Search

Aim: To determine the concentration of Ochratoxin A and Fumonisin B1 mycotoxins in herbal medications available in markets in Ebonyi State. Study Design: This is a cross-sectional study designed to determine the levels of Ochratoxin A and Fumonisin B1 mycotoxins in herbal traditional medications selected from vendor dealers. One hundred and fourteen (114) herbal medication samples were selectively obtained from local market and stores in Ebonyi state using a multistage random sampling technique. Place and Duration of Study: This study was carried out at Abakaliki, Ezza-North, Afikpo North, Ohaukwu, Ikwo and Ebonyi metropolises. This study lasted for 12 months. Methodology: One hundred and fourteen (114) herbal medication samples examined, fifty-seven (57) each of herbal traditional medicine samples, were selectively analysed for the presence of Ochratoxin A and Fumonisin B1 mycotoxins respectively together with the controls. Mycotoxins occurrence and levels were determined using lateral flow immunoassay technique. The data were presented as percentage, mean ± standard deviation. All data were analysed by one sample t-test and descriptive statistics and statistical significant was set at P ≤ 0.05. Results: The content of ochratoxin A was statistically significant different (P < 0.05) compared to a test value of 5 µg/L (ppb) for all the herbal medications. The concentration in Goodswill, Divine roots, Zaram pile, African Iba, Akwasa and Restorative Tonic herbal medications were significantly higher when compared to 5 µg/L (ppb). Contrary, the presence of this mycotoxin in Goko mixture was not detected. The contamination with Ochratoxin A was recorded in 51(89.47%) out of 57 examined samples of herbal medicine. The highest concentration of Ochratoxin A was found in Goodswill (23.66±3.51 µg/L (ppb) followed by restorative tonic (22.67±2.52 µg/L (ppb).In addition, examination of fumonsin mycotoxin content in the reorder as studied herbal medications. showed that the highest concentration was found in Ukwara (634.33±8.00 µg/L (ppb), followed by Divine roots (353.67±50.40 µg/L (ppb) and Cordel silver (281.33±27.30 µg/L (ppb). There was an absence in Iketo-2 mixture. One sample t-test was computed to compare the various concentrations of Fumonisin-B1 found in the studied herbal medications with a test value of 1000 µg/L (ppb) (the maximum tolerance level of Fumonisin in consumable foodstuffs). The result showed a statistically significant decrease (P < 0.05) compared to a test value of 1000 µg/L (ppb) for all the herbal medications studied. This study reported that Fumonisin contaminations in the samples were 47(82.46%) out of 57 herbal medicine examined. Conclusion: Ochratoxin A and Fumonisin B1 mycotoxins prevalence were very high and these occur in concentrations exceeding permissible limits. The co-occurrence of these mycotoxins in herbal samples analyzed in this study raises further awareness of the health risks consumers of these food commodities are exposed to.

Summary Background Mosquitoes are vectors of numerous diseases, including malaria and yellow fever. Mosquito control is therefore a priority in many countries, especially in healthcare settings. Here we investigated the opinions of patients and staff regarding mosquito control at a hospital in Nigeria, and also gathered data on mosquito-control measures in this setting. Methods We conducted a cross-sectional questionnaire study of staff and patients and an observational approach to obtain data on mosquito-control measures used at a tertiary teaching hospital in Abakaliki, Nigeria. Discussion Both staff (N=517) and patients (N=302) reported experiencing more mosquito bites at the hospital than elsewhere. As well as contributing to discomfort, this exposure may put hospital staff and patients at risk of mosquito-borne infections. Complaints from patients about mosquitoes were reported by over 90% of staff, and over 50% of staff respondents were aware of patient discharge against medical advice due to mosquitoes. The most common control method was killing mosquitoes by hand. We observed a lack of door screens in all wards, window screens were absent or torn, and most beds did not have nets. In the children's wards none of the beds had nets. Conclusions Current measures against mosquitoes in this hospital appeared inadequate, and healthcare staff and hospital patients may be at increased risk of mosquito-borne infections. Mosquito control in the hospital requires attention, and the needs for improvement in mosquito control in the healthcare setting more widely should be evaluated and addressed.

Introduction Ebola virus disease (EVD) remains a global threat of international concern. Being at the frontline of medical care, clinicians are at high risk of infection. Inadequate knowledge of, or poor attitudes to, EVD among clinicians may lead to failure in the detection of and timely responses to EVD. We determined the knowledge of and attitudes to EVD among clinicians in Ebonyi State, Nigeria. Materials and methods A descriptive, cross-sectional study was conducted among clinicians attending an EVD training programme in Ebonyi State, Nigeria. Knowledge and attitudes of the clinicians were evaluated using a structured questionnaire. Data were analysed using descriptive and inferential statistics. Results Of 398 clinicians who participated in the study, 274 (68.8%) were 40 years and below and 312 (78.4%) were male. Most of the clinicians surveyed (298, 74.9%) had worked for 10 years or less, and 354 (88.9%) of them had not undergone any training on EVD. The overall mean knowledge score of EVD among respondents was 42.0 ± 3.9 (maximum 51), and 370 (93.0%) respondents had a good overall knowledge of EVD. Overall, 334 (83.9%) respondents had an appropriate attitude towards EVD control, while 64 (16.1%) had a poor attitude towards EVD control. Only male gender was an independent predictor of good knowledge of EVD (adjusted odds ratio 4.0, 95% confidence interval 1.8–9.0). Conclusions There was generally a high level of knowledge and good attitude to EVD among the clinicians surveyed. The gaps in knowledge and attitudes identified should inform post-EVD control strategies and future training programmes.

Background: HIV postexposure prophylaxis (PEP) is an integral aspect of preventive management of HIV/AIDS. Timely provision of HIV PEP after exposures to HIV risky conditions can reduce significantly the possibility of HIV transmission. Objective: To determine the knowledge, attitude and practice of HIV PEP among healthcare workers (HCWs) in a Nigerian tertiary health facility. Methods: Standardized questionnaires designed to assess knowledge, attitude and practice of HIV PEP were administered to 343 HCWs randomly selected from various clinical specialties in the hospital. Their responses were coded, collated and analyzed using SPSS version 24. Simple descriptive statistics was used in the overall analysis and Chi-square statistics for bivariate analysis. Results: Twenty eight (8.2%) of the 343 HCWs had adequate knowledge of HIV PEP. The uptake of HIV PEP among the eligible HCWs was 60% and the provision of HIV PEP to eligible victims of rape was 67.9%. The general attitude on the attitude index was 93.8%. Conclusion: The study revealed a very poor level of knowledge and poor practice of HIV PEP among the HCWs. The attitude towards the HIV PEP intervention was however generally positive.

Tuberculosis (TB) has remained a source of concern for the international community for several decades. Multi-drug-resistant TB and extensively drug-resistant TB have become impending emergencies. All these TB control challenges are magnified by HIV/TB co-morbidity. Although, there are recorded successes in the overall control of TB in adults, the level of success in children is uncertain. The high burden of TB in children is well recognised, but it is not well quantified in many endemic areas due to problems with definitive diagnosis. Childhood TB deserves special attention, because from the perspective of public health, any paediatric TB case is a sentinel event. It indicates recent infection from an adult who has the infection, and who could infect an average of 15 others in a year. It also indicates a possible severe disease and a possible future adult case. To the extent, childhood TB is prevalent, to that extent has TB control failed in the community where the childhood case came from. The objective of this review is to examine all aspects of childhood TB with a view to highlighting the management challenges and making recommendations.

Objective To evaluate the validity of vaginal discharges, urethral discharges, genital rashes, and painful genital ulcers as indicators of early detection of incident herpes simplex virus type 2 (HSV-2) infection among pregnant women in Benin metropolis. Methods Participants were antenatal clinic attendees of University of Benin Teaching Hospital and Central Hospital, Benin. Baseline sociodemographic, obstetric and HSV-2 serological data were collected. The HSV-2-seronegative returned for a repeat HSV-2 antibody assay before delivery date. Data on incidence of genital rashes, abnormal vaginal discharges, painful genital ulcers and urethral discharges were collected. Results The sensitivities of abnormal vaginal discharges, genital rashes, urethral discharges and painful genital ulcers were 82.3%, 70.6%, 41.2% and 28.6% respectively; while their positive-predictive values were 53.8%, 60.0%, 58.3% and 66.7% respective. All the symptoms had >95% specificities and 95% negative-predictive values for seroincident HSV-2 infection. Conclusions Abnormal vaginal discharge, genital rashes, urethral discharges and genital ulcers are valid indicators of seroincident HSV-2 infection and could be useful in formulation of screening tools in resource-limited settings.

Objective: This study investigated the obstetric outcomes of herpes simplex virus (HSV-2) infection among pregnant women. Materials and Methods: In this prospective cohort study, a total of 674 consenting pregnant women attending ante-natal clinic in the University of Benin Teaching Hospital and Central Hospital Benin were recruited between November 2011 and December, 2012. The women were screened for HSV-1, and HSV-2 using glycoprotein-G-based type-specific Enzyme Linked Immunosorbent Assay on archived blood samples; and were followed up to the delivery period and postnatal clinic. The HSV-2-seronegative participants underwent second blood sampling for HSV-2 IgG and IgM assay during the delivery period. The patients were thus categorized into HSV-2 seropositive, HSV-2-seronegative, and incident HSV-2 infection cohorts. The pregnancy outcomes were assessed by review of hospital records. Data analysis was with SPSS version 16 software. Results: Of 674 pregnant women surveyed, 312 (46.3%) were HSV-2 seropositive; while 362 (56.7%) were HSV-2 seronegative. Comparing the HSV-2 seropositive and HSV-seronegative groups, there were no significant differences in occurrence of low birth weight (LBW), prematurity, spontaneous abortions, and stillbirth events (P = 0.96; 0.95; 1.0; and 0.77, respectively). Comparing the incident HSV-2 infection with the HSV-2 seronegative groups, the relative risks of occurrence of LBW deliveries, preterm deliveries, and stillbirths were 12.6, 25.1, and 4.5, respectively. Conclusion: First episode HSV-2 infection among pregnant women in Benin, Nigeria is associated with an increased risk of occurrence of spontaneous abortion, LBW delivery, stillbirths, and preterm delivery.

INTRODUCTION: various dermatoses, due to their morbidity characteristics, have been shown to negatively impact on learning. The most epidemiologically important seem to be the infectious types because of their transmissibility and amenability to simple school-health measures. The aim of this study was to assess the prevalence and sex/age correlates of infectious dermatoses in a rural South-eastern Nigerian community. METHODS: the pupils were proportionately recruited from the three primary schools based on school population. Stratified simple random sampling method was adopted and a table of random numbers was used to select required pupils from each arm. Clinical and laboratory examination was done to establish diagnoses of infectious skin disease. Data collected were analyzed using SPSS version 16. RESULTS: the 400 pupils consisted of 153 males and 247 females. Age range was between 6 and 12 years. The prevalence of infectious dermatoses was 72.3%. The five most prevalent clinical forms of infectious dermatoses, in order of decreasing prevalence, were tinea capitis (35.2%), scabies (10.5%), tinea corporis (5.8%), tinea pedis (5.5%), and impetigo (5.0%). More cases, generally, occurred among males than females (80.4% vs 67.2%)); while some specific clinical types, pediculosis and seborrheic dermatitis, exhibited predilection for females. Pyodermas and scabies were significantly more prevalent in the 7-9 age-group; while tinea capitis, tinea corporis, seborrheic dermatitis and pediculosis were more associated with e"10 age-group. CONCLUSION: infectious dermatoses were highly prevalent in the surveyed population. Many of the clinical types exhibited sex- and age-specificity.

Objective To determine the prevalence of helminth infestation during pregnancy and the associated risks of adverse maternal and infant outcomes. Methods A cross-sectional study of women with a singleton pregnancy of at least 34 weeks was conducted at a teaching hospital in Benin City, Nigeria, between April 1 and September 30, 2010. Socioeconomic and clinical data were obtained. Stool samples were used to determine helminth infection. Birth weight was recorded at delivery. Multivariable analysis was used to assess the link between helminth infestation and maternal and perinatal outcomes. Results Among 178 women, 31 (17.4%) had a helminth infestation (15 [8.4%] had ascariasis, 8 [4.5%] trichuriasis, and 25 [14.0%] hookworm infestation). Multivariate analysis found that helminth infestations was associated with maternal anemia (adjusted odds ratio 12.4; 95% confidence interval 4.2–36.3) and low birth weight (adjusted odds ratio 6.8; 95% confidence interval 2.1–21.9). Conclusion Approximately one in five women had a helminth infestation in the third trimester of pregnancy. Maternal helminth infestation significantly increased the risks of maternal anemia and low birth weight, indicating that routine administration of anthelminthic drugs during early pregnancy might improve perinatal outcomes.

Background: Acinetobacter baumannii, a non-glucose fermenting Gram negative bacillus, has emerged in the last three decades as a major etiological agent of hospital-associated infections giving rise to significant morbidity and mortality particularly in immunocompromised patients. Multidrug resistant A. baumannii (MDR-AB) is fast becoming a global threat, having developed resistance to major classes of antibiotics and carbapenem-resistant isolates have increasingly been reported worldwide as a cause of nosocomial outbreaks. Despite intensive efforts, nosocomial acquisition of MDR-AB is still a problem due to the organism’s great ability to colonize human and environmental reservoirs.Objectives: This study was aimed to determine the prevalence of (MDR) AB and their antibiotic susceptibility pattern.Methodology: A total of 400 specimens which include tracheal aspirates, catheter specimens of urine, wound biopsies and blood culture collectedfrom 100 patients admitted at the Intensive Care Unit of our hospital over a period of nine months were processed following standardmicrobiologic procedure.Results: A total of 155 non-lactose fermenters were isolated out of which 14 (9.0%) were Acinetobacter spp. Eleven (79.0%) out of the 14Acinetobacter spp were A. Baumanii, while 2 (14.0%) were A.lwoffi and 1(7.0%) A.calcoaceticus. All the isolates were resistant to Amoxicillinclavulanate, Ceftriaxone, Ciprofloxacin, Ofloxacin, gentamicin and Ampicillin-sulbactam; while susceptibility to Meropenem, Amikacin and Levofloxacin were 64.3%, 50.0% and 35.7% respectively.Conclusion: The high rate of antibiotic resistance shown by Acintobacter isolates in this study demonstrates the need for antibiotic stewardship protocols to be set up in health facilities to prevent outbreaks of multi-resistant bacterial infections.Key words: Acinotebacter infection, Multidrug resistant, Intensive care unit.

Introduction: The burden of HSV-2 infection, the cause of most cases of genital herpes in Nigeria, varies from region to region; and so are the associated factors. This infection is known to be responsible for several negative pregnancy outcomes. There is currently no documented data on sexual behavioral factors associated with the occurrence of HSV-2 infection or seroprevalence among pregnant women in Nigeria. This study aimed at identifying the sexual behavioral correlates of HSV-2 seroprevalence among pregnant women in Benin City, Nigeria. Methodology: The cross-sectional study design was adopted and the study took place between November 2011 and June 2012. Four hundred and ten consenting ante-natal clinic patients in two major tertiary hospitals in Benin City were consecutively and prospectively included. Data sources were represented by questionnaires, the patient’s case records and laboratory investigations. Each patient’s serum was analyzed for HSV-2 antibody detection. Data analysis was performed using SPSS version 16. Results: Four hundred and ten patients were enrolled with average age 30.6 years. Seroprevalence of HSV-2 antibody was 47.3%. Sexual behavioral factors that were significantly associated with HSV-2 seroprevalence included early exposure to sexual intercourse, number of sex partners, involvement in polygamous marriages, involvement of husband in extra-marital affairs and hormonal contraceptive use. Conclusion: The prevalence of HSV-2 among pregnant women in Benin City is high. Public health campaigns aimed at: delaying onset of sexual activity; encouraging monogamous relationships; and emphasizing that hormonal contraceptives do not protect from STI’s, are recommended.

Background: Bacterial vaginosis (BV) is associated with adverse pregnancy outcomes, especially preterm birth (PTB). Unfortunately, there is a dearth of evidence on the link between BV and PTB occurring in sub-Saharan Africa to inform preventive interventions targeting BV associated with PTB. Objectives: The objective of this study was to evaluate the association between genital tract colonization with BV and PTB. Methods: In this prospective case–control study design, 82 women with spontaneous PTB (cases) or term birth (TB) (controls) were screened for BV. The diagnosis of BV was based on the Nugent scoring system. The association between BV and PTB was evaluated using multivariate logistic regression analysis. Results: BV was significantly higher in women with PTB compared with those with TB (17 [41.5%] vs. 5 [12.2%]; P= 0.005). Furthermore, the odds of BV with PTB were higher among women who had PTB compared with TB after adjusting for a known factor, marital status, which differed significantly between women with preterm and TB (adjusted odds ratio 4.5, 95% confidence interval [1.4–14.4]). Conclusion: Women with BV in pregnancy have increased odds of having PTB. Given the challenge of preterm labor and PTB, screening and treatment of women for BV early in pregnancy may be a veritable strategy to prevent PTB and its consequences.

Background: Hepatitis B and C viral co‑infections with human immunodeficiency virus (HIV) are known to affect progression, management, and outcome of HIV infection. This study was aimed to access the prevalence of hepatitis B and C co‑infections in HIV‑infected adult patients in the University of Benin Teaching Hospital with a view of understanding the gravity of this problem in the local population. Methods: The descriptive cross‑sectional study was carried out on 342 HIV‑infected adult patients on highly active antiretroviral therapy attending HIV Outpatients Clinic of University of Benin Teaching Hospital, between April and September, 2011. Patients’ sera were screened for hepatitis B surface antigen (HBsAg) and anti‑hepatitis C virus (HCV) using immunochromatographic‑based kits. Clinical stage of HIV and CD4+ cell counts were equally evaluated. Data were analyzed using SPSS version 17. Results: Of the 324 HIV‑infected patients screened, 53 (15.5%) were positive for HBsAg, 24 (7.0%) positive for hepatitis C virus antibodies (HCV‑Ab), while 2 (0.6%) were positive for both viruses. Seroprevalence of HBsAg was higher in male (17.8%) than in female (14.7%) ( χ 2 = 0.49, P = 0.49), while the reverse is the case for HCV‑Ab; 7.1% for female and 6.7% for male ( χ 2 = 0.02, P = 0.88). Seroprevalences of HBsAg and HCV‑Ab were also higher among patients in World Health Organization disease stages 3–4 and patients with CD4+ cell count ≤200 cell/μl compared to those in stages 1–2 and with CD4+ cell count >200 cell/μl. Conclusion: Co‑infection with hepatitis B virus and HCV among HIV/acquired immune deficiency syndrome (AIDS) patients is still a problem in our environment. Screening for these viruses among HIV/AIDS patients will allow for early detection and proper management. Keywords: Benin, co‑infection, hepatitis B virus, hepatitis C virus, human immunodeficiency virus/acquired immune deficiency syndrome

Introduction: Asymptomatic bacteriuria (ASB) in pregnancy is associated with acute pyelonephritis, premature deliveries, low birth weight, still birth, pre-eclampsia, hypertension, anaemia, and postpartum endometritis. Early detection and treatment of this condition reduces the incidence of these complications. Objective: To determine the prevalence, associated bacteria agents and susceptibility, and risk factors of ASB among pregnant women at the University of Benin Teaching Hospital. Materials and Methods: Two hundred and sixty five respondents were selected using systematic sampling method, between November 2011 and October 2012. These subjects provided clean catch midstream urine samples that were cultured, significant bacteriuric isolates were identified through biochemical tests and sensitivity against regular antimicrobial agents carried out. Data were analysed using SPSS version 16. Results: Of the 265 urine samples cultured, 28 (10.6%) had asymptomatic bacteriuria. Isolates were predominantly Escherichia coli (46.4%), Proteus species (14.3%), Enterococcus faecalis (10.7%), and Staphylococcus aureus (10.7%). These organisms were generally susceptible to tested antibiotics at different degrees. Risk factors included maternal age, parity, and level of education of the woman, as well as spouse's level of education. Occupation of the woman and that of the spouse, gestational age, religion, and ethnicity were not risk factors. Conclusion: Prevalence of ASB among pregnant women in University of Benin Teaching Hospital was 10.6%. Age, parity, and levels of education of both the women and the spouses were risk factors. Periodic surveillance of prevalence, etiology and antibiotics susceptibility is recommended.

Background: Most tuberculosis (TB) control programs use positive sputum Ziehl-Neelsen (Z-N) smear microscopy results as a basis for TB case confirmation, valid enough to warrant commencement of treatment. Children do not only produce poor quality sputum a proportion cannot produce sputum, at all. Gastric aspirate (GA) smear microscopy, a recommended alternative, is the only available bacteriologic test in most health-care institutions. Objectives: This study was aimed to determine the usefulness of acid fast smears of GA for the diagnosis of pulmonary TB in children. Materials and Methods: A total of 263 GA samples from children with suspected pulmonary TB underwent Z-N staining and culture on Ogawa medium. Acid-fast isolates on Ogawa medium were sub-cultured on Ogawa medium containing para-nitrobenzoic acid (PNBA-Ogawa medium). Lack of growth on PNBA-Ogawa confirmed Mycobacterium tuberculosis complex (MTBC) and ruled out non-tuberculous mycobacteria. Validity parameters were calculated with GA culture as Gold standard. Results: GA samples from 33 (12.5%) of the 263 patients were smearing positive. However, GA culture on Ogawa medium was positive for MTBC in 97 (37%) of the 263 patients. Twenty-nine of the 97 culture-positive GA were also Z-N smear-positive, giving a GA Z-N smear sensitivity of 29.9%. Of the166 culture-negative cases, 162 were Z-N smear-negative, giving a GA Z-N smear specificity of 97.6%. Positive- and negative-predictive values were 88% and 70% respectively. Conclusion: GA smear microscopy is highly specific for diagnosis of pulmonary TB in children. The test can be useful in culture facility-limited settings as acceptable sensitivity can be achieved if specimen collection/handling protocols are strictly adhered to.