Medical Microbiology & Parasitology

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Cryptococcal Meningitis in a newly diagnosed AIDS patient: a case report
(West African College of Physicians and West African College of Surgeons, 2009) Salami, A. K.; Ogunmodede, J. A.; Fowotade, A.; Nwabuisi, C.; Wahab, K. W.; Desalu, O. O.; Fadeyi, A.
"BACKGROUND: Cryptococcus neoformans is a very important cause of fungal meningitis in immunosuppressed patients OBJECTIVE: To describe a case of cryptococcal meningoencephalitis in an HIV/AIDS patient from the University of Ilorin Teaching Hospital. METHODS: An 18 -year -old male student presented with cough, weight loss, and fever. He was clinically assessed and had full laboratory investigations including cerebrospinal fluid CSF and then started on chemotherapy. Both the clinical and neurological evaluation of the patient was described along with the laboratory analyses of his CSF. Outcome of how he was managed was also reported. RESULTS: Cryptococcus neoformans presented as an AIDS defining fungal infection for the first time in this 18 year old undergraduate who was infected probably from transfusion of unscreened blood He had advanced HIV infection (CD4+ count of 29cells/ul) and severe cryptococcal meningoencephalitis. He was unsuccessfully managed with fluconazole, a second choice drug for this condition, amphotericin B being not available. CONCLUSION: Nigerians should have access to effective blood transfusion services at all public and private hospitals across the country. The National Essential Drug list should be expanded to include drugs such as amphotericin B which hitherto were considered exotic.
A review of swine Influenza: an emerging pandemic
(African Journals Online, 2009) Fowotade, A.; Agbede, O.; Nwabuisi, C.; Fadeyi, A.
An unprecedented epizootic swine Influenza A (HINT) virus that is highly pathogenic has crossed the species barrier in Mexico to cause many human fatalities and poses an increasing pandemic threat. This summary describes the aetiopathogenesis of human infection with Influenza A (HINI) and reviews recommendations for prevention and clinical management.
Lassa fever: another infectious menace
(African Journals Online, 2009-09) Adewuyi, G. M.; Fowotade, A.; Adewuyi, B. T.
Nigeria is presently suffering from another Lassa fever epidemic. This was confirmed in the statement of the Minister of Health of the Federation in which he said, “There has been an upsurge in the reported cases of Lassa fever since the beginning of this year, especially in the Federal Capital Territory and its environs. Within two weeks, 12 cases with five deaths due to the disease were recorded. 25 contacts are confirmed by laboratory investigations to have been infected, including 4 health staff working in the National Hospital, Abuja.”1 Lassa fever is an acute viral haemorrhagic fever first described in 1969 in the town of Lassa in Borno state, Nigeria.2 It is endemic in West African countries, and causes 300,000 cases annually with 5000 deaths.3 Lassa fever epidemics occur in Nigeria, Liberia, Sierra Leone, Guinea and the Central African Republic.4 Lassa virus, the agent of the disease is a member of the Arenaviridae family. The virus is pleomorphic with single-stranded and bisegmented RNA genome.3 Its primary host is Natal Multimammate Mouse (Mastomys natalensis). Transmission to man occurs via exposure to the rat excrement through respiratory or gastrointestinal tracts5, exposure of broken skin or mucus membrane to infected material, direct contact, sexually and transplacentally. The prevalence of antibodies to the virus is 8-22%9 in Sierra Leone, 4-55% in Guinea,12 and 21% in Nigeria.13 The disease is mild or asymptomatic in 80% of infected people, but 20% have a severe multisystemic disease. Clinical features are difficult to differentiate from that of other viral haemorrhagic fevers and common febrile illness such as Malaria, Typhoid fever and so on. Definitive diagnosis is by viral isolation, Antigen and Antibody detection and Reverse Transcriptase PCR. Treatment is with Ribavirin, an antiviral agent. No vaccine is currently available. Prevention is by keeping rats away from homes.
Factors influencing students' performance in medical microbiology in Univeristy of Ilorin, Ilorin, Nigeria
(Core publishers, 2010) Odimayo, M. S.; Nwabuisi, C.; Fadeyi, A.; Fowotade, A.; Olorundare, S. A.
Excellent performance by students, in any discipline, depends on a number of factors. We determined teachers and students' factors influencing students' performance in Medical Microbiology, using University of Ilorin Medical programme as a case study. Medical students who had completed at least 2 postings in pathology were selected and interviewed using a self administered questionnaire. A total of 173 students were interviewed among which 119 (68.8%) were males while 54 (31.2%) were females. Majority of the students (81.5%) believed that Medical Microbiology lecturers have the required professional teaching qualities, 82.1% also agreed that the lecturers were interested in their subject. However, 60.4% agreed that the lecturers use poor teaching methods and 55.5% agreed that lecturers teach Microbiology in abstract terms. Cultism and social activities (53,9%), Students' failure in scheduling their time wisely (64.7%), failure to take their practical session seriously (55.5%) and lack of appropriate books (69.9%) affected students' performance negatively. From our study, it was discovered that the use of poor teaching methods, excessive work load and failure of students to manage time appropriately were major factors negatively influencing Medical student's performance in: Medical Microbiology while lecturer's qualification and interest would affect their performance positively in the same subject if properly harnessed. For optimal performance, we recommend the reorganization of pathology training programme to include lectures enhanced with multimedia projection and illustrations, laboratory rounds, role play, teaching rounds and Tutorials.
Reliability of urine multistix and Gram stain in the detection of asymptomatic Bacteriuria in pregnancy
(West African College of Physicians and West African College of Surgeons, 2010) Ajayi, A. B.; Nwabuisi, C,; Aboyeji, A. P.; Fowotade, A.; Fakeye, O. O.
BACKGROUND: Urinary tract infection is a common problem during pregnancy. Asymptomatic bacteriuria can cause the development of serious complications affecting both the mother and foetus. Urine culture, the traditional screening test is relatively expensive, time consuming and requires a microbiology laboratory and trained staff. However simpler, less expensive tests which include urine multistix and urine gramstain better suited for developing countries are available. OBJECTIVE: To determine the sensitivity, specificity and predictive values of multistix nitrite, leucocyte esterase (LE) and urine gram staining for asymptomatic bacteriuria in pregnancy. METHODS: A cross-sectional study was carried out from 1st July to 31st October 2007, at the University of Ilorin Teaching Hospital (UITH) on 125 consenting asymptomatic pregnant women. A structured proforma was used to collect information from the women and a midstream urine specimen collected in two sterile bottles. One was tested with Multistix for the presence of nitrite and leucocyte esterase and the other for bacteriological culture and urine gram stain. RESULTS: Using the gold standard of urine culture, the sensitivities of Multistix nitrite and leucocyte esterase were each 14% and the specificity 100% and 96% respectively. Urine gram stain had a sensitivity of 98% and a specificity of 74.7%. CONCLUSION: Multistix"" nitrite and leucocyte esterase are not sufficiently sensitive to be used as a screening tool for asymptomatic bacteriuria. Urine gram stain can be used in areas where facilities are inadequate for culture but cannot replace it. More studies are required to determine the accuracy of urine gram-stain.
Why is there still Rabies in the world? An emerging microbial and global health threat
(IDOSI Publications, 2010) Okonko, I. O.; Adedeji, O. B.; Babalola, E. T.; Fajobi, E. A.; Fowotade, A.; Adewale, O. G.
This review reports on why is there still rabies in the world?-an emerging microbial and global health threat. Rabies remains an important public health issue in the world. While rabies has been controlled throughout most of the developed world, it remains a significant burden in developing countries, particularly in Africa and Asia. Although industrialized countries have been able to contain recent outbreaks, many resource-limited and transitioning countries have not been able to react adequately. Although, a vaccinepreventable disease, the annual number of human deaths caused by rabies is estimated to be 35,000 per year, mostly in Africa, Asia and Latin America. Though, dogs have been identified as being primarily responsible for the transmission of rabies in human and other domestic animals, known pathogenesis and available data suggest that all or nearly all cases of human rabies attributable to bats were transmitted by bat bites that were minimized or unrecognized by the patients. One of the key for controlling rabies is to focus on the animal reservoir. The high incidence of rabies in some country led to numerous concerns attributed to a potential carrier-dog phenomenon, undocumented transmission of rabies virus from wildlife to dogs, counterfeit vaccines, vaccine mismatching and seroconversion testing in patients after their completion of postexposure prophylaxis. However, the number of reported human rabies cases, particularly in Africa, greatly underestimates the true effects of the disease. Contributing factors include failure to seek treatment at healthcare facilities, failure to make a laboratory diagnosis and failure to report the disease. The disconnection between human and dog rabies in developing world reflects a lack of awareness of the concept of one medicine, or health without regard to species, in approaches to rabies control in the public health system. Another factor contributing to the endemicity of rabies in the world could be attributed to low vaccine coverage. Although there are many factors that contribute to the epidemic or endemic nature of rabies in the world, the single most important factor is the failure to immunize domestic dogs, which transmit rabies to humans. Regional and local disease resurgence occurs, due in part to a combination of political and economic instability, environmental perturbations and shifting government priorities. Indeed rabies is a widely distributed zoonotic disease of major public-health importance and an emerging as well as re-emerging microbial and global health threat but a preventable problem. Surveillance strategies for rabies and other rabies-ralated viruses in the world, particularly Africa must be improved to better understand the epidemiology of this virus and to make informed decisions on future vaccine strategies.
Methicilin resistant Staphylococcus aureus carriage amongst healthcare workers of the critical care units in a Nigerian hospital
(Science Publications, 2010) Fadeyi, A.; Bolaji, B. O.; Oyedepo, O. O.; Adesiyun, O. O.; Adeboye, M. A. N.; Olanrewaju, T. O.; Aderibigbe, A.; Salami, A. K.; Desalu, O. O.; Fowotade, A.; Nwabuisi, C.; Akanbi, A. A.; Raheem, R. A.; Olalere, A.
Problem statement: Methicilin Resistant Staphylococcus Aureus (MRSA) Nosocomial Infection (NI) outbreaks and prevalence among various populations are well reported in literature particularly for developed countries. NI due to MRSA is a known cause of increased hospital stay, cost, morbidity and mortality especially among the critically ill. There is paucity of information on MRSA in developing nations including the carriage by critical healthcare givers who are potential transmitters. In most hospital in developing countries like Nigeria, there is neither surveillance system or control policy for MRSA. Approach: We screened healthcare workers in the critical care units of the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria for MRSA and determined vancomycin susceptibility of the isolates. Swabs of both anterior nares and web spaces of the hands were taken, transported and incubated in Tween 80 at 35°C overnight aerobically before inoculation onto Mannitol Salt Agar (MSA). Inoculated MSA were incubated aerobically at 35°C for 18-24 h. Staphylococcus aureus was identified as Gram positive cocci with positive catalase, coagulase and DNAse test. MRSA were identified by combined oxacillin and cefoxitin discs diffusion method. Sensitivity to vancomycin was by vancomycin discs diffusion and vancomycin agar screen plating. Results: Of the 198 healthcare workers screened, 104 had MRSA either in the nose, hand or both giving a carriage rate of 52.5%. Nasal carriage (38.9%) was higher than hand (25.3%). Doctors (22.7%) and Nurses (16.7%) were the predominant carriers. MRSA isolates were resistant to commonly available antibiotics. Only 1 (1.3%) of the nasal isolates was vancomycin resistant. Conclusion: MRSA carriage among healthcare workers in the critical care units of the Nigerian hospital is high with doctors and nurses being the major carriers. The MRSA isolates were multi-drug resistant which may lead to increased morbidity and mortality if transmitted to the critically-ill. There is need for MRSA control policies in hospitals with settings of our type.
Methicillin resistant staphylococcus aureus: awareness, knowledge and disposition to screening among healthcare workers in critical care units of a Nigerian hospital
(West African College of Physicians and West African College of Surgeons, 2011) Fadeyi, A.; Adeboye, M. A. N.; Fowotade, A.; Nwabuisi, C.; Bolaji, B. O.; Oyedepo, O. O.; Adesiyun, O. O.; Olanrewaju, T. O.; Aderibigbe, A.; Salami, A. K.; Desalu, O. O.; Akanbi II, A. A.; Raheem, R. A.; Olalere, A.
BACKGROUND: Awareness level about methicillin resistant Staphylococcus aureus (MRSA) is high in the western world but the status in developing countries is not well defined. OBJECTIVE: To assess MRSA awareness level, knowledge and disposition to screening among critical healthcare givers (HCGs) in Nigeria. METHODS: A self-administered questionnaire was used to assess the level of awareness and knowledge of HCGs in critical care units of the University of Ilorin Teaching Hospital, Ilorin, Nigeria on MRSA and their willingness to submit to screening. RESULTS: Only 103 (52.0%) of the 198 participants were aware of MRSA but all were favourably disposed to screening for the organism. Awareness was through hospital rounds 65(63.1%) and journals/ textbooks 35(34.0%), and Many, 120 (60.6%) considered MRSA as a threat in the hospital, while only 27 (13.6%) thought otherwise and 51(25.8%) were indifferent. Most HCGs, 124 (87.9%) reported that there were no MRSA control measures in their respective duty post. The age, cadre of work, and number of years in the hospital’s critical care units correlated positively with awareness level. CONCLUSION: Methicillin resistant Staphylococcus aureus awareness level among the HCGs in our hospital is just a little above 50.0% with substantial proportion of them not realizing the medical implication of the organism. However, majority are well disposed to MRSA screening. Inadequate publicity is a major contributor to poor knowledge and awareness. There is need for educational intervention and sensitization programs on MRSA and other infection control techniques for HCGs in developing nations especially Nigeria.
Awareness and practice of safety precautions among healthcare workers in the laboratories of two public health facilities in Nigeria
(Wolters Kluwer Medknow Publications, 2011) Fadeyi, A.; Fowotade, A.; Abiodun, M. O.; Jimoh, A. K.; Nwabuisi, C.; Desalu, O. O.
Aims and objectives: To determine the level of awareness and practice of SP among laboratory workers at two tertiary public health facilities in Nigeria. Methods: A semi-structured, self-administered questionnaire was used to assess the awareness, attitude and adherence to SP among laboratory workers. Information on the availability of safety equipment was also sought. The laboratory safety practice of respondents was assessed based on self-reported observance of basic principles of universal precautions in clinical settings. Results: Study participants were 130, mean age: 28.2 years (SD±6.6), number of years in hospital employment: 3.7 years (SD±2.4) and the male to female ratio was 1.8:1. Many (41.5%) were unaware and 25.4% do not observe SP. Participants attest to availability of various safety devices and equipment including hand gloves (86.2%), disinfectants (84.6%), HBV immunization (46.2%) and post exposure prophylaxis (PEP) for HIV and HBV (79.6%).Attitude to safety is unsatisfactory as 60.0% eat and drink in the laboratory, 50.8% recap needles and 56.9% use sharps box. Even though 83.1% are willing to take PEP, only 1.5% will present self following laboratory injury. Conclusion: This study shows the deficit in the awareness of SP among laboratory personnel and demonstrates that attitude and practice of safety rules are unsatisfactory. Training and re-training on SP is therefore desired. Counselling to induce a positive attitudinal change on HBV immunisation and PEP is similarly necessary.
Cytomegalovirus in immunosuppressed patients: a silent and potential killer.
(African Journals Online, 2012) Fowotade, A.; Nwadike, V. U.
Cytomegalovirus (CMV) is a recognized cause of morbidity and mortality among immunocompromised individuals. This review will concentrate on understanding the pathogenesis, clinical manifestations and laboratory diagnostic options for CMV infection.
Survey of users’ perceptions of clinical microbiology laboratory services in Nigeria
(Oyo National Postgraduate Medical College of Nigeria, 2012) Efunshile, A. M.; Fowotade, A.; Makanjuola, O. B.; Oyediran, E. I. O.; Olusanya, O. O.; Koenig, B.
Background:The Clinical Microbiology laboratory is expected to adequately measure and monitor its performance by actively and routinely soliciting from its clients their level of satisfaction with services received and use the information to develop processes that meet customer’s needs. This survey was done in order to objectively identify some of the challenges faced by laboratory end users in Nigeria with a view to proffering feasible solutions to such problems. Methods: Semi –structured, pre-tested Questionnaires administered to laboratory users in 2 teaching hospitals in Nigeria to find out their level of satisfaction with various aspects of laboratory services. One is a Federal Government hospital with 620 bed spaces and 7 full time Consultant Clinical Microbiologists while the other hospital is owned by State Government and has 280 bed spaces, 1 full time plus 2 visiting Consultant Clinical Microbiologists. Results: There is a general low level customer satisfaction observed in this study. Only 27.8% and 5.4% of respondents from UCH and LTH respectively agreed that laboratory user’s handbook was available while about 38.3% and 22.5% respectively agreed that laboratory turnaround time was satisfactory. Respondents from UCH and LTH who agreed that it was easy to obtain expert advice from Consultant Clinical Microbiologists were 45.1% and 20.2% respectively. About 94.7% and 88.8% of respondents from UCH and LTH respectively agreed that request forms were easy to fill while 76.7% and 68.5% respectively agreed that expert advice obtained from Consultant Clinical Microbiologists were helpful in the management of their patients. Discussion, conclusion and recommendation: The general low level of customer satisfaction observed from the 2 hospitals may be attributable to the general inadequate health workforce and infrastructure in Nigeria where the government spend only 6.4% of its annual budget on health which is far below expectation. The particularly lower level of customer satisfaction in LTH may be due to the fact that there is only one full time Clinical Microbiologist in the in the laboratory. These laboratories can make the best out of the situation at hand by improving their communication with the users so as to make them appreciate the actual cost of tests andtime required to generate results.
A rare case of Salmonella Typhi Meningitis in an eleven month old infant: a case report
(Association of Resident Doctors, University College Hospital, Ibadan, 2012) Nwadike, V. U.; Fowotade, A.; Tuta, K. E.; Olusanya, O. O.
Non-typhoidal Salmonella are infrequent causes of childhood meningitis. Most reports of Salmonella typhi meningeal infections are confined to neonates. A rare instance of S. typhi in an otherwise healthy eleven month old infant is being reported.
Asymtomatic bacteriuria in antenatal patients in Ilorin, NIgeria
(Oman Medical Specialty Board, 2012) Ajayi, A. B.; Nwabuisi, C,; Aboyeji, A. P.; Ajayi, N. S.; Fowotade, A.; Fakeye, O. O.
Objective: To determine the prevalence of asymptomatic bacteriuria, bacteriology and sensitivity pattern in Ilorin using the gold standard of urine culture. Methods: A prospective study was carried out from 1st July to 31st October 2007, at the University of Ilorin Teaching Hospital (UITH) on 125 consenting asymptomatic pregnant women. A structured proforma was used to collect information from the women and a midstream urine specimen collected for bacteriological culture. Results: Of the 125 pregnant women, 50 had bacteriuria on urine culture giving a prevalence of 40%. The mean age of the women was 28.5 years with a standard deviation of 4.95. The age ranged between 14 and 40 years. Staphylococcus aureus was the commonest pathogen isolated (72%), followed by Proteus spp (14%). Most of the organisms showed good sensitivity to Nitrofurantoin and gentamicin. Conclusion: The prevalence of asymptomatic bacteriuria in Ilorin is high and routine urine culture is advocated for all pregnant women at booking.
Utilization of Human papillomavirus (HPV) DNA detection for cervical cancer screening in developing countries: A myth or reality
(Academic Journals, 2013) Fowotade, A.; Manga, M. M.
Persistent infection by human papillomavirus (HPV) is considered to be the main causative agent of cervical cancer and other anogenital cancers. Of the more than 30 genotypes capable of infecting the anogenital tract, it is estimated that, worldwide, HPV 16 and 18 cause 70% of the cervical cancers. Control through primary prevention has become a distinct reality through a prophylactic vaccine, which may take quite some time for its widespread use. Thus control of cervical cancer through cervical screening strategy is the only viable solution now. Despite the high rates of false negative results associated with cervical cytology, it is still considered as the gold standard for cervical cancer screening in developing countries. The advent of highly sensitive and specific HPV DNA detection techniques has offered a lot of promise for cervical cancer prevention. The severe restriction on the availability of infrastructure, resources and funding in developing countries has made it difficult to adopt HPV DNA detection as a routine cervical cancer prevention strategy. This present discourse is a review of relevant literature using internet search engines such as; PubMed and Google. Due to the limitations of Pap smear, there is need to consider HPV DNA detection as a useful adjunct to Pap smear screening, in order to effectively control cervical cancer in developing countries.
Risk factors and outcome of Acinetobacter infection in the intensive care unit of a tertiary center in Oyo State, Nigeria
(Academic Journals, 2013) Nwadike, V. U.; Fayemiwo, S. A.; Fowotade, A.; Bakare, R. A.; Olusanya, O. O.
Acinetobacter plays an important role in the infection of patients admitted to hospitals. Acinetobacter are free living gram-negative coccobacilli that emerge as significant nosocomial pathogens in the hospital setting and are responsible for intermittent outbreaks in the intensive care unit. The aim of this study was to determine the risk factors and outcome of Acinetobacter infections in patients admitted into the intensive care unit of a tertiary center in Oyo State, Nigeria. A total of one hundred patients were recruited for the study, catheter specimen urine, tracheal aspirate and blood culture were collected aseptically from the patients. The specimens were cultured on blood and MacConkey and the organisms identified using Microbact 12E (0xoid). Fourteen (14%) of the 100 patients recruited into the study developed Acinetobacter infection. Chronic obstructive pulmonary disease, endotracheal intubation, and duration of endotracheal intubation were associated risk factors with only duration of endotracheal intubation specifically an 8 to 14 day period being an independent risk factor for Acinetobacter. Six of the patients died of the infection while the remaining eight were discharged from the ICU. The findings that chronic obstructive pulmonary disease and duration of endotracheal intubation being associated with Acinetobacter infection and the attendant mortality associated with the infection should draw attention to this seemingly silent epidemic in our Intensive Care Units so that effective surveillance protocols can be deployed to manage this infection whenever it rears its head.
Low level of pre-vaccination measles antibody among infants receiving measles immunization in ilorin, Kwara state, Nigeria
(Multidisciplinary Digital publishing Institute (MDPI), 2013) Fowotade, A.; Okonko, I. O.; Nwabuisi, C.; Fadeyi, A.; Bakare, R. A.; Adu, F. D.
This study was designed to assess the low levels of pre-vaccination measles antibody among infants receiving measles immunization in Ilorin, Kwara State, Nigeria. Pre-vaccination blood samples were obtained from 400 infants brought to the EPI Clinic of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Blood samples were collected by finger puncture onto ROPACO (Rochester, USA) rectangular filter paper measuring 7 cm by 10 cm. Other information like name, age, sex, date of vaccination was also recorded on the filter paper. The filter papers were dried at ambient temperature and stored in plastic bags at -20℃ until ready for serum extraction. Specimens were analyzed for measles antibody using Hemagglutination Inhibition technique. Data generated were subjected to Chi square statistical test to establish association between categorical variables with dichotomous outcomes. Of all the 400 infants screened for pre-vaccination measles antibodies, 29(7.2%) had protective antibody titer while 156 (39.0%) had low titer since ≥40 HI titer is the study threshold of protection against measles while 215(53.8%) had no detectable measles antibody titer (<1:10). Thirty-one (8.0%) of the infants had measles prior to vaccination. Previous history of measles was significant associated (P=0.0005, X2 = 34.507) with the level of pre-vaccination measles virus antibody. There was no significant difference (p=0.723) in the level of measles virus antibody among the exclusively breastfed infants and those that were not exclusively breast fed. Age (p=0.839) and sex (p=0.1999) were not significantly associated with the level of measles virus antibody. The distribution of this antibody levels appeared stable with no significant difference between age groups, sex and breast feeding pattern. Only the previous history of measles showed statistical association with measles virus antibody proportion. In conclusion, a larger proportion (53.8%) of the children had no detectable anti-measles virus antibody while 39.0% had low (non-protective) titer; these put both groups at risk of developing measles given the endemic nature of Nigeria. Therefore, re-evaluation of 9 months as the age for measles vaccination in Nigeria vis-à-vis 92.8% with <40 HI titer is highly recommended.
Antimalarial use and the associated factors in rural Nigeria following implementation of Affordable Medicines Facility-Malaria (AMFM) price subsidy
(Science Publications, 2013) Efunshile, A. M.; Fowotade, A.; Makanjuola, O. B.; Oyediran, E. I.; Olusanya, O. O.; Koenig, B.
Purpose This study was set out to find out the pattern of antimalarial drug use in a Nigerian rural community following the aggressive price subsidy of Artemisinin Combination Therapy(ACT) recently embarked upon by Roll Back Malaria partners through Affordable Medicines Facility-malaria (AMFm). Methods Questioners were administered to 310 adult members of the community with the most recent malaria episodes so as to find out about the drugs used and some of the factors associated with the choice of the drug. Result Although the overall use of ACT (13.55%) in this community was about 4 times higher than what it used to be, Chloroquine 123(39.62%) and sulphadozine/pyrimathamine 120(38.71%) were the mostly used antimalarial agents. Choice of drug used was significantly associated with perception of efficacy and price among other factors. Respondents liked the price of ACT (33.3%) most, CQ was the drug most liked in terms of efficacy (44.2%) while SP was the drug most liked in terms of lack of side effect (38.9%), taste (61.6%) and convenience (35.7%).( P= 0.001) Conclusion In addition to sustaining the current price control, there is a need to continuously monitor and effectively regulate the quality of the ACTs in circulation so as to gain the confidence of both the prescribers and the end users regarding efficacy and adherence to ACTs. This will help to safeguard the huge investment in ACT subsidy by the Roll Back Malaria partners.
Noscomial Acinetobacter infections in intensive care unit
(Science Publications, 2013) Nwadike, V. U.; Fayemiwo, S. A.; Fowotade, A.; Bakare, R. A.; Olusanya, O.
Acinetobacter plays an important role in the infection of patients admitted to hospitals. Acinetobacter are free living gram-negative coccobacilli that emerge as significant nosocomial pathogens in the hospital setting and are responsible for intermittent outbreaks in the Intensive Care Unit. The aim of this study was to determine the prevalence of Acinetobacter in patients admitted into the Intensive Care Unit and determine their role in infections in the ICU. A total of one hundred patients were recruited for the study, catheter specimen urine, tracheal aspirate and blood culture were collected aseptically from the patients. The specimens were cultured on blood and MacConkey and the organisms identified using Microbact 12E (0xoid). The Plasmid analysis was done using the TENS miniprep method. Fourteen (14%) of the 100 patients recruited into the study, developed Acinetobacter infection. Acinetobacter spp constituted 9% of the total number of isolates. Twelve (86%) of the isolates were recovered from tracheal aspirate, 1(7%) from urine and 1(7%) from blood. All of the isolates harbor plasmids of varying molecular sizes. Ten of the fourteen Acinetobacter were isolated at about the same period of time in the ICU with 6(42.7%) having plasmid size in the 23.1kb band and all showed similar pattern revealing that the isolates exhibit some relatedness. The clonal nature of the isolates suggest that strict infection control practices must be adopted in ICU, also an antibiotic policy must be developed for the ICU to prevent abuse of antibiotics that may lead to selection of resistant bacteria.
Apparent rarity of asymptomatic herpes cervicitis in a woman with intra-uterine contraceptive device
(PAGEPress, 2013) Fowotade, A.; Okolo, A. C.; Manga, M. M.; Anaedobe, C. G.; Salami, A. A.; Akang, E. E. U.
Infection with genital herpes simplex virus (HSV) remains a common viral sexually transmitted disease, often subclinical and a major worldwide problem of women of reproductive age group. Herpes cervicitis is an unusual presentation of Herpes simplex virus infection in females. The finding of herpes cervicitis on routine pap smear of an asymptomatic woman on Intrauterine contraceptive device still further supports the need for increased awareness on the possibility of Herpes simplex virus infection among women, particularly those on Intrauterine contraceptive device. The index case is a 28 years old Nigerian female who was referred to our Special Treatment Clinic on account of an abnormal pap smear cytology which was in keeping with Herpes cervicitis. There was no history of genital ulcer in this patient; however ELISA for HSV 2 IgM was positive in her. We therefore describe a case of herpes cervicitis in an asymptomatic woman on intrauterine contraceptive device. This case highlights to clinicians the need to be aware of the possibility of this association and to carry out relevant investigations so as to identify and treat these patients appropriately. Therefore, there is a need to put in place adequate public health intervention strategy to prevent genital herpes in women of reproductive age group with a view to preventing the possibility of congenital herpes in subsequent pregnancy.
Sexual behavioral correlates with HSV-2 seroprevalence among pregnant women in Nigeria
(Journal of Infection in Developing Countries, 2014) Kalu, E. I.; Ojide, C. K.; Fowotade, A.; Nwadike, V. U.
Introduction: The burden of HSV-2 infection, the cause of most cases of genital herpes in Nigeria, varies from region to region; and so are the associated factors. This infection is known to be responsible for several negative pregnancy outcomes. There is currently no documented data on sexual behavioral factors associated with the occurrence of HSV-2 infection or seroprevalence among pregnant women in Nigeria. This study aimed at identifying the sexual behavioral correlates of HSV-2 seroprevalence among pregnant women in Benin City, Nigeria. Methodology: The cross-sectional study design was adopted and the study took place between November 2011 and June 2012. Four hundred and ten consenting ante-natal clinic patients in two major tertiary hospitals in Benin City were consecutively and prospectively included. Data sources were represented by questionnaires, the patient’s case records and laboratory investigations. Each patient’s serum was analyzed for HSV-2 antibody detection. Data analysis was performed using SPSS version 16. Results: Four hundred and ten patients were enrolled with average age 30.6 years. Seroprevalence of HSV-2 antibody was 47.3%. Sexual behavioral factors that were significantly associated with HSV-2 seroprevalence included early exposure to sexual intercourse, number of sex partners, involvement in polygamous marriages, involvement of husband in extra-marital affairs and hormonal contraceptive use. Conclusion: The prevalence of HSV-2 among pregnant women in Benin City is high. Public health campaigns aimed at: delaying onset of sexual activity; encouraging monogamous relationships; and emphasizing that hormonal contraceptives do not protect from STI’s, are recommended.