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It remains unclear how the collective strong coupling of cavity-confined photons to the electronic transitions of molecular chromophore leverages the distinct properties of the polaritonic constituents for future technologies. In this study, we design, fabricate, and characterize multiple types of Fabry-Pérot (FP) mirco-resonators containing copper(II) tetraphenyl porphyrin (CuTPP) to show how cavity polariton formation affects radiative relaxation processes in the presence of substantial non-Condon vibronic coupling between two of this molecule’s excited electronic states. Unlike the prototypical enhancement of Q state radiative relaxation of CuTPP in a FP resonator incapable of forming polaritons, we find the light emission processes in multimode cavity polariton samples become enhanced for cavity-exciton energy differences near those of vibrations known to mediate non-Condon vibronic coupling. We propose the value of this detuning is consistent with radiative relaxation of Herzberg-Teller polaritons into collective molecular states coupled to the cavity photon coherently. We contrast the feature stemming from light emission from the HT polariton state with those that occur due to polariton-enhanced light absorption. Our results demonstrate the landscape of molecular and photonic interactions enabled by cavity polariton formation using complex chromophores and how researchers can design resonators to leverage these interactions to characterize and control polaritonic properties.

Abstract The stalk of banana is an abundant biomass that can be sustainably converted into bioenergy, biofuels, biosorbents, animal feeds and fibers. The moisture content of freshly harvested banana stalk is high, so drying is essential before its storage and prior to some of the conversion processes. Hence, solar and open sun drying characteristics of banana stalk chips were investigated. Untreated (5, 10 and 15 mm thick) and pretreated (hot water, salt water and sulphite) banana stalk chips were dehydrated in a solar dryer and directly in sunlight. The data were fitted to twelve drying models. The moisture diffusivities were also evaluated. Banana stalk dried mainly in the falling-rate phase and the rate of drying increased with decreasing chip thickness. However, the chips dried slower in direct sunlight compared to the solar dryer. The pretreatments significantly (P

Background: The emphasis on sustainable good health through the consumption of a healthy diet has necessitated the consumption of fresh vegetables, which could harbour the presence of members of the Enterobacteriaceae, antibiotic resistance and extended-spectrum beta-lactamase (ESBL). As a result, this study investigated the presence of antibiotics resistance (AR) and ESBL in Enterobacteriaceae isolated from garden eggs. Methodology: One hundred (100) garden egg samples were randomly purchased from 10 different vendors into sterile bags. Samples were serially diluted and cultured on MacConkey agar for the isolation of Enterobacteriaceae, then characterised and identified. Antibiotic susceptibility test was carried out on isolates following the Kirby-Bauer disc diffusion method. Double disc synergy test (DDST) was used to detect ESBL production. Result: Forty-three isolates were identified to belong to the family Enterobacteriaceae with Klebsiella spp. being the most dominant specie (51.16%), Escherichia coli (30.23%), Salmonella (11.23%) and Enterobacter aerogenes (6.98%). Of all the isolates, (65.12%) were multi-drug resistant (MDR). The isolates showed highest frequency of resistance to erythromycin (90.7%), gentamicin (34.9%), sulfamethoxazole/trimethoprim (32.6%), ofloxacin (30.2%), ciprofloxacin (25.6%), imipenem (14%), ceftriaxone (11.6%) and nalidixic acid (0.0%). For ESBL production, 23(53.49%) were positive. The ESBL positive isolates (n=23) were Klebsiella spp. 14(60.87%) and Escherichia coli 9 (39.13%). No ESBL production was detected in Salmonella spp. and Enterobacter aerogenes isolates. Conclusion: This study detected the presence of AR and ESBL in Enterobacteriaceae from garden eggs. Consumption of garden eggs contaminated with these bacteria pose a potential problem of infection and spread of resistance in the environment through food.

Introduction: Klebsiella pneumoniae is a major pathogen implicated in healthcare-associated infections. Extended-spectrum β-lactamase (ESBL) and carbapenemase-producing K. pneumoniae isolates are a public health concern. This study investigated the existence of some ESBL and carbapenemase genes among clinical isolates of K. pneumoniae in Southwest Nigeria and additionally determined their circulating clones. Materials and Methods: Various clinical samples from 420 patients from seven tertiary hospitals within Southwestern Nigeria were processed between February 2018 and July 2019. These samples were cultured on blood agar and MacConkey agar, and the isolated bacteria were identified by Microbact GNB 12E. All K. pneumoniae were confirmed by polymerase chain reaction (PCR) using the 16s rRNA gene. Antibiotic susceptibility testing (AST) was done on these isolates, and the PCR was used to evaluate the common ESBL-encoding genes and carbapenem resistance genes. Genotyping was performed using multi-locus sequencing typing (MLST). Results: The overall prevalence of K. pneumoniae in Southwestern Nigeria was 30.5%. The AST revealed high resistance rates to tetracyclines (67.2%), oxacillin (61.7%), ampicillin (60.2%), ciprofloxacin (58.6%), chloramphenicol (56.3%), and lowest resistance to meropenem (43.0%). All isolates were susceptible to polymyxin B. The most prevalent ESBL gene was the TEM gene (47.7%), followed by CTX-M (43.8%), SHV (39.8%), OXA (27.3%), CTX-M-15 (19.5%), CTX-M-2 (11.1%), and CTX-M-9 (10.9%). Among the carbapenemase genes studied, the VIM gene (43.0%) was most detected, followed by OXA-48 (28.9%), IMP (22.7%), NDM (17.2%), KPC (13.3%), CMY (11.7%), and FOX (9.4%). GIM and SPM genes were not detected. MLST identified six different sequence types (STs) in this study. The most dominant ST was ST307 (50%, 5/10), while ST258, ST11, ST147, ST15, and ST321 had (10%, 1/10) each. Conclusion: High antimicrobial resistance in K. pneumoniae is a clear and present danger for managing infections in Nigeria. Additionally, the dominance of a successful international ST307 clone highlights the importance of ensuring that genomic surveillance remains a priority in the hospital environment in Nigeria.

Background: The toxic shock syndrome toxin (TSST-1) is important in the pathology of toxic shock syndrome. However, little data exist on its prevalence among clinical isolates of S. aureus in Nigeria. Hence, this study was carried out to detect the tsst-1 gene and associate it with phenotypic antibiotic resistance in clinical isolates of S. aureus. Methods: Staphylococcus aureus isolates were presumptively identified by Gram’s staining and conventional biochemical tests while confirmatory identification was through the detection of the thermonuclease (nuc) gene. Antibiotic sensitivity testing was carried out using the modified Kirby-Bauer disc diffusion method while phenotypic detection of methicillin resistance was carried out using the cefoxitin disc sensitivity assay. The tst gene was detected within the genome of the bacterial isolates using Uniplex polymerase chain reaction (PCR). Results: Of the 152 S. aureus isolates identified in this study, 103 (67.76%) encoded the tst gene. Of these 103 tst-positive isolates, 63 (61.16%) were methicillin-resistant while 40 (38.84%) were methicillin-sensitive. The tst-positive isolates (n=103) were resistant to tetracycline (39.81%), erythromycin (24.27%), gentamicin (22.33%), cotrimoxazole (22.33%), ciprofloxacin (21.36%), fusidic acid (16.5%), fosfomycin (10.68%), and clindamycin (5.82%). Comparatively, tst-negative isolates (n=49) were resistant to tetracycline (69.39%), cotrimoxazole (56.06%), gentamicin (53.06%), ciprofloxacin (51.02%), erythromycin (46.94%), fusidic acid (28.57%), fosfomycin (26.53%), and clindamycin (8.16%). Phenotypic antibiotic resistance is significantly associated with the presence of the tst gene (p < /em>>0.05). Coclusion: Hence, the high prevalence of the tst gene and its association with antibiotic resistance in S. aureus is a cause for worry.

Abstract Background Exposure to cadmium is implicated in the etiology of some neurodegenerative diseases. Compounds isolated from Ipomoea cairica extract are neuroprotective. However, there is no reported neuroprotective activity of the crude extract of I. cairica (ICE). We investigated the neuroprotective activity of I. cairica extract against cadmium-induced biochemical changes in the brain of male Wistar rats. Thirty-six animals were divided into four groups of 9 animals per group: group I (Control); group II (3.5 mg/kg CdCl2); group III (100 mg/kg ICE + CdCl2); and group IV (250 mg/kg ICE + CdCl2). Animals were pretreated with 100 and 250 mg/kg ICE before co-administration with cadmium chloride. Results CdCl2 treatment caused a significant increase in acetylcholineesterase activity, lipid peroxidation, beta-amyloid aggregation, caspase 3 and 9, p53, and glutamate concentration. In addition, CdCl2 caused a significant decrease in catalase activity, superoxide dismutase, glutathione-S-transferase, Na+/K+ ATPase, and glutamate dehydrogenase. ICE was able to reduce the neuronal damaging effect of CdCl2 by acting as an antioxidant, antiapoptotic, anticholinesterase, and antiexcitotoxicity. Conclusions Our findings show that Ipomoea cairica leaf can be developed and included in the natural product in the prevention of neurodegenerative diseases.

Objectives : This study characterizes the gaseous emission from the combustion of PMS of different volumes from Kaduna Refinery and Petrochemical Company. Methods : The E8500 plus combustion analyzer was used for gaseous emission characterization of different volumes. Oxygen (O2), Hydrocarbons (HC), carbon monoxide (CO), carbon dioxide (CO2), Oxides of Nitrogen NOx (NO, NO2), Sulphur dioxide (SO2), and Hydrogen Sulfide (H2S) were measured using the analyzer. The values were recorded and the descriptive statistics graph was plotted. Results and Discussion : The concentrations for the gaseous emission from the combustion of PMS were 69.85 mg/m3 HC, 117.33 mg/m3 CO, 334 mg/m3 NOx for 10 ml, 58.93 mg/m3 HC, 130.33 mg/m3 CO, 784.33 mg/m3 NOx for 20 ml, 50.20 mg/m3 HC, 84.00 mg/m3 CO, 798.67 mg/m3 NOx for 30 ml, 65.48 mg/m3 HC, 160.33 mg/m3 CO, 850.33 mg/m3 NOx for 40 ml, 87.31 mg/m3 HC, 212.67 mg/m3 CO, 801.33 mg/m3 NOx, 3.67 mg/m3 SO2 for 50 ml. This study shows that CO and HC exceeded the permissible limit for stationary sources while NOx and SO2 were below the permissible limit. Conclusions : Hence, there is a need for rapid response and urgent attention from government and regulatory bodies to develop and implement appropriate policies that will help in reducing the effect. Appropriate measures to control air emissions that may be embarked upon by regulatory bodies include increase in the use of low-emission fuels and renewable fuels such as bio-fuels and introduction of the use of devices with low CO emissions.

Introduction: Coronavirus disease 2019 (COVID-19), a highly transmissible viral infection has spread worldwide causing exponential increase in morbidity and mortality. But so far, there is limited information available to describe the presenting characteristics, outcomes and treatment modalities of COVID-19 patients in Nigeria. This study aimed to describe the demographic and clinical characteristics, underlying comorbidities, treatment modalities and outcomes of patients isolated and treated in a repurposed COVID-19 isolation and treatment centre in Abuja, Nigeria. Materials and Methods: A retrospective study which reviewed the medical records of 300 confirmed COVID-19 patients isolated and treated according to the World Health Organisation and Nigeria Centre for Disease Control guidelines between 22nd July and 26th October, 2020 in ThisDay Dome Isolation and Treatment Centre. Data collected from the medical records include demographics, clinical features, treatment measures and outcomes. Results: Out of 300 patients studied, 61.0% were male. The mean age of the participants was 38.2 ± 14.7. Less than half of the patients (40.3%) had one or more underlying comorbidities with hypertension the most common co-morbidity. Majority (62%) of patients were mildly symptomatic, 33% were asymptomatic while only 2% were severely symptomatic. The most common presenting symptoms include cough 34.0%, fever 30.3%, anosmia 28.7% and dysgeusia 22.7%. Older age (P < 0.001), tertiary education and the presence of underlying comorbidity (P < 0.001) were significantly associated with symptomatic presentation of COVID-19. The median duration of time between positive laboratory testing and presentation for treatment was 5 days (0–29). All patients were treated with a combination of Ivermectin, Azithromycin, Zinc and Vitamin C with no recorded death. The median length of stay at facility was 9 days. Conclusion: Close attention should be given to patients with co-morbidities as an inefficient management of such co-morbidities could lead to mortalities which may not be directly attributable to COVID-19.

We earlier reported the protective effect of Solanum dasyphyllum against cyanide neurotoxicity. In furtherance to this, we investigated the protective effect of S. dasyphyllum against rotenone, a chemical toxin that causes brain-related diseases. Mitochondria fraction obtained from the brain of male Wistar rats was incubated with various solvents (hexane, dichloromethane, ethylacetate, and methanol) extracts of S. dasyphyllum before rotenone exposure. Mitochondria respiratory enzymes (MRE) were evaluated along with markers of oxidative stress. The inhibition of MRE by rotenone was reversed by treatment with various fractions of S. dasyphyllum. The oxidative stress induced by rotenone was also reversed by fractions of S. dasyphyllum. In addition, the ethylacetate fraction of S. dasyphyllum was most potent against rotenone-induced neurotoxicity. In conclusion, S. dasyphyllum is rich in active phytochemicals that can prevent some neurotoxic effects of rotenone exposure. Further study can be done in an in vivo model to substantiate our results.

The global community is facing a health crisis caused by coronavirus disease 2019 (COVID-19). The coronavirus pandemic is severely disrupting the global economy. Countries are battling to slow the spread of the virus by testing, employing contact tracing, restricting travel, quarantining citizens, and encouraging use of face mask, hand hygiene and social distancing measures. The lockdown imposed in many countries including Nigeria has resulted in increased cost and shortages of reagents and supplies worldwide. Due to the highly contagious nature of the disease, rapid rate of spread, and lack of an effective therapy, it became necessary for nations of the world to mount an efficient response mechanism to curb the spread of the pandemic. The Nigerian Institute of Medical Research (NIMR) has responded actively to the current pandemic with some innovations with respect to sample collection systems, molecular diagnostics, kit development and validation. Due to the highly infectious nature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) the causative agent of COVID-19, the institute also invested in the production of infection control tools. The extent of response by the institute would not have been possible but for collaboration and partnership with well-meaning organizations and stakeholders. National, State and public cooperation are very essential for effective response to any pandemic. The response of NIMR to the pandemic is herein discussed. Lessons learned and recommendations made are also shared to help institutions interested in combating this and future pandemics of similar nature.

Pseudomonas aeruginosa is a frequent nosocomial pathogen that causes severe disease in many clinical and community settings. The objective of this paper was to isolate Pseudomonas aeruginosa from clinical samples and to investigate the occurrence of metallo β- lactamase enzyme production by collecting 145 males and 90 females’ human clinical specimens from five selected health institutions within Kwara state, Nigeria. The samples were cultured immediately using standard microbiological procedures. Multiple drug resistance patterns of the bacteria to different antibiotics were determined using the Bauer Kirby disc diffusion technique. Metallo – β lactamase production was determined using E – test strip. Data were subjected to descriptive statistics using Statistical Package for Social Sciences (SPSS) software. A total of 145 isolates were identified as Pseudomonas aeruginosa from the clinical samples.Thirty were positive for metallo β lactamase production; 11 (8 %) males and 19 (13 %) females. Absolute resistance to ceftazidime (100 %), gentamicin (100 %), ceftriaxone (100 %) were observed while low resistance to ciprofloxacin (12.4 %), piperacillin (6.9 %) and imipenem (6.9 %). All isolates were sensitive to colistin. This study had demonstrated that there is a high occurrence of metallo β lactamase enzyme producing and antibiotic-resistant strains of P. aeruginosa in clinical specimens from the studied area. Necessary measures must be implemented to stop the problems of this antibiotic resistance.

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.

The first case of COVID-19 in Nigeria was recorded on February 27, 2020, being an imported case by an Italian expatriate, to the country. Since then, there has been steady increase in the number of cases. However, the number of cases in Nigeria is low in comparison to cases reported by other countries with similar large populations, despite the poor health system prevailing in the country. This has been mainly attributed to the low testing capacity in Nigeria among other factors. Therefore, there is a need for innovative ways to increase the number of persons testing for COVID-19. The aim of the study was to pilot a nasopharyngeal swab self-sample collection model that would help increase COVID-19 testing while ensuring minimal person-to-person contact being experienced at the testing center. 216 participants took part in this study which was carried out at the Nigerian Institute of Medical Research between June and July 2020. Amongst the 216 participants, 174 tested negatives for both self-collected samples and samples collected by Professionals, 30 tested positive for both arms, with discrepancies occurring in 6 samples where the self-collected samples were positive while the ones collected by the professionals were negative. The same occurred in another set of 6 samples with the self-collected samples being negative and the professional—collected sample coming out positive, with a sensitivity of 83.3% and a specificity of 96.7%. The results of the interrater analysis are Kappa = 0.800 (95% CI, 0.690 to 0.910) which implies an outstanding agreement between the two COVID-19 sampling methods. Furthermore, since p< 0.001 Kappa (k) coefficient is statistically different from zero, our findings have shown that self-collected samples can be reliable in the diagnosis of COVID-19.

The first case of COVID-19 in Nigeria was recorded on February 27, 2020, being an imported case by an Italian expatriate, to the country. Since then, there has been steady increase in the number of cases. However, the number of cases in Nigeria is low in comparison to cases reported by other countries with similar large populations, despite the poor health system prevailing in the country. This has been mainly attributed to the low testing capacity in Nigeria among other factors. Therefore, there is a need for innovative ways to increase the number of persons testing for COVID-19. The aim of the study was to pilot a nasopharyngeal swab self-sample collection model that would help increase COVID-19 testing while ensuring minimal person-to-person contact being experienced at the testing center. 216 participants took part in this study which was carried out at the Nigerian Institute of Medical Research between June and July 2020. Amongst the 216 participants, 174 tested negatives for both self-collected samples and samples collected by Professionals, 30 tested positive for both arms, with discrepancies occurring in 6 samples where the self-collected samples were positive while the ones collected by the professionals were negative. The same occurred in another set of 6 samples with the self-collected samples being negative and the professional-collected sample coming out positive, with a sensitivity of 83.3% and a specificity of 96.7%. The results of the interrater analysis are Kappa = 0.800 (95% CI, 0.690 to 0.910) which implies an outstanding agreement between the two COVID-19 sampling methods. Furthermore, since p< 0.001 Kappa (k) coefficient is statistically different from zero, our findings have shown that self-collected samples can be reliable in the diagnosis of COVID-19.

The Coronavirus disease 2019 (COVID-19) pandemic has been ravaging Nigeria and the world with increasing morbidity and mortality. Despite efforts by the Nigerian government implemented through the Nigerian Centre for Disease Control (NCDC) to reduce the scourge of the disease through public enlightenment and regular updates, the number of new cases and mortalities from COVID-19 are still increasing. Family physicians (FPs) who are the first contact of care for most patients accessing private and public health facilities in Nigeria have been working tirelessly to reduce the scourge of the pandemic in Nigeria. They continuously update themselves through regular webinars and online resources and guidelines provided by the Society of Family Physicians of Nigeria (SOFPON). Measures adopted by FPs across the country in the fight against the scourge include triaging patients as they present to the family medicine clinics; health education and enlightenment of the populace; and ensuring social distancing, regular handwashing and compulsory use of face mask by both physicians and patients during clinical consultations. Other measures include incorporating family-focused behavioural interventions in their practice, home-based care to reduce the number of persons visiting the hospital, telemedicine and Hospice and palliative care services to the elderly and terminally ill. In conclusion, FPs in Nigeria are helping to reduce the scourge of COVID-19 through patient education and innovative healthcare delivery that does not put patients at increased risk of the disease whilst promptly recognising potential COVID-19 patients and referring them for early diagnosis and treatment.

The objective of this study was to determine the biochemical and morphological changes in the liver and kidney as a result of the acute administration of tramadol and diazepam with classic soft drink Coca-Cola (Coke ). Method: Thirty-six (36) adult male Wistar rats were divided into six groups: Group A-control (distilled water), Group B (Coke ), Group C (tramadol, 50 mg/kg), Group D (tramadol dissolved in Coke, 50 mg/kg), Group E (diazepam, 10 mg/kg) and Group F (diazepam dissolved in Coke 10 mg/kg). All administrations were done intraperitoneal. Twenty-four hours after administration, blood samples were collected via cardiac puncture for evaluation of the liver (Aspartate aminotransferase [AST] and Alanine aminotransferase [ALT]), kidney (urea and creatinine [CREA]) function and the organs were excised and processed for histopathological examination. Result: A significantly increased in AST, creatinine and urea concentrations was observed in Tramadol and Coke Groups compared to control (P0.05), though it caused a significant increase in urea and CREA (P

Background: Pelvic inflammatory disease (PID) is a major cause of gynaecological morbidity globally. Complications from PID include infertility, ectopic pregnancy and chronic pelvic pain. Low socioeconomic status (SES) is a risk factor for the occurrence of PID. Objective: The aim of this study was to determine the association between SES of parents and the occurrence of PID among undergraduates attending Irrua Specialist Teaching Hospital, Irrua. Methodology: The study was a hospital-based, descriptive cross-sectional study. Three hundred and sixty female undergraduates attending the hospital were consecutively recruited and clinically assessed for the presence of PID using the WHO and CDC MMWR 2010 criteria for the clinical assessment of PID. Their SES was determined by Oyedeji social class categorisation. Data were analysed using Epi Info 3.5.4. Descriptive statistics were used to summarise the data, and Chi-square was used to test for association. Results: There was a significant association between SES of parents and multiple sex partners (P < 0.02), previous sexually transmitted infection (STI) (P = 0.05), unprotected sex (P < 0.001), history of induced abortion (P < 0.001) and surgical termination of pregnancy (P < 0.01). There was also association between occurrence of PID among respondents and multiple sexual partners (P < 0.001), previous history of STI (P = 0.02), non-persistent use of condom (P < 0.001), history of induced abortion (P < 0.01) and surgical termination of pregnancy (P < 0.01). There was however no significant association between SES of parents and occurrence of PID (P = 0.14) though PID was highest among respondents from low SES. Conclusion: Occurrence of PID among undergraduates was not associated with their SES. However, identified risk factors for PID among study population such as multiple sex partners, previous STI, unprotected sex and history of induced abortion were associated with the SES.

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.