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Introduction Accurate diagnosis of chikungunya (CHIK) is essential for effective disease management and surveillance. In a cohort of febrile Congolese patients, available diagnostic methods widely used in CHIK diagnosis were evaluated. In addition, plasma cytokines were quantified in CHIK patients and those coinfected with malaria compared with healthy controls. Methods Between June and November 2019, a total of 107 febrile patients with suspected CHIK were subjected to differential diagnosis both for CHIK and malaria. Patients were screened for CHIK virus using molecular diagnosis by real-time PCR, serologic testing by IgM-specific and IgG-specific ELISAs, and lateral flow-based method with rapid diagnostic test (RDT), while malaria diagnosis was confirmed by PCR methods. Pro-inflammatory (IL-12, IL-16, IFN-γ, TNF-α) and anti-inflammatory (IL-4, IL-10, IL-13) cytokines were quantified in patients and healthy controls by ELISA assays. Results Molecular diagnoses revealed that 57% (61/107) were positive for CHIK by RT-PCR, while serologic testing revealed 31% (33/107) and 9% (10/107) seropositivity for anti- IgM and IgG, respectively. None of the patients were CHIK RDT-positive. Also, 27% (29/107) were PCR-positive for malaria. Among the malaria-positive patients, 14% (15/107) were co-infected with CHIK and 13% (14/107) were monoinfection. Plasma IL-12 and TNF-α levels were increased in patients with malaria and IL-13 levels were increased in patients with co-infection (p Conclusion Co-infection of malaria and CHIK were common in febrile Congolese patients. Real-time PCR was a better tool for detecting actual occurrences of CHIK in a malaria holoendemic area.

Introduction Acute viral gastroenteritis is a major public health concern, especially among children younger than 5 years of age. The aim of this study was to determine the occurrence of human astrovirus infection in children with acute gastroenteritis. Methods Stool specimens were collected from 506 children under 5 years of age hospitalized with acute diarrhoea (289 male and 208 female), and human astrovirus was investigated by RT-PCR. Associations of socio-demographic, clinical, and behavioural conditions with infection were analysed. Results The overall prevalence of human astrovirus was found to be 10.3%. The mean age of positive cases was 12.41 ± 6.21 months and this was associated with infection (p = 0.013). Children >18 months of age were at three times the risk of infection when compared to those aged 0–6 months (odds ratio (OR) 3.19, 95% confidence interval (CI) 1.15–8.88; p = 0.026). Children living in houses with more than one room (OR 0.60, 95% CI 0.28–0.96; p = 0.036) and mothers using treated water (OR 0.47, 95% CI 0.25–0.86; p = 0.015) were associated with reduced infection. Conclusions In this study, infection with astrovirus was common in acute gastroenteritis cases among children younger than 5 years of age. Drinking treated water and living in non-crowded environments protected the children from infection.

Background: Antimicrobial resistance (AMR) is of growing concern worldwide, and the AMR status in sub-Saharan Africa (SSA), including the Republic of the Congo, is largely undetermined due to a lack of real-time monitoring. As the incidence of multi-resistant Escherichia coli has been increasing in recent years, an investigation was performed to determine the antibiotic resistance of E. coli isolated from stool samples of Congolese students. Furthermore, factors associated with the carriage of resistant bacteria were investigated. Methods: A total of 339 stool samples from 339 high school students living in the Madibou area of Brazzaville, Republic of Congo, were tested for E. coli. Isolates obtained were tested for susceptibility to 10 antibiotics that are widely used in the region. Results: One hundred and seventy-three (51%) individuals were E. coli-positive in stool, with 61% being female students. Antimicrobial resistance was highest for ceftazidime (65%), followed by amoxicillin (57%), piperacillin–tazobactam (51%), ofloxacin (11%), azithromycin (8%), ciprofloxacin (4%), nalidixic acid (2%), and amoxicillin–clavulanic acid (1%). Antibiotic procurement from non-legalized local vendors had a significant impact on E. coli positivity and antibiotic resistance when compared to procurement from state-licensed pharmacies (p < 0.05). Conclusions: The high prevalence of resistant commensal E. coli in the community justifies further investigation and urges the need for routine monitoring of antimicrobial susceptibility testing in the region.

Background Malaria in pregnancy is associated with considerable morbidity and mortality. Regular surveillance of artemisinin-based combination therapy tolerance, or molecular makers of resistance, is vital for effective malaria treatment, control and eradication programmes. Plasmodium falciparum multiple drug resistance-1 gene (Pfmdr1) N86Y mutation is associated with reduced susceptibility to lumefantrine. This study assessed the prevalence of Pfmdr1 N86Y in Brazzaville, Republic of Congo. Methods A total 1001 of P. falciparum-infected blood samples obtained from asymptomatic malaria pregnant women having a normal child delivery at the Madibou Integrated Health Centre were analysed. Pfmdr1 N86Y genotyping was conducted using PCR-restriction fragment length polymorphism. Results The wild type Pfmdr1 N86 allele was predominant (> 68%) in this study, whereas a few isolates carrying the either the mutant allele (Pfmdr1 86Y) alone or both alleles (mixed genotype). The dominance of the wildtype allele (pfmdr1 N86) indicates the plausible decline P. falciparum susceptibility to lumefantrine. Conclusion This study gives an update on the prevalence of Pfmdr1 N86Y alleles in Brazzaville, Republic of Congo. It also raises concern on the imminent emergence of resistance against artemether–lumefantrine in this setting. This study underscores the importance to regular artemether–lumefantrine efficacy monitoring to inform the malaria control programme of the Republic of Congo.

Introduction: In Nigeria, microscopy and Rapid Diagnostic Tests (RDTs) are majorly used routinely to diagnose malaria in clinical settings. In recent years, molecular diagnosis has emerged as the most sensitive method for malaria diagnosis. This study determined the usefulness of Polymerase Chain Reaction (PCR) in comparison to microscopy (Giemsa stained thick and thin smears) for the diagnosis of asymptomatic malaria in Ilorin, Nigeria. Methods: Th e study enrolled 310 school children aged 4–15 years with no sign or symptoms of malaria. Blood samples were collected for identification of Plasmodium species infection using light microscopy and conventional PCR. Results: The PCR method detected m o r e infection of P. falciparum 107 (34.5%) than slide microscopy 81 (26.1%) in the study. Only P. falciparum was detected by microscopy while PCR detected mono infection of P. malariae (3.2%) and P. ovale (0.6%) and mixed infection of P. falciparum and P. malariae (3.2%). Overall the PCR method detected more malaria parasite compared to microscopy. Conclusion: The PCR technique, although more laborious and expensive than microscopy, have better diagnostic accuracy and are highly useful for the detection of P. falciparum and other malaria species in asymptomatic and low parasitaemia cases.

Background: Regular surveillance of artemisinin−based combination therapy tolerance or resistance molecular makers is vital for effective malaria treatment, control and eradication programmes. P. falciparum multiple drug resistance-1 gene (Pfmdr1) N86Y mutation is associated with reduced susceptibility to lumefantrine. This study assessed the prevalence of Pfmdr1 N86Y in Brazzaville, Republic of Congo. Methods: A total 1001 of P. falciparum−infected blood samples obtained from asymptomatic malaria pregnant women having a normal child delivery at the Madibou Integrated Health Center were analysed.Pfmdr1 N86Y genotyping was conducted using PCR-Restriction fragment length polymorphism (RFLP). Results: The wild type Pfmdr1 N86 allele was predominant (>68 %) in this study whereas a few isolates carrying the either the mutant allele (Pfmdr1 86Y) alone or both alleles (mixed genotype). The dominance of the wildtype allele (pfmdr1 N86) indicates the plausible decline P. falciparum susceptibility to lumefantrine. Conclusion: This study gives an update on the prevalence of Pfmdr1 N86Y alleles in Brazzaville, Republic of Congo. It also raises concern on the imminent emergence of resistance against artemether−lumefantrine in this setting. Our study underscores the importance to regular artemether−lumefantrine efficacy monitoring to inform malaria control programme of the Republic of Congo.

Objective Interleukin-10 (IL-10) is an anti-inflammatory cytokine produced by Th1 cells and macrophages. The rationale of this study was to examine and validate possible contributions of IL-10 promoter polymorphisms in sub-Saharan Africa in children infected with either Plasmodium falciparum or Schistosoma haematobium and in children co-infected with both parasites. Materials and Methods 309 Nigerian children aged 4 to 15 years were recruited. The study group consisted of individuals infected either with P. falciparum (n=76) or S. haematobium (n=94) in mono-infections, a group of children co-infected with both P. falciparum and S. haematobium (n=62) and matched healthy controls (n=77). The IL10 promoter polymorphisms -1082G/A, -819C/T, and -592C/A were genotyped by direct sequencing. Results The frequencies of the IL10 -1082GG genotype, the -1082G allele and haplotype GCC (positions -1082, -819, and -592) were higher in children infected with P. falciparum than in healthy controls, indicating that the -1082GG genotype and the -1082G allele and the GCC haplotype are associated with increased susceptibility to malaria infection (OR=3.4, 95% CI=1.2-10.8, P=0.02; OR=2.5, 95% CI=1.1-3.4, P=0.02; OR=3.8, 95% CI=2.0-7.2, P=0.0001, respectively). Children with the -1082GG genotype had a higher parasitaemia than children with the -1082AA or -1082AG genotypes (P=0.0017). Haplotype GCC occurred more frequently in children infected with S. haematobium, while haplotype GTA was less frequent than in controls (OR=2.2, 95% CI=1.2-4.4, P=0.017 and OR=0.1, 95%CI=0.02-0.5, P=0.0004, respectively). No differences in the frequencies of IL10 promoter polymorphisms were observed between children with P. falciparum-S. haematobium co-infections and healthy controls. Conclusion Although IL10 promoter polymorphisms are not associated with P. falciparum and S. haematobium co-infection, variant -1082G/A and haplotype GCC are associated with malaria, whereas the IL10 haplotypes GCC and GTA are associated with schistosomiasis. This article is protected by copyright. All rights reserved.

This study was carried out to determine the degree of contamination by bacterial agents on the white coats in hospital setting. Multistage method was used to select respondents across cadre, sex and department for the questionnaire. Cuffs, sleeve and mouths of pocket of doctors’ white coats were swabbed using wet sterile swab stick. The swabs were analyzed using standard procedure for bacterial contamination. The study revealed that 77.7% of the coats were contaminated with Staphylococcus aureus (45.1%), Staphylococcus epidermidis (26.2%), Klebsiella pneumoniae (22.6%), Pseudomonas aeruginosa (3.7%) and Enterococcus faecalis (2.4%). White coats of male resident doctors were more contaminated than that of the female resident doctors, while white coats of doctors from the Department of Surgery had the highest degree of contamination than other Departments. There was a significant difference between the age of white coats, usage, frequency of washing and number of white coats per doctor (P 0.05). Conclusively, doctors’ white coats were highly contaminated with pathogenic aerobic bacteria. Proper maintenance and handling practices of the white coats are precautions to be taken in order to minimize the degree of bacterial contamination and to prevent cross contamination of healthcare associated infection pathogens in hospital setting.Keywords: Medical doctors, White coats, Bacteria, Hospital, Infection, Healthcare.

Uncontrolled population of stray and domicile dogs with intestinal protozoan in close proximity to increasing densities of human population in urban environments is a common fact in developing countries, in conjunction with the lack of veterinary attention and zoonotic awareness, increases the risks of disease transmission. We examined using standard method 108 stool specimens of stray and domicile dogs collected randomly from Ilorin, state capital of Kwara State, Nigeria for intestinal protozoan. The prevalence of intestinal parasites from both stray and domicile dogs was 64(59.3%). Three parasites were encountered; Anchylostoma sp, Cryptosporidium sp and Isospora sp. Female dogs were more infected (48.9%) than male dogs (11.1%) (P

Background Malaria and intestinal helminths co-infection are major public health problems particularly among school age children in Nigeria. However the magnitude and possible interactions of these infections remain poorly understood. This study determined the prevalence, impact and possible interaction of Plasmodium falciparum and intestinal helminths co-infection among school children in rural communities of Kwara State, Nigeria. Methods Blood, urine and stool samples were collected from 1017 primary school pupils of ages 4–15 years. Stool samples were processed using both Kato-Katz and formol-ether concentration techniques and microscopically examined for intestinal helminths infection. Urine samples were analyzed using sedimentation method for Schistosoma haematobium. Plasmodium falciparum was confirmed by microscopy using thick and thin blood films methods and packed cell volume (PCV) was determined using hematocrit reader. Univariate analysis and chi-square statistical tests were used to analyze the data. Results Overall, 61.2% of all school children had at least an infection of either P. falciparum, S. haematobium, or intestinal helminth. S. haematobium accounted for the largest proportion (44.4%) of a single infection followed by P. falciparum (20.6%). The prevalence of malaria and helminth co-infection in the study was 14.4%. Four species of intestinal helminths were recovered from the stool samples and these were hookworm (22.5%), Hymenolepis species (9.8%), Schistosoma mansoni (2.9%) and Enterobius vermicularis (0.6%). The mean densities of P. falciparum in children co-infected with S. haematobium and hookworm were higher compared to those infected with P. falciparum only though not statistically significant (p = 0.062). The age distribution of both S. haematobium (p = 0.049) and hookworm (p = 0.034) infected children were statistically significant with the older age group (10–15 years) recording the highest prevalence of 47.2% and 25% respectively. Children who were infected with S. haematobium (RR = 1.3) and hookworm (RR = 1.4) have equal chances of being infected with P. falciparum as children with no worm infection. On the other hand children infected with Hymenolepis spp. (p, Author Summary Malaria, schistosomiasis and intestinal helminths are parasitic diseases responsible for high morbidity and mortality in most tropical areas of the world. These parasitic diseases are common in Nigeria where people are co-infected with more than one parasite. This study investigate the prevalence and impact of these parasite co-infections in school age children in rural communities of Kwara State Nigeria. The result shows that over 61.0% of the school children had at least an infection of either P. falciparum, S. haematobium, or intestinal helminths with S. haematobium and P. falciparum accounting for the largest proportion of a single infection with 44.4% and 20.6% respectively. Children who were infected with S. haematobium (RR = 1.3) and hookworm (RR = 1.4) have equal chances of being infected with P. falciparum as children when compared with children with no infection. On the other hand children infected with Hymenolepis spp. (p

This study aim to determine the prevalence of intestinal parasites among pregnant women attending antenatal clinic in a tertiary health institution in the middle belt of Nigeria. Stool samples of six hundred females, consisting of three hundred each of pregnant women and nonpregnant ladies (controls) were collected and screened for intestinal parasites. The stool samples were microscopically examined fresh for trophozoites, ova and cysts of intestinal parasites before being formol-ether concentrated. Concentrated stool specimens were re-examined for ova and cysts of intestinal parasites and modified Zeihl-Nelson stained to identify and oocysts. The overall prevalence of intestinal parasitic infection was 33.0%. There was a statistically significant difference (p Keywords: prevalence, intestinal, parasite, pregnancy

The focus of the present study is to assess the effect of artemether-lumefantrine treatment of falciparum malaria on urogenital schistosomiasis in co-infected individuals. Urine samples were collected from 159 microscopically confirmed malaria patients and diagnosed for urogenital schistosomiasis before treatment. The schistosomiasis cure rate and egg reduction were determined in co-infected patients, who were treated with artemether-lumefantrine. Out of 103 malaria infected children, 56 were co-infected 54.4% (56/103) with schistosomiasis. All 56 co-infected patients were found urine-negative for Schistosoma haematobium eggs four weeks after treatment. The extent of co-infection was associated with age and sex level. Cure rate and egg reduction rate following the treatment of artemether-lumefantrine were 100% (p=0.0000). Artemetherlumefantrine was effective against S. haematobium in co-infected children. Further studies however, are needed for a better understanding of the efficacy of artemether lumefantrine against schistosome infection with ranges of intensity. Keywords : Urogenital haematobium , malaria, Cure rate, Egg reduction rate.