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BACKGROUND: Morbidity and mortality associated with HIV infection is immune-mediated, and an understanding of HIV immunology will be beneficial in the management of HIV infection OBJECTIVE: The objective of this research was to measure the levels of TNF-α, IL-6 and IFN-γ in asymptomatic HIV patients and non-HIV subjects, as well as their relationship with CD4 count. METHOD: Blood samples were collected from 173 subjects, consisting of 125 asymptomatic HIV patients (44 HAART-naïve and 81 on HAART) and 48 non-HIV subjects. The IFN-, IL-6, and TNF- levels in the blood were determined using enzyme-linked immunosorbent assays, and the CD4 count of all participants was determined using flow cytometry. RESULTS: Regardless of treatment status, the IFN-γ levels of non-HIV subjects were significantly higher than those of HIV patients (p< 0.001). The opposite was true for IL-6, as the levels of IL-6 in non-HIV subjects were significantly lower than those in HAART-naïve HIV patients (p< 0.001) and those on HAART (p< 0.01). TNF-α levels did not differ between HIV patients and their non-HIV counterparts. Generally, the levels of these cytokines was not affected (p> 0.05) by immunosuppression (measured by CD4 count < 200 cells/μL) and there was no significant correlation between CD4 count and these cytokines (p> 0.05). CONCLUSION: In conclusion, asymptomatic HIV infection decreased IFN-γ, increased IL-6, and had no effect on TNF-α levels, regardless of treatment status. Immunosuppression had no impact on these cytokine levels, and there was no relationship between them and CD4 counts.

Background: In pregnancy, the body undergoes modulation of pro-inflammation responses to ensure fetal survival, and these adjustments may decrease maternal immune defenses and promote infections. Objectives: This study was conducted to determine interleukin 2 (IL-2), IL-10, and interferon gamma (IFN-γ) among pregnant women co-infected with HIV and Plasmodium falciparum in Edo State, Nigeria. Methods: This study was conducted at the Central Hospital, Benin City, Edo State. A total of 200 participants were enrolled, consisting of 150 pregnant women co-infected with HIV and P. falciparum and 50 non-pregnant women (as controls) who were neither infected with HIV nor P. falciparum. Venous blood specimen was collected for P. falciparum detection, CD4 T-lymphocyte estimation, and IL-2, IL-10, and IFN-γ assays using standard methods. Results: Among HIV-infected pregnant women, IL-2 (P = 0.0070), IL-10 (P = 0.0179) and IFN-γ (P = 0.1564) values were lower in primiparous women compared with multiparous women. HIV-infected pregnant women who were married had significantly higher IL-2 (P = 0.0085) and IFN-γ levels (P = 0.0332) compared with single women, while marital status did not affect the IL-10 level of pregnant women infected with HIV. Only the IL-2 levels of the HIV-infected pregnant women increased significantly (P = 0.0012) with increasing trimester. The tested cytokine levels were lower in those with malaria compared with those without malaria among HIV-infected pregnant women. Conclusions: The HIV status and not malaria infection affects the cytokine levels of pregnant women co-infected with HIV and malaria.

Background: West Africa includes the most endemic areas in the world with Nigeria being one of the largest countries of West Africa that has been reported to have a high incidence of onchocerciasis. Aim: The aim of this study was to determine Onchocerca volvulus infection among ivermectin-treated population in Ekpan community, Edo State, Nigeria. Setting and Design: A total of 105 participants including 60 males and 45 females with an age range of 15–81 years were recruited in the study. Random sampling technique was employed in the recruitment of participants. Materials and Methods: Two skin snip specimens were taken from the left and right iliac crests of each participant into a microtube containing physiological saline. The skin snips were processed using standard technique and examined microscopically for microfilariae of O. volvulus. Statistical Analysis: The data collected were analyzed using the Chi-square (X2) test and odd ratio. The statistical package used was GraphPad INSTAT. Results: An overall prevalence of 74.3% of O. volvulus infection was observed among ivermectin-treated subjects in Ekpan. Age, occupation, noncompliance of ivermectin treatment, and source of water significantly affected the prevalence of O. volvulus infection among ivermectin-treated population in Ekpan (P < 0.05). Conclusion: Effective distribution of ivermectin and strict compliance of ivermectin treatment are advocated as these efforts will go a long way at controlling as well as reducing the effects of onchocerciasis in this community.

Background: Mobilized colistin resistance (MCR) is a public health problem resulting in limited therapeutic options. Objective: This study aims to phenotypically detect mobilized colistin resistance (MCR)-mediated resistance in a setting where colistin is not used. Method: The combined disk test (CDT) technique and minimum inhibitory concentration (MIC) were used to screen a total of 238 isolates for the existence of MCR producers. Results: Of the 238 isolates, 47 (19.75%) were CDT positive, and 37 out of the 47 had MIC >2mg/L and were referred to as MCR producers. Age, gender, type of specimen and the wards/clinics the isolates were recovered from did not significantly affect the prevalence of MCR producers (p>0.05). Type of isolate significantly (p=0.0184) affected the prevalence of MCR producers. Conclusion: This study underscores a high prevalence [15.55% (37/238)] of phenotypically detected MCR-mediated colistin resistance in a resource-poor setting were colistin is not used.

The rise in prevalence of methicillin resistant staphylococci implicated in clinical infections worldwide continues to elicit interest in nasal colonization rates for these resistant strains. This study was aimed at determining the prevalence of methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative staphylococci (MRCoNS) among apparently healthy students of a tertiary institution in Benin City, Nigeria. A total of 350 students were recruited for the study and nasal swabs were collected alongside demographic data. These swabs were processed microbiologically using standard techniques to recover staphylococci. Antimicrobial susceptibility and methicillin-resistance was determined using a phenotypic method (cefoxitin resistance). A total of 148 (42.3%) of 350 students were culture positive for S. aureus, while 72 (20.6%) were positive for CoNS. Students from Faculty of Dentistry showed the highest prevalence of nasal MRSA (40.0%) and MRCoNS (20.0%). Ofloxacin and gentamicin were the most active antibacterial agents against MRSA with 89.1% and 87.3% respectively been susceptible, while gentamicin was the most active antibiotic against MRCoNS (75.0%). Nasal colonization by MRSA and MRCoNS was unaffected by area of residence and gender (P > 0.05). The nasal carriage rate of MRSA and MRCoNS was 37.2% and 33.3% respectively. The study recommends periodic review of nasal colonization rates among apparently healthy subjects. Regulated use of antimicrobial agents is imperative in order to stem the tide of resistance.

Background: Serine and zinc type carbapenemases are distributed in many genera of bacteria and are typically associated with specific regions or countries. Objectives: This study phenotypically determined the prevalence of serine and zinc-type carbapenemases among Gram-negative bacilli recovered from clinical specimens in Benin, Nigeria. Materials and Methods: Totally, 158 consecutive non-duplicate bacterial isolates (gram-negative bacilli) recovered from clinical samples were screened for serine and zinc-type carbapenemases using the simplified carbapenemase inactivation (sCIM) and ethylenediaminetetraacetic acid -double-disc synergy test methods. Results: The isolates recovered from clinical specimens included 126 Enterobacteriaceae (79.7%), 7 Acinetobacter spp (3.7%), and 28oxidase positive gram negative bacilli (17.7%). Twenty-eight isolates (17.7%) out of the 158 tested samples were carbapenemase positive. There was no significant difference in the prevalence of serine- and zinc-type carbapenemases (P=0.0748). However, the prevalence of zinc-type carbapenemase was significantly higher in Pseudomonas aeruginosa compared with other isolates (P=0.0028) while that of serinetype carbapenemase was not affected by the type of clinical isolates (P=0.7216). Finally, the prevalence of both serine- and zinc-type carbapenemases were not affected (P>0.05) by clinical specimens and the source of isolates (in-patient vs. out-patient) respectively. Conclusion: In general, the prevalence of zinc-type (12%) carbapenemases was insignificantly higher than that of serine-type (5.7%) carbapenemases. The measures to reduce infections caused by carbapenemase-producing organisms (CPOs) are advocated accordingly.

Artemisinin have being used for the control of malaria worldwide for over a decade and its listing by WHO as the first-line drug for treatment of both severe and uncomplicated malaria and the observed treatment failure have warranted the need to screening malaria patients for the presence of antibodies to malaria. In our locality where there is unregulated use of antimicrobials, the need to ascertain the prevalence of antibodies to artemisinin and evaluate the potential risk factors cannot be overemphasised, hence this study. Blood specimens were collected from 400 randomised patients undergoing treatment for malaria in Benin City, Nigeria. Data on socio-demography were collected with the aid of a well-structured questionnaire. Artemisinin antibodies were detected by drug absorption mechanism (DAM) and immune complex reaction (IMC) methods. ABO, rhesus blood group, and haemoglobin (Hb) phenotype were determined by using standard technique. A total of 112(28.00%) out of the 400 participants had artemisinin antibodies. Gender, marital status, level of education, residential area and living arrangement did not significantly affect the prevalence of artemisinin antibodies whereas age and ethnicity significantly affected the prevalence of artemisinin antibodies (p=0.0244 and 0.0001 respectively). Duration of the last artemisinin used and the mostly used brand of artemisinin as well as the ABO and rhesus blood groups and haemoglobin phenotypes did not significantly affect the production of artemisinin antibodies. Although of all the risk factors age and ethnicity were identified as the only risk factors for the development of artemisinin, we therefore advocate the prudent use of artemisinin-containing antimalarial and concerted efforts in combating self-medication with this drugs to avoid the development of resistance.

Background: Multidrug resistant bacteria continue to be a bane in the treatment of clinical infections in Nigeria. Knowledge of trends in resistance mechanisms is vital in determining available therapeutic options. Objective: This study was aimed at determining the prevalence, distribution and antimicrobial susceptibility of extended spectrum β-lactamase (ESBL), AmpC β-lactamase and metallo-β-lactamase (MBL)-producing gram negative bacteria (GNB) recovered from clinical specimens in a tertiary hospital in Southern Nigeria. Materials and Methods: A total of 309 consecutive non-repetitive clinical bacterial isolates were recovered from various clinical specimens. The presence of ESBL, AmpC β-lactamase and MBL as well as the susceptibility profiles were determined using standard microbiological techniques. Results: ESBL was the most prevalent (P < 0.0001) of the 3 enzymes detected in this study. Bacterial isolates recovered from inpatients had a higher likelihood of producing ESBL than those recovered from out-patients (odds ratio [OR] = 2.225, 95% CI = 1.375, 3.599; P = 0.0015). The highest prevalence of ESBL, AmpC and MBL enzyme was observed for Providencia species, Pseudomonas aeruginosa and Citrobacter species respectively. β-Lactamase positive isolates showed poor activity against cephalosporin, amoxicillin-clavulanate, gentamicin and the fluoroquinolones. Isolates that produced any of the three β-lactamase enzymes showed more resistance to antibacterial drugs than β-lactamase negative bacterial isolates. Conclusion: A prevalence of 41.7%, 15.2% and 28.5% was observed for ESBL, AmpC β-lactamase and MBL respectively in this study. Isolates that produced any of the enzymes were more resistant to antibacterial agents. Prudence in antibiotic use is strongly advocated.

Background: Previous studies have relied on culture-dependent methods to determine microbial communities that may be found in the seminal fluids of men seeking reproductive health care. However, understanding the microbiome composition present in seminal fluids with the state-of-art next-generation sequencing technology is more germane than ever before, instead of culture methods which fails to identify over 99% of bacterial organisms present in biological samples. Methods: Forty semen samples were collected and after bacterial DNA extraction, 22 samples that passed quality check were used for amplification of the V4 region of the 16S rRNA using custom bar‑coded primers prior to sequencing with Illumina NextSeq 500 platform. Sequencing was performed in a pair-end modality rendering 2 x 150 base-pair sequences. Sequence reads were imported into Illumina BaseSpace Metagenomics pipeline for 16S rRNA recognition. Distribution of taxonomic categories at different levels of resolution was done using Greengenes database. Results: The taxonomic categories from the dataset produced phyla that ranges from 6 to 25; Class (9-49), Order (16-99), Family (42-214), Genus (55-555) and Species (56-1156). The taxonomic profiles represented 25 phyla, showing 39.5% of the total sequence reads were categorized to Proteobacteria as the most abundant. This was followed by Firmicutes (33.54%), Actinobacteria (20.77%) and Bacteroidetes (4.77%), Fusobacteria (0.613%), Tenericutes (0.31%) and Verrucomicrobia (0.12. At the species taxonomic level 1841 species were identified among the seminal fluid samples. Serratia marcescens (23.61% sequence reads) was the most abundant species found in 9/22 of the samples followed by Lactobacillus iners (18.22%) 13/22, Serratia entomophila (5.54%) 17/22, Haemophilus parainfluenzae (3.64%) 10/22, Corynebacterium tuberculostearicum (3.29%) 21/22, Gardnerella vaginalis 2.39%) 12/22, Lactobacillus taiwanensis (2.08%) 10/22, Enterobacter amnigenus (1.63%) 15/22, Corynebacterium genitalium (1.29%) 12/22, Neisseria lactamica (1.18%) 8/22, Finegoldia magna (1.17%) 16/22, Prevotella bivia (1.14%) 10/22, Corynebacterium imitans (1.12%) 15/22, Corynebacterium jeikeium (1.02%) 17/22 and Lactobacillus acidophilus (1.01%) found in 6/22 of the samples. Conclusions: We investigated the microbiome compositions from seminal fluids and showed that there are varying bacterial diversities that are unique in each sample in contrast to culture-dependent methods.

Background: Ergonomics awareness helps in its right application and contributes significantly to general wellbeing and safety of worker at workplace. Aim: This cross‑sectional descriptive study aimed at assessing the level of awareness and knowledge of the science of ergonomics among Medical Laboratory Scientists in Benin City, Nigeria. Subjects and Methods: A total of 106 medical laboratory scientists comprising 64 and 42 in public and private laboratories, respectively, were recruited for this study using systematic random sampling technique. Data were obtained from the study participants using a questionnaire and subsequently analyzed with the statistical software INSTAT®. Results: Out of 106 study participants, 27 (25.5%) were reported to have heard of the term ergonomics. Awareness was significantly associated with gender (male vs. female: 38.5% [15/39] vs. 17.9% [12/67]; odds ratio = 2.9; 95% confidence interval = 1.2, 7.1;P = 0.02). Awareness of ergonomics was not significantly affected by affiliation (P = 0.18), area of specialization (P = 0.78), post‑qualification experience (P = 0.43), and educational qualification (P = 0.23) of the study participants. Irrespective of the affiliation of the participant, only 6 of 27 (22.2%) participants who were aware of ergonomics knew at least a benefit of right application of ergonomics in the laboratory. Knowledge of risk factors for the development of musculoskeletal disorders was reported by 8 of 27 (29.6%) persons who claimed to be aware of ergonomics. Conclusions: Awareness of ergonomics and knowledge of gains of its right application was poor among the study participants. Regular ergonomic education of medical laboratory scientists in Nigeria is advocated.Keywords: Ergonomics, Medical laboratory scientist, Musculoskeletal disorders, Nigeria

Objectives: Because of lack of data on the prevalence of sulfadoxine antibody, this study was conducted to determine the prevalence of sulfadoxine antibodies and its possible risk factors. Methods: Blood specimens were collected from 500 patients undergoing treatment for malaria at Central Hospital, Benin City, Nigeria. A structured questionnaire was used to collect information and sociodemographic data. Sulfadoxine antibodies were detected by drug absorption (DAT) and immune complex (IMC) methods. ABO, rhesus blood group, and hemoglobin (Hb) phenotype were determined by using standard technique. Results: DAT method had a significantly higher rate of detecting sulfadoxine antibodies compared to IMC method (p = 0.019). Age, gender, and level of education did not affect the prevalence of sulfadoxine antibodies (p > 0.050). Patients that were an artisan (p < 0.001), married (p = 0.025), living in a two-room apartment (p = 0.003), had history of drug reaction, consumed antimalarial drug (maloxine), and consumed sulfadoxine-containing drug within the last month (p < 0.001 each), and significantly affected the prevalence of sulfadoxine antibodies. Individuals with Hb phenotype AA had significantly higher prevalence of sulfadoxine antibodies (p < 0.001), and presence of rhesus D antigen was associated with sulfadoxine antibodies. Conclusions: An overall prevalence of 22.0% among the tested individuals had sulfadoxine antibodies. Prudent use of sulfadoxine containing drugs is advocated.

Lassa fever is endemic in west Africa. Persons at greatest risk are those living in rural areas with poor sanitary conditions and overcrowding. Against this background, this study aimed at assessing public awareness of Lassa fever among residents of three rural communities in Edo State, Nigeria. A total of 380 persons resident in rural Okada, Ogbese and Utese communities of Edo State, Nigeria were enrolled for this study. Age range of participants was between 15 and 69 years. A structured questionnaire was administered to all volunteer subjects to obtain relevant information. Irrespective of community studied, a total of 28 (7.4%) participants reported to have heard of Lassa fever. Male gender was associated with awareness of Lassa fever in all communities surveyed. The television was the most popular source of Lassa fever awareness in all communities studied. Among participants who reported to have heard of Lassa fever, vehicles of transmission of disease mentioned included mosquito bites 9 (32.1%), dog ...

Aim: This study was aimed at determining the prevalence and associated risk factors for hepatitis B virus (HBV) infection among human immunodeficiency virus (HIV)-infected patients in a tertiary teaching hospital in Nigeria. Patients and Methods: Venous blood was collected from a total of 1680 (comprising of 1177 HIV infected and 503 non-HIV infected) patients and tested for the presence of HbsAg using immunochromatographic technique. Results: The seroprevalence of HBV among HIV and non-HIV-infected patients was 3.8% and 3.6%, respectively. HIV was not identified as a risk factor for HBV seropositivity (P = 0.919). A statistically significant association was found to exist between CD4 count

Septicemia is a major cause of death in neonates. Prompt diagnosis and effective treatment is necessary to treat patients with septicemia. However, the prevalence, etiology, and antibiotic susceptibility vary with location and time. This study aimed at determining the prevalence of neonatal septicemia and the effect of age and gender on this prevalence. In addition, the antibacterial susceptibility of etiologic agents was also determined. Blood samples were collected from 534 neonates (322 males and 212 females) between 1 day and 28 days of age with signs and symptoms of septicemia. The blood samples were processed to diagnose septicemia. Identification of bacterial isolates and disc susceptibility testing were performed using standard techniques. Age and gender did not significantly affect the prevalence of neonatal septicemia ( p = 0.554 and 0.127, respectively). Klebsiella species were the predominant microorganism causing neonatal septicemia, in males and within the first 14 days of life. Fluoroquinolones, gentamicin, and β-lactams (with the exception of cloxacillin) were the most active antibacterial agents. An overall neonatal septicemia prevalence rate of 38.95% was observed. Klebsiella species was the most predominant isolate causing neonatal septicaemia. The β-lactam antibiotics recommended in susceptibility testing and the data collected in this study will be helpful in empiric therapy of neonatal septicemia.

Human immunodeficiency virus (HIV)-infected persons are commonly infected with Cryptosporidium species and Enterocytozoon bieneusi in both developed and developing countries, particularly patients with CD4+ cell counts below 200 cells/μL; 285 HIV-infected patients on highly active antiretroviral therapy (HAART) were enrolled in this study, and both stool and blood specimens were collected from participants. The stool specimens were analyzed and typed for E. bieneusi and Cryptosporidium spp. by polymerase chain reaction (PCR) and DNA sequencing. CD4 count was analyzed using flow cytometry. E. bieneusi and Cryptosporidium were detected in 18 (6.3%) and 4 (1.4%) patients, respectively. The E. bieneusi detected mostly belonged to a new genotype group that, thus far, has only been found in a few humans: genotype Nig4 in 2 patients and two new genotypes related to Nig4 in 12 patients. The Cryptosporidium detected included C. hominis (two patients), C. parvum (one patient), and C. felis (one patient), with the two C. hominis infections belonging to an unusual subtype family. Additional studies are required to determine whether some E. bieneusi genotypes and C. hominis subtypes are more prevalent in HIV patients on HAART.

Background The aim of this study was to assess public and private medical diagnostic laboratories in Nigeria for the presence of biosafety equipment, devices, and measures. Methods A total of 80 diagnostic laboratories in biosafety level 3 were assessed for the presence of biosafety equipment, devices, and compliance rate with biosafety practices. A detailed questionnaire and checklist was used to obtain the relevant information from enlisted laboratories. Results The results showed the presence of an isolated unit for microbiological work, leak-proof working benches, self-closing doors, emergency exits, fire extinguisher(s), autoclaves, and hand washing sinks in 21.3%, 71.3%, 15.0%, 1.3%, 11.3%, 82.5%, and 67.5%, respectively, of all laboratories surveyed. It was observed that public diagnostic laboratories were significantly more likely to have an isolated unit for microbiological work ( p = 0.001), hand washing sink ( p = 0.003), and an autoclave ( p ≤ 0.001) than private ones. Routine use of hand gloves, biosafety cabinet, and a first aid box was observed in 35.0%, 20.0%, and 2.5%, respectively, of all laboratories examined. Written standard operating procedures, biosafety manuals, and biohazard signs on door entrances were observed in 6.3%, 1.3%, and 3.8%, respectively, of all audited laboratories. No biosafety officer(s) or records of previous spills, or injuries and accidents, were observed in all diagnostic laboratories studied. Conclusion In all laboratories (public and private) surveyed, marked deficiencies were observed in the area of administrative control responsible for implementing biosafety. Increased emphasis on provision of biosafety devices and compliance with standard codes of practices issued by relevant authorities is strongly advocated.

Diabetes mellitus (DM) is a group of metabolic diseases in which a person has high blood glucose, either because the body does not produce enough insulin, or cells do not respond to the insulin that is produced. This study was conducted to determine the prevalence of intestinal parasitic infections among DM patients as well as the risk factors involved in the acquisition of these parasitic infections. A total of 180 individuals were included in this study. The study group consisted of 150 (41 males and 109 females) DM patients attending clinics, and 30 (7 males and 23 females) non-DM individuals served as controls. Stool and blood specimens were obtained from each participant to detect intestinal parasites and to determine hemoglobin concentration using standard techniques. An overall prevalence of 18.7% of intestinal parasitic infections among DM patients was observed in this study. DM status was significantly associated with intestinal parasitic infections (odds ratio = 14.192; 95% confidence interval = 0.842, 239.22; p = 0.022). Age and type of toilet significantly (p = 0.047 and p

This study aimed at assessing knowledge of HIV/AIDS among residents of three rural communities in Nigeria. A total of 371 persons residing in selected rural communities were recruited for this study. A structured questionnaire was used to collect data from all participants. Results of the study showed a generally high level of awareness of HIV/AIDS in all communities surveyed. However, among study participants, knowledge of mode of prevention and management of HIV infection was poor as was knowledge of HIV status and readiness to utilize free voluntary counseling and testing for HIV/AIDS services. Scale-up of HIV/AIDS education by relevant health authorities is strongly advocated.

Purpose: Infections caused by AmpC-positive bacteria results in high patient morbidity and mortality making their detection clinically important as they cannot be detected in routine susceptibility testing. This study aim to determine the prevalence of AmpC β-lactamase among Gram negative bacteria recovered from clinical specimens in Benin City, Nigeria. Methods: A total of 256 consecutive and non-repetitive Gram negative bacteria were recovered from various clinical specimens. The prevalence of AmpC β-lactamase was determined using a combination of disc antagonism test and cefoxitin-cloxacillin inhibition test. Disc susceptibility test was performed on all isolates using standard techniques. Results: Cefoxitin-cloxacillin inhibition test detected more AmpC β-lactamase than other tests. The prevalence of AmpC β-lactamase did not differ significantly between both genders and between inpatients and out-patients ( p >0.05). Isolates recovered from sputum had significantly higher prevalence of AmpC β-lactamase producers compared with isolates from other clinical specimens ( p =0.0484). The prevalence of AmpC production was significantly higher among isolates of Pseudomonas aeruginosa than other isolates ( p = 0.0085). Isolates that produced AmpC β-lactamase were more susceptible to the test cephalosoprins. Conclusion: An overall prevalence of AmpC β-lactamase (15.23 %) was observed in this study. Pseudomonas aeruginosa was the most prevalent producer of AmpC enzymes. Prudent use of antibiotics is advocated. Keywords: AmpC β-lactamase producers, antibiotics utilization, prevalence, Pseudomonas aeruginosa , routine susceptibility testing

Molecular characterization of Enterocytozoon bieneusi has led to better understanding of microsporidiosis transmission in humans. This study aimed to detect and genotype E. bieneusi in human immunodeficiency virus (HIV)-infected persons. Stool specimens were collected from 463 HIV-infected patients and analyzed for E. bieneusi by polymerase chain reaction (PCR) and DNA sequence analysis of the internal transcribed spacer. E. bieneusi was detected in 77 HIV patients. CD4 cell counts < 200 cells/μL was associated with E. bieneusi infection (P = 0.09). E. bieneusi was significantly associated with weight loss (P < 0.0001), diarrhea (P = 0.006), fever (P < 0.0001), not being married (P < 0.0001), and flush type of toilet (P = 0.0007). Six known genotypes of D, A, IV, CAF2, EbpA, and Peru 8 in 31, 22, 14, 2, 1, and 1 patients, respectively, five novel genotypes of E. bieneusi, and one infection with mixed genotypes were observed in this study. Three of the novel genotypes were genetically distant to the genotypes commonly found in humans.

Intestinal parasitic infections have been reported in persons with human immunodeficiency virus (HIV)/AIDS. This study aimed to determine the prevalence of intestinal parasitic infections in HIV-infected patients on highly active antiretroviral therapy (HAART) in Benin City, Nigeria. A total of 285 (84 male and 201 female) HIV-infected adults in the course of HAART were enrolled. Blood and stool specimens were collected from each participant and processed using standard procedures. CD4 count < 200cells/μL and diarrhea were significant risk factors for acquiring intestinal parasitic infections in HIV-positive patients.Anemia was significantly associated with intestinal parasitic infections. Ascaris lumbricoides, hookworm and Strongyloides stercoralis were the only intestinal parasites recovered. We showed a low prevalence (5.3%) of intestinal parasitic infections among HAART patients. Opportunistic coccidia were not detected in this study. Routine diagnosis of intestinal parasites among HIV-infected patients on HAART is advocated.

Female vaginal contraceptives are associated with increased susceptibility to infections. The prevalence of female reproductive tract infections (RTI) among contraceptive users was determined. A total of 187 female participants including 156 contraceptive users and 31 age-matched noncontraceptive users with signs and symptoms of RTIs were recruited for this study. A questionnaire was used to collect demographic information. High vaginal swabs were collected from each participant and processed using standard technique. Female contraceptive users (40.4%) had an increased risk for developing RTIs compared to noncontraceptive users (19.35%) (OR = 2.833, 95 CI = 1.095, 7.276; p = 0.044). Intrauterine device (IUD) users (53.07%; p = 0.032), users of contraceptives for less than 1 year (60.00%; p = 0.003) and age group of 26-30 years (68.18%; p = 0.0001) had significantly higher prevalence of RTIs among contraceptive users. Candida albicans was the most prevalent etiologic agent of RTIs among contraceptive users irrespective of types of contraceptives, bacteria vaginosis caused by other bacterial isolates was the most common RTIs among noncontraceptive users. In this situation, Klebsiella species was found only among IUD users. The study reveals an overall prevalence of 36.90% of female RTIs. Contraceptive users had 1-7 fold increase in developing RTIs. Vaginal candidiasis and bacterial vaginosis were the most common female RTIs observed among contraceptives and noncontraceptive users. Some valuable measures to reduce infections associated with contraceptive use are advocated.

Background: Deliberate and regular exposure to premium motor spirit fumes is common and could be a risk factor for liver disease in those who are occupationally exposed. A possible association between premium motor spirit fumes and plasma levels of triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol using a rodent model could provide new insights in the pathology of diseases where cellular dysfunction is an established risk factor. Aim: The aim of this study was to evaluate the possible effect of premium motor spirit fumes on lipids and lipoproteins in workers occupationally exposed to premium motor spirit fumes using rodent model. Materials and Methods: Twenty-five Wister albino rats (of both sexes) were used for this study between the 4th of August and 7th of September, 2010. The rats were divided into five groups of five rats each. Group 1 rats were not exposed to premium motor spirit fumes (control group), group 2 rats were exposed for 1 hour daily, group 3 for 3 hours daily, group 4 for 5 hours daily and group 5 for 7 hours daily. The experiment lasted for a period of 4 weeks. Blood samples obtained from all the groups after 4 weeks of exposure were used for the estimation of plasma levels of triglyceride, total cholesterol, high density lipoprotein- cholesterol and low density lipoprotein- cholesterol. Result: Results showed significant increase in means of plasma total cholesterol and low density lipoprotein levels (P

Aim. To determine the prevalence of otitis media in Okada, a rural community in Nigeria, and the effect of age and gender on its prevalence as well as susceptibility profile of the bacterial agents in the community.Material and Methods. Ear discharge from 500 (240 males and 260 females) patients with signs and symptoms of otitis media were processed to recover bacterial agents. Susceptibility test was performed on all bacterial isolates. Results. Male gender was a significant (P = 0.011) risk factor for acquiring otitis media (male Vs female; 36.25% Vs 25.38%. OR = 1.671 95 CI = 1.139, 2.454). Age significantly (P < 0.0001) affected the prevalence of otitis media with children within the age range of 0 – 5years having the highest prevalence of 78.41%. Pseudomonas aeruginosa was the predominant bacteria isolate causing otitis media generally and in both gender. All bacterial isolates showed were poorly susceptible to the antibacterial agents used as less than 50 percent of any bacteria genera were susceptible to any antibacterial agent.Conclusion. An overall prevalence of 30.6% of bacteriologically proven otitis media was observed in this study. The prevalence were higher in males and in children 5 years and younger. Following the high level resistance observed, rational use of antibacterial agents is advocated.

The elderly have an increased risk of developing urinary tract infection (UTI). This study aimed to determine the prevalence of UTI among elderly (≥ 60 years) patients in Benin City, Nigeria. Clean-catch midstream urine was collected from 943 (362 males and 581 females) elderly patients with signs and symptoms of UTI. Significant microbial isolates were identified in the urine specimens and an antimicrobial susceptibility test was performed on bacteria isolates using standard techniques. Male sex was a significant risk factor for acquiring UTI in the elderly (odds ratio = 6.584; 95% confidence interval = 4.081, 10.62; p < 0.0001). There was an inverse relationship between age and prevalence of UTI, as the prevalence of UTI significantly declined with increasing age (p = 0.023). Escherichia coli was the most common uropathogen (36.79%) in both sexes of elderly patients. Bacterial isolates were poorly susceptible to antibacterial agents used. An overall prevalence of 11.03% of UTI was observed among the elderly. Male sex showed an approximately 4-11-fold increased risk of acquiring UTI. The prevalence of UTI among the elderly decreases with increasing age. Rational use of antibiotics is advocated to stem the tide of high antibacterial resistance.

Background: Reproductive tract infections are public health problems in women of reproductive age and can result in serious consequences if not treated. Aims: To determine the prevalence and causes of reproductive tract infections among in-patients and out-patients attending a tertiary health institution in Benin City. The antimicrobial susceptibility profiles of bacterial agents will also be determined. Patients and methods: High vaginal swabs or endocervical swabs and blood were collected from 957 patients consisting of 755 out-patients and 202 in-patients. The swabs were processed and microbial isolates identified using standard technique. Disc susceptibility tests were also performed on microbial isolates. The blood samples were used for serological diagnosis of syphilis. Results: There was no significant difference in the prevalence of female reproductive tract infections between in-patients (52.48%) and out-patients (47.02%), although in-patients showed a significantly higher risk of developing mixed infections (in-patients vs. out-patients; 34.91% vs. 22.25%, OR = 1.873 95% CI = 1.169, 3.001; P = 0.01). Candida albicans was the most prevalent etiologic agent among out-patients studied while Staphylococcus aureus was the most prevalent etiologic agent among in-patients. Trichomonas vaginalis was observed only among out-patients. Ceftriaxone, ciprofloxacin and ofloxacin were the most active antibacterial agents. Syphilis was not detected in any patient. Conclusion: An overall prevalence of 48.17% of female reproductive tract infection was observed among the study population. Although there was no significant difference between in-patients and out-patients, in-patients appeared to have 1-3-fold increase risk of developing mixed infections. The most prevalent etiologic agent differs between in-patients and out-patients. Despite the high activity of ceftriaxone, ciprofloxacin and ofloxacin against bacterial isolates from both in-patients and out-patients, prudent use of antibacterial agents is advocated.

We aimed to determine the prevalence of malaria and anemia among children ≤ 5 years old in Benin City, Edo State, Nigeria. We also assessed the effects of age and sex on disease prevalence. Blood samples were collected from 1325 children (744 males and 581 females) with signs and symptoms of malaria. Malaria parasitemia was diagnosed by microscopy, while anemia was defined as hemoglobin concentration < 11g/dL. Males had a significantly higher risk of malaria infection (odds ratio, OR, 1.399; 95% confidence interval, CI, 1.087–1.801, p < 0.009), while females had a significantly higher risk of anemia (OR, 2.711; 95% CI, 1.872–3.929; p < 0.001). Generally, age did not affect the prevalence of malaria—except among males, where children between 2-3 years old had a significantly (p = 0.006) higher prevalence. Generally and among males, age affected the prevalence of anemia with children 4–5 years old having significantly (p < 0.001) lower prevalence of anemia. Malaria was a risk factor for acquiring anemia (OR, 2.289; 95% CI, 1.630–3.214; p < 0.001). Overall prevalences of 75.77% and 87.32% for malaria and anemia, respectively, were observed. While malaria parasitemia was higher among males, anemia was higher in females. Malaria and anemia were affected by age only in males. Effective control measures against malaria are advocated.

Background : The traditional birth attendant delivers majority of pregnant women in Nigeria. Objective : This study aimed at determining the prevalence and associated risk factors for delivery of low birth weight (LBW) neonates in a Traditional Birth Home (TBH)in Benin City, Nigeria. Methods : A total of 780 pregnant women who received ante-natal care at a TBH and live singletons born to them were recruited for this study. Venous blood was collected from all pregnant women at onset of labour, and haemogblobin concentration determined using standard method. Results : The prevalence of low birth weight was 6.3%, and was significantly affected by maternal age (P =0.039), gestational age (P=0.019), maternal height (P = 0.001), marital status (P = 0.015), and time of registration (P = 0.016). Being in a polygamous union, was significantly associated with the prevalence of LBW (OR = 13.640; 95%CI: = 6.148, 30.261; P =

Background: Phlebotomy is a complex process requiring knowledge and skill to perform safely. This study aimed at identifying deviations from best phlebotomy practices among laboratory workers involved in venous blood draws in Edo State, Nigeria. Methods: A total of 109 participants from public and private laboratories in Edo State, Nigeria were assessed as they performed venous draws on patients. Results: All participants identified patients by their full names only, and did not introduce themselves to patients before initiating venous draws. Only 9 (8.2%) participants obtained patients consent before venous draws. Glove use was significantly associated with participants [medical laboratory scientists: odd ratio (OR), 14.850; 95% confidence interval (CI): 3.345, 65.916; P Conclusions: Marked deviations from best phlebotomy practices were observed among study participants. Phlebotomy training of laboratory workers in Edo State, Nigeria is advocated.

Background: Highly active antiretroviral therapy (HAART) improves immunity and reduces the occurrence of enteroparasitic infections. Aim: This study aimed to determine the prevalence and risk factors of intestinal parasitic infection among human immunodeficiency virus (HIV) patients on HAART in Kogi State, Nigeria. Methods: Blood and stool specimens were collected from 511 subjects including 411 HIV patients on HAART and 100 apparently healthy non-HIV individuals. The blood specimens were used to determine CD4 count and haemoglobin concentration, whereas the stool specimens were processed to detect intestinal parasites using standard techniques. Socio-demographic data were obtained with the aid of a questionnaire. Results: Entamoeba histolytica was the predominant parasites recovered generally and in both genders as well as being the only parasite that was associated with immunodeficiency as measured by CD4 count Conclusion: An overall prevalence of 14.4% of intestinal parasitic infections was observed among HIV patients on HAART in this study. Routine diagnosis of intestinal parasites among HIV patients on HAART is advocated.

Aim: To determine the prevalence of urinary tract infection (UTI) in Okada, a rural community in Nigeria, and the effect of age and gender on its prevalence as well as the etiologic agents and the susceptibility profile of the bacterial agents. Patients and Method: Clean-catch midstream urine was collected from 514 patients (49 males and 465 females). The urine samples were processed and microbial isolates identified. Susceptibility testing was performed on all bacterial isolates. Result: The prevalence of urinary tract infection was significantly higher in females compared to males (female vs. male: 42.80% vs. 10.20%; OR = 6.583. 95% CI = 2.563,16.909; P < 0.0001). Age had no effect on the prevalence of UTI. Escherichia coli was the most prevalent isolate generally and in females, while Staphylococcus aureus was the predominant isolate causing urinary tract infection in males. The flouroquinnolones were the most active antibacterial agents. Conclusion: An overall prevalence of 39.69% was observed in this study. Females had a 3 to 17 fold increase risk of acquiring UTI, than their male counterpart. Escherichia coli were the predominant isolates causing UTI.

Intestinal parasitic infections are associated with morbidity and mortality worldwide. Data on prevalence of intestinal parasitic infection is sparse in rural Nigeria. Against this background, this study aimed at determining the prevalence of intestinal parasitic infections within a four year period in the rural community of Okada, Edo State, Nigeria. Fecal samples obtained from 1528 patients (consisting of 740 males and 788 females) presenting with signs and symptoms of gastroenteritis at the Igbinedion University Teaching Hospital, Okada were examined for presence of ova, cyst and trophozoites of parasites using standard methods. Patient’s age ranged from 6 months to 73 years. Study was conducted between 2007 and 2010. The prevalence of intestinal parasitic infections increased significantly (P=0.003) from 14.7% in 2007 to 22.5% in 2010. In the study period, gender did not affect the prevalence of intestinal parasitic infection (P>0.05). Patients within Ascaris lumbricoides was the most predominant parasitic agent, while Schistosoma japonicum was the least prevalent. With respect to parasite, males were observed to have consistently higher prevalence of Entamoeba histolytica infection. The prevalence of intestinal parasitic infection was observed to significantly increase from 2007 to 2010. Age was a risk factor for acquiring intestinal parasitic infection. Ascaris lumbricoides was the most predominant parasitic agent in all years of study. Control and prevention measures are advocated.

Background: Breastfeeding is an established mode of transmission of human immunodeficiency virus (HIV) infection resulting in clash between socio-cultural values and medical practice. Aims: This study aims to determine the effect of post-natal maternal antiretroviral therapy on transmission of HIV through breastfeeding. Patients and Methods: A total of 318 pregnant women were followed from pregnancy to 6 months post- partum. The women were divided into breast-fed and those who did not breast-feed, while the breast-fed were further divided into those on antiretroviral (ARV) and those not on ARV. After 6 months post-partum, dried blood spots were collected from infants born to these women and tested for HIV using polymerase chain reaction. Results: Generally, breast-feeding had 4 to 13 fold increase risk of transmission of HIV to infants (OR =7.079 95% CI = 3.768, 13.300; P

Background : Wound infections are associated with increased morbidity and mortality. Objectives : To determine the prevalence, aetiology and susceptibility profile of bacterial agents of wound infection among in- and- out patients at a rural tertiary hospital in Nigeria, within a 5 year period. Methods : Wound swabs collected from 156 out-patients and 353 in-patients were, cultured and microbial isolates identified using standard methods. Antibiotic susceptibility testing was done on bacterial isolates. Results : The prevalence of wound infection in 2006, 2007, 2008, 2009 and 2010 was 71.4%, 76.2%, 74.5%, 61.5%, and 67.0% respectively. The overall prevalence of wound infection was 70.1%. In all the years studied, out-patients had a higher prevalence of wound infection, but this was significant in 2007, 2009, and 2010 only. Staphylococcus aureus was the most prevalent pathogen in both in- and out - patients with the exception of 2009 where both Staphylococcus aureus and Pseudomonas aeruginosa had the same prevalence (24.4%) among in - patients. The flouroquinolones were the most potent antimicrobial agents against bacterial isolates from both in – and out –patients. Conclusions : Staphylococcus aureus was the most predominant etiologic agent of wound infection among in and out patients. A generally higher resistance pattern was observed among nosocomial bacterial pathogens. Prudent use of antibiotics is recommended. Keywords : prevalence, wound infection, antibiotic resistances, rural community, Nigeria

The Human immunodeficiency virus (HIV) and malaria are two of the world’s most formidable pathogens. Coinfection has been shown to amplify the effects of both diseases with HIV infection enhancing the severity of malaria. Previous work in our laboratory has shown that individuals infected with malaria and HIV who are taking anti-retrovirals have the Plasmodium parasite in their bloodstream suggesting that the lack of anti-malarials in their drug regimen resulted in Plasmodium infection. In this study, we set out to determine the status of Plasmodium infection in a cohort of patients taking both anti-malarial and anti-retroviral drugs. Blood samples were collected from patients of the Edo district of Nigeria in Benin City co-infected with Plasmodium and HIV. We have found that 31 out of the 317 (9.78%) HIV patients on HAART and ACT had Plasmodium in their blood based on microscopic counts. Surprisingly, using the polymerase chain reaction (PCR), the prevalence was at 25.6% for Plasmodium. In addition, we have identified by PCR that Plasmodium falciparum is the only species infecting these patients. Furthermore, no significant relationship was found to exist between CD4+ T-cell counts and malarial infections (CD4 count

Background: Malaria and HIV diseases kill millions of people yearly, and they are the scourges of developing nations. This study was conducted to determine the coinfections of malaria and HIV, and the effect of demographic characters on HIV-infected patients receiving highly active antiretroviral therapy (HAART) in Kogi State, Nigeria. Methods: Five hundred and eleven participants consisting of 411 (51 males and 360 females) HIV-infected patients on HAART and 100 (8 males and 92 females) apparently healthy HIV-noninfected individuals who served as controls were enrolled in this study. Blood sample was collected from each participant and malaria was diagnosed using the standard procedure. Results: An overall prevalence of 7.8% and 2% of malarial infection was observed in HIV-infected patients on HAART and non-HIV participants, respectively. The prevalence of malaria among HIV patients on HAART differed signifi cantly (P Conclusion: Diagnosis of malaria among HIV patients on HAART is advocated.

Plasmodium falciparum infection is endemic in most tropical countries and will definitely infect Human Immunodeficiency Virus (HIV) positive patients living in this region at one time or the other during the course of their infection. This study was conducted to determine the prevalence of malaria infection in HIV-infected patients on highly active antiretroviral therapy in Benin City, Nigeria.A total of 285 (84 males and 201 females) adults attending the hospital were enrolled in this study between July 2010 and June 2011. Blood specimens were collected from each participant and processed for CD4 counts, P. falciparum detection and hemoglobin concentration using standard procedures. The software INSTAT (GraphPad Software Inc., La Jolla, CA, USA) was used for all statistical analyses.A total of 6 (2.11%) out of 285 HIV infected patients on Highly Active Antiretroviral therapy (HAART) treatment had malaria and anemia. CD4 count200 cells/microl was significantly associated with P. falciparum infection with odd ratio estimate of 11.61 (95% CI: 2.06, 65.48; P0.004). Anemia was significantly associated with asymptomatic malaria infection among HIV patients on HAART with an odd ratio of 16.47 (95%: CI: 0.919, 295.5; P = 0.021).The study reveals a low prevalence of asymptomatic malaria among HIV patients on HAART. Measures to reduce malaria infection and anemia among HIV patients on HAART are advocated.

Background: Frequent exposure to premium motor spirit (PMS) is common and could be a risk factor for liver dysfunction in those occupationally exposed. A possible association between PMS fumes and plasma total antioxidant status as well as plasma levels of zinc, manganese, copper and selenium using a rodent model could provide new insights into the pathology of the liver where cellular dysfunction is an established risk factor. Aim: This study aimed to determine the total antioxidant status and plasma levels of zinc, copper, selenium and manganese in those occupationally exposed using rodent model. Materials and Methods: 25 albino Wistar rats of both sexes were used for this study. The animals were divided into five groups of five rats in each group. Group 1 rats were not exposed to PMS fumes (control group), group 2 rats were exposed for 1 hour daily, group 3 for 3 hours daily, group 4 for 5 hours daily and group 5 for 7 hours daily. The experiment lasted for a period of 4 weeks. Blood samples obtained from all the groups after 4 weeks of exposure were used for the determination of plasma total antioxidant status as well as plasma levels of zinc, manganese, copper and selenium. Results: Results showed significant increases in means of plasma copper (69.70±0.99 for test and 69.20±1.02 for control, P < 0.05) and selenium (72.70±1.58 for test and 68.20±0.86 for control, P < 0.05) in the exposed rats when respective mean values were compared with those of corresponding controls. Mean body weight index (BWI) and percentage weight increase (PWI) were significantly lower (P < 0.05) in exposed rats when compared with the unexposed group. The mean plasma levels of zinc (137.40±4.06 for test and 147.80±2.52 for control) and manganese (65.75±1.02 for test and 70.00±0.71 for control) showed significant decrease (P < 0.05) when compared with control. Plasma level of total antioxidant status (TAS) did not differ significantly in exposed rats when compared with the control group. Conclusion: This study showed that frequent exposure to PMS fumes may lead to increase plasma levels of copper and selenium probably due to liver dysfunction and decrease in plasma levels of zinc and manganese probably as a result of interference in their metabolic pathway of the exposed groups.

Background : Otitis Media continues to be a major presentation in the ear, nose and throat clinic. Aim : This study aimed to isolate, characterize and identify the bacteriological and mycological etiologic agents of otitis media in Benin city. Patients and Methods : Ear discharge from 569 (299 males and 270 females) patients diagnosed clinically of otitis media between August 2009 and August 2010 were processed to recover the bacterial and fungal etiologic agents. Susceptibility test was performed on all bacterial isolate. Result : Pseudomonas aeruginosa (28.3%) was the predominant bacteria isolate causing otitis media followed by Staphylococcus aureus (21.0%), Klebsiella sp (8.9%), Proteus sp (8.2%), Alkaligenes spp (4.3%), Streptococcus pneumoniae (3.9%), Escherichia coli (3.0%) and Citrobacter freundi (1.7%). Fungi isolated were Aspergillus niger (9.2%), Candida albicans (5.4%), Candida tropicalis (3.0%), Aspergillus flavus (2.1%) and Candida parasilopsis (1.5%). 413 had a single organism isolated from the middle ear culture while twenty (3.51%) patients had mixed organisms isolated. Infection was highest among 0 - 5 years, and lowest among aged 18 - 23. All bacterial isolates were poorly susceptible to the antibacterial agents. Conclusion : The study uncovers a high frequency of bacteria associated otitis media with the finding of fungi too as a significant etiologic agent.

Background: Human immunodeficiency virus (HIV) prevalence is high among rural dwellers and pregnant women. Aims: This study aims to determine the prevalence of HIV and anemia among pregnant women attending antenatal clinic in rural community of Okada, Edo State, Nigeria. Patients and Methods: Anticoagulated blood and sera samples were obtained from 480 women consisting of 292 pregnant and 188 non-pregnant women. Antibodies to HIV were detected in the sera samples and hemoglobin concentration of the anticoagulated blood specimens were determined using standard techniques. Anemia was defined as hemoglobin concentration