Medical Microbiology & Parasitology
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Item Comparative analysis of Cervical Human Papillomavirus DNA testing and cytological findings among women presenting for “Pap” smear in a Tertiary Health Centre in Northern Nigeria(SCIENCE DOMAIN International, 2016) Manga, M. M.; Fowotade, A.; Abdullahi, Y. M.; El-Nafaty, A. U.; Adamu, S.; Bojude, A. D.; Pindiga, H. U.; Bakare, R. A.; Osoba, A. O.Aim: This study was conducted to compare different cytological findings with cervical HPV infection among women presenting for cervical cancer screening in Gombe north-eastern Nigeria. Study Design: It is a hospital based cross-sectional study. Place and Duration of Study: Departments of Obstetrics/Gynaecology and Histopathology Federal Teaching Hospital Gombe (FTHG) Nigeria, between August 2013 and May 2014. Methodology: Two hundred and nine (209) women were subjected to liquid-based cervical cytology and HPV DNA testing. Results: Of the 209 participants, cytological findings were normal in 126 (61.6%) women while 80 (39.0%) had abnormal features. Three (1.4%) respondents had unsatisfactory smears. The observed abnormal cytological features include HPV changes 30 (14.4%), HPV changes with inflammation 2 (1.0%), inflammatory changes alone 36 (17.3%), Low Squamous Intraepithelial Lesion; LSIL 3 (1.4%), High Squamous Intraepithelial Lesion; HSIL 5 (2.4%) and malignant changes 3 (1.4%). Positive HPV DNA testing was detected among 100 (48.1%) of the participants. Almost half 60 (47.6%) of the women with normal cytology were positive for HPV. Among women with cytologically detected HPV changes, only 16 (50%) were also HPV DNA positive. The sensitivity and specificity of cervical cytology in detecting HPV infection was 16.2% and 85.0% respectively. Conclusion: This study reports a very low sensitivity but relatively high specificity of cytology in detecting cervical HPV infection. It further justifies the need for introduction of HPV DNA testing to improve efficiency and maximise the sensitivity of cytology based cervical cancer screening for women above 30 years.Item Human papillomavirus correlates of high grade cervical dysplasia among HIV-Infected women at a major treatment centre in Nigeria: a cross-sectional study(African Field Epidemiology Network (AFENET), 2019) Yakub, M. M.; Fowotade, A.; Anaedobe, C. G.; Manga, M. M.; Bakare, R. A.; Abimiku, B. A.Introduction: persistent high-risk HPV (hrHPV) infection is higher among women living with HIV/AIDS thus increasing their risk for cervical cancer. We evaluated the virological and immunological correlates of cervical dysplasia in HIV-infected women. Methods: a cohort of 220 consenting women attending the antiretroviral clinic of the Federal Medical Centre, Keffi, Nigeria was tested for cervical human papilloma virus (HPV) infection using PCR. The prevalent HPV genotypes were determined by DNA sequencing. CD4+T count and type specific HPV was correlated with cervical cytology. Descriptive and inferential statistical analysis of the data was done using the statistical package for social sciences (SPSS) version 20 (SPSS Inc, Illinois, USA) for analysis after validation. Results: overall HPV prevalence was 54.1% while the hrHPV prevalence was 35.9%. Premalignant and malignant lesions were observed among participants with CD4+T counts between 200-300/mm3. A statistically significant association was observed between cervical premalignant lesions and CD4+ count (X2=24.747, P value=0.001) as well as hrHPV infections (X2=46.800, P<0.001). Conclusion: risk stratification with HPV screening among HIV-infected women will help in early case management of cervical precancerous lesions.Item Re-emergence of Monkeypox in Nigeria: a cause for concern and public enlightenment(African Society for Clinical and Experimental Microbiology, 2018) Fowotade, A.; Fasuyi, T. O.; Bakare, R. A.Monkey pox infection is a zoonotic infection transmitted by direct or indirect contact with blood, body fluids and lesions of an infected animal. Human to human spread of Monkey pox has been described and infection is usually self-limiting, with an incubation period of 6-16 days. In Nigeria, the last case of monkey pox infection was recorded over 46 years ago. The recent emergence in Nigeria occurred in the year 2017 and was reported to have spread to 24 states with 228 suspected individuals affected. Laboratory diagnosis, as well as management and prevention of monkey pox infection in Nigeria, remain challenging as Nigeria is a resource-poor country with limited infrastructure, technical skill and training which is required in making a diagnosis. The ability of the monkey pox virus to evolve, its potential bioterrorism potential, as well as its recent emergence in Nigeria further justifies the need for improving the understanding of the presentation and prevention of monkey pox infection.Item Human papillomavirus infection among women attending family planning clinic in Nigeria: prevalence, correlates, and co-infection with Chlamydia trachomatis(Taylor & Francis Ltd, 2018) Fowotade, A.; Osisanwo, D. A.; Bakare, R. A.Infection with high-risk genotypes of human papillomavirus (HPV) is considered the main cause of invasive cervical. A number of epidemiologic studies have suggested that HPV and Chlamydia trachomatis (CT) play a synergistic role in the etiology of cervical intraepithelial neoplasia and subsequent cervical cancer. The current study aimed to evaluate the HPV prevalence and the risk factors for co-infection with CT among women attending family planning clinic in Nigeria. Following enrolment, 90 patients were screened for IgG antibodies to virus-like proteins of HPV types 6, 8, 16, and 18. CT seropositivity was tested by enzyme-linked immunosorbent assay for the detection of IgG and IgM antibodies. The prevalence of HPV IgG was 20%. Seropositivity for CT IgM was 77.8% while the IgG was 0%. A total of 10 women (11.1%) were seropositive for both CT IgM and HPV IgG antibodies. Seropositivity for HPV IgG was significantly associated with age at marriage (P < 0.001), current Chlamydia infection (P < 0.011), and number of children (P < 0.025), while seropositivty for HPV IgG and Chlamydia trahomatis IgM was significantly associated with age at coitarche (P < 0.028), number of life sex partners (P < 0.033), and history of multiple sexual partners (P < 0.002).Item Serosurvey of human T cell lymphotropic virus I/II among blood donors in Gombe (Nigeria)(EDORIUM Journals, 2016) Manga, M. M.; Fowotade, A.; Yuguda, S.; Iya, G. A.; Yahaya, M.; Sheriff, Y. M.; Omoruyi, E. C.; Yola, I. M.; Bakare, R. A.Aim: This study was carried out to determine the prevalence of human T cell lymphotropic virus I/II (HTLV I/II) among blood donors at the Federal Teaching Hospital Gombe (FTHG), North-eastern, Nigeria. Methods: A total of 355 blood donors were recruited at the hematology department of FTHG for a hospital based crosssectional study and were screened/confirmed for HTLV I/II by ELISA and western blot methods. Results: Seroprevalence of HTLV I/II among the 355 participants with mean age of 30.77 years (±8.27) was 6.5% on screening with ELISA but confirmed to be 0% by western blot. Majority were males, 352 (99.2%) and mostly (45.9%) between 21–30 years of age. Donors for family replacements predominated (85.1%) with more than half (58.6%) being first time blood donors. Conclusion: This study reveals the absence of HTLV I/II among blood donors in Gombe Northeastern Nigeria. It also highlights the possibility of false positivity in some of the reported prevalence of HTLV I and II from some parts of Nigeria that were based on screening tests only. The importance of confirmatory testing in all research works on HTLV (including HTLV 3 and HTLV 4) is further strengthened with this study. There is however the need for a larger study and the use of molecular diagnostics to reconfirm this assertion.Item Prevalence, socio-demographic features and risk factors of Hepatitis B virus infection among pregnant women in Southwestern Nigeria(African Field Epidemiology Network (AFENET), 2015) Anaedobe, C. G.; Fowotade, A.; Omoruyi, C. E.; Bakare, R. A.Introduction: Hepatitis B virus is responsible for 50%-80% of Hepatocellular carcinoma cases worldwide. In Nigeria, vertical transmission remains a major route of Hepatitis B virus infection. Primary (vaccines and post-exposure prophylaxis) and secondary prevention of HBV transmission by appropriate sexual and sanitary practices are not yet optimal in the country yet measures for early detection (serological, molecular) and treatment of infected pregnant women is not a practice. This study aimed at identifying the prevalence and risk factors for Hepatitis B virus infection among pregnant women in Ibadan, Southwestern Nigeria. Methods: A cross-sectional study was done at the Ante-natal clinic of the University College Hospital Ibadan. One hundred and eighty pregnant women were recruited from March to August 2013, and tested for Hepatitis B surface antigen (BIORAD FRANCE) using third generation ELISA, as well as HIV-1 and 2 using Uni-Gold Recombigen and ALERE determine (a rapid immunoassay designed to detect antibodies to HIV 1 and/or 2). Positive HBsAg samples were tested for Hepatitis B envelope antigen, antibody and Hepatitis B core antibody (DIAPRO Italy) while serum HBV DNA was detected using PCR. Data were obtained using questionnaires to establish and analysis was performed using SPSS version 20. Results: The seroprevalence of HBsAg was 8.3% out of which 26.7% were positive for HBeAg, 53.3% had HBeAb, 20% had neither HBeAg nor HBeAb, 100% had total HBcAb and 86.7% had HBV DNA in their serum. The mean age was 32.1years, the highest HBV infection rate occurred in 25-29 year age group. Multiple sexual partners (OR- 3.987, P-value=0.026) and early age at sexual debut (OR 11.996, P- value=0.022) were independent risk factors for HBV infection. Conclusion: Hepatitis B virus infection is of high endemicity in Nigeria thus early detection, treatment of infected pregnant women, immunoprophylaxis for exposed newborns and surveillance for those with chronic infection is essential. Health education programs on prevention and control measures must be instituted.Item Epidemiological patterns of cervical human papillomavirus infection among women presenting for cervical cancer screening in North-Eastern Nigeria(BioMed Central Ltd, 2015) Manga, M. M.; Fowotade, A.; Abdullahi, Y. M.; El-nafaty, A. U.; Adamu, D. B.; Pindiga, H. U.; Bakare, R. A.; Osoba, A. O.Background: Sub-Saharan countries including Nigeria have the highest burden of Human Papillomavirus (HPV) infection in the world. Most studies on HPV surveillance in Nigeria were done in the southern part of the country. Geographical and socio-cultural diversity of Nigeria makes these data unlikely to be universally representative for the entire country. Northern Nigeria especially the North-East carries a higher prevalence of cervical cancer and many of its risk factors. The region may be harbouring a higher prevalence of HPV infection with a possibility of different genotypic distribution. This study was carried out to determine the burden and confirm the predominant HPV genotypes among women presenting for cervical cancer screening at the Federal Teaching Hospital Gombe (FTHG), North-eastern, Nigeria. Methods: The study was an observational hospital based cross sectional study among women who presented for cervical cancer screening in FTHG. A total of 209 consenting women were tested for cervical HPV infection using PCR. DNA sequencing was carried out on positive samples to determine the prevalent HPV genotypes. Results: The prevalence of cervical HPV infection among the participants with mean age of 39.6 ± 10.4 years was 48.1 %. The five most predominant genotypes were 18, 16, 33, 31 and 35, with prevalence of 44.7 %, 13.2 %, 7.9 %, 5.3 % and 5.3 % respectively. Other genotypes observed were 38, 45, 56, 58, 82 and KC5. Multiple HPV infections were detected among 7.9 % of participants. Risk factors such as level of education (X2 = 15.897; p = 0.007), age at sexual debut (X2 = 6.916; p = 0.009), parity (X2 = 23.767; p = 0.000), number of life time sexual partners (X2 = 7.805; p = 0.005), age at first pregnancy (X2 = 10.554; p = 0.005) and history of other malignancies (X2 = 7.325; p = 0.007) were found to have a statistically significant association with HPV infection. Conclusion: This study identified a high burden of HPV infection in Northern Nigeria while also confirming HPV 18 and 16 as the most predominant genotypes. It further justifies the potential benefit of the currently available HPV vaccines in the area. A larger and community based study is however recommended for better representation of the area.Item 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.Item 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.Item Risk factors and outcome of Acinetobacter infection in the intensive care unit of a tertiary center in Oyo State, Nigeria(Academic Journals, 2013) Nwadike, V. U.; Fayemiwo, S. A.; Fowotade, A.; Bakare, R. A.; Olusanya, O. O.Acinetobacter plays an important role in the infection of patients admitted to hospitals. Acinetobacter are free living gram-negative coccobacilli that emerge as significant nosocomial pathogens in the hospital setting and are responsible for intermittent outbreaks in the intensive care unit. The aim of this study was to determine the risk factors and outcome of Acinetobacter infections in patients admitted into the intensive care unit of a tertiary center in Oyo State, Nigeria. A total of one hundred patients were recruited for the study, catheter specimen urine, tracheal aspirate and blood culture were collected aseptically from the patients. The specimens were cultured on blood and MacConkey and the organisms identified using Microbact 12E (0xoid). Fourteen (14%) of the 100 patients recruited into the study developed Acinetobacter infection. Chronic obstructive pulmonary disease, endotracheal intubation, and duration of endotracheal intubation were associated risk factors with only duration of endotracheal intubation specifically an 8 to 14 day period being an independent risk factor for Acinetobacter. Six of the patients died of the infection while the remaining eight were discharged from the ICU. The findings that chronic obstructive pulmonary disease and duration of endotracheal intubation being associated with Acinetobacter infection and the attendant mortality associated with the infection should draw attention to this seemingly silent epidemic in our Intensive Care Units so that effective surveillance protocols can be deployed to manage this infection whenever it rears its head.