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Background: Antimicrobial prescription becomes inappropriate when there is overprescribing, unsuitable dosage and when patients do not complete their treatments. In the outpatient settings, irrational prescription of antibiotics is more evident and has led to the development of resistance, adverse reactions, and increased health care costs. Understanding the knowledge, driving forces and practices of prescribing antibiotics is a step towards ensuring rational use of antibiotics. The study aimed to assess the knowledge, attitude, and practice of antimicrobial prescription among doctors in the outpatient departments of Lagos University Teaching Hospital Idi-Araba. Methods: This was a cross-sectional study conducted consecutively among 259 doctors in the outpatient departments of LUTH. Data entry and analysis were performed using Epi info software version 7. The level of statistical significance was at P < 0.05. Results: The mean age of the respondents was 33.5 ± 6.9 years. Majority of the respondents were males (58.7%). One-third (39%) had between 6 and 10 years of work experience. One-fifth (20.8%) of the respondents were from the department of surgery. Almost all (98.8%) had an overall good knowledge of antibiotics. Majority, (95.4%) had a good attitude towards prescribing. Two-third (63%) requested for a laboratory test before prescribing. However, less than half (44.4%) prescribed based on guidelines and more than half (56.8%) had received trainings on antibiotics prescriptions. Two-third (63.7%) of the respondents had good prescribing practices. There was a statistically significant association between the years of work experience and knowledge of prescribing antibiotics (P = 0.036). Conclusion: Majority had good knowledge and positive attitude toward prescribing. The severity of infection, availability of the drug, cost of the drug, and clinical response of the patients were the major predictors of antimicrobial prescription of the respondents. Antimicrobial stewardship programs should be enhanced and antibiotic surveillance should be improved.

Background: Worldwide, there was an estimated 7.1 million new cases of syphilis in 2020, and most of the infections were found in developing countries like Nigeria. The objective of the study was to determine the prevalence and risk factors for syphilis among human immunodeficiency virus (HIV)‑infected patients in Lagos. Methods: A cross‑sectional study was conducted in an HIV Clinic in Lagos, Nigeria, from April to June 2017 and 385 HIV‑infected adult participants 18 years and above were recruited into the study. Structured questionnaires were used to collect data on sociodemographic and risk factors for syphilis. Blood samples were collected from all participants and tested for syphilis using rapid plasma reagin and Treponema pallidum hemagglutination assay test kits. Data were analyzed using SPSS (IBM) V. 20. Bivariate analysis was carried out using Chi‑square, Fisher’s exact test, and Student’s t‑test on sociodemographic and risk behavioral factors. Multivariable logistic regression analysis was performed with variables that were significantly associated with syphilis in bivariate analysis. A P < 0.05 was considered to be statistically significant. Results: Out of 388 HIV‑infected patients recruited into the study, 262 (67.5%) were female. The mean age was 43.6 ± 10.1 years, and 137 (35.3%) of them were in the age group of 41–50 years. The prevalence of syphilis in HIV‑infected patients was 1.8%. The prevalence of syphilis was significantly higher in males (4.8%) than females (0.4%). The prevalence of syphilis was higher in those with no education or primary school education, and multiple sexual partners were statistically significant in the bivariate analysis but not in the multivariate analysis. Male gender was the only independent risk factor for syphilis, with an odds ratio of 11.79 (95% confidence interval [1.26–106.5], P = 0.03) in multivariate analysis. Conclusion: The prevalence of syphilis in this study was lower than previous work done in other HIV‑positive cohorts in Nigeria. Males were more affected significantly in this study. Routine screening and testing for syphilis should be integrated into HIV care, especially in males. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) is an important cause of chronic liver disease with 296 million people worldwide living with chronic HBV infection as at 2019. Most people infected with the hepatitis B virus are asymptomatic and often unaware of their infection. This study was conducted to determine the prevalence of and risk factors for HBV infection among apparently healthy individuals in Lagos. Method: This was a retrospective cross-sectional study in which the prevalence of hepatitis B virus surface antigen (tested using the Roche Elecsys HBsAg II Qualitative assay) was determined among apparently healthy individuals who presented for health screening at a private laboratory facility in Lagos from May 2014 to June 2016. The health records of those who met the inclusion criteria were systematically reviewed to extract demographic and clinical information. Result: Out of 1448 apparently healthy individuals included in the study, 60.8% were male. The mean age of the participants was 47.1±12 years, and 840 (58.1%) of them were in the age group 31 - 50 years. The prevalence rate of hepatitis b surface antigen was 5.3%. Males had a statistically higher prevalence of HBV infection than females (7.2% versus 2.5%) ([OR, 3.55 (95% CI 1.89 - 6.68], p = 0.00009). The liver enzymes, aspartate transaminase and alanine transaminase, were significantly higher in those with Hepatitis B virus infection (p = 0.04 and p = 0.02 respectively). Conclusion: Strategies for population-based screening of HBV need to be instituted, with appropriate linkage to care of those who test positive. [ABSTRACT FROM AUTHOR]

Background Ebola virus (EBOV) caused more than 11,000 deaths during the 2013–2016 epidemic in West Africa without approved vaccines or immunotherapeutics. Despite its high lethality in some individuals, EBOV infection can produce little to no symptoms in others. A better understanding of the immune responses in individuals who experienced minimally symptomatic and asymptomatic infection could aid the development of more effective vaccines and antivirals against EBOV and related filoviruses. Methodology/Principle findings Between August and November 2017, blood samples were collected from 19 study participants in Lagos, Nigeria, including 3 Ebola virus disease (EVD) survivors, 10 individuals with documented close contact with symptomatic EVD patients, and 6 control healthcare workers for a cross-sectional serosurvey and T cell analysis. The Lagos samples, as well as archived serum collected from healthy individuals living in surrounding areas of the 1976 Democratic Republic of Congo (DRC) epidemic, were tested for EBOV IgG using commercial enzyme-linked immunosorbent assays (ELISAs) and Western blots. We detected antibodies in 3 out of 3 Lagos survivors and identified 2 seropositive individuals not known to have ever been infected. Of the DRC samples tested, we detected antibodies in 9 out of 71 (12.7%). To characterize the T cell responses in the Lagos samples, we developed an anthrax toxin-based enzyme-linked immunospot (ELISPOT) assay. The seropositive asymptomatic individuals had T cell responses against EBOV nucleoprotein, matrix protein, and glycoprotein 1 that were stronger in magnitude compared to the survivors. Conclusion/Significance Our data provide further evidence of EBOV exposure in individuals without EVD-like illness and, for the first time, demonstrate that these individuals have T cell responses that are stronger in magnitude compared to severe cases. These findings suggest that T cell immunity may protect against severe EVD, which has important implications for vaccine development.

Introduction: Inappropriate use of antibiotics for childhood illnesses, especially for non-bacterial infections, contributes to the development of antimicrobial resistance (AMR). Globally, implementation of antimicrobial stewardship programme (ASP) in all healthcare institutions is a strategic intervention to improve the appropriate use of antibiotics, reduce antimicrobial consumption and tackle AMR. The aim of this study was to evaluate the effect of prospective audit with intervention and feedback as an antimicrobial stewardship strategy on antimicrobial use, evaluate prescribers' response to recommendations and determine the rate of AMR in the Paediatrics Department of the Lagos University Teaching Hospital, Nigeria., Materials and Methods: This was an implementation study of the paediatrics Antimicrobial Stewardship Programme (ASP) over a period of 6 months. It was initiated with a point prevalence survey (PPS) to describe the antimicrobial prescribing patterns and followed by prospective audit with interventions and feedback using an antimicrobial checklist and the existing antimicrobial guidelines in the Paediatrics Department., Results: The antibiotic prescribing prevalence was high (79.9%) at baseline PPS with 139 patients on admission, of which 111 (79.9%) were treated with 202 antibiotic therapies. Over the 6 months of study, 582 patients on 1146 antimicrobial therapies were audited. Compliance with departmental guidelines was 58.1% of the total 1146 prescriptions audited (n = 666), making the antimicrobial prescription inappropriate in 41.9% (n = 480) of therapies. The most recommended intervention for inappropriateness was 'change antibiotics' 48.8% (n = 234), followed by 'stop antibiotics' 26% (n = 125), 'reduce the number of antibiotics' 19.6% (n = 194) and 'de-escalate' 2.4% (n = 11). Agreement with ASP interventions occurred in 193 (40.2%) cases, and the least agreed intervention was 'stop antibiotics' (n = 40, 32%). However, there was a steady increase in compliance rates with ASP interventions over the 6 months of period study, which was statically significant (χ 2: 30.005; P = 0.001)., Conclusion: ASP prospective audit with intervention and feedback was of significant benefit in improving compliance with antimicrobial guidelines, thereby improving antimicrobial therapy in the Paediatrics Department of LUTH, Nigeria.