Medical Microbiology & Parasitology

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A 4-Year cross-sectional study of Hepatitis B virus infection among pregnant women: need for policy decision
(Ecronicon, 2022-03) Fowotade, A.; Omoruyi, E. C.; Adesina, O.; Adekanmbi, O.; Adetunji, S.; Akande, K. O.; Adepoju, A.
Background: The elimination of hepatitis B virus (HBV) in Nigeria, especially among pregnant women requires commitment from the government and health policy makers. This is predicated on comprehensive surveillance and epidemiological data. The objective of the current study is to provide the epidemiological data and unique perspectives that will inform accurate advocacy and influence policy decisions. Materials and Methods: A 4-year cross-sectional study was conducted among 2,428 consecutively recruited consenting pregnant women attending antenatal care at the University College Hospital, Ibadan, Oyo State, Nigeria. Venous blood was screened for HBsAg using Enzyme Linked Immunosorbent Assay (ELISA). HBsAg sero-negative samples were further tested for other HBV serological markers (anti-HBc, HBeAg and anti-HBe by ELISA. Socio-demographic and clinical details were obtained using a semi-structured questionnaire. Results: Overall HBsAg prevalence was 5.1% (2,305/2,482). Twenty three (1%) of the HBsAg sero-negative women tested positive to both anti-HBc and anti-HBe while 5.3% and 0.8% tested positive to only anti-HBc and anti-HBe, respectively. Additionally, 6.4% (38/594) of the HBV fully vaccinated pregnant women tested positive to HBsAg. Conclusion: Hepatitis B is endemic among Nigerian pregnant women. Serological patterns indicated possible occult hepatitis B infection. More political commitment from government and policy makers is urgently required.
Blueprint for health security in Nigeria by 2050: infectious diseases perspective
(University College Hospital, University of Ibadan, 2019) Adekanmbi, O.; Fowotade, A.; Ogunbosi, B.; Oladokun, R.
Background: Infectious Diseases remain a leading cause of morbidity and mortality in Nigeria. Notably, natural and socio-cultural differences across Nigeria account for significant differences in types of infectious diseases that occur in different parts of the country. The communicable nature of infectious diseases either from person to person or via vectors has made it difficult to eradicate or even stem the tide of these diseases. HIV/AIDS, tuberculosis and malaria in particular are well established and enduring contributors to the infectious disease burden in Nigeria and this is very likely to continue to be the case in the foreseeable future. Method: Literature from PubMed and Google was extracted using the keywords; Health Security, Year 2050 and Infectious Diseases Results: In more recent times in Nigeria, the problem of emerging and re-emerging infections, often of epidemic importance as well as antimicrobial resistance also add to the infectious disease burden and compete for the already inadequate resources available to battle infectious disease. Many infectious diseases can be prevented by simple, effective and relatively low-cost interventions. Such interventions need to be emphasized to maximize cost-effectiveness of any resources expended. Nigeria’s young, trainable, potential healthcare workforce and existing infrastructure such as the primary healthcare system, disease surveillance systems and widespread mobile phone use need to be strengthened arid leveraged for a good approach to infectious disease control. Conclusion: As Nigeria’s population is set to double by 2050, health security from an infectious disease standpoint will require policy change to support continuous training and re-training all cadres of healthcare workers to respond specifically to the problems that are fed back from the population while being fully aware of predictable (corruption, inadequate financing) and unpredictable (disease outbreaks, climate change, microbial mutation) factors that can serve as a hindrance.
Malaria and COVID-19 co-infection: a symptom diagnostic challenge in a malaria endemic setting
(Verduci International, 2021) Fowotade, A.; Bamidele, F. R.; Adekanmbi, O.; Fasina, O. N.; Famuyiwa, O.; Alonge, T. O.
Objective: To determine the prevalence and risk factors for malaria and COVID-19 co-infection. Patients and methods: A total of 135 COVID-19 positive patients were consecutively recruited from the Infectious Diseases Hospital, Olodo, Ibadan, Oyo State. Nasopharyngeal and oropharyngeal swab samples were obtained during hospitalization and tested by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) using the BGI SARS-Cov-2 kit (China). Blood was also obtained by needle prick and malaria tests were performed using the SD BIOLINE Malaria Ag P.f/Pan test. Risk factors were entered into individual case investigation forms. Results: Malaria and COVID-19 co-infection rate was 7%. The predominant clinical manifestation was fever (28.1%) and the study showed that COVID-19 and malaria co-infection was associated with increased odds of fever compared to COVID-19 mono-infection (p-value=0.415, OR=4.960). Significant risk factors for malaria/COVID-19 are age of participants (p= 0.000) and CT values for by SARS-Cov2 RTPCR (p=0.013). Fever is a common symptom in either malaria or COVID-19 infection thus posing a diagnostic challenge. Proper risk assessment of febrile patients and laboratory evaluation for COVID-19 and/ or malaria is a prerequisite for appropriate distinction.
Point Prevalence Survey of Antimicrobial Prescribing in a Nigerian Hospital: Findings and Implications on Antimicrobial Resistance
(West African College of Physicians and West African College of Surgeons, 2020) Fowotade, A.; Fasuyi, T.; Aigbovo, O.; Versporten, A.; Adekanmbi, O.; Akinyemi, O.; Goossens, H.; Kehinde, A.; Oduyebo, O.
BACKGROUND: Antimicrobial resistance is a global health challenge. There is inadequate information on antimicrobial prescribing practices in many sub-Saharan African countries including Nigeria. A standardized method for surveillance of antimicrobial use in hospitals was employed to assess the antimicrobial prescribing practices in UCH, Ibadan, Nigeria. METHODS: A point prevalence survey (PPS) was conducted in December 15, 2017 at the UCH Ibadan. The survey included all in-patients receiving an antimicrobial on the day of PPS. Data collected included details on the antimicrobial agents, reasons and indications for treatment as well as a set of quality indicators. A web-based application was used for data-entry, validation and reporting as designed by the University of Antwerp (www.global-pps.be). RESULTS: This survey included 451 patients from 38 different wards of which 59.6% received at least one antimicrobial. The neonatal medical wards contributed the highest number of patients who received antibiotics. A total of 172 therapeutic antibiotic prescriptions were issued, mainly for Community- Acquired Infections (n=119; 69.2%). Most prescriptions for Healthcare Associated Infections (n=53) were intervention related (47.2%). Frequently used antibiotics include third generation cephalosporins (23.9%; mainly ceftriaxone); followed by combination of penicillin's (17.4%; mainly amoxicillin with enzyme inhibitor) and fluoroquinolones (16.6%). Majority, 312(69.9%) of the patients had parenteral antibiotics and only 95 (21.3%) of all antibiotic prescriptions had a documented stop or review date. Although the reason for antibiotic prescription was indicated for 413 (92.4%) prescriptions, targeted therapy was the basis for only 17 (3.8%) of these prescriptions. For surgical prophylaxis, 98.7% of all prescriptions were given for more than one day. Compliance to guidelines was non-existent. CONCLUSION: Our findings showed high broad spectrum prescribing, high number of intervention related health care infections, high use of prolonged surgical prophylaxis, inexistence of local guidelines; and low utilization of laboratory facilities. Hospital related intervention should include development of antibiotic guideline and increased enlightenment on rational prescribing practices.
The effect of Hepatitis D co-infection on the immunologic and molecular profile of Hepatitis B in asymptomatic Chronic Hepatitis B patients in southwest Nigeria
(Taylor & Francis Ltd, 2020) Akande, K. O.; Fowotade, A.; Adekanmbi, O.
Introduction: Hepatitis D infection causes severe form of viral hepatitis in humans and only affects those with hepatitis B either as a co-infection or superinfection. The aim of this study was to determine the prevalence of Hepatitis D and its effect on the immunologic and molecular profile of Hepatitis B among asymptomatic Chronic Hepatitis B patients in Abeokuta. Methodology: A cross-sectional study of 99 chronic HBV patient who met the inclusion criteria. All the patients were tested for HBsAg, anti HCV, HDV antigen, anti HDV, HBsAg quantification, and HBV DNA quantification. Associations were tested for and P value less than 0.05 was considered significant. Results: The participants included 53 (58%) male and 38 (42%) females with ages ranging from 18 to 69 (means 39 ± 11) years. Ten (11%) participants were positive for HDV-Ag while 1 (1.1%) was positive for anti-HDV. Five (5.5%) were positive for HIV 1 &2 while 1 (1.1%) was positive for anti HCV. HBV DNA quantification ranged from 15 to 17,000,000 IU/ml while HBsAg quantification ranged from 0.25 to45,520 IU/ml. There was no statistically significant relationship between HDV-Ag and age (p = .51), sex (p = .73), HBV DNA (p = .8) and HBsAg quantification (p = 1). Conclusion: The prevalence of HDV-Ag among asymptomatic treatment naïve chronic hepatitis B patients in Abeokuta was 11% and there was no significant difference in the levels of HBV DNA and HBsAg among those with or without hepatitis D.