FACULTY OF BASIC MEDICAL SCIENCES
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Item Hepatitis B virus infection among pregnant women on antenatal visits: rapid tests or ELISA?(African Society for Clinical and Experimental Microbiology, 2021) Fowotade, A.; Adetunji, S. O.; Amadi, E.; Ishola, I. O.; Omoruyi, E. C.Background: Hepatitis B virus (HBV) infection is a global public health challenge with over 360 million people infected worldwide, and is one of the leading causes of death worldwide. The hepatitis B surface antigen (HBSAg) is the most important marker for HBV screening, and HBSAg rapid screening test methods are the most widely used compared with the enzyme-linked immunosorbent assay (ELISA) and nucleic acid testing methods. The objectives of this study are to evaluate the comparative efficacy of rapid test kits and ELISA for HBV screening among pregnant women on antenatal visits and to screen for other HBV serological markers among HBsAg positive patients. Methodology: This is a cross-sectional study of 172 pregnant women who were recruited consecutively on their first antenatal visit at the University College Hospital, Ibadan, Nigeria between November 2018 and February 2019. All participants were screened for HBsAg using both rapid immunochromatographic test (ICT) and ELISA techniques. HBsAg negative samples were further screened for anti-HBeAg/Ab, anti-HBcAg and anti-HBs by ELISA. Socio-demographic data of the participants were obtained using a semi-structured questionnaire, and data were analyzed using EPI INFO 7.2 statistical software. Results: The prevalence rate of HBsAg among pregnant women in this study was 10.5% (18/172). The sensitivity, specificity, accuracy, positive predictive value (PPV) and the negative predictive value (NPV) of the rapid ICT kit were 72.2%, 97.4%, 94.8%, 76.5% and 96.8% respectively. Level of education, previous history of sexually transmitted infections (STIs) and previous positive HBV results were significantly associated with HBsAg seropositivity. Majority of the pregnant women (66.9%) tested negative to all the serological markers. Conclusion: The low efficacy of rapid ICT kits compared to ELISA justifies the need to develop a safer antenatal screening strategy for HBV by combining the use of the less sensitive rapid screening techniques with the more sensitive ELISA method to limit vertical transmission of hepatitis B virus.Item Comparative analysis of rapid test and Enzyme linked Immunosorbent assay for screening of blood donors for Hepatitis B surface Antigen seropositivity(West African College of Physicians and West African College of Surgeons, 2021) Adeleke, A. S.; Fasola, F. A.; Fowotade, A.BACKGROUND: The Hepatitis B surface Antigen (HBsAg) is the most utilized indicator marker of hepatitis B infection. This study assesses the accuracy of the two most common screening assays used to detect HBsAg among blood donors. MATERIALS AND METHODS: A total of 350 eligible blood donors were screened for HBsAg using both Bio-Check HBsAg Rapid screening kit (BioCheck Inc, South San Francisco, USA) and a fourth-generation Enzyme-Linked Immunoassays (ELISA) kit, MonolisaTM HBs Ag Ultra (Bio-Rad Laboratories, Marnes-la-Coquette-France). Questionnaires were used to inquire about risk factors for HBV infection among blood donors. The calculation of sensitivity, specificity, negative predictive and positive predictive values were carried out by comparing the performance of the rapid kit with ELISA test as the reference standard. RESULTS: The prevalence of HBV infection using Rapid Diagnostic Test (RDT) was 5.7% but was 14.6% by ELISA. Using ELISA as a reference, the sensitivity and specificity of RDT were 31.4% and 98.7% respectively. The positive predictive value and negative predictive value for RDT were 80.0% and 89.4% respectively. Overall non-compliance with transfusion-transmitted infection (TIT) risk-related deferral criteria was 38%. CONCLUSION: The low sensitivity of RDT kits precludes its continuous use in high HBV endemic regions where many donors fail to disclose full and truthful information about their risk for TTI. It is suggested that blood banks should complement the use of RDT with a more sensitive assay such as ELISA.Item Profiles of Hepatitis B Virus Serological Markers among Asymptomatic Population in Anambra State, Southeastern Nigeria(SciTechnol, 2017) Bakarey, A. S.; Ifeorah, I. M.; Adewumi, M. O.; Faleye, T. O. C.; Akere, A.; Omoruyi, C. E.; Ogunwale, A. O.; Uttah, C. C.; Oketade, M. A.; Adeniji, J. A.Hepatitis B Virus (HBV) infection is apparent in endemic countries affecting millions of people. Further, the asymptomatic nature of the pathogen is a major public health concern. This study was designed to assess the burden of HBV by exploring the serologic markers of infection among consenting asymptomatic community dwellers in two cities in southeastern Nigeria. A total of 405 blood specimens were tested for HBsAg, anti-HBs, HBeAg, anti-HBe, total anti-HBc and anti-HBc-IgM using ELISA technique. Overall, 14(3.5%) of the participants had detectable HBsAg out of which 1 (7.1%) had HBeAg and 13, anti-HBe. Two of the HBsAg positives (14.3%) had detectable anti-HBc-IgM. A total of 144 (35.5%) had detectable anti-HBc, even as 65 (57.0%) of them had the marker as the only serologic evidence of HBV exposure. Thirty-seven (9.1%) participants had anti-HBs only although all of them were born before the start of the childhood HBV vaccination. Altogether, 224 (57.3%) had no detectable serological markers of HBV infection or immunity and were obviously at risk ofHBV infection. This study described various patterns of HBV serologic markers of infection in the study population and probable risk of viru spread. Our results support the need for urgent intervention and implementation of measures to control the spread of HBV infection in Nigeria.Item High Prevalence of Anti-HCV Antibodies Among Pregnant Women in Southwestern Nigeria(IISTE, 2017) Japhet, M. O.; Donbraye, E.; Adesina, O. A.; Adewumi, M. O.Hepatitis C virus (HCV) is the most common cause of cirrhosis, hepatocellular carcinoma and liver transplantation. While universal screening for other blood-borne viruses (BBVs) such as HIV and HBV among pregnant women is recommended in Nigeria, no such recommendation exist for HCV in the country. Despite recently developed direct-acting antiviral agents (DAAs) to cure HCV at high rates and at very high cost, the absence of an HCV vaccine or approved therapy during pregnancy makes prevention of vertical transmission impossible at the moment. Using a commercially available enzyme linked immunoassay technique, prevalence of antibodies to hepatitis C virus (anti-HCV) was determined among pregnant women attending antenatal clinics in Southwestern Nigeria. Of the 273 serum samples obtained from the pregnant women 9.5% was positive for anti-HCV antibody. There were differences in anti-HCV prevalence by age and locality. Results of the study confirm endemicity of HCV among pregnant women in the country, consequently, we advocate free screening, among other essential measures for HCV intervention in Nigeria.Item High prevalence of HIV p24 antigen among HIV antibody negative prospective blood donors in Ile Ife, Nigeria(Taylor & Francis, 2016) Japhet, M. O.; Adewumi, M. O.; Adesina, O. A.; Donbraye, E.Blood transfusion service centers in Nigeria screen donated blood for markers of HIV infection using antibody- (Ab) based rapid test and in some centers, positives are re-tested using Ab-based ELISA. Paucity of data exists on p24 antigen prevalence among HIV Ab-negative donors in Nigeria. This study aims at detecting HIV p24 antigen among prospective blood donors in Osun State, Nigeria. Prospective blood donors negative for HIV antibodies using Determine test kit were re-tested using BIORAD GENSCREEN Ultra Ag-Ab ELISA kit, a fourth-generation ELISA kit that detects HIV antibodies/p24 antigen. Of the 169 HIV Abnegative prospective donors, 10 (5.9%) were positive for HIV antigen and 70% (7/10) of them were in the age range 18–30 years. Results of this study show that blood transfusion is still one of the major routes of HIV transmission in Nigeria and a higher proportion is among youth. Inclusion of p24 antigen testing into the blood donor screening will help reduce transfusion associated HIV in Nigeria if Nucleic Acid Testing (NAT) of all blood donor samples is not affordable; also, HIV enlightenment programs tailored toward youth may help reduce this rate among donors since more young people donate blood in low/middle income countries than in high-income countries.Item Hepatitis B Core IgM antibody (anti-HBcIgM) among Hepatitis B Surface antigen (HBsAg) negative blood donors in Nigeria(Springer Nature, 2011) Japhet, M. O.; Adesina, O. A.; Donbraye, E.; Adewumi, M. O.Background: Transfusion associated Hepatitis B virus (TAHBV) continues to be a major problem despite mandatory screening for Hepatitis B surface Antigen (HBsAg). Presence of HBsAg is the common method for detecting hepatitis B infection. Unfortunately, this marker is not detected during the window period of the infection. Nigeria being a developing country cannot afford DNA testing of all collected units of blood which serve as the only possibility of achieving zero risk of transfusion associated HBV. Five different serological makers of hepatitis B virus (HBV) infection were therefore assessed to evaluate the reliability of using HBsAg marker alone in diagnosis of HBV infection among blood donors and to detect the serological evidence of the infection at the window period. This will preclude the possibility of transmitting hepatitis B through transfusion of Hepatitis B surface antigen (HBsAg) negative blood in Nigeria. Methods: Between July and August 2009, 92 blood donors were enrolled for the study. The prevalence of 5 different markers of Hepatitis B virus infection was detected using Enzyme Linked Immunosorbent Assay (ELISA). Demographic factors were assessed during the study.Results: HBsAg and its antibody (anti-HBs) was detected in 18 (19.6%) and 14(15.2%) of the 92 blood donors respectively. Anti-HBc IgM was found in 12(13.0%) of the 92 blood donors while Hepatitis B envelope antigen (HBeAg) and its antibody (anti-HBe) were detected in 4(8.9%) and 12(26.7%) respectively from 45 donors sampled. HBeAg is a marker of high infectivity and appears after HBsAg. At least one serological marker was detected in 30(32.6%) of the blood donors. Five (5.4%) of the 92 donors had anti-HBc IgM as the only serological evidence of hepatitis B virus infection. Conclusions: The result of this study shows that five donors have anti-HBcIgM as the only serological evidence of HBV infection. Inclusion of anti-HBcIgM in routine screening of blood donors in Nigeria should be encouraged. This is the first study to assess anti-HBcIgM in the country.