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Nosocomial infections or Health Care-Associated Infections (HCAIs) occur due to prolonged hospital stay and has been implicated in antimicrobial resistance, and an increase in socio-economic disturbance, long term disability, and increased mortality rate. There is paucity information on the burden of HCAIs because of poorly developed surveillance systems and inexistent control methods. We aimed to investigate the prevalence of nosocomial infection due to prolonged hospital stay in selected tertiary hospitals of Kano metropolis. Retrospective data were collected from three hospitals with a total number of admitted patients and the number of prolonged hospital stays during the month of study. A total of 401 clinical samples collected from patients admitted for ≥ 14 days and the age of ≥ 18 years from all study sites. Examples include wound swabs, urine samples, urine catheters, and nasal intubation. All the samples were processed by the standard bacteriological laboratory procedure of the Clinical laboratory standard institute. The results showed that the percentage of prolonged hospital stay reveals that in Kano 40.34%, Murtala Muhammad Specialist Hospital (MMSH) 50.54% with the least at Muhammad Abdullah! Wase Specialist (MAWSH) 28.91%. Age served as significant factors for acquired HCAIs; participants aged were 41 -- 70 years have a higher prevalence of nosocomial infections. From 138 positive isolates observed, Murtala Muhammad Specialist Hospital (MMSH) has height nosocomial infection of 41.4%, with the least Aminu Kano Teaching Hospital (AKTH) has 29%. Among the Site of infection, 34.8% isolates were wounds Swabs (SSIs), urine (UTI) 31.2%, and least was nasal intubation 11.6%. Among pathogens isolated E. coli is the most prominent organism with 26.1% and the least Streptococcus pyogenes (7.9%). This study showed that the prevalence of Prolong hospital stay in Kano was 40.34%, AKTH 39.53%, MMSH50.50%, and MAWSH 28.91%. The prevalence of nosocomial infection was 34.3%. Gram-negative bacteria were the predominant isolates. [ABSTRACT FROM AUTHOR]

Malaria and typhoid fever are among important and endemic diseases in the tropical countries such as Nigeria. Diagnosis of most cases of malaria/typhoid co-infections are based on clinical suspicion alone or unreliable diagnostic tools leading to poor or misdiagnosis. A retrospective analysis was conducted on the positivity rate for malaria parasite and typhoid fever among patients who attended the Bayero University, Kano (BUK) Health Clinic from January to December 2013. A prospective study was also carried out on 200 febrile patients and 80 apparently healthy subjects (controls) with the view to determine the diagnostic profiles of malaria and/or typhoid fever co-infection using standard protocols (microscopy, rapid diagnostic test (RDT) for malaria parasite (MP), Widal test, stool and blood cultures for typhoid fever). Both test and control subjects were evaluated for the presence or otherwise of the malaria and/or typhoid aetiologic agents. Results obtained from the retrospective study for the period January to December 2013 indicated that, of the 2362 tests conducted, 318 (13.5%) were positive for MP using RDT and 722 (30.6%) were positive for typhoid fever using Widal test. Co-infection rate obtained was 89 (3.8%). Of the 200 subjects evaluated for the prospective study however, 42 (21%) and 34 (17%) were positive for MP using microscopic technique and RDT respectively. Microscopy was established to be more sensitive than RDT. Eighty nine (45%) were Widal positive. The culture method for typhoid fever diagnosis was negative. Co-infection rate stood at 17 (8.5%). No association however was found between the two disease conditions (p=0.6032). Significant proportion of the patients 86 (43%) were neither positive for malaria nor for typhoid fevers. Three isolates of non-typhoid salmonella specie and three other bacterial isolates were recovered from the stool and blood samples of the patients respectively. Baseline titre value for Widal test at BUK community was established as 160 and above for O antibodies to S. typhi, hence the criterion employed in the prospective evaluation. Laboratory evidence of malaria and typhoid co-infection rate at a titre of =160 was 8.5% using microscopy and 7% using RDT. The use of RDT is simple and easy, but has less sensitivity, thus may leave some patients with malaria un-detected. Based on the results of these findings, vis a vis the proportion of individuals negative for both malaria and typhoid fevers, clinicians should revisit causes of febrile illnesses other than malaria or typhoid and hence the need to include other tests for the detection of other causes. [ABSTRACT FROM AUTHOR]

Cervical cancer is the most common female cancer in northern Nigeria, yet the pattern of infection with human papillomavirus, the principal aetiologic agent is unknown. This was a preliminary study conducted in two referral hospitals in order to establish base-line data on the prevalence and risk factors for the infection in Kano state, Nigeria. Fifty (50) randomly selected women aged 18 years and above were recruited from gynaecology clinics in Murtala Muhammad Specialist Hospital and Aminu Kano teaching Hospital. Relevant sexual and socio-demographic information were obtained from each subject using a questionnaire. Exfoliated cervical cells were harvested and processed using Polymerase Chain Reaction to identify the DNAs of high-risk HPV types 16 and 18. The prevalence rate of HPV infection was 76% [(38/50) at 95% CI=61.8-86.9] with 60.5% (23/38) having co-infections with both HPV type 16 and 18. Risk factors of the infection include low literacy level; living in rural settlements; low parity; early menarche (<15 years of age); early onset of first sexual intercourse (⩽16 years of age) and multiple sexual partners. There was however, no statistically significant association between oral contraceptive usage and acquisition of the infections. Findings of this study suggest a high prevalence of HPV types 16 and 18 among women attending gynaecology clinic in Kano and thus called for more elaborate community based study in order to establish the magnitude of the problem from wider perspective. [ABSTRACT FROM AUTHOR]

This study compared the value of pigment containing leucocytes (neutrophils and monocytes) counts and the malaria parasite density in the prognosis of severe malaria on four hundred and twenty (420) patients with clinical evidence of severe malaria in Kano-Nigeria. Three clinical groups comprising patients with impaired consciousness, patients with cerebral malaria and those with severe anaemia were identified. Samples were analysed for Malaria parasitemia and pigment count Giemsa's thick and Leishman's thin film respectively. Patients with impaired consciousness (n=217) recorded the highest malaria pigment count of 342.86 (±177.34) monocytes pigments/microliter. The highest parasite count of 234,962 (±264.5) per microliter was recorded among the cerebral malaria group. Patients with severe malaria and anaemia had the least neutrophils pigment and parasite counts of 219.0 (±140.96)/microliter and 212,232(±12.61)/microliter respectively. A linear relationship between the malaria parasite count and the Intraneutrophilic malaria pigment count in severe malaria was demonstrated. Pigment count proved a higher prognostic value in severe malaria compared to Parasitaemia. [ABSTRACT FROM AUTHOR]

The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is a new virus that is responsible for COVID-19, a disease that complicate health conditions and results in death. The total diversion of attention of government and health care workers (HCWs) to prevent the escalation of the pandemic disease has placed a great barrier to diagnosis and treatment of other illnesses that share common symptoms with COVID-19, and that has consequently enabled the endemic practice of self-antimicrobial medication to increase in Nigeria. Development of secondary infections in COVID-19 and in other conditions, caused by antibiotic resistant pathogens could make them more deadly now or in the future. The mitigation strategies adopted in Nigeria and its States, which include enforcing social distancing, partial or total lockdown, and restricting access to health care facilities for non COVID-19 patients, have further increased the demand of antimicrobial agents from unauthorized outlets in communities for inappropriate use. A cross-sectional survey of 162 randomly selected individuals that visited medical stores and 170 medical store owners to evaluates the level of self-medication with five oral broad spectrum antibiotics and antimalaria during the lockdown revealed an increase (68.5%) in practice of self-medication with at least one of the antimicrobial and emergence of new abusers. Blind treatment of symptoms of malaria and common cold without diagnosis and health care consultation was nearly 100%. Irrational use of sanitizers, disinfectants and other cidal agents that can fuel antimicrobial resistance has drastically increased in communities. Exposure of microorganisms in the environment without caution to large volume of fumigants is increasing on daily basis. We strongly recommend that while mitigating SARS-CoV-2 virus spread, efficacious and feasible technological, social, economic and behavioral interventions that will also control the evolution and spread antimicrobial resistant microorganisms should be applied., Competing Interests: The authors declare no competing interest., (Copyright: Ibrahim Yusuf et al.)

The Nigerian Government is scaling up the distribution of insecticide-treated bed nets for malaria control, but the lack of surveillance data, especially in the Sudan/Sahel region of the country, may hinder targeting priority populations. Here, the vectorial role and insecticide resistance profile of a population of a major malaria vector Anopheles funestus sensu stricto from Sahel of Nigeria was characterised. An. funestus s.s. was the only vector found, with a high human blood index (100%) and a biting rate of 5.3/person/night. High Plasmodium falciparum infection was discovered (sporozoite rate = 54.55%). The population is resistant to permethrin (mortality = 48.30%, LT 50 = 65.76 min), deltamethrin, DDT (dichlorodiphenyltrichloroethane) and bendiocarb, with mortalities of 29.44%, 56.34% and 54.05%, respectively. Cone-bioassays established loss of efficacy of the pyrethroid-only long-lasting insecticidal nets (LLINs); but 100% recovery of susceptibility was obtained for piperonylbutoxide (PBO)-containing PermaNet ® 3.0. Synergist bioassays with PBO and diethyl maleate recovered susceptibility, implicating CYP450s (permethrin mortality = 78.73%, χ 2 = 22.33, P < 0.0001) and GSTs (DDT mortality = 81.44%, χ 2 = 19.12, P < 0.0001). A high frequency of 119F GSTe2 mutation (0.84) was observed (OR = 16, χ 2 = 3.40, P = 0.05), suggesting the preeminent role of metabolic resistance. These findings highlight challenges associated with deployment of LLINs and indoor residual spraying (IRS) in Nigeria.

Introduction: Superbugs are pathogenic micro-organism and especially a bacterium that has developed resistance to the medications normally used against it. As the superbug family increases, the need for appropriate diagnostic, treatment, prevention and control strategies cannot be over emphasized. Therefore, this work determined the distribution of superbug bacteria among patients on prolonged hospital admissions in three tertiary hospitals of Kano state, Nigeria., Methods: A descriptive cross sectional study was undertaken among 401 patients from medical, surgery, orthopedic and burn centre wards in a three tertiary hospitals in Kano state. A sample collected comprises wound/pus, urine, urine catheter and nasal intubation and were analysed using standard microbiological methods for Acinetobacter spp and other related nosocomial bacterial pathogens. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method., Results: One hundred and thirty eight (138) isolates were recovered, from the studied participants. More than 80% of the nosocomial infections (NIs) were caused by Gram-negative bacteria, predominantly Escherichia coli, Klebseilla spp, Proteus spp, Pseudomona spp and Acinetobacter spp. In-vitro antibiotic susceptibility test revealed that acinetobacter were 100% resistant to amoxicillin, co-trimoxazole, perfloxacin and imipenem., Conclusion: Superbugs (Acinetobacter species) significantly contributed to delayed hospital admissions through observed 100% resistance to used antibiotics. The healthcare managers of these hospitals and the ministry of health need to take measures against this resistant bacteria ( Acinetobacter spp) especially on prescribing antibiotics that showed 100% resistant from these studied hospitals., Competing Interests: The authors declare no competing interests.

Background: Studies in northern Nigeria have suggested a linear relationship between urinary schistosomiasis and individual water-related activities. Knowledge of the perceptions of the local populace about schistosomoasis and of gender and cultural restrictions could be beneficial to control programmes. We studied the prevalence of urinary schistosomoasis and the socio-demographic factors associated with the disease in Danjarima community of Kano, northern Nigeria., Methodology: A cross-sectional survey involving 890 subjects was conducted in the community. Urine samples were collected and examined for ova of Schistosoma haematobium using sedimentation technique. A semi-structured questionnaire was administered to the subjects in order to determine their knowledge and perceptions about urinary schistosomiasis in relation to their cultures., Results: Eggs of S. haematobium were demonstrated in 370 (41.6%) of the urine sampled examined. The highest prevalence rate of 54.4% infection with S. haematobium was recorded in Zaura sub-village while the lowest rate of 6.4% was observed in Sabon-Fegi. More males (55.9%) were infected than females (3.7%) and the difference between the infection rate in males and females was statistically significant (P

Background: The World Health Organization (WHO) has recommended the integration of malaria microscopy quality assessment (QA) with that of other microscopically diagnosed diseases, but there is no evidence that it has been attempted. We assessed the feasibility of linking malaria microscopy into the existing tuberculosis (TB) microscopy QA system in Kano, Nigeria., Methodology: Five TB microscopy centres were selected for implementing the integrated TB and malaria microscopy QA scheme in the state. A model system was designed for selecting and blinded rechecking of TB and malaria slides from these laboratories. Supervision and evaluation was conducted at 3-month intervals for 24 months., Results: TB microscopy QA was strengthened in four laboratories. Full integration of the QA for TB and malaria microscopy was achieved in two laboratories, and partial integration in two other laboratories. The programme resulted in an increase in the specificity of both TB and malaria microscopy results. At the final assessment, 100% specificity was achieved for TB microscopy results in four laboratories. There was an increased concordance rate and decreased false positivity and false negativity rates of TB microscopy results in all five laboratories., Conclusions: It is feasible to integrate the QA system and training for TB and malaria microscopy for assessing and improving quality of both services. However, the integrated system needs testing in different settings in order to be able to develop sound recommendations to guide the complex scaling-up process.

Objectives: The study examined the factors associated with recurrent cholera epidemics in Kano State of Northern Nigeria, the management of the epidemics and health outcomes., Methods: Using epidemiological data from the Public Health Department of the Kano State Ministry of Health, the study examined the frequency and geographical distribution of the epidemics for the period 1995 to 2001; procedures for detection; control measures as well as results of biological and bacteriological testing of water from different sources. Mapping and testing for significance of faecal contamination of water sources were done., Results: The number of cholera cases in the city was 2 630; 847 and 2 347 in 1995/6, 1997 and 1999 respectively. The State Epidemiological Unit which is responsible for surveillance detected epidemics using set thresholds and activated multi-sectoral emergency responses. Control measures encompassed accurate diagnosis at the reference laboratory, Kaduna; registration of cases; case management and public health measures targeting personal hygiene and water treatment. The cholera epidemics attracted worldwide attention with emergency responses from many agencies including WHO, UNICEF and Medicens Sand Frontiers (MSF). Case fatality rates decreased from 15% in 1995/6 to 5% in 1997 and 2% in 1999. The organism responsible for all the outbreaks was Vibrio cholerae, el-tor of inaba serotype. Water contamination of all sources was the principal cause of the epidemics. There were statistically significant differences in levels of faecal contamination of water sources, wells being most affected, followed by piped water, chi2 = 11.556, (p < 0.02). Bore holes were relatively safer sources of water. Point source epidemics always started from Kano City before fanning out to the rest of the State., Conclusion: Multi-sectoral Epidemic Preparedness and Response (EPR) approaches have contributed to the reduction in case fatality rates over the years and should be sustained. However, in order to prevent future cholera epidemics, there is need to introduce intervention measures that address the root problems of poor sanitation and unsafe water supplies.