Medical Microbiology & Parasitology
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Item Prevalence of intestinal parasites in newly diagnosed HIV/AIDS patients in Ilorin, Nigeria(Alexandria University Faculty of Medicine, 2017) Obateru, O. A.; Bojuwoye, B. J.; Olokoba, A. B.; Fadeyi, A.; Fowotade, A.; Olokoba, L. B.Background: Human immune-deficiency virus/acquired immune-deficiency syndrome predisposes to opportunistic parasitic infestations of the gastrointestinal tract. This study aimed to determine the prevalence of intestinal parasites in newly diagnosed treatment naı¨ve HIV/AIDS patients. Methods: This hospital-based cross-sectional study was carried out from December 2010 to June 2011. Questionnaires were administered to 238 HIV/AIDS subjects, and 238 age and sexmatched controls. CD4+ T cell count was carried out on HIV-positive subjects. Stool samples were examined using direct microscopic and modified Ziehl-Neelsen methods. Positivity of intestinal parasites was taken as the presence of worms, oocyst, cyst, ova or larvae in the stool samples. Results: Ninety males and 148 females were studied for the HIV-positive and HIV-negative controls respectively. Intestinal parasitic infestation in HIV-positive subjects was 68.5%, and was significantly higher than in the HIV-negative controls 49.2% (P < 0.05). In HIV-positive subjects, Cryptosporidium spp. was the commonest (55.0%) parasite isolated. Others were Cyclospora cayetanensis (41.2%), Isospora belli (3.0%), Entamoeba histolytica (8.4%), Giardia lamblia (3.7%), Ascaris lumbricoides (2.5%), Strongyloides stercoralis (1.7%), Trichuris trichiura (0.8%) and Schistosoma mansoni (0.4%). HIV-positive patients with CD4+ T cell count of less than 200 cells/ul were more at risk of opportunistic parasites compared to the HIV-negative controls. Conclusion: The prevalence of intestinal parasites in newly diagnosed HIV/AIDS individuals was high, and its association with CD4+ T cell count was demonstrated. Routine screening for parasitic infestations at diagnosis is indicated to reduce the burden of the disease.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 Methicillin resistant staphylococcus aureus: awareness, knowledge and disposition to screening among healthcare workers in critical care units of a Nigerian hospital(West African College of Physicians and West African College of Surgeons, 2011) Fadeyi, A.; Adeboye, M. A. N.; Fowotade, A.; Nwabuisi, C.; Bolaji, B. O.; Oyedepo, O. O.; Adesiyun, O. O.; Olanrewaju, T. O.; Aderibigbe, A.; Salami, A. K.; Desalu, O. O.; Akanbi II, A. A.; Raheem, R. A.; Olalere, A.BACKGROUND: Awareness level about methicillin resistant Staphylococcus aureus (MRSA) is high in the western world but the status in developing countries is not well defined. OBJECTIVE: To assess MRSA awareness level, knowledge and disposition to screening among critical healthcare givers (HCGs) in Nigeria. METHODS: A self-administered questionnaire was used to assess the level of awareness and knowledge of HCGs in critical care units of the University of Ilorin Teaching Hospital, Ilorin, Nigeria on MRSA and their willingness to submit to screening. RESULTS: Only 103 (52.0%) of the 198 participants were aware of MRSA but all were favourably disposed to screening for the organism. Awareness was through hospital rounds 65(63.1%) and journals/ textbooks 35(34.0%), and Many, 120 (60.6%) considered MRSA as a threat in the hospital, while only 27 (13.6%) thought otherwise and 51(25.8%) were indifferent. Most HCGs, 124 (87.9%) reported that there were no MRSA control measures in their respective duty post. The age, cadre of work, and number of years in the hospital’s critical care units correlated positively with awareness level. CONCLUSION: Methicillin resistant Staphylococcus aureus awareness level among the HCGs in our hospital is just a little above 50.0% with substantial proportion of them not realizing the medical implication of the organism. However, majority are well disposed to MRSA screening. Inadequate publicity is a major contributor to poor knowledge and awareness. There is need for educational intervention and sensitization programs on MRSA and other infection control techniques for HCGs in developing nations especially Nigeria.Item Awareness and practice of safety precautions among healthcare workers in the laboratories of two public health facilities in Nigeria(Wolters Kluwer Medknow Publications, 2011) Fadeyi, A.; Fowotade, A.; Abiodun, M. O.; Jimoh, A. K.; Nwabuisi, C.; Desalu, O. O.Aims and objectives: To determine the level of awareness and practice of SP among laboratory workers at two tertiary public health facilities in Nigeria. Methods: A semi-structured, self-administered questionnaire was used to assess the awareness, attitude and adherence to SP among laboratory workers. Information on the availability of safety equipment was also sought. The laboratory safety practice of respondents was assessed based on self-reported observance of basic principles of universal precautions in clinical settings. Results: Study participants were 130, mean age: 28.2 years (SD±6.6), number of years in hospital employment: 3.7 years (SD±2.4) and the male to female ratio was 1.8:1. Many (41.5%) were unaware and 25.4% do not observe SP. Participants attest to availability of various safety devices and equipment including hand gloves (86.2%), disinfectants (84.6%), HBV immunization (46.2%) and post exposure prophylaxis (PEP) for HIV and HBV (79.6%).Attitude to safety is unsatisfactory as 60.0% eat and drink in the laboratory, 50.8% recap needles and 56.9% use sharps box. Even though 83.1% are willing to take PEP, only 1.5% will present self following laboratory injury. Conclusion: This study shows the deficit in the awareness of SP among laboratory personnel and demonstrates that attitude and practice of safety rules are unsatisfactory. Training and re-training on SP is therefore desired. Counselling to induce a positive attitudinal change on HBV immunisation and PEP is similarly necessary.Item Factors influencing students' performance in medical microbiology in Univeristy of Ilorin, Ilorin, Nigeria(Core publishers, 2010) Odimayo, M. S.; Nwabuisi, C.; Fadeyi, A.; Fowotade, A.; Olorundare, S. A.Excellent performance by students, in any discipline, depends on a number of factors. We determined teachers and students' factors influencing students' performance in Medical Microbiology, using University of Ilorin Medical programme as a case study. Medical students who had completed at least 2 postings in pathology were selected and interviewed using a self administered questionnaire. A total of 173 students were interviewed among which 119 (68.8%) were males while 54 (31.2%) were females. Majority of the students (81.5%) believed that Medical Microbiology lecturers have the required professional teaching qualities, 82.1% also agreed that the lecturers were interested in their subject. However, 60.4% agreed that the lecturers use poor teaching methods and 55.5% agreed that lecturers teach Microbiology in abstract terms. Cultism and social activities (53,9%), Students' failure in scheduling their time wisely (64.7%), failure to take their practical session seriously (55.5%) and lack of appropriate books (69.9%) affected students' performance negatively. From our study, it was discovered that the use of poor teaching methods, excessive work load and failure of students to manage time appropriately were major factors negatively influencing Medical student's performance in: Medical Microbiology while lecturer's qualification and interest would affect their performance positively in the same subject if properly harnessed. For optimal performance, we recommend the reorganization of pathology training programme to include lectures enhanced with multimedia projection and illustrations, laboratory rounds, role play, teaching rounds and Tutorials.Item Methicilin resistant Staphylococcus aureus carriage amongst healthcare workers of the critical care units in a Nigerian hospital(Science Publications, 2010) Fadeyi, A.; Bolaji, B. O.; Oyedepo, O. O.; Adesiyun, O. O.; Adeboye, M. A. N.; Olanrewaju, T. O.; Aderibigbe, A.; Salami, A. K.; Desalu, O. O.; Fowotade, A.; Nwabuisi, C.; Akanbi, A. A.; Raheem, R. A.; Olalere, A.Problem statement: Methicilin Resistant Staphylococcus Aureus (MRSA) Nosocomial Infection (NI) outbreaks and prevalence among various populations are well reported in literature particularly for developed countries. NI due to MRSA is a known cause of increased hospital stay, cost, morbidity and mortality especially among the critically ill. There is paucity of information on MRSA in developing nations including the carriage by critical healthcare givers who are potential transmitters. In most hospital in developing countries like Nigeria, there is neither surveillance system or control policy for MRSA. Approach: We screened healthcare workers in the critical care units of the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria for MRSA and determined vancomycin susceptibility of the isolates. Swabs of both anterior nares and web spaces of the hands were taken, transported and incubated in Tween 80 at 35°C overnight aerobically before inoculation onto Mannitol Salt Agar (MSA). Inoculated MSA were incubated aerobically at 35°C for 18-24 h. Staphylococcus aureus was identified as Gram positive cocci with positive catalase, coagulase and DNAse test. MRSA were identified by combined oxacillin and cefoxitin discs diffusion method. Sensitivity to vancomycin was by vancomycin discs diffusion and vancomycin agar screen plating. Results: Of the 198 healthcare workers screened, 104 had MRSA either in the nose, hand or both giving a carriage rate of 52.5%. Nasal carriage (38.9%) was higher than hand (25.3%). Doctors (22.7%) and Nurses (16.7%) were the predominant carriers. MRSA isolates were resistant to commonly available antibiotics. Only 1 (1.3%) of the nasal isolates was vancomycin resistant. Conclusion: MRSA carriage among healthcare workers in the critical care units of the Nigerian hospital is high with doctors and nurses being the major carriers. The MRSA isolates were multi-drug resistant which may lead to increased morbidity and mortality if transmitted to the critically-ill. There is need for MRSA control policies in hospitals with settings of our type.Item A review of swine Influenza: an emerging pandemic(African Journals Online, 2009) Fowotade, A.; Agbede, O.; Nwabuisi, C.; Fadeyi, A.An unprecedented epizootic swine Influenza A (HINT) virus that is highly pathogenic has crossed the species barrier in Mexico to cause many human fatalities and poses an increasing pandemic threat. This summary describes the aetiopathogenesis of human infection with Influenza A (HINI) and reviews recommendations for prevention and clinical management.Item Cryptococcal Meningitis in a newly diagnosed AIDS patient: a case report(West African College of Physicians and West African College of Surgeons, 2009) Salami, A. K.; Ogunmodede, J. A.; Fowotade, A.; Nwabuisi, C.; Wahab, K. W.; Desalu, O. O.; Fadeyi, A."BACKGROUND: Cryptococcus neoformans is a very important cause of fungal meningitis in immunosuppressed patients OBJECTIVE: To describe a case of cryptococcal meningoencephalitis in an HIV/AIDS patient from the University of Ilorin Teaching Hospital. METHODS: An 18 -year -old male student presented with cough, weight loss, and fever. He was clinically assessed and had full laboratory investigations including cerebrospinal fluid CSF and then started on chemotherapy. Both the clinical and neurological evaluation of the patient was described along with the laboratory analyses of his CSF. Outcome of how he was managed was also reported. RESULTS: Cryptococcus neoformans presented as an AIDS defining fungal infection for the first time in this 18 year old undergraduate who was infected probably from transfusion of unscreened blood He had advanced HIV infection (CD4+ count of 29cells/ul) and severe cryptococcal meningoencephalitis. He was unsuccessfully managed with fluconazole, a second choice drug for this condition, amphotericin B being not available. CONCLUSION: Nigerians should have access to effective blood transfusion services at all public and private hospitals across the country. The National Essential Drug list should be expanded to include drugs such as amphotericin B which hitherto were considered exotic.