FACULTY OF CLINICAL SCIENCES

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    Asymptomatic bacteriuria among HIV positive pregnant women
    (2010) Awolude, O. A.; Adesina, O. A.; Oladokun, A.; Mutiu, W. B.; Adewole, I. F.
    The prognostic significance of asymptomatic bacteriuria resides in the observation that the prevalence is, relatively, high in persons with certain medical conditions, such as diabetes mellitus and pregnancy. This prevalence might, even, be higher in patients with human immunodeficiency virus infection. Hence, this study set out to determine the prevalence of asymptomatic bacteriuria among symptom free and newly enrolled HIV infected pregnant women attending PMTCT unit of Antiretroviral Clinic of University College Hospital, Ibadan, Nigeria between 1st May and 30th September 2007. Information was obtained on the socio-demographic characteristics of the subjects, CD4 count and viral load. Microbial culture was carried out on aseptically collected urines from the patients. Statistical analysis was done with SPSS 12 package. There were 161 analyzable samples from the participants. The mean age and gestational age at presentation of participants was 30.49 ± 4.3 years and 27.3 ± 3.2 weeks, respectively with modal parity of 2. Twenty-five (15.5%) of the urine samples significantly grew bacteria. The CD4 cells were significantly lower and the viral loads significantly higher (250.52 vs. 355.57 cells/mm3; 88,731 vs. 55,384 copies/ml; p = <0.0000) for the urine culture positive patients. Eshcherichia coli were isolated in 48%, Proteus in 16.0%, Klebsiella in 8.0% and Staphylococcus aureus in 28.0% of the urine positive cultures. The study showed that the prevalence of asymptomatic bacteriuria among PLWHAs is high. The microbial isolate from the urine samples were not different from those of HIV-negative patients.
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    Emergency obstetric patients in a developing country and prevalence of HIV infection
    (2009) Awolude, O. A.; Oladokun, A.; Adesina, O. A.; Mutiu, W. B.; Adewole, I. F.
    The availability of VCT for HIV for booked antenatal patients offers a unique opportunity for best obstetrics practice but not for patients presenting with emergencies and unknown HIV status. Health workers who attend to such patients are at higher risk of acquiring HIV infections. Between 1st March 2005 and 30th September 2007, unbooked emergency obstetric patients in the labour ward of a teaching hospital who consented were tested using double rapid immunodiagnostic technique and confirmed by Western Blot. HTV positive patients were post-test counselled and offered single dose nevirapine tablet (200mg) in labour with syrup given to the baby at birth at 2mg/kg followed by syrup zidovudine for 6 weeks: The results showed that 275 (89.0%) of the 309 women pre-test counselled agreed to testing. The mean age of clients was 27.7 years (± 4.4 SD). The mean gestational age at presentation was 36.4 weeks (± 4.2 weeks). Primigravidae constituted 37.5% of the patients. Twenty-one (7.6%) of these consenting patients were H3V positive. In conclusion, the HIV prevalence of 7.6% among these unbooked obstetric patients is higher than the 4,7% among our booked antenatal patients and National prevalence of 4.4%. This poses substantial risk of transmission of HIV to attending health workers considering the readiness with which needle prick accident can occur in emergency situations.
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    Bacterial antibiotic sensitivity pattern from urine of asymptomatic HIV positive pregnant women
    (2011) Awolude, O. A.; Adesina, O. A.; Mutiu, W. B.; Adewole, I. F.
    Introduction: Asymptomatic bacteriuria (ASB) in pregnancy with adverse pregnancy outcome has been well documented with Escherichia coli and other gram-negative rods being the common organism associated. However, most of these studies were done in patients without additional immunosuppressant except for pregnancy. However; the additional risk of HIV infection in pregnant woman necessitates the evaluation of the microbial isolates and antibiotic sensitivity pattern from the urine samples of these patients without any symptom. Methods: A prospective cohort study was undertaken among HIV positive pregnant women attending our Antiretroviral clinic between 1st May and 30th September 2007. Information recorded from the patient questionnaire included age, parity, marital status, occupation, and level of education. Culture and antibiotic sensitivity was carried out on aseptically collected urines from the patients. Results: Twenty-five. (15.5%) of the 161 urine samples cultured significantly grew organisms. Four of the urine specimen had, in addition, Candida isolated. The mean age of participants was 30.6 ± 4.3 years .and the modal parity was 2. The mean gestational age at presentation was 27.3± 3.2 weeks. Escherichia coli was isolated in 48%, Proteus in 16:0%, Klebsiella in 8.0%, and Staphylococcus aureus in 28.0%. The antibiotic sensitivity test showed that the organisms were 100% sensitive to ciprofloxacin, 80% sensitive to cefuroxime, 60% sensitive to ofloxacin and augmentin but only 36%, 20%, 8.0% and 4.6% sensitive to co-trimoxazole, amoxycillin, chloramphenicol, erythromycin, nitrofurantoin and gentamycin, respectively. The organisms were 100% resistant to tetracycline and ampicillin. Conclusion: This-study shows that the microbial isolates of the ASB among HIV positive pregnant women are similar to those of HIV-negative counterparts but with varying drug sensitivities.
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    Asymptomatic bacteriuria among HIV positive pregnant women
    (Taylor and Francis, 2010-06) Awolude, O. A.; Adesina, O. A.; Oladokun, A.; Mutiu, W. B.; Adewole, I. F.
    The prognostic significance of asymptomatic bacteriuria resides in the observation that the prevalence is, relatively, high in persons with certain medical conditions, such as diabetes mellitus and pregnancy. This prevalence might, even, be higher in patients with human immunodeficiency virus infection. Hence, this study set out to determine the prevalence of asymptomatic bacteriuria among symptom free and newly enrolled HIV infected pregnant women attending PMTCT unit of Antiretroviral Clinic of University College Hospital, Ibadan, Nigeria between 1st May and 30th September 2007. Information was obtained on the socio-demographic characteristics of the subjects, CD4 count and viral load. Microbial culture was carried out on aseptically collected urines from the patients. Statistical analysis was done with SPSS 12 package. There were 161 analyzable samples from the participants. The mean age and gestational age at presentation of participants was 30.49 ± 4.3 years and 27.3 ± 3.2 weeks, respectively with modal parity of 2. Twenty-five (15.5%) of the urine samples significantly grew bacteria. The CD4 cells were significantly lower and the viral loads significantly higher (250.52 vs. 355.57 cells/mm3; 88,731 vs. 55,384 copies/ml; p = <0.0000) for the urine culture positive patients. Eshcherichia coli were isolated in 48%, Proteus in 16.0%, Klebsiella in 8.0% and Staphylococcus aureus in 28.0% of the urine positive cultures. The study showed that the prevalence of asymptomatic bacteriuria among PLWHAs is high. The microbial isolate from the urine samples were not different from those of HIV-negative patients.