FACULTY OF BASIC MEDICAL SCIENCES
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Item Enhanced wound contraction in fresh wounds dressed with honey in wistar rats (rattus novergicus)(West African College of Physicians and the West African College of Surgeons, 2004) Osuagwu, F. C.; Oladejo, O. W.; Imosemi, I. O.; Aiku, A.; Ekpo, O. E.; Salami, A. A.; Oyedele, O. O; Akang E. U.Background: Due to reports that honey accelerates wound healing, an investigation on its role in wound con- traction in fresh wounds inflicted on wistar rats was car- ried out. Method: Twenty adult male wistar rats had 2cm by 2cm square wound inflicted on their right dorsolateral trunk. They were divided into two groups. The experimental group had their wounds dressed with honey while the control group had normal saline dressing. Wound dress- ing was done every five days and measurements taken at each dressing. Wound morphology was also assessed. Results: Dressing with honey significantly enhanced percentage wound contraction on day 10 with value of 79.20±2.94 compared to control value of 53.50 ±4.32. p=0.0. The mean wound measurement on day 10 reduced significantly in honey group, 1.15±0.18 compared to con- trol group 2.38±0.28. p=0.002. However, there was no significant difference in fibroblast count per high power field in honey group 68.0 ±2.59 compared to control 90.2 17.40, p=0.242. Honey dressing increased mean blood vessel count per high power field, 18.8±3.77 albeit non significantly when compared to control value of 13.4±2.44, p=0.264. Also honey dressing caused increased granulation tissue for- mation in wounds dressed with honey compared to con- trol group. Conclusion: Our study suggests that honey dressing enhances wound contraction in fresh wounds which is one of the key features of wound healing.Item 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.Item 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.Item 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.Item Traditional crop farmers in Kogi East, Nigeria elucidate elevated HIV and AIDS prevalence level during a five -year study period(Academic Journals (Academic Journals Inc., Lagos, Nigeria), 2009) Sule, W. F.; Enemuor, S. C.; Adewumi, M. O.; Attah, O. C.The United Nations reported that HIV and AIDS have negative impact upon agriculture and increasing hunger in sub-Saharan Africa. Such a situation is postulated to synonymously occur in Nigeria. This study therefore, aimed to investigate the prevalence level of HIV antibodies and AIDS among traditional crop farmers and non-farmers comprising traders, drivers, teachers and students in Kogi East. This is one of the primary agricultural areas of Kogi State, Nigeria and is therefore of great importance to perform an assessment depicting the prevalence of local HIV infection. Documented records of HIV antibody screening from the year 2002 to 2006 at the Voluntary Counselling and HIV Testing Unit of General Hospital, Ankpa, Kogi East were reviewed. Selected data was statistically analyzed with Chi2 - test using SPSS 13.0. A total of 11,077 patients from the ages of two months to 72 years were screened during the five years. Of this, 2,510 HIV positive cases (overall prevalence of 22.70%; mean = 21.86%; n= 5; standard deviation [SD] = 5.64%) and 322 mean = 12.47%; n = 5; SD = 2.23%) AIDS-related deaths were documented. The letter group included 250 (77.6%, mean = 71.91%; SD = 15.72%) farmers. A significant higher number of farmers were seropositive (_2 = 72.710; p = 0.001, df = 1, _ = 0.05) and died (_2 = 93.255; p = 0.001, df = 1, _ = 0.05) of AIDS-related illness compared to the non-farmers. The ages of people that died range from 12 to 49 years (n = 322) with a mean age of 44.1 years. Throughout the specified five years sampling duration, more non-farmers than farmers partook in HIV antibody screening. Farmers that were seropositive for HIV antibodies and died of AIDS-related illness were significantly higher in proportion than the non-farmers.Item Human immunodeficiency virus (HIV) specific antibodies among married pregnant women and female commercial sex workers attending voluntary counseling and HIV testing (VCT) centre in Abuja, Nigeria(Medical Microbiology and Parasitology Society of Nigeria (MMSN), 2009) Sule,W. F; Adewumi, M. O.; Samuel, T. C.Generally, married women and commercial sex workers (CSWs) engage in sexual activity - an important risk factor for contracting HIV. We therefore tested a hypothesis that prevalence of HIV-1/2 antibodies among married pregnant women (PW) is not different from that of female CSWs. One hundred married PW and 99 female CSWs enrolled in the study. They were consecutively selected as they visited the VCT centre for HIV antibody test. Pertinent data were obtained from each subject using questionnaire forms; venous blood sample was aseptically collected from subjects that gave verbal consent. Plasma obtained from each sample was tested using parallel testing algorithm with DETERMINE® HIV-1/2 and HIV-1/2 STAT-PAK® test was used for statistical analysis of the data. The overall prevalence of HIV-1/2 antibodies was 29.1% (n = 199). Seroprevalence of 39.4 and 19.0% were observed for the CSWs and the PW, respectively. Using various variables, comparison of HIV-1/2 serostatus of the CSWs with that of the married PW showed that the CSWs generally had significantly higher seroprevalence. CSWs who were inconsistent in the use of condom with their clients prior to sexual intercourse in the past three months before this study (P = 0.0001, OR = 11.2) and those aged _ 39 years had significantly (P =0.004, OR = 2.6) higher seroprevalence. Though both groups recorded seropositivity, inconsistency in the use of condom appeared to be the factor mostly responsible for the significantly higher seropositivity of the female CSWs.Item Reliability of testing and potential impact on HIV prevention in Nigeria(Medical and Dental Consultants Association of Nigeria (MDCAN), 2006) Odaibo, G. N; Donbraye, E.; Adewumi, M. O.; Bakarey, A. S.; Ibeh, M. A.; Olalcye, D. O.Several factors including variability of human immunodeficiency virus (HIV), laboratory facilities, cost and competence of personnel handling the tests are some of the important factors that affect accuracy and reliability of HIV testing in most parts of Africa. Recently investigators in Africa have observed that antibody detection assays based on antigens derived from HIV-1 subtype B show moderate to significantly lower sensitivity for detection of infection by various non-B subtypes. In this study, we evaluated the reliability of two El A and 12 rapid HIV-1/2 test kits that are commercially available in Nigeria using the Western immune blotting technique as reference. A panel of 100 sera from Western blot confirmed symptomatic or asymptomatic HIV-1 infected persons and 90 seronegative patients from those referred for testing in our laboratory were used for this study. Each sample was tested with two HIV-1/2 EIA, and 12 HIV-1/2 rapid test kits commercially available at one time or the other for HIV-1/2 testing in Nigeria. Overall, the sensitivity of the two EIA kits were 100% and 91.0% with specificity of 96.7% and 91.1% respectively. The sensitivity of the rapid test kits ranged from 88% to 98.0% with specificity of 92.2% to 100%. Further analysis showed significant variation in the sensitivity and specificity of the same kit based on whether an individual had asymptomatic or symptomatic infection the results of this study highlight the problem of diagnosis of HIV infections in Africa. It shows that the sensitivity of most of the rapid assays shall not be adequate for detection of early infection. The implications of possible misdiagnosis on the various intervention strategies that rely predominantly on correct HIV status of an individual are enormous. Thus, there is an urgent need for review of the current HIV testing assays or algorithms in Nigeria and other parts of Africa.Item Prevalence of measles neutralizing Antibody In Children under 15years In Southwestern Nigeria(Medical Microbiology and Parasitology Society of Nigeria (MMSN), 2005) Opaleye, O. O.; Adewumi, M. O.; Donbraye E,; Bakarey, A. S. .; Odaibo, G. N.; Olaleye, O. DThe immune status of children under 15 years in the Southwestern region of Nigeria against measles virus was determined using the neutralization test with a view to assessing the herd immunity to the virus in these communities. A total of 256 serum samples collected from children were tested by the beta method of neutralization. Forty (15.6%) of these samples were found to be positive at a titre of 1:256, 35 (13.7%) at 1:128, 36(14.1%) at 1:64, 37(14.5%) at 1:32, 38 (14.8%) at 1:16, 27 (10.5%) at 1:8 and 16 (6.3%) at 1:4. Twenty-seven (10.5%) of the 256 samples had no detectable antibody to the measles virus. There was no significant relationship between the antibody titre to measles virus and the gender of the children (p > 0.05). Also, there was no significant difference using Chi square analysis between the neutralizing antibody titres and the age of the children (p > 0.05). All the children whose samples were tested were vaccinated against measles as attested to by their parents. However, the vaccination does not seem to protect all the children, for some of them had no detectable neutralizing antibody while some had low neutralizing antibody titre. In Nigeria, where only a single dose of measles vaccine is given at 9month, measles may remain a serious threat to the children population with its attendant high morbidity and mortality.Item Neutralizing antibodies against poliovirus serotypes among Children in Southwest Nigeria(Oxford University Press, 2005) Adewumi, M. O.; Donbraye, E.; Odaibo, G. N.; Bakarey, A. S.; Opaleye, O. O.; Olaleye, D. O."In May 1988, the World Health Assembly resolved to eradicate poliomyelitis globally by the year 2000. Despite the reported success in national immunization days, acute flaccid paralysis surveillance and accelerated efforts to meet the deadline including ‘mopping-up’ were executed in 1999 and subsequent years. Nigeria remains one of the major reservoirs for wild poliovirus transmission. Neutralizing antibody titre to the three poliovirus serotypes was determined among children from different communities in southwest of Nigeria, and analysed by age, gender and location. About 0.5–2 ml of blood sample was collected by venepuncture from each child. Aliquot of serum from each blood sample was inactivated prior to neutralization test by the beta method for poliovirus antibodies. A total of 347(59.6 per cent) out of 500 and 82 children enrolled for the study had at least antibody titre of 1:8 against each of the three poliovirus serotypes. Immunity level to the three poliovirus serotypes increased with age and peaked in children aged 4–6 years. Seven (53.8 per cent) out of 13 unvaccinated children tested in the study had detectable neutralizing antibody to the three serotypes. Immunity pattern of P2`P1 and P3 was observed but no correlation between gender and antibody to the poliovirus serotypes.The populations had 59.6 per cent herd immunity for the three poliovirus serotypes. In a country with high incidence of poliomyelitis this situation leaves a high number of non-immunized children at the risk of infection with one or more poliovirus serotypes."Item Sexual risk nehaviour of street Youth in South West Nigeria(East African Public Health Association, 2009) Owoaje, E.T.; Uchendu, O. C.Objectives Previous studies have mainly focused on sexual behaviour of in-school Nigerian youths with little attention to those on the street. This survey was conducted to determine the sexual risk behaviours of young people on the streets of Ibadan, Nigeria. Methodology A cross sectional survey was conducted among youths aged 15-24 years in the major markets, motor parks and commercial areas in two local government areas in Ibadan. Participants in the study areas were identified in groups based on their occupational activity and all consenting young people were interviewed. A semi-structured questionnaire was used to obtain information on sexual behaviours, condom use and history of sexually transmitted infections. Data was managed using SPSS version 11. Results Most (68.8%) were males, 79.0%, were sexually experienced, the median age at sexual debut for males was 15 years and 16 years for females. More females (53.9%) compared to (34.5%) males reported that their first partners were five or more years older, p<0.01. Condom use during the first sexual intercourse was reported by only 32.2%. Sex with a commercial sex worker or exchange of sex for money was reported by 18.2% (20.6% of males versus 12.2% of females, p=0.01). Factors significantly associated with history of transactional sex were; male gender; older age (20-24 years); being out of school and regular alcohol use. Multiple sexual partnering was reported by 58.2%, the significant predictors were male gender; early age at sexual debut; regular alcohol use and history of transactional sex. Inconsistent condom use was reported by 44.8%, the predictors were female gender; regular alcohol use and history of transactional sex in the previous year. Conclusion Majority of these young people on the streets are sexually active and many engage in high risk sexual behaviours. Development of appropriate sexual and reproductive health interventions is recommended.