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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.

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.

Background: Pseudomonas aeruginosa (P. aeruginosa) is a frequent nosocomial pathogen that causes severe diseases in many clinical and community settings. Strains of P. aeruginosa are associated with increased morbidity, mortality and healthcare costs. The rapid emergence of antimicrobial resistance among these strains is a public health crisis. Moreover, there is paucity of data on characterization of P. aeruginosa isolates from human clinical samples in Kwara State. Objectives: The objectives are to investigate the occurrence of metallo β-lactamase enzyme, multiple antibiotic resistant P. aeruginosa among clinical samples and detection of antibiotic resistance genes among them. Methods: Two hundred and thirty-five samples comprising of 145 males and 90 females human clinical specimens were collected aseptically from five selected health institutions within Kwara state, Nigeria. The samples were cultured immediately using standard microbiological procedures. Multiple drug resistance patterns of the micro-organisms to different antibiotics were determined using the Bauer Kirby disc diffusion technique. Metallo β-lactamase production was determined using E – test strip and the DNA samples of the multiple resistant P. aeruginosa strains were extracted and subjected to Polymerase Chain Reaction (PCR) for resistant genes determination. Data were subjected to descriptive statistics using Statistical Package for Social Sciences (SPSS) software. Results: A total of 145 isolates were identified for P. 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. The prevalence of various encoding genes blaVIM, , blaCTX-M and blaTEM were 34.4 %, 46.7 %, 16.7 % and 37.7 % respectively. Conclusion: This study has shown that there is a high occurrence of metallo β-lactamase enzyme producing and antibioticresistant strains of P. aeruginosa in clinical specimens from the studied area. Necessary measures must therefore be implemented to stop the problems of this antibiotic resistance.

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.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 22Out 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 (P0.001), tertiary education and the presence of underlying comorbidity (P0.001) 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.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.

Objective The objective of this study is to develop an isotope dilution liquid chromatography tandem mass spectrometry assay to screen for hepatorenal tyrosinemia (HT) from newborn filter paper samples using pooled extracts to increase high throughput screening. Design and methods Succinylacetone (SUAC), the marker for HT, was extracted from dried blood spots with the formation of the hydrazone derivative of SUAC; up to eight sample extracts were pooled and the SUAC-derivative was analyzed by mass spectrometry methods with an injection-to-injection time of one minute. If any pooled sample extract screened positive, then the samples comprising the pooled sample were assayed individually. Results Two newborn infants were identified with high levels of SUAC (7 & 23 μM) and later confirmed to have HT. Three older children whose initial filter paper samples were taken at 195 days to 614 days of age with elevated SUAC (range 4.9–5 μM) were identified; one of the three had clinical signs of HT and was placed on treatment (diagnosis of the other two are unavailable). Conclusion MS/MS analysis of pooled dried blood sample extracts permits sensitive, reduced instrumental analytical time and increase high throughput screening for HT.

The prevalence of heart diseases, such as coronary artery disease and congestive heart failure, increases with age. Optimal therapeutic interventions that antagonize aging may reduce the occurrence and mortality of adult heart diseases. We discuss here how molecular mechanisms mediating life span extension affect aging of the heart and its resistance to pathological insults. In particular, we review our recent findings obtained from transgenic mice with cardiac-specific overexpression of Sirt1, which demonstrated delayed aging and protection against oxidative stress in the heart. We propose that activation of known longevity mechanisms in the heart may represent a novel cardioprotection strategy against aging and certain types of cardiac stress, such as oxidative stress.

Sexually transmitted infections (STIs) are major public health challenge especially in developing countries. This study was designed to determine the prevalence of Hepatitis B virus (HBV), Hepatitis C Virus (HCV), Human immunodeficiency virus (HIV), and Human T-cell lymphotropic Virus type I (HTLV-I) among pregnant women attending antenatal clinic, in Ladoke Akintola University Teaching Hospital, Osogbo, and South-Western Nigeria. One hundred and eighty two randomly selected pregnant women were screened for HBsAg, anti-HCV, anti-HIV and HTLV-1 IgM antibodies using commercially available ELISA kit. Of the 182 blood samples of pregnant women screened whose age ranged from 15-49 years, 13 (7.1%), 5 (2.7%), 9 (4.9%), and 44 (24.2%) were positive for HBsAg, anti-HCV, anti-HIV, and HTLV-1 IgM antibodies, respectively. The co-infection rate of 0.5% was obtained for HBV/HCV, HBV/HIV, HIV/HTLV-1, and HCV/HTLV-1 while 1.1% and 0% was recorded for HBV/HTLV-1 and HCV/HIV co-infections, respectively. Expected risk factors such as history of surgery, circumcision, tattooing and incision showed no significant association with any of the viral STIs (P > 0.05). This study shows that there is the need for a comprehensive screening of all pregnant women for HBsAg, anti-HCV, anti-HIV and HTLV-1 to prevent mother to child transmission of these viral infections and its attending consequences.

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.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.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.There was a significant association between SES of parents and multiple sex partners (P0.02), previous sexually transmitted infection (STI) (P = 0.05), unprotected sex (P0.001), history of induced abortion (P0.001) and surgical termination of pregnancy (P0.01). There was also association between occurrence of PID among respondents and multiple sexual partners (P0.001), previous history of STI (P = 0.02), non-persistent use of condom (P0.001), history of induced abortion (P0.01) and surgical termination of pregnancy (P0.01). 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.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.

Background: Adherence to highly active antiretroviral therapy (HAART) has been proven to be the only effective treatment for HIV/AIDS worldwide. Good adherence to HAART might require good family support. Objective: To determine the family dynamics and social support of people living with HIV/AIDS (PLWHA) and its roles on HAART adherence at an ARV treatment clinic in Osogbo, Nigeria Method: Descriptive cross-sectional study. Consenting PLWHA on HAART were interviewed using pre-tested semistructured questionnaire incorporating Perceived Social Support- Family Scale and Family APGAR. HAART adherence was measured using patient self report. Results: A total of 379 PLWHA were interviewed. Their mean age was 40.8 (SD=9.9) years. Most (60.7%) were females. More than half (55.7%) were currently married and the majority (72.1%) had secondary education and were Yoruba (86.3%). Most respondents (95.5%) were adherent to HAART. Over 90% were satisfied with support received from their family while 82.3% were treated like other family members. Most attributed their HAART adherence to the care and support received from their family. Conclusion: Most PLWHA had good social support and were adherent to HAART. Keywords: Family dynamics; HAART adherence; Nigeria African Health Sciences 2013; 13(4): 920 - 926

Citizens of 9 different English-speaking countries (N = 619) evaluated the average, or typical, citizen of 5 English-speaking countries (Great Britain, Canada, Nigeria, United States, Australia) on 9 pairs of bipolar adjectives. Participants were drawn from Australia, Botswana, Canada, Kenya, Nigeria, South Africa, the United States, Zambia, and Zimbabwe. There were statistically significant similarities in the rankings of the 5 stimulus countries on 8 of the 9 adjective dimensions and a strong convergence of autostereotypes and heterostereotypes on many traits. The results relate to previous stereotyping research and traditional methods of assessing the accuracy of national stereotypes.

Heterotopic pregnancy (HP) is the co-existence of intrauterine and ectopic pregnancies; it is said to be rare. We report the case of a 22 year old woman with HP after unsuccessful attempts at abortion. This report illustrates the treatment difficulties encountered in a delayed presentation, and the nature HP is assuming in rural practice. It also highlights the role of family physicians in reducing maternal mortality in resource-limited settings.

The progression of renal failure was evaluated in seven patients with established chronic renal failure (mean serum creatinine 4.17 mg%), while on a supervised dietary regimen consisting of low protein of high biological value (20-30 g/day), and a high calorie content (3000 kcal/day) for a period of between 18 and 28 months. Five other patients with a comparable degree of chronic renal failure whose protein intake was unrestricted (evaluated to vary between 40 and 60 g per day) served as controls. In the study group, serum creatinine levels stabilized or improved in five, while a moderate rise was observed in two. In contrast, a considerable and significant rise in serum creatinine values was observed in all the controls. Two significantly different slopes (P less than 0.01) were also obtained from the linear regression analysis of the reciprocal of serum creatinine values against time, for the two groups. Our preliminary observation of a beneficial effect of this regimen in our patients is particularly relevant to the developing countries because of the high prevalence of chronic renal failure against the background of grossly inadequate facilities for maintenance dialysis or renal transplantation.