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INCIDENCE OF HEPATITIS C VIRUS INFECTION IN A SEMI-URBAN COMMUNITY OF SOUTHWESTERN NIGERIA
(2014-11) BAKAREY, A. S.
Hepatitis C Virus (HCV) infection is an important cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma. Its epidemiology has been well described in developed countries. In Nigeria, previous studies on the virus were hospital-based or point prevalence from which the burden of HCV cannot be accurately determined. A population-based prospective study was therefore designed to assess the burden of HCV infection in a semi-urban community in southwestern Nigeria. A cohort of 490 purposively recruited consenting participants in Saki, a border town in Nigeria were enrolled and followed up for nine years (2003-2012). Blood samples were collected and tested for the presence of HCV antibodies using the ELISA technique from each participant at baseline, one year, 2 years and 9th year. The participants included 299 male and 191 female members of two occupational groups, auto-mechanics (n=236) and fashion designers (n=254) with age range of 15 to 65 years (median age=26years). A structured questionnaire was administered to capture information on awareness of HCV infection as well as predisposing factors including sharing of sharp objects, transfusion of blood and blood product, polygamy and multiple sexual partnership. The cohort was continuously provided education on prevention of sexually transmitted diseases and blood borne pathogens during the follow-up period. Data were analysed using descriptive statistics and ANOVA at p=0.05. Incidence of infection was reported as number of HCV cases/1000 person years. The rate of HCV infection at baseline was 8.4%. A total of 27 new cases of infection were identified in the cohort giving an overall incidence of 27.8 per 1000 person years. Incidence of HCV increased from first to the second (9.0 Vs 24.7 per 1000 person years) year but declined thereafter (11.3 per 1000 person years). Incidence of the infection increased with age and peaked among persons 45-54 years (34.5 and 38.5 per 1000 person years). The incidence was higher among male than female (21.2 Vs 14.5 per 1000 person years). Incidence in both male and female groups increased from first to second point but declined sharply thereafter. Incidence of HCV infection was higher among auto-mechanics (31.4 per 1000 person years), a male occupational group than fashion designers (23.9 per 1000 person years), a female dominated occupational group. Similarly, HCV incidence was higher in male (49.9 per 1000 person years) than female (14.6 per 1000 person years) members of the fashion designer group (Risk Ratio = 2.7, CI=1.32-5.87). The only significant risk factor identified was sharing of sharp objects (RR=2.4, CI=1.0-5.56, χ20.05:1=4.329, p=0.04). There was a substantial burden of HCV infection in the studied community. Sharing of sharp objects is a significant predisposing factor for HCV infection among the study populations. The high burden of the infection indicates the need for urgent implementation of measures to control HCV infection in Nigeria.
Clinical and immunological profile of pediatric HIV infection in Ibadan, Nigeria
(SAGE, 2011) Brown, B. J.; Oladokun, R. E.; Odaibo, G. N.; Olaleye, D. O.; Osinusi, K.; Kanki, P.
In spite of the increasing number of children living with HIV in Nigeria, published data on their clinical profile are few. We describe the clinical profile at presentation of HIV-infected children at the University College Hospital, Ibadan, in a prospective study. Among 272 children studied (149 [54.8%] males; mean age 4.2 years [range 2 months to 15 years]), infection was acquired through vertical transmission in 252 (92.6%), blood transfusion in 5 (1.80%), and undetermined routes in 15 (5.5%) cases. Clinical features included weight loss (62.5%), prolonged fever (55.4%), generalized lymphadenopathy (48.6%), chronic cough (45.4%), and persistent diarrhea (28.3%). Tuberculosis was present in 45.3%, World Health Organization (WHO) clinical stages 3 and 4 disease in 70.6% and severe immunosuppression in 44.5% of cases. Pediatric HIV in Ibadan is acquired mainly vertically and most cases present with severe disease. Improved access to prevention services and early diagnosis are recommended.
Service uptake and performance of the prevention of mother-to-child transmission (PMTCT) programme in Ibadan, Nigeria
(2010) Oladokun, R. E.; Awolude, O.; Brown, B. J.; Adesina, O.; Oladokun, A.; Roberts, A.; Odaibo, G.; Osinusi, K.; Olaleye, D.; Adewole, I. F.; Kanki, P.
The Prevention of Mother to Child Transmission (PMTCT) programme in the University College Hospital (UCH), Ibadan has been in existence for more than five years and has scaled up to other sites. The study evaluated the service uptake and performance of the programme using national key indicators. Antenatal and delivery records of women enrolled between July 2002 and June 2007 were reviewed. A total of 51952 women attended first antenatal visits and received HIV pre-test counselling. Of these, 51614 (99.5%) accepted HIV test and 49134 (95.2%) returned for their results. Out of the tested patients, 2152 (4.2%) were identified to be HIV positive. Partners of positive patients accepting HIV testing were 361 (16.7%) with 87 (18.6%) testing positive. There were a total of 942 deliveries out of which 39.2% of the mothers and 95.2% of the babies respectively received ARV prophylaxis. In all, 85.8% (788/918) of the mothers opted for formula as the method of infant feeding. Out of the 303 babies eligible for ELISA testing, 68.3% reported for the test and 17 (8.7%) tested positive. There has been progress in the programme, reflected in the increase in the number of new clients accessing the PMTCT service. However, partner testing and follow up of mother-infant pairs remain formidable challenges that deserve special attention.

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