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A case of urinary tract infection due to Candida albicans and responding to fluconazole is presented

The year 2020 made 52 years since the first report of Lassa fever (LF) outbreaks from Nigeria, but what progress has been made in its control? We sought to answer this through an epidemiologic analysis of the temporal and spatial trends of the outbreaks from 1969 to 2020. The analysis showed an overall strengthening of the outbreaks, hallmarked by the change from irregular to regular annual and from limited local to nationwide outbreaks, while there was a sharp contrast between the upward trend in case numbers and downward trend in case fatality. Pending the availability of effective vaccines, greater effort is required to reverse the upward trend in case numbers and sustain the downward trend in case fatality. We discuss the factors associated with the observed trends as well as the prerequisites for further improvements.

Background: The general lack of comprehensive data on the trends of Lassa fever (LF) outbreaks contrasts with its widespread occurrence in West Africa and is an important constraint in the design of effective control measures. We reviewed the contribution of LF to admissions and mortality among hospitalized patients from 2001 to 2018 in the bid to address this gap. Methods: Observational study of LF caseload and mortality from 2001 to 18 in terms of the contribution of confirmed LF to admissions and deaths, and case fatality (CF) among patients with confirmed LF at a specialist center in Nigeria. The diagnosis of LF was confirmed using reverse transcription polymerase chain reaction (RT-PCR) test, and medians and frequencies were compared using Kruskal-Wallis, Mann-Whitney and χ2 tests, with p -values <0.05 taken as significant. Results: The contribution of confirmed LF to deaths (362/9057, 4.0%) was significantly higher than to admissions (1,298/185,707, 0.7%; OR [95% CI] = 5.9 [5.3, 6.7], p < 0.001). The average CF among patients with confirmed LF declined from 154/355 (43%) in 2001-09 to 183/867 (21.1%) (OR [95% CI] = 2.9 [2.2, 3.7], p < 0.001) in 2011-18. The annual CF declined from 94% in 2001 to 15% in 2018 whereas the caseload increased from 0.3 to 3.4%. The outbreaks were characterized by irregular cycles of high caseload in 2005-2007, 2012-2014, and 2016-2018, and progressive blurring of the seasonality. Conclusion: LF outbreaks in Nigeria have upgraded spatially and temporally, with the potential for cycles of increasing severity. The strategic establishment of LF surveillance and clinical case management centers could be a pragmatic and cost-effective approach to mitigating the outbreaks, particularly in reducing the associated CF. Urgent efforts are needed in reinvigorating extant control measures while the search for sustainable solutions continues.

Next-generation sequencing (NGS) has the potential to transform the discovery of viruses causing unexplained acute febrile illness (UAFI) because it does not depend on culturing the pathogen or a priori knowledge of the pathogen's nucleic acid sequence. More generally, it has the potential to elucidate the complete human virome, including viruses that cause no overt symptoms of disease, but may have unrecognized immunological or developmental consequences. We have used NGS to identify RNA viruses in the blood of 195 patients with UAFI and compared them with those found in 328 apparently healthy (i.e., no overt signs of illness) control individuals, all from communities in southeastern Nigeria. Among UAFI patients, we identified the presence of nucleic acids from several well-characterized pathogenic viruses, such as HIV-1, hepatitis, and Lassa virus. In our cohort of healthy individuals, however, we detected the nucleic acids of two novel rhabdoviruses. These viruses, which we call Ekpoma virus-1 (EKV-1) and Ekpoma virus-2 (EKV-2), are highly divergent, with little identity to each other or other known viruses. The most closely related rhabdoviruses are members of the genus Tibrovirus and Bas-Congo virus (BASV), which was recently identified in an individual with symptoms resembling hemorrhagic fever. Furthermore, by conducting a serosurvey of our study cohort, we find evidence for remarkably high exposure rates to the identified rhabdoviruses. The recent discoveries of novel rhabdoviruses by multiple research groups suggest that human infection with rhabdoviruses might be common. While the prevalence and clinical significance of these viruses are currently unknown, these viruses could have previously unrecognized impacts on human health; further research to understand the immunological and developmental impact of these viruses should be explored. More generally, the identification of similar novel viruses in individuals with and without overt symptoms of disease highlights the need for a broader understanding of the human virome as efforts for viral detection and discovery advance.

Background & Objectives: High mortality and morbidity in sickle-cell disease has been associated with malaria infection especially in countries where chloroquine is used. Chloroquine resistance has been associated with the emergence of Pfcrt mutant genes. This study aimed at comparing the prevalence rate of Pfcrt T76 mutation in Plasmodium falciparum isolates from infected individuals with sickle-cell disease and sickle-cell trait. This study was carried out in Benin City between the months of April and June 2006. This period is marked with high transmission rate of malaria., Methods: The genotype of the subjects was screened using haemoglobin electrophoresis system and the P. falciparum. Pfcrt genotyping was carried out using PCR-restriction fragment length polymorphism (RFLP)., Results: Four hundred and twenty-four subjects comprising of 207 haemoglobin AA, 136 haemoglobin AS and 81 haemoglobin SS typed individuals were enrolled for this study. No significant difference existed in the prevalence rate of malaria in the three groups (p > 0.05). However, the prevalence rate of Pfcrt K76T mutant gene was higher in the haemoglobin SS genotyped individuals than the haemoglobin AA and AS subjects (p < 0.05)., Interpretation & Conclusion: An uncontrolled use of chloroquine has been incriminated as the major cause of chloroquine resistance in Nigeria. Therefore, rapid intervention measures are needed as a matter of urgency to curb the up rise in the prevalence of the chloroquine resistant genes in our environment.

Background: Chlamydia infections have been reported to cause silent infections in communities which becomes endemic and could remain unnoticed for a very long time. In most parts of Nigeria these organisms are not screened for, and hence relative information about frequencies of the organisms are sparse., Method: Five hundred and sixty five blood samples and ten umbilical cord fluids were collected from various patients attending clinics in South Eastern Nigeria and were screened for Chlamydia Complement Fixing Antibody (CCFA). Endocervical swabs and urethral discharges or swabs were collected from patients whose serum was positive and were cultured into embryonic eggs which was later observed, harvested and stained using the Romanowsky-Giemsa staining techniques. The positive sera were further confirmed by distinguishing the species of Chlamydia using the monoclonal antibody spot test kit., Result: Of the five hundred and sixty five (565) samples collected only three hundred and forty were positive to CCFA, of which 141 were males and 204 females. From the cultured samples 230 were positive for Chlamydia trachomatis and 99 positive to Chlamydia pneumoniae. Statistical analysis using the student's t test at 95% confidence interval shows that there was no significant difference between the number of females and males that presented themselves for screening., Conclusion: Proper screening of patients to include Chlamydia should be encouraged at all levels of medical diagnosis in the country so as to proffer treatment. Otherwise the infection will remain a "silent epidemic", as is the case currently.

There is a broad group of venereal disease that is referred to as the "Tropical Venereal Disease". They are so-called because they are most frequently seen in the tropical and sub-tropical areas of the world. Among them are conditions like chancroid, lymphogranuloma venereum (LGV or climatic bubo) and granuloma inguinale (chronic venereal sores). Chancroid is variously called "soft sore" or "soft chancre" because it bleeds easily and "ulcus moile".1 It is an acute infection and auto-innoculable disease. The extent of chancroid genital ulceration in Nigeria is greater in the Northern partly due to permissive sexual practices especially for men.

A new differential and selective medium, DYS agar, was developed and evaluated from the isolation of Yersinia enterocolitica. Ther bile salts content of the medium resulted in high selectivity, and inclusion of arabinose, lysine, and arginine rendered Y. Enterocolitica very distinct from Proteus spp., Pseudomonas spp., and other members of the family Enterobacteriaceae. DYS medium was more efficient for the isolation of Y. enterocolitica from experimentally inoculated fecal specimens than MacConkey, deoxycholate-citrate, and salmonella-shigella agars. Although the medium showed selectivity similar to that of another relatively new medium. Y medium (a selective medium for Y. enterocolitica containing sodium oxalate). DYS agar was found to be superior to Y medium in terms of differentiation of Y. enterocolitica from other intestinal organisms. DYS medium is simple to prepare.

Five Yersinia strains, biochemically mimicking Yersinia intermedia, were isolated from patients with acute diarrheal diseases seen at the University of Lagos (Nigeria) Teaching Hospital between October 1979 and September 1982. The five isolates utilized citrate as their source of carbon and fermented sucrose, L-rhamnose, and alpha-methyl-D-glucoside, but unlike any other Y. intermedia biogroup, they failed to ferment D-melibiose or D-raffinose. They all belonged to serogroup O:52,53. Four autoagglutinated and were calcium dependent for growth at 37 degrees C. Three caused conjunctivitis in the guinea pig eye model, but none possessed the 42-megadalton virulence plasmid. Four of the isolates caused diarrhea in orally infected mice and rabbits but were nonlethal for these animals. These results suggest that these isolates represent yet another Yersinia species with disease-producing capabilities in humans.

From patients in Nigeria with acute gastroenteritis, strains of Yersinia were isolated from 14 (1.3%) of 1082 specimens of faeces examined specifically for yersiniae by direct plating and after cold enrichment. Clinical significance was ascribed to six isolates of Y. enterocolitica (serotypes 03, 05,27 and 09) but not to seven isolates of Y. intermedia or one isolate of Y. frederikseni.