Browsing by Author "Okonko, I. O."

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High seropositivity of IgG and IgM antibodies against cytomegalovirus (CMV) among HIV-1 seropositive patients in Ilorin, Nigeria
(Makerere University Medical School, 2015) Fowotade, A.; Okonko, I. O.; Agbede, O. O.; Suleiman, S. T.
Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is a major public health problem in sub-saharan Africa. Cytomegalovirus (CMV) has been reported to enhance HIV replication and accelerate the progression of HIV infection to AIDS. Objective: This study reports on the high seropositivity of immunoglobulin (Ig) G and M antibodies against CMV and the risk factors for CMV infection among HIV/AIDS patients in Ilorin, Nigeria. Method: A total of 180 consented HIV-1 seropositive patients (age-range 16-56 years; 108 females and 72 males) were consecutively recruited. Socio-demographic/behavioral data and 5 ml blood samples were collected from each patient. Plasma of each sample was assayed for anti-CMV IgG/IgM using a CMV IgG and IgM Enzyme Linked ImmunoSorbent Assay (ELISA) kit. Results: Twenty (11.1%) of the 180 HIV-1 seropositive subjects were positive for anti-CMV IgM antibody while 169(93.9%) were positive for anti-CMV IgG antibody. Age, marital status, number of sexual partners, CD4 cells counts and previous history of blood transfusion were the main correlates of CMV seropositivity among these patients. However, occupation, sex, highly active antiretroviral therapy (HAART) were not statistically associated with CMV seropositivity in this study. Conclusion: This study has shown that greater percentages of HIV-1 seropositive patients had active CMV infection. It has further shown that CMV is hyperendemic in HIV-1 seropositive patients in Ilorin, Nigeria.
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.
Measles vaccine potency and Sero- conversion rates among infants receiving measles immunization in Ilorin, Kwara state, Nigeria.
(Taylor & Francis, 2014) Fowotade, A.; Okonko, I. O.; Nwabuisi, C.; Bakare, R. A.; Fadeyi, A.; Adu, F. D.
This study was designed to assess the seroconversion rate of measles vaccine among infants receiving measles immunization in Ilorin, Nigeria. The pre- and post-measles vaccination sera of the children were tested using the Haemagglutination Inhibition test. The measles vaccines administered at the immunization centre were also tested for their potency using in-vitro titration method. Only 286 (71.5%) of the vacinees returned to give post-vaccination samples. All the infants screened had low pre-vaccination measles antibody titers. Thirty one (8.0%) of the infants had measles prior to vaccination. The seroconversion pattern showed that 196 (68.6%) of the infants developed protective antibody titers. Low seroconversion rate reported in this study was due to low vaccine potency. The titers of vaccines with low potency ranged between log10−1.0–log10−2.25 TCID/per dose. This was beside other non specific antiviral substances exhibited virus neutralizing activity. Only 3 (50%) of the 6 vaccine vials tested had virus titers of log10−3.25 to log10−3.5, which fell above the cut-off point recommended by the World Health Organization for measles vaccines. The sero-conversion rate of 68.6% observed among vaccinees is far lower than the immunity level of 95% required stopping measles transmission in an endemic community. Failure of 31.4% of these infants to sero-convert post vaccination can be attributed partly to administration of sub-potent vaccines. There is need for improvement and maintenance of effective vaccine cold chain system in Nigeria. There is need also for periodic monitoring of post-vaccination antibody titers as well as vaccine potency status in order to ensure development of protective seroconversion rates.
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.