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The emergence and reemergence of antibacterial resistance has made it more difficult for a choice of effective antibiotics that treat bacterial infections. Bacteria that are resistant to antimicrobial agents are usually spread from person to person, or from non-human sources in the environment. These non-human sources could aid in the spread of resistant genes as well as resistant pathogens. Systematic review was conducted in accordance to the guideline of PRISMA, 55 relevant literatures from the 152 searched were identified from PubMed, Google Scholar and AJOL using related specific search terms. Only studies carried out or related to Nigeria from January, 2000 to August, 2022. All data obtained from the reviewed articles were presented in percentages using MS Excel 2013. The most prevalent antibacterial genes were blaCTX-M-15 and blaTEM with the prevalence of 2.77%; sul1 and tetA with the prevalence rate of 2.31%; tetM with the prevalence rate of 2.08%; and blaCTX-M, blaSHV, mecA, sul2 and tetB having a prevalence of 1.85%. The sources from which these resistance genes were identified are humans (55.7%) and non-humans (44.3%). The most prevalent bacteria harboring these resistant genes were Escherichia coli (13.2%), Staphylococcus aureus (5.66%) and Klebsiella pneumoniae (5.03%). Antibiotics resistance has continued to threaten the success of modern medicine, with more resistance strains emerging constantly. The wide distribution of antibacterial resistance genes in non-human sources makes them reservoirs of these resistant genes which have the potential of being transferred from commensal microorganisms to human pathogens. [ABSTRACT FROM AUTHOR]

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The prevalence and hematological parameters of trypanosomosis in slaughter cattle in Nsukka, Southeastern Nigeria, were investigated. Blood samples from 200 randomly selected cattle were collected following slaughter into labeled sample bottles with anticoagulant. The sex and breed of the sampled cattle were properly noted. Standard trypanosome detection techniques involving wet blood film examination, buffy coat technique, examination of Giemsa-stained blood smears, and mice inoculation were used to detect and identify the trypanosome species present. The hematological parameters—packed cell volume (PCV), hemoglobin concentration (HbC), total erythrocyte count (TEC), total leucocyte count (TLC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC)—were determined following standard procedures. A prevalence rate of 1.5% (95% CI = 0.005–0.043) was obtained for bovine trypanosomosis in Nsukka with 1% (95% CI = 0.003–0.036) and 0.5% (95% CI = 0.001–0.028) prevalence rates in female and male cattle, respectively. Whereas a prevalence rate of 1.5% (95% CI = 0.005–0.043) was recorded in the White Fulani breed, the Sokoto Gudali had 0% prevalence rate. The prevalence recorded in this study was not associated (P ˃ 0.05) with sex or breed. The mean PCV, HbC, TEC, MCV, MCH, MCHC, and TLC values of the infected cattle differed (P < 0.05) from that of the uninfected cattle. In conclusion, trypanosomosis is prevalent in cattle slaughtered in Nsukka, Southeastern Nigeria, with associated hematological changes. Hence, the need for the adoption and implementation of national trypanosomosis integrated control strategies. [ABSTRACT FROM AUTHOR]

A cross-sectional study to determine the prevalence and hematological parameters of Fasciola gigantica-infected cattle in Nsukka, Southeastern Nigeria, was carried out between March and May, 2008. Blood samples were collected immediately after slaughter into labeled sample bottles containing EDTA. Characteristics of each slaughtered cattle such as sex and breed were noted. Postmortem examination of the liver, bile ducts, and gall bladder were carried out. Standard techniques were used to determine the packed cell volume (PCV), red blood cell count (RBC), white blood cell count (WBC), and hemoglobin concentration (HbC) while mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were calculated appropriately using standard formulae. A total of 200 cattle were examined at postmortem with 23.5% prevalence (95% CI = 0.181–0.299). Fifteen percent (95% CI = 0.107–0.206) of the infected cattle were males while 8.5% (95% CI = 0.054–0.132) were females. White Fulani, Sokoto Gudali, and Red Bororo breeds recorded 20.5% (95% CI = 0.155–0.266), 3% (95% CI = 0.014–0.064), and 0% (95% CI = 0.000–0.019) prevalence respectively. However, no significant association (P ˃ 0.05) exists between Fasciola infections and the breed and sex of sampled animals. The mean PCV, HbC, RBC, and WBC values of the infected cattle were significantly low (P < 0.05) when compared to the uninfected cattle. Public enlightenment on the zoonotic importance of Fasciola gigantica and periodic anthelmintic intervention is hereby recommended. [ABSTRACT FROM AUTHOR]

Farmers in south-eastern Nigeria depend greatly on cassava for its many products. The production however is beset with a myriad of constraints of which the rural farmers despite the influx of modern scientific knowledge still carry out indigenous production practices. Recently the Farmer Field School (FFS) strategy has come to fore, with a view to up-scaling Indigenous Knowledge (IK) to scientific knowledge. This study used the FFS approach to compare improved and indigenous cassava production practices. The study was carried out in Owerri North Local Government Area, Eastern part of Nigeria. Data were collected with the aid of structured questionnaire. 100 respondents were randomly selected from the study area. Descriptive statistics was applied in the data analysis. At the end of the 1st year planting season of 12 months, yield of cassava on Integrated Pest Management (IPM) plot of 1 ha was 33 t of cassava. Using farmers' local cassava variety, farmers' plot of 1 ha gave a total yield of 8 t of cassava. Finally, in the 2nd planting season yield on the farmers' plot using improved cassava variety gave a total yield of 18 t, while the IPM plot was 34 t. It was recommended therefore that farmers can improve on yield if they include some of the IPM practices in addition to the use of improved cassava varieties as was carried out in the FFS which is an effective and, bottom-top, participatory method of technology transfer. [ABSTRACT FROM AUTHOR]

Introduction: Nigeria has the highest number of children who have not received any vaccines in Africa. The training-of-trainers (TOT) model used to train program managers (PMs) and health care workers (HCWs) is ineffective for adult learning and limits immunization programs' success. We incorporated adult learning principles (ALPs) in designing and delivering TOT for immunization PMs and HCWs to use data to engage communities for tailored immunization strategies. Methods: Our study was implemented in 3 local government areas (LGAs) of the Federal Capital Territory, Nigeria. A training curriculum was developed, integrating ALPs and technical and operational content based on best practices in delivering immunization training and the training needs assessment findings. State PMs (n=10), LGA PMs (n=30), and HCWs (n=42) were trained on the human-centered design for tailoring immunization programs (HCD-TIP) approaches using ALPs. We used interviews and surveys with purposively and conveniently sampled PMs and HCWs, respectively, and observations to assess participants' satisfaction, knowledge and competence, behavior changes, and results. The interviews were analyzed thematically, and surveys were statistically. Results: There was a high level of satisfaction with the training among LGA PMs (100%), state PMs (91%), and HCWs (85%), with significant knowledge and competence improvements post-training ( P <.001). The trained participants conducted 2 HCD sessions with 24 undervaccinated communities and co-designed 24 prototype solutions for testing. Results showed increased coverage of the pentavalent vaccine first dose (54%) and third dose (188%) across 12 participating communities. Improved community colaboration, communication skills, and data-driven approaches were the most cited behavior changes in practice. Conclusion: The application of ALPs in training, use of HCD-TIP approaches and tools, and supportive supervision enhanced PMs' and HCWs' capacity for tailored interventions. Countries should consider adopting a holistic approach that focuses on using these approaches in immunization programs to strengthen the health system for equitable vaccine coverage., (© Obi-Jeff et al.)

&lt;b&gt;Background and Objective:&lt;/b&gt; Group B &lt;i&gt;Streptococci&lt;/i&gt; (GBS) are globally recognized as a major risk factor for neonatal infections and various obstetric complications. More so, biofilm formation has been suggested to be important for GBS pathogenesis. The aim of this study was to determine the prevalence and antibiotic susceptibility pattern of GBS among pregnant women and their capacity to form biofilm. &lt;b&gt;Materials and Methods:&lt;/b&gt; A total of 87 pregnant women at 34 to 37 weeks' gestation aged 17-45 years were recruited from 3 healthcare centres in Delta State, Nigeria. Cultures for the isolation of GBS were carried out using recto-vaginal swabs, according to standard microbiological methods. All strains isolated were used for susceptibility tests to various antibiotics as recommended by CLSI using the disk-diffusion method. &lt;b&gt;Results:&lt;/b&gt; The overall prevalence of GBS colonization among pregnant women was 43.6% (38/87). The &lt;u&gt;<&lt;/u&gt;30 age group had the highest rate of GBS colonization. Resistance to erythromycin and vancomycin was 48.2 and 66.4%, respectively. The fluoroquinolones had the lowest resistant rates with no isolate showing resistance to ofloxacin. Multidrug resistance (MDR) (&lt;u&gt;>&lt;/u&gt;3 drug classes) was detected in 73.7% (28/38) of the GBS isolates. All GBS isolated in this study were either strong, moderate or weak biofilm producers. However, most 28 (73.7%) were strong biofilm producers. Resistance of GBS isolates to erythromycin and vancomycin, drugs used for treating GBS infection was high. &lt;b&gt;Conclusion:&lt;/b&gt; This suggested the importance of testing antimicrobial susceptibilities in GBS colonized pregnant women in order to guide antibiotic therapy and minimize newborn infection and co-morbidity.

Objectives: Community involvement depends on the level of linked and targeted activities for health by community members. This study examines the collaborations employed within communities to ensure sustainable access and improved use of healthcare in the community., Methods: This study was conducted in rural and urban local government areas in Anambra, Kano, and Akwa-Ibom, Nigeria. About 90 in-depth interviews and 12 focus group discussions were conducted with community stakeholders and service users. The findings were transcribed and coded via thematic analysis, guided by the Expanded Health Systems framework., Results: Various horizontal collaborations in communities foster increased use of PHC services; promoting community health. Major horizontal collaborations in these communities were community-led, primary health facility-led, and Individual-led collaborations. Their actions revolved around advocacy, building and renovating PHC centers, equipping facilities, and sensitization to educate community members on the need to utilize services at PHC centers., Conclusion: Strategic involvements and collaborations of local actors within communities give rise to improvements in the utilization of primary healthcare centres, reportedly resulting in improved access to PHC healthcare services for community members., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2024 Obi, Ojiakor, Etiaba and Onwujekwe.)

Background: Gram-negative bacteria (GNB) including Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae represent the most relevant reservoir of resistance genes such as metallo-β-lactamase (MBL) and AmpC genes that give them the undue advantage to resist antimicrobial onslaught. This study aimed to investigate the occurrence of MBL (bla IMP-1 , bla IMP-2 , bla VIM-1 , bla VIM-2 ) and AmpC (bla FOX , bla DHA , bla CMY , bla ACC ) resistance genes in aforementioned GNB collected from abattoir and poultry sources in Nigeria., Results: In total, 370 isolates were collected from abattoir tables (n = 130), anal region of cows (n = 120), and the cloacae of poultry birds (n = 120). The test isolates showed high rate of resistance to cephalosporins and carbapenems. The MBLs were phenotypically detected in 22 E. coli, 22 P. aeruginosa, and 18 K. pneumoniae isolates using combined disc test (CDT). However, only 11 E. coli, 24 P. aeruginosa, and 18 Klebsiella pneumoniae isolates were phenotypically confirmed to be AmpC producers using cefoxitin-cloxacillin double disk synergy test (CC-DDST). MBL encoding genes (particularly the bla IMP-1 genes and bla IMP-2 genes) were detected by polymerase chain reaction (PCR) in 12 (54.6%) E. coli, 15 (83.3%) K. pneumoniae, and 16 (72.7%) P. aeruginosa isolates. AmpC genes (particularly the bla CMY genes and bla FOX genes) were found in a total of 5 (29.4%) E. coli isolates, 5 (27.8%) isolates of K. pneumoniae, and 10 (41.7%) isolates of P. aeruginosa., Conclusions: Our study showed the circulation of MBL and AmpC genes in GNB from abattoir and poultry origin in Nigeria. Adoption of regular control policies is necessary to reduce the spread of these species as soon as possible, especially in poultry and slaughterhouses.

Background: Diabetes mellitus (DM) and depression are common chronic disease states of public health importance with huge burden and the potential to impact many aspects of life. They are said to be related though this relationship is not fully understood. The presence of depression among patients with DM is associated with poor glycemic control, complications, and poor self-care., Method: This was a descriptive cross-sectional study conducted at the Diabetes Clinic of the Jos University Teaching Hospital. Three hundred and ten (310) patients with diabetes mellitus were recruited consecutively. The depression module of the Mini International Neuropsychiatric Interview (M.I.N.I.) version 5.0 was used to ascertain depression among these patients. Other demographic data were obtained using a questionnaire. Blood pressure, weight, and height were also measured and the body mass index (BMI) calculated., Results: One hundred and eighty four (59.35%) of the study population were females and the mean age (SD) of the study population was 54 ± 12 years. The mean age (SD) of the females was 53 ± 11 years and that of the males was 54 ± 12 years with no significant statistical difference (P = 0.35). Two hundred and forty nine (80.32%) of the study population were urban dwellers with 140 (45.16%) earning less than N500, 000 (794 USD) yearly. Current major depression was found in 35 (11.3%) patients, among whom 7 (2.3%) had recurrent depression. The presence of DM complications (OR: 3.50, 95% CI 1.16-10.61) and a positive family history of depression (OR: 4.03, 95% CI 1.32-12.29) were found to be correlates of current major depression., Conclusion: The prevalence of current major depression among patients with diabetes mellitus in this study is high. We recommend that all patients with DM should be screened for depression and treated appropriately to reduce its consequences., Competing Interests: None

Despite the effectiveness of antiretroviral therapy (ART) in the prevention of mother-to-child transmission of HIV (PMTCT), some HIV-infected women in PMTCT care are at risk of transmitting HIV to their babies. Using a 1:1 unmatched case-control study design, we assessed the risk factors for perinatal transmission among women who received ART for PMTCT in Sokoto State, Nigeria. Data were abstracted from medical records of cases (94 HIV-infected babies) and controls (94 HIV-uninfected babies) and their mothers who accessed PMTCT services in three purposefully selected secondary health facilities. We conducted univariate and multivariate logistic regressions to determine if sociodemographic characteristics, time of enrolment, type of maternal ART, receipt of infant antiretroviral (ARV) prophylaxis, place of delivery, or feeding practice were associated with HIV infection among HIV-exposed babies. Sixteen percent of the mothers of babies in the case group had early enrolment while 90% of those in the control group enrolled early. Infant prophylaxis was received in 54% of cases and 95% of controls. In both groups, 99% of the mothers practiced mixed feeding. In the univariate analysis, factors that were significantly associated with HIV infection were religion (islam), rural residence, late⁠ enrolment, and non-receipt of infant ARV prophylaxis. In the multivariate analysis, rural residence (Adjusted odds ratio (aOR) = 8.01, 95% CI = 1.79-35.78), late enrolment (aOR = 41.72, 95% CI = 15.16-114.79), and non-receipt of infant ARV prophylaxis (aOR = 4.1, 95% CI = 1.18-14.33) remained statistically significant. Findings from this study indicate that eliminating MTCT in Nigeria requires interventions that will enhance timely access of ART by mother-baby dyads.

The effects of Trypanosoma brucei infection on testicular morphology and function and the changes associated with treatment of infected dogs with diminazene aceturate were studied using fifteen Nigerian adult male dogs. The dogs were randomly assigned into three groups A, B and C consisting of five dogs each. Groups A and B were infected with 1 × 10(6) trypanosomes and group C was the uninfected control. Following infection, parasitaemia levels were monitored daily whereas the rectal temperature, body weight, packed cell volume, scrotal circumference and serum testosterone levels were monitored weekly. At parasitaemia peak, dogs in group A were orchidectomised while dogs in group B were treated with 7.0mg/kg body weight of diminazene aceturate (DA). Dogs in groups B and C were later orchidectomised on day 73 of the experiment. The harvested testes and epididymides were weighed and the epididymal sperm reserves of all the dogs determined. Also the sperm quality (mass activity, sperm motility and sperm morphology) were determined. The testes were sectioned after processing and studied histomorphologically. Acute trypanosomosis was observed following infection. The low serum testosterone levels observed from day 14 post infection (pi) gradually improved following treatment. Testicular weight, epididymal weight and sperm quality were significantly low (p<0.05) in the infected dogs when compared to the control group but gradually improved following treatment. Histomorphological studies revealed testicular degeneration characterized by depopulation of seminiferous tubules and depletion of spermatogenic cells in dogs of group A whereas the tissue sections of the testes of dogs in group B were similar to those of the control group. It was therefore concluded that infection of dogs with T. brucei adversely affected testicular morphology and function. Treatment with diminazene aceturate reversed the reproductive abnormalities caused by the parasite., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Objectives: To determine the prevalence of bacteria that could cause diarrhoea in stool specimens of individuals with and without diarrhoea in both urban and rural areas of Nigeria. To ascertain the antibiotic susceptibilities of the bacterial diarrhoeagenic agents isolated. To document the predominant signs and symptoms associated with the various bacterial agents of diarrhoea., Design: Prospective study., Setting: Patients/individuals attending government and private clinics in Lagos, Edo and Cross-River States of Nigeria., Subjects: A total of 1,200 stool samples were collected from patients with diarrhoea. Another total of 1,200 stool specimens were obtained from controls., Results: For diarrhoea cases in urban areas Campylobacter spp. were more predominant (28%) and were followed by enteropathogenic Escherichia coli (EPEC) (28%) whereas in rural areas, EPEC were the most commonly isolated bacteria (18%), closely followed by Salmonella spp. (16%). Controls had a similar distribution pattern. Higher rates of isolation of these enteric bacteria were recorded among diarrhoea cases than in controls (p < 0.05). Diarrhoea due to Vibrio, Yersinia, Aeromonas, Plesiomonas and EPEC was mainly watery whereas it mainly consisted of blood/mucus for Shigella and Salmonella. All were associated with abdominal pain and fever. Results presented also indicate that over 80% of Shigella species, Salmonella, EPEC and P. shigelloides were susceptible to nalidixic acid and nitrofurantoin. Virtually all the enteropathogens were resistant to commonly used antibiotics such ampicillin, erythromycin, tetracyclines and streptomycin., Conclusion: Results show that distributional patterns of bacterial agents of diarrhoea may vary in urban and rural areas and have revealed the effectiveness of nalidixic acid, gentamicin and nitrofurantoin, in that order, against these enteropathogens.

A total of 2,400 stool samples comprising 1,200 from patients with diarrhoea (600 each from urban and rural area) and 1,200 similarly divided controls were obtained from school children and clinic attendants of government and private clinics around three designated study centres of Edo, Lagos and Cross River states, Nigeria. These were screened for the prevalence of bacteria that could cause diarrhoea. Diarrhoea cases in urban areas had a high prevalence rate for Campylobacter spp. (28%), followed by enteropathogenic Escherichia coli (22%), Salmonella spp. (17%), Shigella spp. (14%), Aeromonas spp. (5%), and Yersinia enterocolitica (4%), whereas in rural areas E. coli was the most frequently encountered pathogen (18%), followed by Salmonella spp. (16%), Aeromonas spp. (15%), Shigella spp. (9%), Campylobacter spp. (8%), and Plesiomonas shigelloides (8%). A similar distribution but with lower rates was noted for controls in both urban and rural areas, however, no P. shigelloides was isolated. Results highlight a possible difference between the prevalence of enteric bacteria in rural and urban areas and reveals the strong association of Aeromonas and Plesiomonas species with cases of diarrhoea in Nigeria.

Objectives: To ascertain the antibiotic resistance patterns and plasmids of Staphyl coccus aureus and coagulae negative staphylococci isolated from different clinical specimens in Lagos, Nigeria., Design: Prospective study involving the screening of specimens of blood, urine, skin and soft tissue infections, vagina, urethra, eye, ear, nose, pleural fluid and seminal fluid obtained from patients attending the Lagos University Teaching Hospital (LUTH) and Providence Hospital Diagnostic Laboratories, Lagos, Nigeria., Setting: A laboratory based study conducted in the Microbiology Unit, University of Lagos and the National Institute for Medical Research (NIMR) Lagos, Nigeria. The patients were from different communities in Lagos., Subjects: A total of 200 patients that were positive for the presence of S. aureus and coagulase negative staphylococci (CONS) were employed in the study., Main Outcome Measures: Frequency of isolation of S. aureus and coagulase negative staphylococci (CONS) from the different clinical specimens determination of their resistance profile using standard techniques for the isolation of both organisms and the Kirby-Bauer disc diffusion method for antibiotic testing., Results: All the S. aureus and CONS isolates were sensitive to novobiocin and ofloxacin. Ninety eight (80 pc) of S. aureus isolates were resistant to tetracycline (Tet), 73 (60 pc) to Streptomycin (Str), and 49 (40 pc) to Chloramphenicol (Chl). All the S. aureus isolates were resistant to Penicillin (P) and only two (2 pc) and four (three pc) were resistant to Cefuroxime (Cxm) and Ceftriasone (Cro) in that order. Twenty six (21 pc) of S. aureus isolates were resistant to Methicillin. For CONS, 92 pc were resistant to Penicillin, 47 (60 pc) to streptomycin and 40 (51 pc) to tetracycline. Nineteen (24 pc) were resistant to Methicillin. Further antibiotic sensitivity results revealed the following patterns: 87 (71 pc) and 29 (36 pc) of S. aureus and CONS respectively showed P RTet"R, pattern of resistance. The resistance pattern PREryRGmRCazRCxmR was shown by only one (17 pc) of S. aureus and none (Opc) of CONS. Only 59% and four pc of S. aureus and CONS isolates showed resistance pattern ChlREryR, CazR respectively. Results of plasmid profiles showed that 48 (96 pc) of 50 S. aureus and 26 (87 pc) of 30 CONS isolates harboured one or more plasmids of molecular sizes ranging from 1.0 Kb to 19.5 Kb. Nine (19 pc) of 48 S. aureus and three (12 pc) of CONS isolates showed plasmid identity., Conclusion: We assert that although isolates of S. aureus and CONS showed multiple antibiotic resistance which could be plasmid mediated, only about five pc of both organisms showed resistance pattern ChlREryRCazRTetRCxmRSxtRGmR and EryRGmRCazRCxmR and this is of chemotherapeutic importance. Both organisms, were highly sensitive to Ceftriazone, Ceforoxime and Gentamicin. The high levels of resistance of many antibiotics may be attributable to indiscriminate use or antibiotic abuse in the community.

One hundred patients with diarrhoea and 50 asymptomatic individuals attending various hospitals in Edo State, Nigeria, were screened for serum complement-fixing and agglutinating antibodies to Plesiomonas shigelloides using the complement-fixation and agglutination tests. Seventy (70%) of the 100 patients and 20 (40%) of the 50 asymptomatic individuals had detectable complement-fixing antibodies at titres ranging from 1:32 to 1:128 and 1:8 to 1:32 respectively. Results suggest that cases of diarrhoea in this environment may be due to P. shigelloides, but the demonstration of antibodies in asymptomatic individuals show that they also have serum antibodies against P. shigelloides. The exclusive use of antibody responses in the diagnosis of P. shigelloides infections should, therefore, be interpreted with caution.

Two thousand four hundred stool samples comprising 1 200 each from diarrhoeal and non-diarrhoeal (control) cases with 600 of each category from urban and rural areas were screened for the prevalence of Aeromonas and Plesiomonas species in the different groups. Thirty (5 pc) and (14,8 pc) of Aeromonas species and 14 (2,3 pc) and 46 (7,7 pc) of Plesiomonas shigelloides were isolated from urban and rural areas respectively for diarrhoea cases. Only eight (1,3 pc) and 18 (3 pc) of Aeromonas spp. from urban and rural areas respectively and none of P. shigelloides were isolated from controls. Both organisms were more commonly associated with females than males. This may be attributable to the fact that both organisms are environmental water bacteria and in rural areas, because females engage more in domestic activities than males have more frequent contacts with the water sources such as rivers, streams, ponds. Most rural areas lack piped water supply. Diarrhoea due to both organisms was associated with fever and vomiting: mainly watery but mucoid and bloody stools were also noted. Antiobiogram of isolates showed over 70 pc resistance to ampicillin and streptomycin in both rural and urban areas whereas over 90 pc of both organisms were sensitive to nalidixic acid and gentamycin in urban and rural areas. Antibiogram of isolates was independent of age, sex and area of residence. Finally, for cases of infections due to Aeromonas spp. and P. shigelloides, the use of gentamycin, nalidixic acid and nitrofurantoin would be appropriate in both urban and rural areas.

A total of one hundred and two cases of otitis media were screened for the isolation of bacterial flora of ears. Out of this, Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae accounting for 41.2%, 25.5% and 13.3% respectively were isolated. A further two hundred and four sputum samples from cases of lower respiratory tract infections were screened. Moraxella catarrhalis, S. aureus, S. pneumoniae and H. influenzae constituting 20.9%, 37%, 30% and 21% were isolated in that order. Thirty-one point seven percent of the Moraxella catarrhalis isolates were beta-lactamase positive. Beta-lactamase M. catarrhalis were resistant to penicillin and ampicillin while the non-beta-lactamase producers were sensitive to these antimicrobial agents. However, both beta-lactamase producers and non-producers were resistant to trimethoprim but sensitive to erythromycin, tetracycline and amoxycillin. Staphylococcus aureus, S. pneumoniae and H. influenzae was also sensitive to penicillin while S. pneumoniae was also sensitive to erythromycin and H. influenzae to chloramphenicol.

Ear swabs from 350 patients with chronic otitis media attending different orthorhinolaryngological clinics at different hospitals and health centres in Benin City and Ekpoma in Edo State were screened for the presence of bacterial agents of chronic otitis media. Results revealed the presence of 19 different species indicating polymicrobial infections. Species isolated comprised Staphylococcus aureus (33.6%), Pseudomonas aeruginosa (19.3%), Proteus mirabilis (17%), Alcaligenes faecalis (6.2%) and Klebsiella aerogenes (4.3%). Others included Escherichia coli (3.3%), Proteus rettgeri (2.8%), and Staphylococcus epidermidis (2.2%), Klebsiella pneumoniae, Proteus vulgaris, Acinetobacter spp, Proteus morgani, Haemophilus influenzae, Providencia spp, Streptococcus pyogenes, Streptococcus pneumoniae, Streptococcus faecalis, non-haemolytic streptococci and Diphotheroids, each accounted for less than 2% of isolates. The study also showed a higher prevalence of chronic otitis media among males (55.7%) than females (44.3%). Cases of chronic otitis media were highest among the age groups (0-5 years) with a prevalence rate of 50% and least among the 6-10 year age group with a prevalence rate of 14.9%. Antibiogram of isolates revealed marked sensitivities (over 90% of the isolates) to ciproxin, tarivid, rocephin and fortum whereas over 70% were resistant to penicillin and ampicillin. Results have indicated that Staphylococcus aureus, Pseudomonas aeruginosa and Proteus mirabilis are leading bacterial agents of otitis media and highlights the high risk involved in the use of penicillin, ampicillin, streptomycin, tetracycline, chloramphenicol, erythromycin, cloxacillin and septrin in the management of chronic otitis media in our locality.

The antibacterial effect of local honey on local isolates of bacterial agents of diarrhoea was determined by an in vitro method involving the impregnation of filter paper discs in undiluted honey and different honey concentrations ranging from 10%-50%. The discs were later placed on plates that have been seeded with the different bacteria and zones of inhibition of growth were measured after a 48 hr. period of incubation. Results presented show that undiluted honey and honey at concentrations of 40% and above were inhibitory to all enteropathogens tested. Zones of inhibition of growth around the disc margin of the various enteropathogens tested ranged from 16-18mm in diameter for the local undiluted honey and 7-12mm in diameter for concentrations of honey at 40% and 50%. The possible mechanisms of this inhibitory effect of local honey are discussed.

A total of 257 stool specimens comprising 203 from diarrhoeal children and 54 asymptomatic controls were collected from patients attending different hospitals/clinics in Lagos and Ekpoma, Nigeria and were screened for fungal agents using standard methods. Of the total number screened, 165 (64.2%) patients had fungal agents in their stools. Of these, 157 (77.3%) patients had diarrhoea and 8 (14.8%) patients were asymptomatic. Of these total number of positive isolates, Candida albicans, C. tropicalis, C. pseudotropicalis, C. glabrata and C. parasilosis accounted for 59.4%, 30.9%, 5.0%, 3.0% and 1.8% in that order. Results revealed a significant relationship (p < 0.05) between fungi and incidence of diarrhoea in children. There was no significant relationship (p > 0.05) between the age group studied and the incidence of fungal diarrhoea in children. The sex of the children also showed no significant relationship (p > 0.05) with the incidence of fungal diarrhoea. Results have revealed the emergence of Candida species in cases of childhood diarrhoea in our environment.

Sixteen isolates of four species of Yersinia comprising five of Yersinia enterocolitica and Yersinia fredricksenii, four of Yersinia intermedia and two of Yersinia kristensenii isolated from domestic and wild animals in villages in Edo and Delta States, Nigeria, were evaluated for their pathogenicity using laboratory animal models and virulence characteristics tests which included autoagglutinability, calcium dependency for growth, heat-stable enterotoxin production and conjunctivities in guinea pig eye. Results obtained revealed that Yersinia enterocolitica isolates were enteropathogenic as demonstrated by the production of diarrhoea and eventual recovery from faeces, spleen and liver of the infected animals. Three (60%) (2 serotypes 0:3 and 1 serotype 0:8) of the five Yersinia enterocolitica isolates were lethal to the animals. Other Yersinia isolates (Yersinia kristensenii, Yersinia fredricksenii and Yersinia intermedia) were uniformly non pathogenic to the animals. However, a strain of Yersinia intermedia isolate produced diarrhoea in the inoculated animals and caused lethality in guinea pigs and mice, but was negative for autoagglutination test, calcium dependency, conjunctivities, and positive for heat-stable enterotoxin production. We are of the view that this strain may be another Yersinia intermedia--like bacterium, previously isolated in Nigeria. Results therefore, suggest an emergence of a pathogenic Yersinia intermedia species in this environment.

Two hundred and fifty apparently healthy pregnant women attending the Obstetrics and Gynecology Clinic of the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria were screened for a comparison of the prevalence of HIV seropositivity and hepatitis B surface antigenemia (HBs Ag) amongst them. The Karpas AIDS cell test for HIV seropositivity and Bioman Hepatitis test kits were used as described by the manufacturers. HIV seropositive cases were confirmed using the Western blot test. Results revealed that out of the 250 pregnant women screened, 2 (0.8%) and 11 (4.4%) were HIV-1 and HBs Ag seropositive, respectively. However, the same 2 pregnant women now constituting 2 (18.2%) of the 11 HBs Ag positive pregnant women were simultaneously HIV-1 seropositive. Antibody to HIV-2 was not recorded in all HIV seropositive cases. This is the first report on the simultaneous prevalence of HBs Ag and HIV seropositivity among apparently healthy pregnant women in Lagos, Nigeria.

Objective: To determine the prevalence of human immunodeficiency virus (HIV) in pregnancy in our community., Method: A prospective study on 250 pregnant women currently attending the antenatal clinic at the Lagos University Teaching Hospital was carried out in 1991., Result: Results obtained showed that of the 250 pregnant women screened only two (0.8%) were seropositive for HIV. This indicates the risk of vertical or materno-fetal HIV transmission in our community and underscores the need for urgency for prospective monitoring of infants born to HIV seropositive women., Conclusion: Although the prevalence rate of HIV seropositivity amongst the otherwise healthy Nigerian pregnant women is only 0.8%, we advocate universal screening of HIV during pregnancy.

One hundred and thirteen rectal swabs and 87 faecal samples obtained from the Paediatric casualty of the Lagos University Teaching Hospital, Lagos, Nigeria were processed for Campylobacter jejuni/coli. Twenty-two (11%) of the specimens were positive for C. jejuni. Biotyping results showed that nine (41%) and eight (36%) belonged to C. jejuni biotypes I and II respectively, while three (14%) and two (9%) belonged to C. coli biotypes I and II. Serotyping results revealed that C. jejuni biotypes I and II and C. coli biotypes I and II belonged to different serotypes with serotypes A9 and A36 being the most prevalent. In-vitro antibiotic sensitivity testing using the disc method showed that 18 (82%) of the Campylobacter jejuni/coli isolates were sensitive to erythromycin and nalidixic acid, while 16 (73%) were sensitive to streptomycin. All were resistant to penicillin, while four (18%) and six (27%) were sensitive to tetracycline and cloxacillin respectively. We therefore recommend the use of erythromycin and streptomycin for cases of Campylobacter enteritis requiring antimicrobial therapy in Lagos, Nigeria.

Seventy patients with acute diarrhoea and sixty asymptomatic children in Lagos, Nigeria were screened for complement fixing and agglutinating antibodies to Campylobacter jejuni in wells of microtitre plates using automatic microtitre pipettes. Out of the seventy patients with acute diarrhoea, 55 (78.6%) had complement fixing antibody, while 48 (68.5%) had agglutinating antibody in their sera. Twenty-nine (48.3%) and 21 (35%) out of the sixty asymptomatic children screened had complement fixing and agglutinating antibody respectively. Generally 84 (64.6%) of 130 children (both symptomatic and asymptomatic) had antibody to C. jejuni in their sera. The difference in the incidence rate between the symptomatics and asymptomatic is not statistically significant. The result suggest an antibody response to C. jejuni among children with diarrhoea, indicating that most of the diarrhoea cases in our environment may be due to Campylobacter but the successful demonstration of antibody response to C. jejuni among asymptomatic individuals may also suggest that even "normal" individuals have in their sera, antibody that can agglutinate C. jejuni in Nigeria. Use of antibody responses alone to C. jejuni in the diagnosis of C. jejuni infections in Nigeria should therefore be interpreted with caution.

Limulus gelation assay and dermal Schwartzman reaction provided a sensitive and reproducible means of testing the endotoxic activity of hospital strains of Campylobacter jejuni in Lagos, Nigeria. All the 22 isolates of Campylobacter jejuni tested for the limulus gelation assay were positive for the production of endotoxin. Furthermore, the Campylobacter suspensions caused a positive dermal Schwartzman reaction in rabbits. The area of skin reaction was less extensive than that produced by Escherichia coli 01114B and E7539/77 which served as positive controls. Five local strains of Campylobacter jejuni tested for enterotoxin production showed negative reaction in the infant mouse test whereas enterotoxin production was observed in Campylobacter jejuni strain 11168 and Escherichia coli E7539/77. Consequently, the infant mouse test may not be suitable for enterogenicity testing of our local isolates of Campylobacter jejuni.

The sensitivity of Campylobacter jejuni strains LA4, LA12, LA36, LA53, LA1214, LA1308 and LA1309 constituting the most prevalent strains of C. jejuni isolated in Lagos, Nigeria to the bactericidal activity of normal human serum was determined using microtiter technique. Results obtained shows that only strains LA 36 and LA53 were serum resistant while others (strains LA4, LA12, LA1214, LA1308 and LA1309) were serum sensitive. This finding is important epidemiologically and is the first report on serum sensitivity of local isolates of C.jejuni in Nigeria.

A total of 200 serum specimens comprising 100 specimens from patients with streptococcal disease conditions, 50 from patients with other diseases and another 50 specimens from apparently healthy individuals were collected from Lagos University Teaching Hospital and from various areas of Lagos metropolis and screened for the presence of anti-streptolysin O (ASO). For streptococcal disease conditions, other diseases and for apparently healthy persons, anti-streptolysin O titres above 250 iu/ml recorded for each category of clinical conditions in terms of the number examined were 34%, 36% and 28% respectively. It is therefore suggested that high anti-streptolysin O (ASO) titres occur in apparently healthy individuals with no history of streptococcal infection and individuals with disease conditions other than those of streptococcal origin. Consequently the diagnosis of streptococcal diseases based on high titres of ASO in Lagos, is not pathognomonic, should be interpreted with caution and must not be definitive since healthy individuals and others without streptococcal infections develop high ASO titres.