use of azithromycin as palliative treatment for COVID-19 symptomatic patients.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Coinfection with Malaria in Selected States in Nigeria

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.

Comparison of three PCR methods for detection of Helicobacter pylori DNA and detection of cagA gene in gastric biopsy specimens

AIM:To comparatively evaluate PCR and other diagnostic methods (the rapid urease test and/or culture) in order to determine which of the three PCR methods (ureA,glmM and 26-kDa,SSA gene) was most appropriate in the diagnosis of Helicobacterpylori(Hpylori) infection and also to evaluate the detection of a putative virulence marker of H pylori,the cage,gene,by PCR in biopsy specimens. METHODS:One hundred and eighty-nine biopsy specimens were collected from 63 patients (three biopsies each) undergoing upper gastroduodenal endoscopy for various dyspeptic symptoms.The PCR methods used to detect H pylori DNA directly from biopsies were the glmM,26-kDa, ureA and then cagA was used to compare the culture technique and CLO for urease with the culture technique being used as the gold standard. RESULTS:Thirty-five percent of the biopsies were positive for H pylori DNA using the 3 PCR methods,while 68% of these were positive for the cagA gene.Twenty-four percent of the biopsies were negative for H pylori DNA in all PCR methods screened.The remaining 41% were either positive for ureA gene only,glmM only,26-kDa only,or ureA+glmM, ureA+26-kDa,glmM+26-kDa.Out of the 35% positive biopsies,41% and 82% were positive by culture and CLO respectively,while all negative biopsies were also negative by culture and cagA.Cag A+ infection was also predominantly found in H pylori DNA of the biopsies irrespective of the clinical diagnosis. CONCLUSION:This method is useful for correctly identifying infections caused by H pylori and can be easily applied in our laboratory for diagnostic purposes.

The Effectiveness of Infection Control Practices among Health Care Workers Responding to the COVID-19 Pandemic in Nigeria

Background: The world is currently experiencing a healthcare crisis caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Healthcare workers (HCWs) are at the forefront of controlling the spread of the disease;this response has resulted in a huge number of infections amongst HCWs and unfortunately some casualties. Infection prevention and control practices (IPC) are practical, proven methods that prevent avoidable harm to patients and protect health workers from contagious infection. This study was done to evaluate the effectiveness of IPC practices utilized in COVID-19 testing drive through facility in Lagos Nigeria. Method: The facility recruited 42 HCWs who were trained on IPC and use of Personal Protective Equipment (PPEs). Training on donning and doffing of PPEs, preparation of decontaminants and sample handling were done for relevant personnel. A daily log for monitoring COVID-19 symptoms was deployed to all HCWs;to help early detection of COVID-19 infection and prevent transmission amongst staff. Results: Of 42 personnel, 92.8% had a tertiary level of education while 71.4% had at least 5 years work experience. A total of 5 (11.9%) out of 42 HCWs were positive by week six of the study. All infected persons worked at the drive through centre. Most common symptom filled in the daily log tool was headache and fatigue. Conclusion: Despite all the measures introduced, 11.9% of HCWs became positive within 6 weeks, showing the highly infectious nature of the virus and the need to research into more effective measures in preventing the transmission of highly infectious pathogens to HCWs during outbreaks.

Occurrence and Clinical Characteristics of Vaginitis among Women of Reproductive Age in Lagos, Nigeria

Background: Vaginitis is an important public health problem globally. It is associated with gynaecological and obstetric complications. Vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis are mainly responsible for vaginitis. The aim of this study is to determine the occurrence, clinical characteristics and associated risk factors of vulvovaginal candidiasis and bacterial vaginosis among women of reproductive age attending Primary Health Care centres in Lagos Nigeria. Methods:This cross-sectional study recruited 258 women with genital complaints after obtaining their informed written consent between May 2017 and March 2018. Structured questionnaires were administered and high vaginal swabs were collected for laboratory examination. The results were analysed with descriptive statistics, chi-square and simple logistic regression. Results: Out of the 210 (81.4%) of the women with one or more vaginal infections, 105 (50.0%), 26 (12.4%) had bacterial vaginosis, and vulvovaginal candidiasis respectively while 78 (37.1%) had both vulvovaginal candidiasis and bacterial vaginosis. Only 1 (0.5%) participant had trichomoniasis and bacterial vaginosis. History of abortion and age below 25 years were associated with vulvovaginal candidiasis while pregnancy, history of miscarriage, age at first sexual activity and discharge were associated with bacterial vaginosis. Itching was associated with both vulvovaginal candidiasis and bacterial vaginosis. Conclusion: This study revealed vulvovaginal candidiasis and bacterial vaginosis as important cause of genital complaints among reproductive age women in Lagos. Health education, robust diagnosis and early treatment are needed in order to reduce the associated risk factors, disease burden and complications.

Antimicrobial Resistance and Plasmid Profiles of <i>Salmonella enterica</i>Serovars from Different Sources in Lagos, Nigeria

Introduction: Salmonella enterica Serovars remains one of the leading pathogens that cause diarrhoea and bloodstream infections in developing countries. The emergence of multidrug resistant (MDR) Salmonella has become a serious problem globally. This study investigated the antibiotic resistance and plasmid profiles of Salmonella isolates from different sources. Methods: Seventy-three samples comprised of clinical (30), hand swab (15), food (10) and water (18) were analyzed bacteriologically. Salmonella isolates were identified and characterized by standard procedures. Isolates were subjected to antimicrobial susceptibility testing and were further screened for plasmid DNA by standard methods. Results: A total of 27 Salmonella isolates made up of 5 (18.5%) S. typhi, 6 (22.2%) S. enteritidis, 9 (33.3) S. typhimurium, 5 (18.5%) S. cholerasuis, and 1 (3.7%) each of S.arizonae and S. vichow were obtained in this study. All the isolates developed resistance to three or more antibiotics evaluated. Four distinct resistance profiles: TetAmpCol, TetAmpColCot, TetAmpColCip and TetAmpColCotCip were recorded with 63% of the isolates exhibiting resistance profile TetAmpColCot. Specifically 23 of 27 (85.2%) of the isolates harboured plasmid DNA comprised of 12 distinct plasmid profiles of different sizes ranging from 3.2 kb to 30.2kb. Salmonella isolates of the same species from different sources differed in plasmid profile. Plasmid profile was found to show good discriminatory capability compared to antibiotics resistance profile. Conclusion: This study revealed that both resistance antibiogram and plasmid profile are still viable epidemiological tools for tracing the source of Salmonella isolates. A need for prudent use of antibiotics is suggested.

Inhibitory Activities of Lactic Acid Bacteria against Multi-Drug Resistant Uropathogenic <i>Staphylococcus saprophyticus</i>Isolated from Symptomatic Women in Lagos, Nigeria

The uropathogenic Staphylococcus saprophyticus is reported severally to be resistant to the drugs often used empirically for treatment of urinary tract infections (UTIs). Their ability to exhibit resistance to multiple drugs is a great deal of threat to successes recorded in the management of UTIs caused by this pathogen. Lactic acid bacteria (LAB) have been demonstrated to exhibit antimicrobial activities but studies about their prospect against multi-drug resistant S. saprophyticus are quite few. This study therefore investigated activities of LAB against the multi-drug resistant S. saprophyticus recovered from urine samples of symptomatic women. The three different species of LAB (Lactobacillus fermentum BTA 62, Lactobacillus johnsonii BTA 86 and Weissella confusa BTA 40) previously isolated and identified by 16S rRNA sequencing were selected based on their history of antimicrobial activities. Their metabolites were employed in the antagonistic assays against six (6) multi-drug resistant test pathogens recovered from urine samples of symptomatic, non-pregnant women attending clinics in Lagos, Nigeria and the control (S. saprophyticus subs bovis strain DSM 18669) following standard procedures. The pathogens showed resistances to almost all the antibiotics except levofloxacin, ciprofloxacin, imipenem while the control showed resistance to three. The LAB, L. fermentum inhibited five (83.3%) of the pathogens with zone diameter of 12 - 17 mm, followed by W. confusa inhibiting three (50%) with 15 - 17 mm. Lactobacillus johnsonii on the other hand, inhibited a pathogen and the control with zones of 13 mm and 14 mm respectively. In conclusion, the extracted metabolites of LAB inhibited the growth of multi-drug resistant clinical isolates of uropathogenic S. saprophyticus and may therefore be potent alternatives to antibiotics.

The -250G>A polymorphism in the hepatic lipase gene promoter influences plasma lipid profile and lipoprotein ratio in patients with ischemic stroke

Objective:To evaluate the influence of–250G>A(rs2070895)polymorphism in hepatic lipase gene(LIPC)promoter on plasma lipid parameters of ischemic stroke patients.Methods:A total of 100 stroke patients and 100 control subjects matched for sex(59 men and 41 women)and age were selected.Hepatic lipase activity and lipid profiles were measured while lipoprotein ratios were calculated.Genotyping of the–250G>A promoter polymorphism of the LIPC was performed by the polymerase chain reaction and restriction fragment length polymorphism method combined with 2%gel electrophoresis and then confirmed by direct sequencing.The LIPC promoter gene sequencing data were compared with refseqNG011465.1 LIPC from GenBank.Results:The frequencies of GG,GA and AA genotypes of LIPC rs2070895 polymorphism were 39%,45%and 16%for the control,10%,37%and 53%for the stroke subjects(P<0.0001),respectively.The frequencies of G and A alleles were 61.5%and 38.5%for the control,and 28.5%and 71.5%for the stroke subjects(P<0.0001).Our study shows that the mutant allele of the LIPC promoter was associated with dyslipidemia,lower hepatic lipase activity,and this variation contributed to the increased defective plasma high-density lipoprotein-cholesterol(HDL-C),HDL2-C and HDL3-C concentration for both subjects.The control subjects had 6 single nucleotide polymorphism and 6 amino acid substitutions while the stroke subjects had 32 single nucleotide polymorphism and 20 amino acid substitutions.Conclusions:LIPC–250G>A polymorphism can influence plasma lipid profiles and lipoprotein ratios in patients with ischemic stroke.

Prevalence and Pattern of Intestinal Parasitic Infestations among HIV Infected Children in Lagos, Nigeria

Introduction: Intestinal parasitic infections significantly affect paediatric population globally with over 800 million children at risk. The chronic nature of these infestations is associated with chronic disabilities approaching 9 million Disability Adjusted Life Years (DALYs). Co-infection of Human Immunodeficiency Virus (HIV) and intestinal parasitic infections adorned the pre-Highly Active Antiretroviral Therapy (HAART) era resulting in impaired nutritional state and dysfunctional immune system, especially amongst affected children. The success of HAART in conjunction with other life-saving measures has improved the outcome of children living with HIV. This study aimed to evaluate the prevalence and pattern of parasitic infections among children living with HIV in Lagos. Methodology: Consecutive children attending the paediatric anti-retroviral clinic were enrolled. Socio-demographic and clinical characteristics elicited from the clinical examination were recorded. Fresh stool samples of the children were obtained and examined for intestinal parasites. Data were analyzed with the Statistics Package for Social Sciences (SPSS) 20 software. Results: A total of 102 children participated in the study with a majority being males (52.9%), in primary school (73.5%) and living in urban settings (82.4%). Six children were found to harbour intestinal parasites giving a prevalence of 5.9% with Ascaris lumbricoides (50%) and Entamoeba histolytica (33.3%) being the prevalent parasites seen. Children with a Body Mass Index (BMI) Z-score < ?1 had higher estimates of intestinal parasitic infestations [p value < 0.05, OR 10.27, CI 1.72 - 61.20]. Conclusion: The prevalence of intestinal infestation was 5.9% with Ascariasis being the commonest intestinal parasitosis in our study. Malnutrition was found to be significantly associated with its occurrence.

Prescription of intermittent preventive therapy (IPTp) among doctors practicing in an army hospital in Lagos, Nigeria

Background: Malaria infestation in pregnancy is a major public health concern and ranks amongst the commonest complications of pregnancy in Nigeria. Approximately 50,000 Nigerian women die each year from largely preventable pregnancy related complications. Intermittent preventive therapy for malaria in pregnancy (IPTp) is a key recommendation in the National guideline for malaria treatment in Nigeria. This study assessed the prescription pattern of intermittent preventive therapy with Sulphadoxine-Pyrimethamine for pregnant women among doctors practicing in 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. Methods: This was a retrospective study using case notes of pregnant women seen at antenatal clinic of 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria from January, 2008 to December, 2008. A total of 336 case notes were reviewed. The findings were precoded, data entry and analysis was done using EPI INFO 2002. Results: A good proportion of the women (82.9%) booked for antenatal clinic within the first and second trimesters of pregnancy. Most commonly prescribed by doctors was the weekly pyrimethamine (daraprim) for malaria prophylaxis in pregnancy (100.0%). Very few doctors prescribed intermittent preventive therapy with sulfadoxine-pyrimethamine, and the few who did prescribed just one dose. Conclusion: The study showed a very low level of prescription of IPTp among doctors practicing at 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. There is a great need for training of these doctors and other health professionals on the recommendations of the current National Antimalarial Treatment Guidelines.

Knowledge, Attitude, and Perception of COVID-19 among Maritime Workers in the United Kingdom and Nigeria during the First Wave of the Pandemic

In this study, knowledge, attitude and perception (KAP) of maritime workers’ towards COVID-19 during the rapid outbreak in Nigeria and the UK were examined. The study participants completed a self-developed online KAP questionnaire prepared by the convenience sampling method. The knowledge questionnaire comprised questions regarding the clinical characteristics and prevention of COVID-19. The assessments regarding the maritime workers’ attitudes and perceptions towards COVID-19 included questions on preventive measures such as wearing masks on the ships and the attitude towards continuous trade with the Chinese communities. A multiple logistic regression analysis was done using SPSS Statistics version 23.0 to analyse the results of the two groups. The three explanatory variables, gender, residence and age used in the two models applied were not significant predictors of the participants’ knowledge, attitude and perception about COVID-19. The odds ratio was small, except for the age group, which was 6.72 in the first model. This implies that the odds of having knowledge about COVID-19 during the pandemic were 6.72 times higher for the older age group. The odds ratios were generally low for attitude and perception about COVID-19, as shown in Table 4. Participants had considerable knowledge about COVID-19 and could stay healthy during the first wave of the novel coronavirus in 2019 because of the policies and measures imposed by the governments of Nigeria and the United Kingdom to curtail the spread of COVID-19.

Utilization of the current national antimalarial treatment guidelines among doctors in army hospitals in Lagos, Nigeria

Introduction: Human malaria infection remains a problem of public health importance in many regions of the world. The infection continues to spread particularly in sub-Saharan Africa. In Nigeria, malaria and its treatment have been affected by factors like wrong diagnosis, wrong attitude of the people, unavailability of drugs, fake and substandard drugs, attitude and practices of medical and paramedical personnel. Nigeria’s national standard for malaria treatment was recently changed to artemisinin combination therapy. Methods: A descriptive study using a structured questionnaire was administered to all doctors (123) practicing in the three Army hospitals in Lagos. The study was done between March, 2009 and April, 2009. The findings were precoded;data entry and analysis was done using EPI INFO version 3.5.1 statistical software. Results: Presumptive/clinical diagnosis was still a common practice for diagnosing malaria among doctors, as well as the use of microscopy. None of the doctors had the facility for diagnosing malaria with rapid diagnostic test in their hospitals. Fifty one percent of the doctors stated that they utilized the current National antimalarial treatment guidelines. Significant proportion of the doctors used Artemisinin-based Combination Therapy (ACTs) as first line treatment of uncomplicated malaria in adults and children. Chloroquine was the commonest drug for first line treatment of uncomplicated malaria in pregnancy. Only 45.5% of the doctors had correct knowledge of Intermittent Preventive Treatment in pregnancy (IPTp), while 33.3% knew the stage of pregnancy in which a pregnant woman should receive IPTp with sulphadoxine-pyrimethamine. Awareness and the content of knowledge of the current National antimalarial treatment guideline were not affected by the category or current position of the doctors. Thirteen percent of the respondents had attended training/update workshop organized by the Federal Ministry of Health (FMOH) Roll Back Malaria programme on the current National antimalarial treatment guideline. Conclusion: The study showed that there is need to improve use of recommended antimalarial medicines for all categories of patients by doctors in Army Hospitals in Lagos. More effort should be made by the Federal Ministry of Health and other stakeholders to organize training and refresher courses on the current National antimalarial treatment guidelines for all categories of health care providers.

Outcome of Symptom-Based RT-PCR Testing for SARS-CoV-2: Experience from a Large Public Testing Centre in Nigeria

Background: Access to testing for SARS-CoV-2 in Nigeria is still highly restricted. Only patients who are symptomatic for SARS-CoV-2 are selected for testing. This pattern of testing will miss a large proportion of individuals with the infection who are asymptomatic and presymptomatic. This study reports the experience of a symptom-based study from a large testing centre in Nigeria. Methods: A cross-sectional study, reviewing data collected from respondents presenting at the Nigerian Institute of Medical Research (NIMR) modified drive-through center for COVID-19 test between the period March 31st and August 31st, 2020 were included in the analysis. Results: A total of 9891 participants were recruited into the study and 2465 participants (24.9%) had a positive PCR result for SARS-CoV-2. The majority of the respondents were above 18 years old, n = 9163 (93.4%). The average age of the respondents was 36.7 years (sd 13.8 years). The age of the participants has a significant effect on SARS-CoV-2 status (AOR = 1.009, CI, 1.005 to 1.012, p = 0.0001). There was a male preponderance, n = 5652 (57.6%). The odds of having a positive status for SARS-CoV-2 were 0.9 times lower for female participants. The majority of the respondents had a history of travel, n = 6788 (68.6%). Cough was the commonest symptom, n = 1062 (10.7%) followed by fever, n = 979 (9.9%). The mortality rate was 0.1%. Among the participants with comorbidity, 31 (51.7%) had positive results for SARS-CoV-2 while 29 (48.3%) had negative results. Conclusion: Symptom-based approach to testing for SARS-CoV-2 in Nigeria revealed a high positivity rate, while mortality from those tested in the study is low. Age and gender appear to play a significant role in the dynamics of the disease.