57 results on '"Audu RA"'
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2. Enhancing surveillance for dengue fever in Oyo State, Nigeria - a one health approach.
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Animasaun OS, Shaibu JO, Akomolafe BK, Animasaun OP, Niyang PM, Olugbade OT, Akinyode AO, Omisakin IA, Adeogun AO, and Audu RA
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Background: Dengue fever (DF) poses a growing global threat, necessitating a comprehensive one-health approach to address its complex interplay between human, animal, and environmental factors. In Oyo State, Nigeria, the true burden of DF remains unknown due to underdiagnosis and misdiagnosis as malaria, exacerbated by poor health-seeking behavior, weak surveillance systems, and inadequate health infrastructure. Adopting a one-health approach is crucial to understanding the dynamics of DF transmission., Methods: A cross-sectional study was conducted from January 2022 to April 2023 in 10 high-risk LGAs of Oyo State. It involved screening DENV in 289 febrile human blood samples and 1,015 Aedes species mosquitoes. Viral RNA from human and mosquito specimens was extracted and analyzed using RT-qPCR. A one-step lateral flow immunoassay cassette test kit detected DENV-specific IgM and IgG in humans. DENV IgM-positive participants were screened for Lassa Virus (LASV) to rule out coinfection due to an outbreak of Lassa fever. Mosquitoes recovered were morphologically identified and classified using appropriate taxonomical keys. Meteorological data was obtained from the Nigeria Meteorological Agency. Data was abridged as proportions and correlation analysis was performed., Result: The overall seroprevalence of DENV was 128/289 (44.2%) with 19/289 (6.6%) and 109/289 (37.7%) being IgM and IgG positive respectively. DENV was detected all year round with more cases in the rainy season. LASV and DENV coinfection were detected in a participant. DENV RT-qPCR analysis in febrile patients and mosquitoes was negative. There was a high abundance of Aedes aegypti (79.5%) in all the locations surveyed with Aedes albopictus (12.3%) detected in Ido LGA and Ibadan South-East LGA and Aedes simpsoni (9.1%) in Iwajowa LGA. DF shows moderate to strong positive correlations with Aedes mosquito population, humidity, and rainfall (r = 0.419-0.61, p < 0.05), and a negative correlation with temperature (r =-0.465, p < 0.05)., Conclusion: The study reveals a significant burden of DENV in Oyo State. The presence of both IgM and IgG antibodies suggests past exposure and possible recent circulation of the virus. The co-detection of LASV and DENV in one participant highlights the likely potential for co-infection. Although DENV was not detected in febrile patients and mosquitoes through RT-qPCR, the high abundance of Aedes species underscores the risk of transmission. These findings emphasize the need for enhanced surveillance systems, strengthened laboratory services, targeted vector control, and increased awareness., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval was obtained from the Institutional Review Board (IRB) of the Nigerian Institute of Medical Research (NIMR) IRB-19-006. Further permission was obtained from the Oyo State Ministry of Health Department of Public Health (SMOH/EPID/016/005) and the various officers-in-charge in the healthcare facilities before the commencement of the study. Informed consent was obtained from study participants, specifically, we obtained oral and written informed consent (signed or thumb printed) from all participants, including minors and those with minimal reading and writing skills. We provided clear, simple explanations of the study's purpose, risks, and benefits in the local language. For minors, we obtained consent from their parents or guardians, in addition to assent from the minors themselves, also voluntary participation was ensured stating that participants could withdraw at any time without consequences, we maintained participants' confidentiality by using unique identifiers and storing data securely also guaranteed participants of privacy during interviews and data collection, we also explained potential harms as a temporary discomfort during sample collection to study participants. Consent for publication: Not applicable. Competing interests: All Authors declare that we do not have any competing interests., (© 2025. The Author(s).) more...
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- 2025
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3. Genetic tracking of Crimean-Congo haemorrhagic orthonairovirus in Hyalomma population infesting cattle in Nigeria.
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Daodu OB, Shaibu JO, Audu RA, and Oluwayelu DO
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- Animals, Cattle, Nigeria epidemiology, Tick Infestations veterinary, Tick Infestations epidemiology, Hemorrhagic Fever Virus, Crimean-Congo genetics, Hemorrhagic Fever Virus, Crimean-Congo isolation & purification, Hemorrhagic Fever Virus, Crimean-Congo classification, Ixodidae virology, Phylogeny, Hemorrhagic Fever, Crimean epidemiology, Hemorrhagic Fever, Crimean virology, Hemorrhagic Fever, Crimean veterinary, Cattle Diseases virology, Cattle Diseases epidemiology
- Abstract
Crimean-Congo haemorrhagic fever virus (CCHFV), a Biosafety level 4 pathogen transmitted by ticks, causes severe haemorrhagic diseases in humans but remains clinically silent in animals. Over the past forty years, Nigeria lacks comprehensive genetic data on CCHFV in livestock and ticks. This study aimed to identify and characterize CCHFV strains in cattle and their Hyalomma ticks, the primary vector, in Kwara State, Nigeria. Blood samples and Hyalomma ticks were collected from cattle, with ticks identified to species, pooled, and homogenized for RNA extraction. The CCHFV S-segment was detected using specific primers via reverse transcriptase polymerase chain reaction, followed by sequencing of amplicons. Among 318 cattle, 318 sera samples and 2855 Hyalomma ticks (H. dromedarii (49.0%), H. truncatum (44.5%), and H. rufipes (6.5%)) were obtained. Only two tick pools of H. truncatum tested (2/319 pools) were positive for CCHFV, with no positive cattle sera detected. The sequenced positive pools, denoted as CCHFV/NGR/ILN/2021/F22_S-segment (1228 bp) and CCHFV/NGR/ILN/2021/F101_S-segment (863 bp), showed 98.21% nucleotide identity with 15 variations. These strains shared 98.13% and 98.93% nucleotide identity with CCHFV IbAr10200/UCCR4401 isolated from Nigerian ticks, but only 93.88% and 93.63% similarity with CCHFV isolated in 2016 from humans in Nigeria. Additionally, compared to CCHFV isolate IbAr10200 (KY484036), sequences from this study exhibited 9-23 nucleotide variable positions with 3-4 non-synonymous amino acid replacements. Phylogenetic analysis revealed clustering of these strains around IbAr10200, suggesting ongoing circulation. This study underscores the need for broader surveillance to understand the full spectrum of CCHFV strains and clades circulating in Nigeria., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Daodu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) more...
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- 2025
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4. Seromolecular survey and risk factor analysis of Crimean-Congo haemorrhagic fever orthonairovirus in occupationally exposed herdsmen and unexposed febrile patients in Kwara State, Nigeria.
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Daodu OB, Shaibu JO, Audu RA, and Oluwayelu DO
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- Humans, Nigeria epidemiology, Male, Risk Factors, Seroepidemiologic Studies, Adult, Female, Middle Aged, Cross-Sectional Studies, Animals, Young Adult, Fever epidemiology, Antibodies, Viral blood, Ticks virology, Adolescent, Hemorrhagic Fever, Crimean epidemiology, Hemorrhagic Fever, Crimean virology, Hemorrhagic Fever Virus, Crimean-Congo immunology, Occupational Exposure adverse effects
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Crimean-Congo haemorrhagic fever virus (CCHFV) is a globally significant tick-borne zoonotic pathogen that causes fatal haemorrhagic disease in humans. Despite constituting an ongoing public health threat, limited research exists on the presence of CCHFV among herdsmen, an occupationally exposed population that has prolonged contact with ruminants and ticks. This cross-sectional study, conducted between October 2018 and February 2020 in Kwara State, Nigeria, was aimed at assessing CCHFV seroprevalence among herdsmen and non-herdsmen febrile patients, and identifying the associated risk factors. Blood samples from herdsmen (n = 91) and febrile patients in hospitals (n = 646) were analyzed for anti-CCHFV IgG antibodies and CCHFV S-segment RNA using ELISA and RT-PCR, respectively. Results revealed a remarkably high CCHFV seroprevalence of 92.3% (84/91) among herdsmen compared to 7.1% (46/646) in febrile patients. Occupational risk factors like animal and tick contact, tick bites, and hand crushing of ticks significantly contributed to higher seroprevalence in the herdsmen (p<0.0001). Herdsmen were 156.5 times more likely (p<0.0001) to be exposed to CCHFV than febrile patients. Notably, the odds of exposure were significantly higher (OR = 191.3; p<0.0001) in herdsmen with a history of tick bites. Although CCHFV genome was not detectable in the tested sera, our findings reveal that the virus is endemic among herdsmen in Kwara State, Nigeria. CCHFV should be considered as a probable cause of febrile illness among humans in the study area. Given the nomadic lifestyle of herdsmen, further investigations into CCHF epidemiology in this neglected population are crucial. This study enhances our understanding of CCHFV dynamics and emphasizes the need for targeted interventions in at-risk communities., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Daodu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) more...
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- 2024
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5. Detection of High-Risk Human Papillomavirus Genotypes Among HIV-Infected Women in Four States in Nigeria.
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Okwuraiwe AP, Ogbonne EL, Adeniyi AO, Ihurhe PI, Musa BO, Abe TR, Shodipe OO, and Audu RA
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Introduction The World Health Organization states that almost all cervical cancer cases are linked to infection with high-risk human papillomaviruses transmitted through sexual contact. Implementing effective surveillance and preventive measures would enable the prevention of most cervical cancer cases, especially in HIV-infected women. Every year, about 12,000 women in Nigeria are diagnosed, with almost 8,000 deaths. HPV cervical cancer testing capacity is low in Nigeria. Testing scale-up and sensitization efforts across health facilities, including cervical tissue sample collection, are needed to reduce the cases of cervical cancer. This study aimed to assess the genotype-specific prevalence of clinically relevant high-risk HPV among women living with HIV in Nigeria. Methods A descriptive, cross-sectional study was conducted among adult HIV-infected women attending health facilities in four Nigerian states. From August to October 2022, cervical tissue was collected into PCR cell media, transported to the Nigerian Institute of Medical Research, and assayed for HPV presence and genotype using the Cobas 6800 System (Roche Diagnostics). Statistical analysis was conducted with Stata 2. Results A total of 4423 cervical swab samples were tested. The ages of women ranged from 18 to 72 years (mean 36.61±8.61). In our study, we found that 16.3% of participants tested positive for HPV. Among the high-risk HPV genotypes detected, HPV16 was present in 1.44% of participants, HPV18 in 1.29%, and other high-risk HPV (OHR-HPV) in 11.35%. Additionally, co-infections were observed, with 0.98% of participants testing positive for both HPV16 and OHR-HPV, 1.12% for HPV18 and OHR-HPV, and 0.12% for HPV16, HPV18, and OHR-HPV concurrently. However, 7.4% of the total results were deemed invalid. Conclusion OHR-HPV is prevalent among HIV-infected women across the north and west geopolitical zones of Nigeria. Policies and interventions geared towards curtailing the incidence of cervical cancer are fervently solicited., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Okwuraiwe et al.) more...
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- 2024
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6. Implementation of antimicrobial stewardship programs: A study of prescribers' perspective of facilitators and barriers.
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Chukwu EE, Abuh D, Idigbe IE, Osuolale KA, Chuka-Ebene V, Awoderu O, Audu RA, and Ogunsola FT
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- Humans, Adult, Cross-Sectional Studies, Nigeria, Pharmacists, Anti-Bacterial Agents therapeutic use, Antimicrobial Stewardship methods, Physicians
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Background: Despite promising signs of the benefits associated with Antimicrobial Stewardship Programs (ASPs), there remains limited knowledge on how to implement ASPs in peculiar settings for a more elaborate impact. This study explored prescriber experiences and perceptions of the usefulness, and feasibility of strategies employed for the implementation of antimicrobial stewardship (AMS) interventions as well as challenges encountered., Methods: This is a cross-sectional mixed-method survey of prescribers' perspective of the facilitators and barriers of implementing ASP. The quantitative approach comprised of a semi-structured questionnaire and data collected were analyzed using SPSS version 26 while the qualitative approach used focus group discussions followed by content analysis., Results: Out of the thirty people that participated in the workshop, twenty-five completed the questionnaires which were analyzed. The respondents included 15 (60.0%) medical doctors and 10 (40.0%) pharmacists. The mean age of the respondents was 36.39±7.23 years with mean year of practice of 9.48±6.01 years. Majority of them (84.0%) were in a position to provide input on the implementation of AMS in their facilities, although their managements had the final decision. The pharmacists (100%) were more likely to agree that antibiotic resistance was a problem for their practice than the medical doctors (78.6%) while equal number (80.0%) of respondents (pharmacists and medical doctors) believed that inappropriate prescribing was a problem. Having a specialized and dedicated team with effective monitoring was recognized as crucial for effective ASP while inadequate personnel was identified as a major barrier. We identified stakeholder's engagement, policies and regulation, as well as education as themes for improving AMS in the country., Conclusion: The results gave insight into the prescribers' perspective on the facilitators and barriers to antimicrobial stewardship; challenges and possible solutions to implementing ASPs in health facilities in Lagos State. We further identified pertinent contextual factors that need to be addressed when developing ASPs in healthcare facilities in a resource-poor setting., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Chukwu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) more...
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- 2024
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7. Preliminary Study on Open Labelled Randomized Controlled Trial of the Safety and Efficacy of Hydroxychloroquine and Chloroquine Phosphate for the Treatment of Persons Infected with 2019 Coronavirus Disease in Nigeria.
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Aina OO, Busari AA, Oladele DA, Esezobor C, Akase IE, Okwuraiwe AP, Okoyenta CO, Otrofanowei E, James AB, Bamidele TA, Olopade OB, Ajibaye O, Musa AZ, Salako AO, Agabi OP, Olakiigbe AK, Akintan PE, Amoo OS, Ima-Edomwonyi E, Raheem TY, David AN, Akinbode GO, Nmadu N, Osuolale KA, Fadipe B, Abiola A, Tade T, Audu RA, Adeyemo WL, Ezechi OC, Bode C, and Salako BL more...
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- Adult, Humans, Middle Aged, Nigeria epidemiology, Chloroquine adverse effects, SARS-CoV-2, Treatment Outcome, Hydroxychloroquine adverse effects, COVID-19
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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a causative agent of COVID-19 is a leading cause of ill-health and deaths worldwide. Currently, COVID-19 has no known widely approved therapeutics. Thus, the need for effective treatment., Objectives: We investigated the safety and efficacy of two (2) therapeutic agents; chloroquine phosphate (CQ), 2- hydroxychloroquine (HCQ) and a control (standard supportive therapy) among hospitalized adults with COVID-19., Methods: The clinical trial was done in accordance to the World Health Organization master protocol for investigational therapeutics for COVID-19. Atotal of 40 participants with laboratory-confirmed positive COVID-19 were enrolled. Blood samples and oropharyngeal (OP) swabs were obtained on days 1,3,15 and 29 for safety and efficacy assessments., Results: The baseline demographics showed that the median ages in years (range) were 45 (31-57) in CQ, 45 (36.5-60.5) in HCQ, 43 (39.5-67.0) and 44.5 (25.3-51.3) in the control (P<0.042).At randomization, seven (7) participants were asymptomatic, thirty-three (33) had mild symptoms, eight (8) had moderate symptoms while three (3) had severe symptoms. The average day of conversion to negative COVID-19 was 15.5 days for CQ, 16 days for HCQ and 18 days for the control(P=0.036)., Conclusion: The safety assessment revealed no adverse effect of the drugs in COVID-19 patients after treatment. These findings proved that chloroquine and hydroxychloroquine are effective for the treatment of COVID-19 among hospitalized adults. It also confirmed that they are safe., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2023 by West African Journal of Medicine.) more...
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- 2023
8. Seroprevalence of SARS-CoV-2 IgG among healthcare workers in Lagos, Nigeria.
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Ige FA, Ohihoin GA, Osuolale K, Dada A, Onyia N, Johnson A, Okwuraiwe AP, Odediran O, Liboro G, Aniedobe M, Mogaji S, Nwaiwu SO, Akande IR, Audu RA, and Salako BL
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- Humans, Cross-Sectional Studies, Nigeria epidemiology, Seroepidemiologic Studies, Antibodies, Viral, Immunoglobulin G, Health Personnel, SARS-CoV-2, COVID-19 epidemiology
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Healthcare workers (HCWs) are disproportionately infected with SARS-CoV-2 when compared to members of the general public; estimating the seroprevalence of SARS-CoV-2 antibody and SARS-CoV-2 infection rate among HCWs is therefore crucial. This study was carried out in four health facilities in Lagos Nigeria to determine the prevalence of IgG antibodies (seroprevalence) and SARS-CoV-2 active infection rate via a positive rtPCR result, the cross-sectional study was conducted between December 2020 and July 2021. Nasopharyngeal and blood samples were collected from HCWs and screened for SARS-CoV-2 infection using the rtPCR technique and antibody using the Abbott anti-SARS-CoV-2 IgG CMIA assay, respectively. Demographic and occupational exposures data were obtained and analysed using descriptive and inferential statistics, variables significant via inferential statistics were subjected to a multivariate analysis. A total of 413 participants were enrolled, with a mean age in years of 38.4±11.0. The seroprevalence was 30.9% (115/372) while 63/395 (15.9%) were actively infected with the virus. HCWs whose job role had direct contact with patients had a higher percentage of SARS-CoV-2 infection when compared with those not in direct contact, also being a health care worker was significantly associated with getting a positive COVID-19 PCR result. In conclusion the SARS-CoV-2 seroprevalence seen in this study was higher than national serosurvey estimates indicating HCWs are at higher risk of COVID-19 infection when compared to the general public. Vaccination and effective implementation of infection control measures are important to protect HCWs., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ige et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) more...
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- 2023
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9. Seromolecular surveillance of rabbit haemorrhagic disease virus in Nigeria.
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Daodu OB, Shaibu JO, Aderounmu EA, Jolaoso TO, Oluwayelu DO, Akanbi OB, Olorunshola ID, Aiyedun JO, Oludairo OO, Audu RA, and Daodu OC
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- Animals, Rabbits, Nigeria epidemiology, Phylogeny, Seroepidemiologic Studies, Autopsy veterinary, Hemorrhagic Disease Virus, Rabbit genetics
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Following the first 2020 rabbit haemorrhagic disease virus (RHDV) outbreak in Nigeria which caused massive mortalities in several rabbitries, there was a need to know the spread and strains circulating in the affected states. Over 100 rabbitries still existing post-RHDV outbreak in Ogun and Kwara States were investigated. A commercial enzyme-linked immunosorbent assay kit was used to screen for RHDV immunoglobulin G in 192 rabbit sera, while RHDV VP60 gene was amplified in RNA extracted from these sera and tissues (liver and/or spleen harvested from 37 carcasses necrotized) by reverse transcription-polymerase chain reaction (RT-PCR). Sequences obtained from the amplicons were subjected to phylogenetic analysis. The results revealed a seroprevalence of 82.3% (158/192). RHDV VP60 gene was detected in 15/17 (88.2%) and 2/20 (10.0%) carcasses from Ogun and Kwara States, respectively, while none of the sera was positive. Sequences of the two positive amplicons selected (one from each states) shared 98.95% nucleotide identity and belonged to RHDV 2/GI.2 strain. Also, nBLAST of these sequences revealed 98.43-99.55% homology with the prototype Nigerian RHDV strain RHDV/NGR/ILN/001 (MT996357.1). Furthermore, these strains clustered with this prototype and a German RHDV strain (LR899166.1). Pathologic lesions affecting the respiratory, cardiovascular, renal, lymphatic, and digestive systems were observed in necropsied carcasses. This study indicated that RHDV 2/GI.2 strain was the cause of 2020 RHD outbreak in Nigeria. Thus, while continuous public sensitization about RHD especially among rabbit farmers in Nigeria is important, efforts aimed at design and implementation of RHD vaccination policy, preferably using indigenous seed, should be expedited., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.) more...
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- 2023
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10. Molecular surveillance of arboviruses in Nigeria.
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Shaibu JO, Akinyemi KO, Uzor OH, Audu RA, and Bola Oriowo Oyefolu A
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- Animals, Humans, Nigeria epidemiology, Cross-Sectional Studies, Phylogeny, RNA, Viral genetics, Arboviruses genetics, Yellow Fever, Zika Virus Infection, Zika Virus genetics
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Arboviral infections are fast becoming a global public health concern as a result of its high fatality rate and sporadic spread. From the outbreak of Zika virus in the Americas, the endemicity of Yellow fever in West Africa and South America, outbreaks of West Nile virus in South Africa to the year-round and national risk of Dengue fever in Mainland China and India. The war against emerging and re-emerging viral infection could probably lead to the next pandemic. To be above the pending possible arboviral pandemic, consistent surveillance of these pathogens is necessary in every society. This study was aimed at conducting a surveillance for Yellow fever virus, Zika virus, Chikungunya virus, Dengue virus and Rift Valley fever virus in four states in Nigeria using molecular techniques. A cross-sectional study involving 1600 blood samples collected from febrile patients in Lagos, Kwara, Ondo and Delta States between 2018 and 2021 was conducted using Real time polymerase chain reaction for detection of the pathogens. Extraction and purification of viral RNA were done using Qiagen Viral RNA Mini Kit. Samples were analyzed using One Step PrimeScript III RT-PCR mix (Takara Bio) alongside optimized primers and probes designed in-house. Positive samples were sequenced on MinION platform (Nanopore technologies). Bioinformatic and phylogenetic analysis were performed with DNASTAR Lasergene 17.3. All the RNA extracted from samples collected from the four states were negative for ZIKV RNA, RVFV RNA, CHIKV RNA and DENV RNA. However, twelve of the samples (2%) tested positive for YFV RNA. Three full genomes of sizes 10,751 bp, 10,500 bp and 10,715 bp were generated and deposited in GenBank with accession numbers: ON323052, ON323053 and ON323054 respectively. Phylogenetic analysis shows clustering within lineage 3 of West African genotype. This result shows an active spread of Yellow fever in Delta State, Nigeria. However, there is no emergence of a new genotype There is a need for an intense surveillance of Yellow fever virus in Nigeria to avert a major outbreak., (© 2023. BioMed Central Ltd., part of Springer Nature.) more...
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- 2023
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11. High prevalence of resistance to third-generation cephalosporins detected among clinical isolates from sentinel healthcare facilities in Lagos, Nigeria.
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Chukwu EE, Awoderu OB, Enwuru CA, Afocha EE, Lawal RG, Ahmed RA, Olanrewaju I, Onwuamah CK, Audu RA, and Ogunsola FT
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- Male, Female, Humans, Infant, Child, Preschool, Child, Adolescent, Young Adult, Adult, Middle Aged, Aged, Aged, 80 and over, Microbial Sensitivity Tests, Prevalence, Nigeria epidemiology, Escherichia coli, Enterococcus, Delivery of Health Care, Cefotaxime, Staphylococcal Infections epidemiology
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Background: Antimicrobial resistance (AMR) in bacterial pathogens is a worldwide concern that demands immediate attention. Most information on AMR originates from high-income countries and little is known about the burden in Africa, particularly Nigeria. Using four sentinel sites (General hospitals) in Lagos State, this study sought to estimate the burden of AMR., Methods: This is a hospital-based surveillance using secondary health care centres. Four sites were randomly selected and included in the study. Clinical isolates were collected over a period of 6 months for each site from August 2020 to March 2021. All isolates were characterised and analysed for resistance to 15 antibiotics using the Kirby-Baur method. Multiplex PCR assay was used for the detection of Extended spectrum beta lactamase genes. Data analysis was done using SPSS version 27.0., Results: Four hundred and ninety-nine (499) patients consented and participated in this study, consisting of 412 (82.6%) females and 87 (17.4%) males. The mean age ± SD of the participants was 33.9 ± 13.8 with a range of 1-89 years. The majority (90.8%) of the participants were outpatients. Two hundred and thirty-two (232) isolates were obtained from 219 samples, comprising of 120 (51.7%) Gram positive and 112 (48.3%) Gram negative organisms. Key bacterial pathogens isolated from this study included Staphylococcus aureus (22.8%), Escherichia coli (16.4%), Staphylococcus spp. (15.9%), Enterococcus spp. (7.3%) and Klebsiella pneumoniae (6.5%). There was high prevalence of multi-drug resistance (79.3%) among the isolates with 73.6% of Staphylococcus aureus phenotypically resistant to methicillin and 70% possessed the MecA gene. 76.5% of Enterococcus spp. isolated were Vancomycin resistant. Overall, resistance to Cephalosporins was most frequently/commonly observed (Cefotaxime 87.5%)., Conclusion: A high incidence of AMR was identified in clinical bacteria isolates from selected general hospitals in Lagos State, highlighting the necessity for the implementation of national action plans to limit the prevalence of AMR. Surveillance via collection of isolates has a lot of promise, especially in resource-limited environments., (© 2022. The Author(s).) more...
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- 2022
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12. The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.
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Tegally H, San JE, Cotten M, Moir M, Tegomoh B, Mboowa G, Martin DP, Baxter C, Lambisia AW, Diallo A, Amoako DG, Diagne MM, Sisay A, Zekri AN, Gueye AS, Sangare AK, Ouedraogo AS, Sow A, Musa AO, Sesay AK, Abias AG, Elzagheid AI, Lagare A, Kemi AS, Abar AE, Johnson AA, Fowotade A, Oluwapelumi AO, Amuri AA, Juru A, Kandeil A, Mostafa A, Rebai A, Sayed A, Kazeem A, Balde A, Christoffels A, Trotter AJ, Campbell A, Keita AK, Kone A, Bouzid A, Souissi A, Agweyu A, Naguib A, Gutierrez AV, Nkeshimana A, Page AJ, Yadouleton A, Vinze A, Happi AN, Chouikha A, Iranzadeh A, Maharaj A, Batchi-Bouyou AL, Ismail A, Sylverken AA, Goba A, Femi A, Sijuwola AE, Marycelin B, Salako BL, Oderinde BS, Bolajoko B, Diarra B, Herring BL, Tsofa B, Lekana-Douki B, Mvula B, Njanpop-Lafourcade BM, Marondera BT, Khaireh BA, Kouriba B, Adu B, Pool B, McInnis B, Brook C, Williamson C, Nduwimana C, Anscombe C, Pratt CB, Scheepers C, Akoua-Koffi CG, Agoti CN, Mapanguy CM, Loucoubar C, Onwuamah CK, Ihekweazu C, Malaka CN, Peyrefitte C, Grace C, Omoruyi CE, Rafaï CD, Morang'a CM, Erameh C, Lule DB, Bridges DJ, Mukadi-Bamuleka D, Park D, Rasmussen DA, Baker D, Nokes DJ, Ssemwanga D, Tshiabuila D, Amuzu DSY, Goedhals D, Grant DS, Omuoyo DO, Maruapula D, Wanjohi DW, Foster-Nyarko E, Lusamaki EK, Simulundu E, Ong'era EM, Ngabana EN, Abworo EO, Otieno E, Shumba E, Barasa E, Ahmed EB, Ahmed EA, Lokilo E, Mukantwari E, Philomena E, Belarbi E, Simon-Loriere E, Anoh EA, Manuel E, Leendertz F, Taweh FM, Wasfi F, Abdelmoula F, Takawira FT, Derrar F, Ajogbasile FV, Treurnicht F, Onikepe F, Ntoumi F, Muyembe FM, Ragomzingba FEZ, Dratibi FA, Iyanu FA, Mbunsu GK, Thilliez G, Kay GL, Akpede GO, van Zyl GU, Awandare GA, Kpeli GS, Schubert G, Maphalala GP, Ranaivoson HC, Omunakwe HE, Onywera H, Abe H, Karray H, Nansumba H, Triki H, Kadjo HAA, Elgahzaly H, Gumbo H, Mathieu H, Kavunga-Membo H, Smeti I, Olawoye IB, Adetifa IMO, Odia I, Ben Boubaker IB, Muhammad IA, Ssewanyana I, Wurie I, Konstantinus IS, Halatoko JWA, Ayei J, Sonoo J, Makangara JC, Tamfum JM, Heraud JM, Shaffer JG, Giandhari J, Musyoki J, Nkurunziza J, Uwanibe JN, Bhiman JN, Yasuda J, Morais J, Kiconco J, Sandi JD, Huddleston J, Odoom JK, Morobe JM, Gyapong JO, Kayiwa JT, Okolie JC, Xavier JS, Gyamfi J, Wamala JF, Bonney JHK, Nyandwi J, Everatt J, Nakaseegu J, Ngoi JM, Namulondo J, Oguzie JU, Andeko JC, Lutwama JJ, Mogga JJH, O'Grady J, Siddle KJ, Victoir K, Adeyemi KT, Tumedi KA, Carvalho KS, Mohammed KS, Dellagi K, Musonda KG, Duedu KO, Fki-Berrajah L, Singh L, Kepler LM, Biscornet L, de Oliveira Martins L, Chabuka L, Olubayo L, Ojok LD, Deng LL, Ochola-Oyier LI, Tyers L, Mine M, Ramuth M, Mastouri M, ElHefnawi M, Mbanne M, Matsheka MI, Kebabonye M, Diop M, Momoh M, Lima Mendonça MDL, Venter M, Paye MF, Faye M, Nyaga MM, Mareka M, Damaris MM, Mburu MW, Mpina MG, Owusu M, Wiley MR, Tatfeng MY, Ayekaba MO, Abouelhoda M, Beloufa MA, Seadawy MG, Khalifa MK, Matobo MM, Kane M, Salou M, Mbulawa MB, Mwenda M, Allam M, Phan MVT, Abid N, Rujeni N, Abuzaid N, Ismael N, Elguindy N, Top NM, Dia N, Mabunda N, Hsiao NY, Silochi NB, Francisco NM, Saasa N, Bbosa N, Murunga N, Gumede N, Wolter N, Sitharam N, Ndodo N, Ajayi NA, Tordo N, Mbhele N, Razanajatovo NH, Iguosadolo N, Mba N, Kingsley OC, Sylvanus O, Femi O, Adewumi OM, Testimony O, Ogunsanya OA, Fakayode O, Ogah OE, Oludayo OE, Faye O, Smith-Lawrence P, Ondoa P, Combe P, Nabisubi P, Semanda P, Oluniyi PE, Arnaldo P, Quashie PK, Okokhere PO, Bejon P, Dussart P, Bester PA, Mbala PK, Kaleebu P, Abechi P, El-Shesheny R, Joseph R, Aziz RK, Essomba RG, Ayivor-Djanie R, Njouom R, Phillips RO, Gorman R, Kingsley RA, Neto Rodrigues RMDESA, Audu RA, Carr RAA, Gargouri S, Masmoudi S, Bootsma S, Sankhe S, Mohamed SI, Femi S, Mhalla S, Hosch S, Kassim SK, Metha S, Trabelsi S, Agwa SH, Mwangi SW, Doumbia S, Makiala-Mandanda S, Aryeetey S, Ahmed SS, Ahmed SM, Elhamoumi S, Moyo S, Lutucuta S, Gaseitsiwe S, Jalloh S, Andriamandimby SF, Oguntope S, Grayo S, Lekana-Douki S, Prosolek S, Ouangraoua S, van Wyk S, Schaffner SF, Kanyerezi S, Ahuka-Mundeke S, Rudder S, Pillay S, Nabadda S, Behillil S, Budiaki SL, van der Werf S, Mashe T, Mohale T, Le-Viet T, Velavan TP, Schindler T, Maponga TG, Bedford T, Anyaneji UJ, Chinedu U, Ramphal U, George UE, Enouf V, Nene V, Gorova V, Roshdy WH, Karim WA, Ampofo WK, Preiser W, Choga WT, Ahmed YA, Ramphal Y, Bediako Y, Naidoo Y, Butera Y, de Laurent ZR, Ouma AEO, von Gottberg A, Githinji G, Moeti M, Tomori O, Sabeti PC, Sall AA, Oyola SO, Tebeje YK, Tessema SK, de Oliveira T, Happi C, Lessells R, Nkengasong J, and Wilkinson E more...
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- Africa epidemiology, Genomics, Humans, COVID-19 epidemiology, COVID-19 virology, Epidemiological Monitoring, Pandemics, SARS-CoV-2 genetics
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Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times 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 illuminate 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 reemerging 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. more...
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- 2022
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13. Factors Affecting COVID-19 Testing Behaviours Among the Population in South Western Nigeria.
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Amoo OS, Tijani B, Onuigbo TI, Oraegbu JI, Kareithi DN, Obi JC, Adeniji ET, Dosunmu AA, Karera S, Filani T, Akinreni T, Ezike E, Owoseni K, Audu RA, and Salako BL
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- Female, Male, Humans, Cross-Sectional Studies, Nigeria epidemiology, COVID-19 Testing, Health Knowledge, Attitudes, Practice, COVID-19 diagnosis, COVID-19 epidemiology
- Abstract
Objectives: The objective of this study was to assess the factors affecting testing behaviours amongst the population in Ondo and Lagos States. Methods: A cross-sectional study involving 704 individuals who were considered eligible for COVID-19 testing in 4 local governments in Lagos (307) and Ondo (397) states in Nigeria, was conducted from April-June 2021. Respondents were selected using simple random sampling. A close-ended questionnaire was administered using a digital survey platform known as SurveyCTO. Data were analyzed using R 4.1.0. Results: In Lagos state, 52.4% were females, 47.2% were males while in Ondo, 55.2% were females, 44.6% were male. Chi-square tests of association revealed that socio demographic factors significantly associated with testing patterns was education level in Lagos, and none in Ondo. Testing behavior associated with testing patterns included awareness of nearby COVID-19 testing centers, internet access, knowledge of preexisting conditions and having another member of the family testing positive at 5% significance level. Conclusion: Knowledge of pre-existing conditions, knowledge of COVID-19 symptoms, and knowing where to go when having symptoms were significantly associated with testing and willingness to test., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Amoo, Tijani, Onuigbo, Oraegbu, Kareithi, Obi, Adeniji, Dosunmu, Karera, Filani, Akinreni, Ezike, Owoseni, Audu and Salako.) more...
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- 2022
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14. Seroprevalence of SARS-CoV-2 in four states of Nigeria in October 2020: A population-based household survey.
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Audu RA, Stafford KA, Steinhardt L, Musa ZA, Iriemenam N, Ilori E, Blanco N, Mitchell A, Hamada Y, Moloney M, Iwara E, Abimiku A, Ige FA, William NE, Igumbor E, Ochu C, Omoare AA, Okunoye O, Greby SM, Rangaka MX, Copas A, Dalhatu I, Abubakar I, McCracken S, Alagi M, Mba N, Anthony A, Okoye M, Okoi C, Ezechi OC, Salako BL, and Ihekweazu C more...
- Abstract
The observed epidemiology of SARS-CoV-2 in sub-Saharan Africa has varied greatly from that in Europe and the United States, with much lower reported incidence. Population-based studies are needed to estimate true cumulative incidence of SARS-CoV-2 to inform public health interventions. This study estimated SARS-CoV-2 seroprevalence in four selected states in Nigeria in October 2020. We implemented a two-stage cluster sample household survey in four Nigerian states (Enugu, Gombe, Lagos, and Nasarawa) to estimate age-stratified prevalence of SARS-CoV-2 antibodies. All individuals in sampled households were eligible for interview, blood draw, and nasal/oropharyngeal swab collection. We additionally tested participants for current/recent malaria infection. Seroprevalence estimates were calculated accounting for the complex survey design. Across all four states, 10,629 (96·5%) of 11,015 interviewed individuals provided blood samples. The seroprevalence of SARS-CoV-2 antibodies was 25·2% (95% CI 21·8-28·6) in Enugu State, 9·3% (95% CI 7·0-11·5) in Gombe State, 23·3% (95% CI 20·5-26·4) in Lagos State, and 18·0% (95% CI 14·4-21·6) in Nasarawa State. Prevalence of current/recent malaria infection ranged from 2·8% in Lagos to 45·8% in Gombe and was not significantly related to SARS-CoV-2 seroprevalence. The prevalence of active SARS-CoV-2 infection in the four states during the survey period was 0·2% (95% CI 0·1-0·4). Approximately eight months after the first reported COVID-19 case in Nigeria, seroprevalence indicated infection levels 194 times higher than the 24,198 officially reported COVID-19 cases across the four states; however, most of the population remained susceptible to COVID-19 in October 2020., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.) more...
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- 2022
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15. Mechanism of Viral Suppression among HIV Elite Controllers and Long-Term Nonprogressors in Nigeria and South Africa.
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Ahmed RA, Adekoya KO, Onwuamah CK, Oboh BO, Iyer SS, Oluwatosin AS, Audu RA, and Ezechi OC
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- Elite Controllers, Humans, Nigeria epidemiology, Prevalence, South Africa epidemiology, Viral Load, HIV Infections drug therapy, HIV Infections genetics
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A subgroup among people living with HIV (PLHIV) experience viral suppression, sometimes to an undetectable level in the blood and/or are able to maintain a healthy CD4+ T-cell count without the influence of antiretroviral (ARV) therapy. One out of three hundred PLHIV fall into this category, and a large sample of this group can be found in areas with a high prevalence of HIV infection such as Nigeria and South Africa. Understanding the mechanism underpinning the nonprogressive phenotype in this subgroup may provide insights into the control of the global HIV epidemic. This work provides mechanisms of the elite control and nonprogressive phenotype among PLHIV in Nigeria and South Africa and identifies research gaps that will contribute to a better understanding on HIV controllers among PLHIV. more...
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- 2022
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16. Significance of hematologic abnormalities in COVID-19 severity among infected patients in Lagos, Nigeria.
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Amoo OS, Onyia N, Onuigbo TI, Vitalis SU, Davies-Bolorunduro OF, Oraegbu JI, Adeniji ET, Obi JC, Abodunrin ON, Ikemefuna AS, Adegbola RA, Audu RA, and Salako BL
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Background: There have been suggestions that hematologic abnormalities in COVID-19 are linked with the progression and severity of diseases and mortality. Lymphopenia, sepsis, and thrombocytopenia were highly reported in patients with COVID-19. This study investigated the significance of hematologic abnormalities in patients with COVID-19 in Lagos, Nigeria, and its potential as a diagnostic tool for COVID-19 severity., Results: This was a retrospective observational study with a total of 340 patients with COVID-19 (236 patients included in the analysis). These patients were categorized into two groups, comprising 71 patients with severe COVID-19 (SCP) and 165 patients with non-severe COVID-19 (NSCP). The majority were males in both categories (SCP 74.6% and NSCP 63.6%). The mean ± SD ages for SCP and NSCP were 52.28 ± 16.87 and 42.44 ± 17.18 years, respectively. The SCP (52.1%) and NSCP (20.0%) had underlying health conditions. The SCP exhibited significantly higher neutrophil counts ( P < 0.05) and significantly lower mean hemoglobin, red blood cell (RBC), packed cell volume (PCV), and lymphocyte values ( P < 0.05). Anemia and lymphocytopenia were more prominent in the SCP group than in the NSCP group ( P < 0.05). Hemoglobin, RBC, PCV, and lymphocytes were inversely correlated with age-group in the SCP, while only lymphocytes and platelets were inversely correlated with age-group in the NSCP. The highest area under the ROC curve (AUC) for neutrophils was 0.739 with a sensitivity of 62.0% and specificity of 80.0%, while white blood cells had an AUC of 0.722 with a sensitivity of 73.2% and specificity of 61.2%. The AUC for neutrophil-lymphocyte ratio (NLR) was 0.766 with a sensitivity of 63.3% and specificity of 83.5%, while that for the platelet-lymphocyte ratio (PLR) was 0.695 with a sensitivity and specificity of 61.7% and 77.8%., Conclusions: COVID-19 affected the levels of hemoglobin, RBC, PCV, and lymphocytes in the blood, and the differences were significant between the SCP and NSCP. The significant changes in neutrophil and lymphocyte counts may be useful in the prognosis and management of COVID-19 severity in hospital settings. Furthermore, NLR and PLR may be used in the prognosis and management of severe COVID-19 infection, as well as provide an objective basis for early identification and management in low-resource settings., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2022.) more...
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- 2022
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17. Evaluation of respiratory tract bacterial co-infections in SARS-CoV-2 patients with mild or asymptomatic infection in Lagos, Nigeria.
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Davies-Bolorunduro OF, Fowora MA, Amoo OS, Adeniji E, Osuolale KA, Oladele O, Onuigbo TI, Obi JC, Oraegbu J, Ogundepo O, Ahmed RA, Usman OA, Iyapo BG, Dada AA, Onyia N, Adegbola RA, Audu RA, and Salako BL more...
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Background: A common complication of any respiratory disease by a virus could be a secondary bacterial infection, which is known to cause an increase in severity. It is, however, not clear whether the presence of some opportunistic pathogens called pathobionts contributes to the severity of the disease. In COVID-19 patients, undetected bacterial co-infections may be associated with the severity of the disease. Therefore, we investigated the implications of bacterial co-infections in COVID-19 cases., Results: This is a cross-sectional study that involved archived specimens collected from nasopharyngeal samples of 150 people for COVID-19 screening in Lagos. DNA extraction from the samples was carried out to determine the presence of five respiratory bacterial pathogens using nested real-time PCR, and data were analysed using the Chi-square test. Of the 150 samples collected, 121 (80.7%) were positive for SARs-CoV-2 infection and 29 were negative. The proportion of patients with bacteria co-infection in COVID-19-negative, asymptomatic, and mild cases were 93.1%, 70.7%, and 67.5%, respectively. There was no statistically significant difference between mild COVID-19 conditions and bacteria co-infection ( p = 0.097). There was also no significant difference in the nasal carriage of Staphylococcus aureus , Mycoplasma pneumoniae , and Haemophilus spp. However, there was a statistically significant increase in the carriage of Moraxella catarrhalis and Chlamydophila pneumoniae among COVID-19-negative patients when compared with the positive patients ( p value = 0.003 and 0.000 for Moraxella catarrhalis and Chlamydophila pneumoniae , respectively)., Conclusions: The current study shows that bacterial co-infection and superinfection with COVID-19 are not associated with mild and asymptomatic COVID-19 cases in our setting. However, given the high prevalence of Staphylococcus aureus and Mycoplasma pneumoniae among the mild COVID-19 cases seen in this study, early diagnosis and treatment of these bacterial co-infections are still encouraged to mitigate the effect on the severity of COVID-19., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2022.) more...
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- 2022
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18. SARS-CoV-2 sequencing collaboration in west Africa shows best practices.
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Onwuamah CK, Kanteh A, Abimbola BS, Ahmed RA, Okoli CL, Shaibu JO, James AB, Ajibaye O, Okwuraiwe AP, Fowora M, Otuonye N, Worwui A, Iwalokun B, Kanteh D, Audu RA, Adegbola RA, D'Alessandro U, Salako BL, and Sesay AK more...
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- Africa, Western epidemiology, COVID-19 epidemiology, COVID-19 virology, Humans, Cooperative Behavior, Interinstitutional Relations, SARS-CoV-2 genetics, Whole Genome Sequencing
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Competing Interests: We declare no competing interests.
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- 2021
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19. Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020-April 2021.
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Akande OW, Elimian KO, Igumbor E, Dunkwu L, Kaduru C, Olopha OO, Ohanu DO, Nwozor L, Agogo E, Aruna O, Balogun MS, Aderinola O, Ahumibe A, Arinze C, Badaru SO, Nwachukwu W, Dada AO, Erameh C, Hamza K, Mohammed TB, Ndodo N, Obiekea C, Ofoegbunam C, Ogunbode O, Ohonsi C, Tobin EA, Yashe R, Adekaiyaoja A, Asuzu MC, Audu RA, Bello MB, Bello SO, Deeni YY, Disu Y, Joseph G, Ezeokafor C, Habib ZG, Ibeh C, Ike IF, Iwara E, Luka-Lawal RK, Namara G, Okwor T, Olajide L, Ilesanmi OO, Omonigho S, Oyiri F, Takpa K, Ugbogulu NU, Ibekwe P, Oladejo J, Ilori E, Ochu CL, and Ihekweazu C more...
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- Adult, Female, Humans, Nigeria epidemiology, Retrospective Studies, SARS-CoV-2, COVID-19, Pandemics
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Background: With reports of surges in COVID-19 case numbers across over 50 countries, country-level epidemiological analysis is required to inform context-appropriate response strategies for containment and mitigation of the outbreak. We aimed to compare the epidemiological features of the first and second waves of COVID-19 in Nigeria., Methods: We conducted a retrospective analysis of the Surveillance Outbreak Response Management and Analysis System data of the first and second epidemiological waves, which were between 27 February and 24 October 2020, and 25 October 2020 to 3 April 2021, respectively. Descriptive statistical measures including frequencies and percentages, test positivity rate (TPR), cumulative incidence (CI) and case fatality rates (CFRs) were compared. A p value of <0.05 was considered statistically significant. All statistical analyses were carried out in STATA V.13., Results: There were 802 143 tests recorded during the study period (362 550 and 439 593 in the first and second waves, respectively). Of these, 66 121 (18.2%) and 91 644 (20.8%) tested positive in the first and second waves, respectively. There was a 21.3% increase in the number of tests conducted in the second wave with TPR increasing by 14.3%. CI during the first and second waves were 30.3/100 000 and 42.0/100 000 respectively. During the second wave, confirmed COVID-19 cases increased among females and people 30 years old or younger and decreased among urban residents and individuals with travel history within 14 days of sample collection (p value <0.001). Most confirmed cases were asymptomatic at diagnosis during both waves: 74.9% in the first wave; 79.7% in the second wave. CFR decreased during the second wave (0.7%) compared with the first wave (1.8%)., Conclusion: Nigeria experienced a larger but less severe second wave of COVID-19. Continued implementation of public health and social measures is needed to mitigate the resurgence of another wave., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) more...
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- 2021
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20. Whole genome sequencing of clinical samples reveals extensively drug resistant tuberculosis (XDR TB) strains from the Beijing lineage in Nigeria, West Africa.
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Olawoye IB, Uwanibe JN, Kunle-Ope CN, Davies-Bolorunduro OF, Abiodun TA, Audu RA, Salako BL, and Happi CT
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- Adult, Antitubercular Agents pharmacology, Antitubercular Agents therapeutic use, Capreomycin pharmacology, Capreomycin therapeutic use, DNA, Bacterial chemistry, DNA, Bacterial metabolism, Extensively Drug-Resistant Tuberculosis complications, Extensively Drug-Resistant Tuberculosis drug therapy, Extensively Drug-Resistant Tuberculosis microbiology, Female, Fluoroquinolones pharmacology, Fluoroquinolones therapeutic use, HIV Infections complications, HIV Infections diagnosis, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Mycobacterium tuberculosis classification, Mycobacterium tuberculosis drug effects, Mycobacterium tuberculosis isolation & purification, Nigeria, Phylogeny, Rifampin pharmacology, Rifampin therapeutic use, Whole Genome Sequencing, Young Adult, Extensively Drug-Resistant Tuberculosis diagnosis, Mycobacterium tuberculosis genetics
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Multi-drug (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) continues to be a global public health problem especially in high TB burden countries like Nigeria. Many of these cases are undetected and go on to infect high risk individuals. Clinical samples from positive rifampicin resistant Xpert®MTB/Rif assay were subjected to direct whole genome sequencing and bioinformatics analysis to identify the full antibiotics resistance and lineage profile. We report two (2) XDR TB samples also belonging to the East-Asian/Beijing family of lineage 2 Mycobacterium tuberculosis complex from clinical samples in Nigeria. Our findings further reveal the presence of mutations that confer resistance to first-line drugs (rifampicin, isoniazid, ethambutol and pyrazanimide), second-line injectables (capreomycin, streptomycin, kanamycin and/or amikacin) and at least one of the fluoroquinolones (ofloxacin, moxifloxacin, levofloxacin and/or ciprofloxacin) in both samples. The genomic sequence data from this study not only provide the first evidence of XDR TB in Nigeria and West Africa, but also emphasize the importance of WGS in accurately detecting MDR and XDR TB, to ensure adequate and proper management treatment regimens for affected individuals. This will greatly aid in preventing the spread of drug resistance TB in high burden countries., (© 2021. The Author(s).) more...
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- 2021
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21. Low level SARS-CoV-2 RNA detected in plasma samples from a cohort of Nigerians: Implications for blood transfusion.
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Okwuraiwe AP, Onwuamah CK, Shaibu JO, Amoo SO, Ige FA, James AB, Okoli LC, Ahmed AR, Ponmak J, Sokei JO, Akanmu S, Salako BL, and Audu RA
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- Adolescent, Adult, Aged, COVID-19 blood, COVID-19 epidemiology, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Nigeria epidemiology, RNA, Viral blood, RNA, Viral genetics, SARS-CoV-2 genetics, Sensitivity and Specificity, Young Adult, COVID-19 diagnosis, COVID-19 Nucleic Acid Testing, RNA, Viral analysis, SARS-CoV-2 isolation & purification
- Abstract
The present global pandemic triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has lingered for over a year in its devastating effects. Diagnosis of coronavirus disease 2019 (COVID-19) is currently established with a polymerase chain reaction (PCR) test by means of oropharyngeal-, nasopharyngeal-, anal-swabs, sputum and blood plasma. However, oral and nasal swabs are more commonly used. This study, therefore, assessed sensitivity and specificity of plasma as a diagnostic in comparison with a combination of oral and nasal swab samples, and the implications for blood transfusion. Oropharyngeal (OP) and nasopharyngeal (NP) swab samples were obtained from 125 individuals suspected to have COVID-19 and stored in viral transport medium (VTM) tubes. Ten millilitres of blood samples in EDTA were also obtained by venepuncture and spun to obtain plasma. Viral RNA was obtained from both swabs and plasma by manual extraction with Qiagen QIAamp viral RNA Mini Kit. Detection was done using a real time fluorescent RT-qPCR BGI kit, on a QuantStudio 3 real-time PCR instrument. Average age of study participants was 41 years, with 74 (59.2%) being male. Out of the 125 individuals tested for COVID-19, 75 (60%) were positive by OP/NP swab. However, only 6 (4.8%) had a positive plasma result for COVID-19 with median Ct value of 32.4. Sensitivity and specificity of RT-PCR SARS-CoV-2 test using plasma was 8% and 100% respectively. There was no false positive recorded, but 69 (55.2%) false negatives were obtained by plasma. SARS-CoV-2 viral RNA was detected, albeit low (4.8%) in plasma. Plasma is likely not a suitable biological sample to diagnose acute SARS-CoV-2 infection. The implication of transfusing blood in this era of COVID-19 needs further investigations., Competing Interests: The authors have declared that no competing interests exist. more...
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- 2021
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22. Antimicrobial stewardship programmes in healthcare facilities in Lagos State, Nigeria: a needs assessment.
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Chukwu EE, Oshun PO, Osuolale KA, Chuka-Ebene VO, Salako A, Idigbe IE, Oladele D, Audu RA, and Ogunsola FT
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- Cross-Sectional Studies, Health Facilities, Humans, Needs Assessment, Nigeria, Antimicrobial Stewardship
- Abstract
Objectives: Optimising antibiotic use in healthcare settings through antimicrobial stewardship programmes (ASPs) is critical to effectively treat infections, protect patients from harms caused by unnecessary antibiotic use, and combat antimicrobial resistance. This needs assessment was designed to provide the current status of ASPs in healthcare facilities in Lagos State and identify gaps for future interventions., Methods: A descriptive cross-sectional survey was conducted using a self-administered questionnaire to ascertain the extent and nature of ongoing ASPs among selected healthcare facilities and identify gaps for future interventional studies., Results: Of 32 questionnaires distributed, 25 (78%) were completed and returned from three tertiary, six secondary, eleven primary and five private healthcare facilities. The mean years of practice of respondents was 13.96 ± 7.8 years (2-31 years). Six facilities (24%) had a team responsible for ASP operating at varying degrees of capacity, while five (20%) had a formal ASP. All six facilities with an antimicrobial stewardship (AMS) team had a medical doctor as the team lead, and 5 (20%) also had a pharmacist involved in implementation efforts. Routine pre-authorisation for specific antibiotic was performed in six facilities (24%), four of which monitor pre-authorisation interventions. Only two facilities (8%) performed prospective audit and feedback for specific antibiotic agents. Private healthcare facilities were more likely to have information technology (IT) capability to support the needs of AMS activities., Conclusion: This study revealed minimal ASP activities in healthcare facilities in Lagos State and highlighted possibilities of leveraging on available IT resources for a co-ordinated AMS strategy., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.) more...
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- 2021
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23. Immunological screening of Lassa Virus among Health workers and Contacts of patients of Lassa fever in Ondo State.
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Shaibu JO, Salu OB, Amoo OS, Idigbe I, Musa AZ, Ezechi OC, Abejegah C, Ayodeji O, Salako BL, Omilabu SA, and Audu RA
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- Antibodies, Viral blood, Antibodies, Viral immunology, Enzyme-Linked Immunosorbent Assay methods, Humans, Lassa Fever diagnosis, Lassa Fever transmission, Mass Screening, Nigeria epidemiology, Public Health Surveillance, Contact Tracing, Health Personnel, Lassa Fever epidemiology, Lassa Fever virology, Lassa virus immunology
- Abstract
Background: The increasing trends of morbidity and mortality of Lassa fever is becoming more alarming in Nigeria. Information about immune response to the virus is limited. At exposure, the level of immunity plays a vital role in the vulnerability of individuals infected., Objective: Investigating the immune status of health workers, infected cases and contacts of infected cases of Lassa fever in Ondo State., Study Design: Blood samples were collected from 233 individuals comprising 102 health workers, 22 infected cases and 109 contacts of infected cases from Owo and Ose Local Government Areas and transported in triple level packaging. Plasma samples were analyzed for IgG and IgM markers using ReLASV® Pan-Lassa NP IgG/IgM ELISA Kit (Zalgen Labs, LLC, USA) while RNAs extracted from IgM positive samples were analyzed for LASV RNA according to manufacturers' instructions., Result: Among the health workers, 20/102 (19.6%) and 2/102 (2.0%) were IgG and IgM positive respectively. While 16/22 (72.7%) and 14/22 (63.6%) were IgG and IgM positive respectively among the infected cases. Of the contacts of infected cases screened, 64/109 (58.7%) were IgG positive while 4/109 (3.7%) were positive for IgM. There was no detectable LASV RNA in the samples analyzed., Conclusion: These findings suggest that majority of the health workers are naïve to the virus and hence may be prone to the viral infection. It could also be suggestive that a good personal protective procedure is been practiced by the health workers, hence the low exposure. However, most of the contacts of infected cases show exposure to the virus., (Copyright © 2021. Published by Elsevier GmbH.) more...
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- 2021
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24. Determinants of Antimicrobial Use for Covid-19 Related Symptoms among Nigerians.
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Chukwu EE, Musa AZ, Enwuru C, Ohihion A, Bamidele T, Olukosi A, Idigbe I, Osuolale KA, Gab-Okafor C, Salako A, David O, Otuonye N, David A, Toyosi R, Aina O, Adewale B, Odunukwe NN, Ezechi O, Audu RA, and Salako BL more...
- Subjects
- Adolescent, Anti-Bacterial Agents therapeutic use, Communicable Disease Control, Cross-Sectional Studies, Female, Humans, Male, Nigeria epidemiology, SARS-CoV-2, Surveys and Questionnaires, Anti-Infective Agents therapeutic use, COVID-19
- Abstract
Background: Antimicrobial use plays a key role in development and spread of antimicrobial resistance. Following the global coronavirus disease 2019 (COVID-19) pandemic and the report of the first confirmed case in Nigeria, several states embarked on either a full or partial lockdown as a measure to prevent or curtail the spread of the virus with its attendant challenges. This survey was designed to provide a snapshot of public antimicrobial use and common perception related to antimicrobial use for COVID-19 related symptoms among Nigerian populace., Methods: We developed and tested a 29-question electronic questionnaire with Google forms asking respondents about their antimicrobial use and perceptions regarding appropriate antimicrobial use for real or perceived symptoms during the outbreak period. Respondents aged 18 years and above were recruited through crowd sourcing and they received the link to the survey tool through emails and social media including WhatsApp, Twitter, Facebook, LinkedIn, and Instagram. All data analysis was performed using SPSS version 26.0., Results: A total of 410 responses were received from the six geopolitical zones in Nigeria comprising 200 (48.8%) females and 210 (51.2%) males. Majority (62.9%) of the respondents had taken antimicrobials in the 3 months period preceding the survey, while less than half (46.8%) received prescription for it. Previous intake of antimicrobial for similar illness was a predictor of antimicrobial intake (OR: 0.55, 95%CI: 0.30-1.01). The most consumed antimicrobial was antimalarial drugs, specifically Artemisinin-based combination therapy (43.4%), followed by antibiotics [Ciprofloxacin (20.2%)]., Conclusion: There was high levels of antimicrobial use for COVID-19 related symptoms by the Nigerian public. This is likely to escalate the already high prevalence of antimicrobial use previously reported and may further fuel the emergence of antimicrobial resistance., Competing Interests: The Authors declare that no competing interest exists. more...
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- 2021
25. Detection and molecular characterization of a first isolate of rabbit haemorrhagic disease virus in Nigeria.
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Daodu OB, Shaibu JO, Richards AB, Folaranmi EB, Adegoke S, Ajadi A, Olorunshola ID, Akanbi OB, Afolabi AA, Daodu OC, Aiyedun JO, Oludairo OO, Halleed NI, Audu RA, and Oluwayelu DO
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- Animals, Disease Outbreaks, Nigeria epidemiology, Phylogeny, Caliciviridae Infections epidemiology, Caliciviridae Infections veterinary, Hemorrhagic Disease Virus, Rabbit genetics
- Abstract
Rabbit haemorrhagic disease virus (RHDV) was recovered from necropsied rabbits that died during an outbreak characterized by epistaxis, incoordination, paralysis, and multi-organ haemorrhages in Ilorin, Nigeria. The haemagglutination test (HA) and RT-PCR assay targeted against a fragment of the RHDV VP60 gene were performed on liver, spleen, and kidney homogenates; faeces; and urine obtained from the rabbits. Amplicons were purified, sequenced, and phylogenetically analysed. The liver homogenates yielded the highest HA titres while RT-PCR of liver, spleen, and kidneys yielded the expected 1252 bp band. Sequence and phylogenetic analyses revealed that the Nigerian RHDV strain (RHDV/NGR/ILN/001) was 98.57%, 97.95%, and 96.70% homologous with RHDV2 (RHDVGI.2) strains from the Netherlands, Germany, and France, respectively. RHDV/NGR/ILN/001 induced tracheal, intestinal, and mediastinal lymph node haemorrhages, pulmonary oedema and congestion, and enlarged, necrotic liver in experimentally inoculated rabbits. The implications of this study, which is the first report of RHDV in Nigeria, are discussed. more...
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- 2021
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26. Full length genomic sanger sequencing and phylogenetic analysis of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Nigeria.
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Shaibu JO, Onwuamah CK, James AB, Okwuraiwe AP, Amoo OS, Salu OB, Ige FA, Liboro G, Odewale E, Okoli LC, Ahmed RA, Achanya D, Adesesan A, Amuda OA, Sokei J, Oyefolu BAO, Salako BL, Omilabu SA, and Audu RA more...
- Subjects
- Base Sequence, COVID-19 epidemiology, Genome, Viral, High-Throughput Nucleotide Sequencing, Humans, Nigeria epidemiology, Phylogeny, RNA, Viral genetics, Reverse Transcriptase Polymerase Chain Reaction, COVID-19 virology, SARS-CoV-2 genetics
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In an outbreak, effective detection of the aetiological agent(s) involved using molecular techniques is key to efficient diagnosis, early prevention and management of the spread. However, sequencing is necessary for mutation monitoring and tracking of clusters of transmission, development of diagnostics and for vaccines and drug development. Many sequencing methods are fast evolving to reduce test turn-around-time and to increase through-put compared to Sanger sequencing method; however, Sanger sequencing remains the gold standard for clinical research sequencing with its 99.99% accuracy This study sought to generate sequence data of SARS-CoV-2 using Sanger sequencing method and to characterize them for possible site(s) of mutations. About 30 pairs of primers were designed, synthesized, and optimized using endpoint PCR to generate amplicons for the full length of the virus. Cycle sequencing using BigDye Terminator v.3.1 and capillary gel electrophoresis on ABI 3130xl genetic analyser were performed according to the manufacturers' instructions. The sequence data generated were assembled and analysed for variations using DNASTAR Lasergene 17 SeqMan Ultra. Total length of 29,760bp of SARS-CoV-2 was assembled from the sample analysed and deposited in GenBank with accession number: MT576584. Blast result of the sequence assembly shows a 99.97% identity with the reference sequence. Variations were noticed at positions: nt201, nt2997, nt14368, nt16535, nt20334, and nt28841-28843, which caused amino acid alterations at the S (aa614) and N (aa203-204) regions. The mutations observed at S and N-gene in this study may be indicative of a gradual changes in the genetic coding of the virus hence, the need for active surveillance of the viral genome., Competing Interests: The authors have declared that no competing interests exist. more...
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- 2021
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27. Antimicrobial resistance awareness and antibiotic prescribing behavior among healthcare workers in Nigeria: a national survey.
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Chukwu EE, Oladele DA, Enwuru CA, Gogwan PL, Abuh D, Audu RA, and Ogunsola FT
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- Adolescent, Adult, Cross-Sectional Studies, Female, Health Knowledge, Attitudes, Practice, Health Personnel statistics & numerical data, Humans, Male, Middle Aged, Nigeria, Practice Patterns, Physicians', Surveys and Questionnaires, Young Adult, Anti-Bacterial Agents therapeutic use, Attitude of Health Personnel, Drug Prescriptions statistics & numerical data, Drug Resistance, Bacterial
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Background: Antimicrobial resistance (AMR) is a global problem compromising the effective treatment of infectious diseases. The World Health Organization (WHO) is encouraging and promoting awareness creation among health workers as one of its strategies to reduce the rate of emergence and transmission of AMR. Available data on the prescribing behavior of healthcare workers (HCWs) in Nigeria remains incomplete. This study was designed to provide an up-to-date estimate of the knowledge, attitude and antibiotic prescribing behavior of HCWs in Nigeria., Methods: This is a cross-sectional study. Self-administered questionnaires were distributed to healthcare workers selected from six states, one each from the 6 geopolitical zones in Nigeria. A multi-stage sampling technique was used to reflect the three tiers of healthcare: primary, secondary and tertiary levels. Quantitative data was summarized using descriptive statistics. All data analysis was done using the Statistical package for social sciences version 26.0., Results: Of the 420 questionnaires distributed, 358 (85.2%) responded. The mean year of practice of the respondents was 9.32 ± 7.8 years. About a half (50.3%) agreed that their prescribing behavior could promote antimicrobial resistance. 49.2% had a good knowledge of AMR and physicians had significantly better knowledge than other HCWs (X
2 = 69.59, P < 0.001). Several participants prescribed antibiotics for common viral infections such as sore throats (75.7%), measles (37.7%), common cold and flu (21.2%). Over 60.3% admitted prescribing antibiotics just to be on the safe side. In general, 70.9% of the respondents frequently or moderately use practice guidelines while 25.7% often apply the delayed antibiotic prescription (DAP) strategy to reduce antimicrobial prescription., Conclusion: This study reveals an overall moderate level of knowledge of AMR and attitude towards minimizing the emergence of antimicrobial resistance though this did not translate significantly to practice. Further efforts must be made in order to improve rational prescription of antimicrobials among HCWs in Nigeria. more...- Published
- 2021
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28. Prevalence and Clinical Characteristics of Coronavirus Disease 2019 Seen at a Testing Centre in Lagos Nigeria.
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Salako AO, Amoo OS, Odubela OO, Osuolale KA, James AB, Oladele DA, Musa AZ, Ige FA, Okwuraiwe AP, Onwuamah CK, Shaibu JO, David AN, Audu RA, Ezechi OC, Odunukwe NN, and Salako BL
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- Adolescent, Cough epidemiology, Cough etiology, Fatigue epidemiology, Fatigue etiology, Fever epidemiology, Fever etiology, Headache epidemiology, Headache etiology, Humans, Male, Nigeria epidemiology, Pharyngitis epidemiology, Pharyngitis etiology, Prevalence, Retrospective Studies, COVID-19 epidemiology, Pandemics, SARS-CoV-2
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Background: The SARS-CoV-2 infection continues to ravage the global community since it was declared a pandemic. The socio-demographic and clinical characteristics defining the disease are mainly from Europe and Asia. The disease symptomatology is similar to the prevalent diseases in our environment, this could result in the delay in prompt identification and appropriate management of suspected cases toward combating community transmission. This study evaluates the prevalence, socio-demographic and clinical characteristics of positive cases of COVID -19., Methods: This was a retrospective cohort study. Data on the socio-demographic, clinical characteristics and the results of the SARS-CoV-2 test of participants at the Nigerian Institute of Medical Research [NIMR] Modified Drive-through Centre for COVID-19 test sample collection over two months [24th February 2020- 27th April 2020] were retrieved from the electronic medical records (EMR). Data obtained were analyzed using SPSS version 22.0., Results: A total number of 481 clients were evaluated in this review. The prevalence of SARS-CoV-2 infection in the population was 14.6%. The mean age of the positive cases was 42.2 [±15.9] years. The common symptoms reported by the positive cases were fever (40.0%), cough (32.9%), sore throat (17.1%) and running nose (15.7%). Fever depicted statistical significance with positive cases with the majority being of mild to moderate clinical severity., Conclusion: The prevalence of SARS-CoV-2 infection among this cohort was 14.6% with a male preponderance. Fever and sore throat were the variables that predicted SARS CoV-2 infection among our cohort. more...
- Published
- 2021
29. Hepatitis C viral load and genotypes among Nigerian subjects with chronic infection and implication for patient management: a retrospective review of data.
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Audu RA, Okwuraiwe AP, Ige FA, Adeleye OO, Onyekwere CA, and Lesi OA
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- Adolescent, Adult, Aged, Aged, 80 and over, Female, Genotype, Hepacivirus isolation & purification, Hepatitis C, Chronic drug therapy, Humans, Male, Middle Aged, Nigeria, Prevalence, Retrospective Studies, Viral Load, Young Adult, Antiviral Agents administration & dosage, Hepacivirus genetics, Hepatitis C, Chronic virology
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Introduction: Hepatitis C Virus (HCV) is highly infectious with no currently available vaccine. Prior to treatment, it is recommended to confirm HCV infection with either quantitative or qualitative nucleic acid test. Access to these assays in Nigeria is limited but for effective management of patients, HCV viral load (VL) prior to therapy is required and genotype may be needed in some instances. This study aimed at reviewing the pattern of HCV viral load and genotype in the country, and its implication in patient management., Methods: this was a retrospective study that involved data abstraction from an electronic database of an accredited laboratory between June 2013 and May 2017. De-linked data were abstracted from records of adult subjects with HCV VL and genotype results, these were analysed using Microsoft Excel 2010 and SPSS v20., Results: within the study period, 346 subjects had baseline VL and 134 (38.7%) had genotype results available. Of these, 202/346 (58.4%) had detectable VL results with higher prevalence in males (64.7%) and ≥51years (42.5%) age group. The median VL among 202 subjects was 407,430 (IQR: 96,388 - 1,357,012) IU/mL. Distribution of genotypes showed that genotypes 1 and 4 had prevalence of 63.2% and 16.8% respectively., Conclusion: genotypes 1 and 4 have the highest prevalence. A greater proportion of subjects had VL values ≤800,000 IU/mL, an indication that they are more likely to respond well to available antiviral therapy hence, access to these antivirals will greatly improve management of HCV infection in Nigeria., Competing Interests: The authors declare no competing interests., (Copyright: Rosemary Ajuma Audu et al.) more...
- Published
- 2020
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30. Monitoring of Lassa virus infection in suspected and confirmed cases in Ondo State, Nigeria.
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Salu OB, Amoo OS, Shaibu JO, Abejegah C, Ayodeji O, Musa AZ, Idigbe I, Ezechi OC, Audu RA, Salako BL, and Omilabu SA
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- Adult, Cross-Sectional Studies, Disease Outbreaks, Female, Humans, Lassa Fever diagnosis, Lassa Fever drug therapy, Male, Middle Aged, Milk, Human virology, Nigeria epidemiology, Reverse Transcriptase Polymerase Chain Reaction, Semen virology, Antiviral Agents administration & dosage, Lassa Fever epidemiology, Lassa virus isolation & purification, Ribavirin administration & dosage
- Abstract
Introduction: Lassa virus (LASV), the causative agent of Lassa fever (LF), an endemic acute viral haemorrhagic illness in Nigeria, is transmitted by direct contact with the rodent, contaminated food or household items. Person-to-person transmission also occurs and sexual transmission has been reported. Thus, this study investigated the presence of LASV in body fluids of suspected and confirmed cases., Methods: this was a cross-sectional study between March 2018 and April 2019 involving 112 consenting suspected and post ribavirin confirmed cases attending the Lassa fever treatment center in Ondo State. Whole blood was collected from 57 suspected and 29 confirmed cases. Other samples from confirmed cases were 5 each of High Vaginal Swab (HVS) and seminal fluid; 12 breast milk and 4 urine. All samples were analyzed using reverse transcription-PCR (RT-PCR) targeting the S-gene of LASV., Results: analysis of whole blood by RT-PCR showed that 1/57 (1.8%) suspected and 1/29 (3.4%) confirmed post ribavirin treated cases were positive. While LASV was detected in 2/5 (40%) post ribavirin treated seminal fluids and 1/11 (8.3%) breast milk. However, LASV was not detected in any of the HVS and urine samples., Conclusion: the detection of LASV in seminal fluid and breast milk of discharged post ribavirin treated cases suggests its persistence in these fluids of recovering Nigerians. The role of postnatal and sexual transmissions in the perennial outbreak of LF needs to be further evaluated., Competing Interests: The authors declare no competing interests., (Copyright: Olumuyiwa Babalola Salu et al.) more...
- Published
- 2020
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31. Implementation of a modified drive-through sampling strategy for SARS-CoV-2-the Nigerian experience.
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Amoo OS, Ohihoin AG, Musa AZ, Idighe I, Ige F, Giwa-Tubosun T, Oloko S, Abiola A, Ohihoin EN, David AN, Salako A, Oladele D, Gab-Okafor CM, Bamidele TA, Aina OO, Chukwu E, Odunukwe NN, Ezechi OC, Audu RA, and Salako BL more...
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- COVID-19 prevention & control, Humans, Interviews as Topic, Nigeria, Specimen Handling, COVID-19 diagnosis, COVID-19 Testing statistics & numerical data, SARS-CoV-2
- Abstract
Introduction: effective and safe means of sample collection is a crucial component of testing for Covid-19. Uptake of testing is key to containing and controlling the spread of the virus. Scientists have been working on various strategies that will increase the uptake of testing for COVID-19. One such method involves the use of the drive-through sampling strategy., Methods: data was collected by both qualitative and quantitative methods. An eligibility form was filled online. While in-depth interviews were conducted for the qualitative aspect of the study., Results: 2,600 visits were recorded at the website, 2300 (88.46%) participants successfully registered for the test. 57.4% were found eligible of which 78.0% presented for the test. This Consisted of 78.0% drive-through and 22.0% walk-in. The average time for transiting through the drive-through site was 19.2 ± 4.6minutes while that of the walk-in was 28 ± 9.2min. This difference was statistically significant (p<0.001). In the qualitative component, respondents opined that maximum safety measures were deployed to protect both participants and health workers. Most said that the turnaround time for the sampling process was short., Conclusion: the sampling strategy although largely successful, is largely dependent on Internet penetrability, thus this sampling modality will be best utilized as an adjunct to established models of sample collection., Competing Interests: The authors declare no competing interests., (©Olufemi Samuel Amoo et al.) more...
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- 2020
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32. A national survey of public awareness of antimicrobial resistance in Nigeria.
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Chukwu EE, Oladele DA, Awoderu OB, Afocha EE, Lawal RG, Abdus-Salam I, Ogunsola FT, and Audu RA
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- Adult, Aged, Cross-Sectional Studies, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Nigeria, Surveys and Questionnaires, Urban Health, Young Adult, Anti-Bacterial Agents therapeutic use, Drug Resistance, Bacterial
- Abstract
Background: One of the objectives of the Global Action Plan by the World Health Organization (WHO) to contain antimicrobial resistance (AMR), is to improve global awareness through effective communication and education. Comprehensive information on the level of awareness of AMR among Nigerian public is deficient. This study was therefore designed to assess the current level of awareness and knowledge of the Nigerian public of AMR., Methods: Pre-tested and validated questionnaire was used to obtain information from the general public across the six geopolitical zones (North Central, North East, North West, South East, South South and South West) in Nigeria. Multi-stage sampling was used to select one state from each zone and respondents were selected through a multi-stage sampling technique. Responses to eight questions were used to grade the level of knowledge categorized as poor, fair and good. Collation and analysis of data were performed at the Microbiology Department of the Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria, using SPSS version 24.0., Results: Questionnaires from 482 respondents comprising 242 (50.2%) females and 240 (49.8%) males from six states (Lagos, Ebonyi, Delta, Plateau, Borno and Jigawa) were analyzed. Of the 482 respondents, 322 (66.8%) had taken antibiotics in the last six months out of which 31.3% were without prescription. 26.1% of respondents believe they don't need to complete the dosage as long as they feel better. Although 272(56.5%) of the respondents were familiar with the term "antibiotic resistance", only 40(8.3%) had good knowledge of AMR. A majority (76.6%) believed that they were powerless to stop the spread of AMR. There was no association between the gender of respondents and knowledge of AMR (p = 0.13). However, respondents from Ebonyi and Delta states in southern Nigeria were more likely to have good knowledge of AMR (X
2 = 53.22, P < 0.0001). The respondents in the urban area had a higher score for knowledge level compared to the rural dwellers, though this was not statistically significant within and across states., Conclusion: This survey provides an insight into the level of AMR awareness and antibiotic use in the wider Nigeria public. Our findings show that about a third of the general public consume antibiotics obtained without prescription. There is an overall poor understanding of antimicrobial resistance and/or proper use of antibiotics among respondents. It is critical that more holistic public enlightenment programs are carried out to increase awareness of AMR and promote responsible use of antibiotics. more...- Published
- 2020
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33. Serological and virological markers of nigerian patients with hepatitis B infection.
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Lesi OA, Audu RA, Okwuraiwe AP, Adeleye OO, Ige FA, and Iwuorah JC
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- Adult, Biomarkers blood, Female, Hepatitis B diagnosis, Hepatitis B epidemiology, Hepatitis B Antibodies blood, Hepatitis B Surface Antigens blood, Hepatitis B e Antigens blood, Hepatitis B virus genetics, Humans, Male, Middle Aged, Nigeria epidemiology, Retrospective Studies, Viral Load, Virus Replication, DNA, Viral analysis, Hepatitis B blood, Hepatitis B virology, Hepatitis B virus isolation & purification
- Abstract
Background: The natural history of chronic hepatitis B virus (HBV) infection and the spectrum of diseases attributable to chronic hepatitis B are diverse. It is estimated that 15%-25% of chronic carriers will die from complications of progressive disease such as liver cirrhosis, hepatocellular carcinoma, and hepatic decompensation. The main aim of this study is to evaluate the serological and virological profile of patients with hepatitis B infection to enhance the evaluation of the natural history of viral hepatitis in an endemic population., Methods: Characteristics of hepatitis B surface antigen (HBsAg) patients (2010-2016) were extracted from the database of a reference laboratory in Lagos. These included serological tests for hepatitis B antigens (HBeAg, HBsAg), antibodies (anti-HBcIgM, anti-HBeAb) (DIA.PRO), and HBV DNA (Roche Diagnostics). SPSS version 20.0 was used for data analysis., Results: Of the 1,983 patients, 1,252 were male and 731 female. HBeAg was detected in 8.0% (128/1,605) of the subjects, anti-HBe was positive in 90.0% (1,257/1,396), while HBcore subclass IgM antibody was detected in 12.6% (116/930). Detectable HBV DNA was identified in 1,781 (89%), with viral load exceeding 2,001 IU/mL in 712 (35.9%) subjects. HBV viral loads >200,000 IU/mL were more frequently detected in HBeAg-positive compared with HBeAg-negative subjects (65.7% vs 4.9%, P < 0.0001)., Conclusion: We have demonstrated the predominance of low replicative phase HBV infection and highlighted the importance of HBeAg-negative infections that may require antiviral therapy. HBeAg-positive infections occurred significantly in younger adults with new or acute infections. Our findings have implications for patient evaluation and planning of hepatitis treatment programs., Competing Interests: None more...
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- 2019
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34. Occult Hepatitis B virus infection in previously screened, blood donors in Ile-Ife, Nigeria: implications for blood transfusion and stem cell transplantation.
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Olotu AA, Oyelese AO, Salawu L, Audu RA, Okwuraiwe AP, and Aboderin AO
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- Adult, Cross-Sectional Studies, Enzyme-Linked Immunosorbent Assay, Female, Hepatitis B virology, Hepatitis B Surface Antigens blood, Humans, Male, Nigeria epidemiology, Prevalence, Prospective Studies, Real-Time Polymerase Chain Reaction, Risk Assessment, Stem Cell Transplantation adverse effects, Transfusion Reaction, Blood virology, Blood Donors, DNA, Viral blood, Hepatitis B epidemiology, Hepatitis B virus isolation & purification
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Background: Hepatitis B virus (HBV) transmission through blood transfusion is reduced by screening for hepatitis B surface antigen (HBsAg). However this method cannot detect the presence of occult hepatitis B virus infection. This study sought to determine the prevalence of occult hepatitis B virus infection among blood donors in Ile-Ife, Nigeria. For the first time in Nigeria we employed an automated real-time PCR- method to investigate the prevalence of occult HBV in blood donors., Methods: Blood donors screened with HBsAg immunochromatographic rapid test kits at the blood transfusion units of two hospitals and found to be negative were recruited into the study. Questionnaires to elicit risk factors for HBV infection were administered and then 10 ml of blood was collected from each donor. Plasma samples obtained from these HBsAg negative blood donors were screened again for HBsAg using an enzyme-linked immunosorbent assay (ELISA) method, and those found negative were screened for the presence of total antibody to the HBV core antigen (anti-HBc) using ELISA method. Those positive to anti-HBc were then tested for HBV DNA, using an automated real-time PCR method., Results: Five hundred and seven blood donors found HBsAg negative by immunochromatographic rapid test kits at both blood transfusion units, were tested for HBsAg using ELISA and 5 (1 %) were HBsAg positive. The 502 found negative were tested for anti-HBc and 354 (70.5 %) were found positive implying previous exposure to HBV and 19 (5.4 %) of the 354 anti-HBc positive had HBV DNA signifying occult HBV infection. No risk factors were found to be associated with the presence of HBV DNA among those who tested positive., Conclusion: Occult HBV infection exists in blood donors in Ile-Ife, Nigeria and the use of HBsAg alone for screening prospective donors will not eliminate the risk of HBV transmission in blood transfusion or stem cell transplantation. more...
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- 2016
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35. Potential for false-positive HIV test results using rapid HIV testing algorithms.
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Audu RA, Okoye RN, Onwuamah CK, Ige FA, Musa AZ, Odunukwe NN, Onwujekwe DI, Ezechi OC, Idigbe EO, and Kanki PJ
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Background: In order to scale up access to HIV counselling and testing in Nigeria, an HIV diagnostic algorithm based on rapid testing was adopted. However, there was the need to further evaluate the testing strategy in order to better assess its performance, because of the potential for false positivity., Objectives: The objective of this study was to compare positive HIV test results obtained from the approved rapid testing algorithm with results from western blot tests performed on samples from the same patient., Methodology: A retrospective review was conducted of HIV screening and confirmatory results for patients seen between 2007 and 2008. Rapid test and western blot results were extracted and compared for concordance. Discordant results were further reviewed using a combination of HIV-1 RNA viral load and CD4+ cell count test results and clinical presentation from medical records., Results: Analysis of 2228 western blot results showed that 98.3% ( n = 2191) were positive for HIV-1, 0.4% ( n = 8) were positive for HIV-2 and 0.3% ( n = 7) were dual infections (positive for both HIV-1 and HIV-2); 0.6% ( n = 13) were indeterminate and 0.4% ( n = 9) were negative. Further investigation of the 13 indeterminate results showed nine to be HIV-1 positive and four to be HIV-negative, for a total of 13 negative results. The positive predictive value of the HIV counselling and testing algorithm was 99.4%., Conclusion: Using the rapid testing algorithm alone, false positives were detected. Therefore, effective measures such as training and retraining of staff should be prioritised in order to minimise false-positive diagnoses and the associated potential for long-term psychological and financial impact on the patients., Competing Interests: The authors declare that they have no financial or personal relationship(s) that may have inappropriately influenced them in writing this article., (© 2015. The Authors.) more...
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- 2015
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36. Proficiency testing for HIV, tuberculosis and malaria diagnosis in clinical laboratories in Nigeria.
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Audu RA, Onubogu CC, Okoye RN, Nwokoye NN, Onwuamah CK, Musa AZ, Raheem TY, Aniedobe MN, Nduaga SJ, Essien IO, and Idigbe EO
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Background: Proficiency testing (PT) is a means of verifying the reliability of laboratory results, but such programmes are not readily available to laboratories in developing countries. This project provided PT to laboratories in Nigeria., Objectives: To assess the proficiency of laboratories in the diagnosis of HIV, tuberculosis and malaria., Methods: This was a prospective study carried out between 2009 and 2011. A structured questionnaire was administered to 106 randomly-selected laboratories. Forty-four indicated their interest in participation and were enrolled. Four rounds of pre-characterised plasma panels for HIV, sputum films for tuberculosis and blood films for malaria were distributed quarterly by courier over the course of one year. The results were returned within two weeks and scores of ≥ 80% were reported as satisfactory. Mentoring was offered after the first and second PT rounds., Results: Average HIV PT scores increased from 74% to 95% from the first round to the third round, but decreased in the fourth round. For diagnosis of tuberculosis, average scores increased from 42% in the first round to 78% in the second round; but a decrease to 34% was observed in the fourth round. Malaria PT performance was 2% at first, but average scores increased between the second and fourth rounds, culminating in a fourth-round score of 39%. Many participants requested training and mentoring., Conclusions: There were gross deficiencies in the quality of laboratory services rendered across Nigeria. In-country PT programmes, implemented in conjunction with mentoring, will improve coverage and diagnosis of HIV, tuberculosis and malaria., Competing Interests: The authors declare that they have no financial or personal relationship(s) which may have inappropriately influenced them in writing this article. more...
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- 2014
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37. Foetal loss and enhanced fertility observed in mice treated with Zidovudine or Nevirapine.
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Onwuamah CK, Ezechi OC, Herbertson EC, Audu RA, Ujah IA, and Odeigah PG
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- Animals, Female, Fertility drug effects, Fetal Death, Male, Mice, Pregnancy, Sex Ratio, Anti-HIV Agents toxicity, Nevirapine toxicity, Zidovudine toxicity
- Abstract
Background: Health concerns for HIV-infected persons on antiretroviral therapy (ART) have moved from morbidity to the challenges of long-term ART. We investigated the effect of Zidovudine or Nevirapine on reproductive capacity across two mouse generations., Methods: A prospective mouse study with drugs administered through one spermatogenic cycle. Mouse groups (16 males and 10 females) were given Zidovudine or Nevirapine for 56 days. Males were mated to untreated virgin females to determine dominant lethal effects. Twenty females (10 treated and 10 untreated) mated with the treated males per dose and gave birth to the F1 generation. Parental mice were withdrawn from drugs for one spermatogenic cycle and mated to the same dams to ascertain if effects are reversible. The F1 generation were exposed for another 56 days and mated to produce the F2 generation., Results: Foetal loss was indicated in the dominant lethal assay as early as four weeks into drug administration to the males. At the first mating of the parental generation to produce the F1 generation, births from 10 dams/dose when the 'father-only' was exposed to Zidovudine (10, 100 and 250 mg/kg) was 3, 2 and 1 while it was 7, 1 and 4 respectively when 'both-parents' were exposed. Similarly births from the parental generation first mating when the 'father-only' was exposed to Nevirapine (5, 50 and 150 mg/kg) was 2, 2 and 0 while it was 6, 5 and 9 respectively when 'both-parents' were exposed. However, fertility was not significantly different neither by dose nor by the parental exposure. The F1 mice mated to produce the F2 generation recorded only one birth., Conclusion: The dominant lethal analysis showed foetal loss occurred when the "fathers-only" were treated while fertility was enhanced when "both-parents" were on therapy at the time of mating. more...
- Published
- 2014
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38. Improving quality in national reference laboratories: The role of SLMTA and mentorship.
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Audu RA, Onubogu CC, Nwokoye NN, Ofuche E, Baboolal S, Oke O, Luman ET, and Idigbe EO
- Abstract
Background: The Nigerian Institute of Medical Research houses two reference laboratories: the virology and tuberculosis laboratories. Both were enrolled in the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme., Objective: To describe the impact of SLMTA and discuss factors affecting the results, with an emphasis on mentorship., Methods: The SLMTA programme was implemented from April 2010 through November 2012. Participants attended three workshops and executed quality improvement projects; laboratory auditors evaluated performance using a standard checklist. The virology laboratory did not receive mentorship; however, the tuberculosis laboratory had an international mentor who visited the laboratory four times during the programme, spending two to four weeks embedded within the laboratory during each visit., Results: There was an overall improvement in the performance of both laboratories, with the virology laboratory increasing 13% (from 80% at baseline to 93% at exit audit) and the tuberculosis laboratory increasing 29% (from 66% to 95%). These scores were maintained nine months later at the surveillance audit., Conclusion: The SLMTA programme resulted in improved and sustained quality management performance for both laboratories. Mentoring was a possible factor in the substantial improvement made by the tuberculosis laboratory and should be considered in order to augment the training received from the SLMTA workshops., Competing Interests: The authors declare that they have no financial or personal relationship(s) which may have inappropriately influenced them in writing this article. more...
- Published
- 2014
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39. Exposure of Allium cepa root cells to zidovudine or nevirapine induces cytogenotoxic changes.
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Onwuamah CK, Ekama SO, Audu RA, Ezechi OC, Poirier MC, and Odeigah PG
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- DNA Damage, Drug Evaluation, Preclinical, Inhibitory Concentration 50, Mitosis drug effects, Mitotic Index, Mutagens pharmacology, Onions cytology, Onions drug effects, Plant Roots cytology, Plant Roots drug effects, Anti-HIV Agents pharmacology, Nevirapine pharmacology, Zidovudine pharmacology
- Abstract
Antiretroviral drugs have proved useful in the clinical management of HIV-infected persons, though there are concerns about the effects of exposure to these DNA-reactive drugs. We investigated the potential of the plant model Allium cepa root tip assay to demonstrate the cytogenotoxicity of zidovudine and nevirapine and as a replace-reduce-refine programme amenable to resource-poor research settings. Cells mitotic index were determined in squashed root cells from Allium cepa bulbs exposed to zidovudine or nevirapine for 48 hr. The concentration of zidovudine and nevirapine inhibiting 50% root growth after 96 hr exposure was 65.0 µM and 92.5 µM respectively. Root length of all antiretroviral-exposed roots after 96 hr exposure was significantly shorter than the unexposed roots while additional root growth during a subsequent 48 hr recovery period in the absence of drug was not significantly different. By ANOVA, there was a significant association between percentage of cells in mitosis and zidovudine dose (p=0.004), but not nevirapine dose (p=0.68). Chromosomal aberrations such as sticky chromosomes, chromatin bridges, multipolar mitoses and binucleated cells were observed in root cells exposed to zidovudine and nevirapine for 48 hr. The most notable chromosomal aberration was drug-related increases in sticky chromosomes. Overall, the study showed inhibition in root length growth, changes in the mitotic index, and the induction of chromosomal aberrations in Allium bulbs treated for 96 hr or 48 hr with zidovudine and nevirapine. The study reveals generalized cytogenotoxic damage induced by exposure to zidovudine and nevirapine, and further show that the two compounds differ in their effects on mitosis and the types of chromosomal aberrations induced. more...
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- 2014
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40. Accumulation of protease mutations among patients failing second-line antiretroviral therapy and response to salvage therapy in Nigeria.
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Rawizza HE, Chaplin B, Meloni ST, Darin KM, Olaitan O, Scarsi KK, Onwuamah CK, Audu RA, Chebu PR, Imade GE, Okonkwo P, and Kanki PJ
- Subjects
- Adult, Anti-HIV Agents pharmacology, Drug Resistance, Viral genetics, Female, Genotype, HIV Infections drug therapy, HIV Infections genetics, Humans, Male, Mutation, Nigeria, Anti-HIV Agents therapeutic use, HIV-1 drug effects, HIV-1 enzymology, Peptide Hydrolases genetics, Salvage Therapy methods
- Abstract
Background: To date, antiretroviral therapy (ART) guidelines and programs in resource-limited settings (RLS) have focused on 1(st)- and 2(nd)-line (2 L) therapy. As programs approach a decade of implementation, policy regarding access to 3(rd)-line (3 L) ART is needed. We aimed to examine the impact of maintaining patients on failing 2 L ART on the accumulation of protease (PR) mutations., Methods and Findings: From 2004-2011, the Harvard/APIN PEPFAR Program provided ART to >100,000 people in Nigeria. Genotypic resistance testing was performed on a subset of patients experiencing 2 L failure, defined as 2 consecutive viral loads (VL)>1000 copies/mL after ≥6 months on 2 L. Of 6714 patients who received protease inhibitor (PI)-based ART, 673 (10.0%) met virologic failure criteria. Genotypes were performed on 61 samples. Patients on non-suppressive 2 L therapy for <12 months prior to genotyping had a median of 2 (IQR: 0-5) International AIDS Society (IAS) PR mutations compared with 5 (IQR: 0-6) among patients failing for >24 months. Patients developed a median of 0.6 (IQR: 0-1.4) IAS PR mutations per 6 months on failing 2 L therapy. In 38% of failing patients no PR mutations were present. For patients failing >24 months, high- or intermediate-level resistance to lopinavir and atazanavir was present in 63%, with 5% to darunavir., Conclusions: This is the first report assessing the impact of duration of non-suppressive 2 L therapy on the accumulation of PR resistance in a RLS. This information provides insight into the resistance cost of failing to switch non-suppressive 2 L regimens and highlights the issue of 3 L access. more...
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- 2013
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41. Prevalence and risk factors of asymptomatic bacteriuria among pregnant Nigerians infected with HIV.
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Ezechi OC, Gab-Okafor CV, Oladele DA, Kalejaiye OO, Oke BO, Ekama SO, Audu RA, Okoye RN, and Ujah IA
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- Adult, Bacteriuria complications, Bacteriuria microbiology, CD4 Lymphocyte Count, Cross-Sectional Studies, Escherichia coli isolation & purification, Female, HIV Infections blood, HIV Infections epidemiology, HIV-1 genetics, Hemoglobins analysis, Humans, Nigeria epidemiology, Pregnancy, Proteus mirabilis isolation & purification, RNA, Viral analysis, RNA, Viral blood, Risk Factors, Urinary Tract Infections complications, Viral Load, Bacteriuria epidemiology, HIV Infections complications, Pregnancy Complications, Infectious epidemiology
- Abstract
Objective: There are conflicting report on the association of HIV infection and asymptomatic bacteriuria (ASB). Most of these studies were from areas with low HIV burden. This study determined the prevalence and risk factors of ASB in HIV positive pregnant women., Methods: A cross sectional study among HIV positive pregnant women seen at a large PMTCT clinic in Lagos Nigeria. The women were evaluated for ASB at first clinic attendance. Blood samples were also collected for viral load, CD4 count and hemoglobin levels assessment. Data were managed with SPSS for windows version 19., Results: 102 (18.1%) women out of 563 studied were found positive for asymptomatic bacteriuria. Ninety-seven (95.1%) of the positive samples yielded single bacterial isolates. Escherichia coli (44.3%) and Proteus mirabilis (21.6%) were the most common bacterial isolates. Previous urinary tract infection (OR: 4.3), HIV-1 RNA greater than 10,000 copies/ml (OR: 3.9), CD4 count <200 cells/mm3 (OR: 1.4) and maternal hemoglobin <11 g/dl (OR: 1.4) were factors significantly associated with ASB after controlling for possible confounders., Conclusion: ASB is common in HIV positive pregnant women in our environment and is associated with previous UTI, high viral load, low CD4 count and maternal hemoglobin <11 g/dl. more...
- Published
- 2013
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42. Experience of quality management system in a clinical laboratory in Nigeria.
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Audu RA, Sylvester-Ikondu U, Onwuamah CK, Salu OB, Ige FA, Meshack E, Aniedobe M, Amoo OS, Okwuraiwe AP, Okhiku F, Okoli CL, Fasela EO, Odewale EO, Aleshinloye RO, Olatunji M, and Idigbe EO
- Abstract
Issues: Quality-management systems (QMS) are uncommon in clinical laboratories in Nigeria, and until recently, none of the nation's 5 349 clinical laboratories have been able to attain the certifications necessary to begin the process of attaining international accreditation. Nigeria's Human Virology Laboratory (HVL), however, began implementation of a QMS in 2006, and in 2008 it was determined that the laboratory conformed to the requirements of ISO 9001:2000 (now 2008), making it the first diagnostic laboratory to be certified in Nigeria. The HVL has now applied for the World Health Organization (WHO) accreditation preparedness scheme. The experience of the QMS implementation process and the lessons learned therein are shared here., Description: In 2005, two personnel from the HVL spent time studying quality systems in a certified clinical laboratory in Dakar, Senegal. Following this peer-to-peer technical assistance, several training sessions were undertaken by HVL staff, a baseline assessment was conducted, and processes were established. The HVL has monitored its quality indicators and conducted internal and external audits; these analyses (from 2007 to 2009) are presented herein., Lessons Learned: Although there was improvement in the pre-analytical and analytical indicators analysed and although data-entry errors decreased in the post-analytical process, the delay in returning laboratory test results increased significantly. There were several factors identified as causes for this delay and all of these have now been addressed except for an identified need for automation of some high-volume assays (currently being negotiated). Internal and external audits showed a trend of increasing non-conformities which could be the result of personnel simply becoming lax over time. Application for laboratory accreditation, however, could provide the renewed vigour needed to correct these non-conformities., Recommendation: This experience shows that sustainability of the QMS at present is a cause for concern. However, the tiered system of accreditation being developed by WHO-Afro may act as a driving force to preserve the spirit of continual improvement., Competing Interests: The authors declare that they have no financial or personal relationship(s) which may have inappropriately influenced them in writing this paper. more...
- Published
- 2012
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43. Immunological and virological response to haart in HIV-1 patients co-infected with hepatitis B and C viruses.
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Okwuraiwe AP, Audu RA, Salu OB, Onwuamah CK, Amoo OS, Ige FA, Meshack EH, Jamda PD, Odunukwe NN, Onwujekwe DI, Ezechi OC, and Idigbe EO
- Subjects
- Adult, Antiretroviral Therapy, Highly Active methods, Antiretroviral Therapy, Highly Active statistics & numerical data, CD4 Lymphocyte Count methods, Case-Control Studies, Coinfection, Drug Monitoring, Female, Hepatitis B Surface Antigens blood, Hepatitis C Antibodies blood, Humans, Male, Monitoring, Immunologic, Nigeria epidemiology, Treatment Outcome, Viral Load drug effects, Viral Load methods, Anti-HIV Agents immunology, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV Infections epidemiology, HIV Infections immunology, HIV Infections virology, HIV-1 drug effects, HIV-1 immunology, Hepatitis B, Chronic epidemiology, Hepatitis B, Chronic immunology, Hepatitis C, Chronic epidemiology, Hepatitis C, Chronic immunology
- Abstract
Background: Among the countries highly endemic for viral hepatitis, Nigeria is found. Information on how triple infected persons (HIV, HBV, and HCV) fare on HAART in the country is lacking. Laboratory based investigation was carried out to assess the virological and immunological parameters of HIV-1 infected patients co-infected with Hepatitis B and C, accessing care at the Nigerian Institute of Medical Research. It was a case controlled study., Objectives: The study aimed to compare the laboratory data of HIV-HBV-HCV patients seen between 2006 and 2009 with HIV-1 monoinfected patients in the same period, on HAART according to the national guideline and followed up for 12 months., Methods: Detection of Hepatitis B surface Antigen (HBsAg) and Hepatitis C Virus Antibody (HCVAb) were assayed using ELISA techniques (Bio Rad and DIA PRO respectively). The CD4 and HIV viral load were determined using the Cyflow Counter/Kits (Partec) and the Amplicor HIV-1 Monitor Test V1.5 (Roche) techniques respectively., Results: Forty-one (0.4%) of the 10,214 HIV-1 patients seen during the period were co-infected with both HBV and HCV. Over the 12 month-period, median HIV-1 viral load and CD4 count reduced and increased respectively (12,205-200 RNA copies/mL; 210-430 cells/mL from baseline - 12th month), and for the HIV-1 monoinfected patients (36,794-200 RNA copies/mL [p=0.5485] and 206-347 cells/mL [p=0.7703] from baseline - 12th month)., Conclusion: There seems to be no significant influence of hepatitis B and C in HIV infection on HAART judging by the CD4 and viral load profiles which were similar in the two groups. more...
- Published
- 2012
44. Hepatitis D infection in Nigeria.
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Onyekwere CA, Audu RA, Duro-Emmanuel F, and Ige FA
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- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Nigeria epidemiology, Young Adult, Hepatitis D epidemiology
- Published
- 2012
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45. Genetic studies in the Nigerian population implicate an MSX1 mutation in complex oral facial clefting disorders.
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Butali A, Mossey PA, Adeyemo WL, Jezewski PA, Onwuamah CK, Ogunlewe MO, Ugboko VI, Adejuyigbe O, Adigun AI, Abdur-Rahman LO, Onah II, Audu RA, Idigbe EO, Mansilla MA, Dragan EA, Petrin AL, Bullard SA, Uduezue AO, Akpata O, Osaguona AO, Olasoji HO, Ligali TO, Kejeh BM, Iseh KR, Olaitan PB, Adebola AR, Efunkoya E, Adesina OA, Oluwatosin OM, and Murray JC more...
- Subjects
- Case-Control Studies, Child, Child, Preschool, Cleft Lip epidemiology, Cleft Palate epidemiology, Female, Genotype, Humans, Infant, Infant, Newborn, Male, Nigeria epidemiology, Polymerase Chain Reaction, Sequence Analysis, DNA, Black People genetics, Cleft Lip genetics, Cleft Palate genetics, MSX1 Transcription Factor genetics, Mutation, Missense genetics
- Abstract
Background: Orofacial clefts are the most common malformations of the head and neck, with a worldwide prevalence of 1 in 700 births. They are commonly divided into CL(P) and CP based on anatomic, genetic, and embryologic findings. A Nigerian craniofacial anomalies study (NigeriaCRAN) was set up in 2006 to investigate the role of gene-environment interaction in the origin of orofacial clefts in Nigeria., Subjects and Methods: DNA isolated from saliva from Nigerian probands was used for genotype association studies and direct sequencing of cleft candidate genes: MSX1 , IRF6 , FOXE1, FGFR1 , FGFR2 , BMP4 , MAFB, ABCA4 , PAX7, and VAX1 , and the chromosome 8q region., Results: A missense mutation A34G in MSX1 was observed in nine cases and four HapMap controls. No other apparent causative variations were identified. Deviation from Hardy Weinberg equilibrium (HWE) was observed in these cases (p = .00002). A significant difference was noted between the affected side for unilateral CL (p = .03) and bilateral clefts and between clefts on either side (p = .02). A significant gender difference was also observed for CP (p = .008)., Conclusions: Replication of a mutation previously implicated in other populations suggests a role for the MSX1 A34G variant in the development of CL(P). more...
- Published
- 2011
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46. Effect of HIV-1 infection and increasing immunosuppression on menstrual function.
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Ezechi OC, Jogo A, Gab-Okafor C, Onwujekwe DI, Ezeobi PM, Gbajabiamila T, Adu RA, Audu RA, Musa AZ, Salu OB, Meschack E, Herbertson E, Odunukwe N, and Idigbe OE
- Subjects
- Adolescent, Adult, Body Mass Index, Cross-Sectional Studies, Enzyme-Linked Immunosorbent Assay, Female, HIV Infections drug therapy, HIV Infections epidemiology, HIV Seropositivity drug therapy, HIV Seropositivity epidemiology, Humans, Menstruation Disturbances complications, Nigeria epidemiology, Odds Ratio, Prevalence, Risk Factors, HIV Infections complications, HIV Seropositivity complications, Immunosuppression Therapy, Menstruation Disturbances epidemiology
- Abstract
Aim: The aim of this study was to determine the prevalence, pattern and determinants of menstrual abnormalities in HIV-positive Nigerian women., Methods: A cross-sectional study was carried out involving 3473 (2549 HIV-seropositive and 924 seronegative) consecutive and consenting women seen at the HIV treatment centers at the Nigerian Institute of Medical Research, Lagos and the Federal Medical Centre, Markurdi., Results: The sociodemographic characteristics of the two groups were comparable, except for body mass index (BMI): the HIV-negative women (28.1 ± 8.1) had statistically significantly (P < 0.005) higher BMI compared to the HIV-positive women (21.9 ± 7.5). Menstrual abnormalities were significantly more common in women living with HIV/AIDS (29.1%) compared to the HIV-negative (18.9%) women (P < 0.001). The proportions of women in the two groups with intermenstrual bleeding, menorrhagia, hypermenorrhea, and postcoital bleeding were similar (P > 0.005), however amenorrhea, oligomenorrhea, irregular periods and secondary dysmenorrhea were more common in the HIV-positive women (P < 0.02). Primary dysmenorrhea was less common in HIV-positive women (P < 0.03). Among the HIV-positive women, menstrual dysfunction was more common in women living with HIV/AIDS with opportunistic infections, CD4 count < 200, not undertaking therapy, symptomatic disease and BMI < 20. However, after controlling for cofounders, only CD4 < 200 (odds ratio [OR], 3.65; 95% confidence interval [CI], 1.2-9.7), BMI < 20 (OR, 2.4; 95%CI, 1.3-3.5) and not taking antiretroviral drugs (OR, 2.05; CI, 1.7-6.5) were associated with amenorrhea, oligomenorrhea, irregular periods and secondary dysmenorrhea., Conclusion: HIV-positive women in this study experienced more menstrual abnormalities of amenorrhea, oligomenorrhea, and irregular periods compared to the HIV-negative controls. HIV-positive women with CD4 count < 200, BMI < 20 and who do not take antiretroviral drugs are at the greatest risk. more...
- Published
- 2010
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47. T-lymphocyte subsets in apparently healthy nigerian children.
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Idigbe EO, Audu RA, Iroha EO, Akinsulie AO, Temiye EO, Ezeaka VC, Adetifa IM, Musa AZ, Onyewuche J, and Ikondu SU
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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. more...
- Published
- 2010
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48. Establishment of reference values of CD4 and CD8 lymphocyte subsets in healthy Nigerian adults.
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Oladepo DK, Idigbe EO, Audu RA, Inyang US, Imade GE, Philip AO, Okafor GO, Olaleye D, Mohammed SB, Odunukwe NN, Harry TO, Edyong-Ekpa M, Idoko J, Musa AZ, Adedeji A, Nasidi A, Ya'aba Y, and Ibrahim K
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, CD4 Lymphocyte Count, CD4-CD8 Ratio, Female, Humans, Male, Middle Aged, Reference Values, Young Adult, Leukocyte Count, Lymphocyte Subsets immunology
- Abstract
A total of 2,570 apparently healthy human immunodeficiency virus-negative adults from the six geopolitical zones in the country were enrolled in our study in 2006. The samples were assayed using the Cyflow technique. Data were analyzed using the Statistical Package for Social Scientists (SPSS). The majority (64%) of the participants had CD4 counts within the range of 501 to 1,000 cells/microl. The reference range for CD4 was 365 to 1,571 cells/microl, while the reference range for CD8 was 145 to 884 cells/microl. more...
- Published
- 2009
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49. Evaluation of the Nigerian national antiretroviral (ARV) treatment training programme.
- Author
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Idigbe EO, Odutolu O, Okonkwo P, Folayan MO, Uwakwe CB, Audu RA, Jolayemi OM, and Osagbemi M
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- Acquired Immunodeficiency Syndrome epidemiology, Adult, Curriculum, Female, HIV Infections epidemiology, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Nigeria epidemiology, Surveys and Questionnaires, Acquired Immunodeficiency Syndrome drug therapy, HIV Infections drug therapy, Health Personnel education, Health Workforce statistics & numerical data
- Abstract
There is an understanding that greater availability of HIV treatment for the 40.3 million people currently infected with HIV is a humanitarian imperative that could prolong the lives of millions, restore economic productivity, and stabilise societies in some of the world's hardest-hit regions. The Nigerian government recognises that the country has the third highest burden of infection, with people living with HIV estimated to total 4.0 million, and so in 2002 commenced the implementation of one of Africa's largest antiretroviral (ARV) treatment programmes. A successful ARV programme requires that all components of a functional management system be put in place for effective and efficient functioning. This would include logistics, human resources, financial planning, and monitoring and evaluation systems, as well as sustainable institutional capacities. The Nigerian national ARV treatment training programme was conceived to meet the human resource needs in hospitals providing ARV therapy. This paper reports on the evaluation of the training programme. It examines knowledge and skills gained, and utilisation thereof. Recommendations are made for improved training effectiveness and for specific national policy on training, to meet the demand for scaling up therapy to the thousands who need ARV. more...
- Published
- 2006
- Full Text
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50. Estimation of the rate of mother to child transmission of HIV in Nigeria.
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Audu RA, Salu OB, Musa AZ, Onyewuche J, Funso-Adebayo EO, Iroha EO, Ezeaka VC, Adetifa IM, Okoeguale B, and Idigbe EO
- Subjects
- Anti-HIV Agents therapeutic use, Antiretroviral Therapy, Highly Active, Cross-Sectional Studies, Female, HIV Infections diagnosis, HIV Infections drug therapy, HIV Infections epidemiology, HIV-1 genetics, HIV-1 isolation & purification, Humans, Infant, Infant, Newborn, Male, Nevirapine therapeutic use, Nigeria epidemiology, Pilot Projects, Polymerase Chain Reaction, Pregnancy, RNA chemistry, Risk Factors, HIV Infections transmission, Infectious Disease Transmission, Vertical prevention & control
- Abstract
Definitive diagnosis of HIV infection in infants < 18 months of age who were born to HIV-infected mothers is still posing some difficulty in Nigeria and other developing countries. Within this age definitive diagnosis can only be carried out by antigen based techniques which are indeed not available in these developing countries. This has resulted in the absence of authoritative data on the rate of mother-to-child transmission in these countries. Nigeria inclusive. The present pilot study was therefore carried out to generate some information on the rate of mother to child transmission in Nigeria using the PCR technique. Plasma samples were obtained from 68 children of both sexes less than 18 months of age and who were born to HIV infected mothers. The samples were collected from two pediatric departments. in Lagos and in Benin. The presence of HIV 1 RNA in each of the samples. was determined using the Amplicor Monitor V 1.5 technique (Roche Diagnostics). Data showed that HIV-1 RNA was detected in 15 of the 68 samples tested. This gave an HIV-1 RNA detection rate of 22%. Among women who had some intervention, the rate of transmission of infection was 11% while the rate among those without intervention was 30%. The 22% transmission rate recorded in this study is close to the range of 25 to 35% that has been reported in several developed and a few developing countries. A multicenter nationwide study will still be needed to determine the national mother to child transmission rate in Nigeria. more...
- Published
- 2006
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