Medical Microbiology & Parasitology
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Item 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.Item Haemocytometric profile of Nigerian patients with Covid-19(Faculty of Basic Mdical Sciences, University of Ibadan, 2021) Arinola, O. G.; Edem V. F.; Rahamon, S. K.; Fowotade, A.; Onifade, A. A.; Adekanmbi, O. B.; Salami, O. I.; Fashina, O. A.; Ishola, O. C.; Akinbola, I. O.; Akinbile, A. S.; Eegunjobi, O. A.; Bello, M. D.; Famuyiwa, O. I.; Olaoti, A. J.; Olaniyan, O. A.; Oke, C. A.; Johnson, O. J.; Fagbemi, S. O.; Alonge, T. O.The haemocytometric changes and possible interplay with duration of hospital stay, gender and age in Nigerians with COVID-19 were determined in this study. Routine haemocytometry was evaluated using a standard method and thereafter, neutrophil-lymphocyte ratio (NLR); a marker of inflammation was calculated. Neutrophil percentage, total white blood cell (WBC) count and NLR were significantly higher while lymphocyte percentage was significantly lower in patients with COVID-19 compared with the controls. In females with COVID-19, neutrophil percentage was significantly higher compared with the males. Considering length of hospital stay, monocyte percentage was significantly higher in patients who spent more than 10 days on admission compared with those with 10 or fewer days of admission. At discharge, the proportion of patients with monocyte percentage above the reference range was significantly lower compared with baseline. Also, monocyte percentage in COVID-19 patients had significant positive correlation with days on admission. Alteration in haemocytometry worsens with increasing age as percentages of monocyte and neutrophil, NLR and WBC count were significantly higher while the lymphocyte percentage was significantly lower in patients aged 40 years and above compared with younger patients. Also, age had significant positive correlation with percentages of monocyte and neutrophil, NLR and WBC count but a significant negative correlation with lymphocyte percentage. Haemocytometric changes and inflammation in COVID-19 patients increase with age. Also, monocyte count could be an indicator of longer hospital stay and its reduction might be an indicator of recovery from the disease.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 Seroprevalence of hepatitis E among restaurant food handlers in Ibadan, Nigeria(National Institute for Medical Research (NIMR), 2019) Fowotade, A.; Akande, O.; Gbaja, A. T.; Ogunleye, V. O.; Ajayi, A.; Kehinde, A. O.Background: Hepatitis E virus (HEV) is one of the causative agent of acute viral hepatitis in humans. HEV is an important public health disease in many parts of the world because it is transmitted faeco-orally. Majority of the documented studies on hepatitis E virus in Nigeria have focused on pregnant women and animal handlers with limited data among food handlers. Thus the current study aimed at investigating the prevalence of HEV infection among food handlers operating within the premises of a tertiary care facility. Methods: One hundred and seventy seven (177) food handlers were screened using commercial Enzyme- Linked Immuno-Sorbent Assay (ELISA) to detect IgM antibodies to Hepatitis E. A semi-structured questionnaire was used to assess risk factors for HEV infection. Results: HEV IgM antibodies were detected in 16 (9.0%) of the participants. Age-specific HEV IgM seroprevalence appeared to decrease with age, however there were no significant differences in HEV IgM seropositivity regarding age (P=0.251), gender (P = 0.231), marital status (P=0.735) and religion (P = 0.906). Significant risk factors for HEV IgM seropositivity included source of water for drinking (P=0.03) and the use of soap for hand washing (P=0.02). Conclusion: Our findings suggest that HEV remains a public health problem, as the virus circulates at low but considerable levels especially among food handlers; thus posing a threat to potential contacts. Proper hand washing practices as well as provision of portable water are important factors for the control of Hepatitis E.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 Recent Rubella infection among childbearing women in a tertiary hospital in Nigeria: a Seroepidemiological indication for vaccination need(African Society for Clinical and Experimental Microbiology, 2016) Suleiman, S. T.; Bakare, R.; Akanbi, A. A.; Fowotade, A.; Billiaminu, S. A.; Durowade, K. A.Background: Congenital Rubella Infection can be prevented and future generation saved from disability by protecting women of reproductive age through vaccination. The study is aimed at determining serological evidence of recent rubella infection among women of childbearing age. Method: A cross sectional study was carried out among 285 women aged between 15 and 49 years. Enzyme immunoassay method was used to detect and quantify human IgM and IgG antibodies with avidity for Rubella virus in sera of participants. Socio-demographic characteristics of the subjects, along with recent history of fever, rash and adverse pregnancy outcome among others were obtained using a questionnaire. Statistical analysis was carried out using the program statistical package for social sciences (SPSS) version 16. Majority (78.3%) of the women recruited for the study were within 15-34 years age range. Of the 285 sera assayed for Rubella IgM antibodies, 23 (8.1%; 95% CI: 4.9%-11.3 %.) was IgM seropositive, while the remaining 262 (91.9%) were seronegative. A total of 7 (2.5%) of reproductive age women in Ilorin had a recent primary infection while 16 (5.6%) had a persistent Rubella infection or recent re-infection. In conclusion, there is need for vaccination of susceptible women of reproductive age in Ilorin as a large number of women have Rubella in their reproductive age.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 Rubella antibody avidity among rubella seropositive women attending a tertiary care facility in Nigeria(Aras Part Medical International Press, 2015) Suleiman, S. T.; Bakare, R.; Akanbi II, A. A.; Fowotade, A.; Billiaminu, S. A.; Durowade, K. A.Objectives: The aim of this study was to determine the seroprevalence of rubella virus antibodies among women of reproductive age group and assess risk factors of rubella infection. Materials and Methods: A cross-sectional study was carried out among 285 women aged between 15 and 49 years. Enzyme-linked immunosorbent assay (ELISA) method was used to detect and quantify human immunoglobulin G (IgG) antibodies with avidity for rubella virus in sera of participants. Socio-demographic characteristics of the participants, along with recent and previous history of fever and rash among others were obtained using a questionnaire. Statistical analysis was carried out using SPSS version 16. Results: Seroprevalence of rubella IgG among women of reproductive age in Ilorin was 92.3% (95% CI: 89.2%-95.4%). Thus susceptibility rate to rubella infection was 7.7%. Majority (87.1%) of the IgG seropositive participants had high rubella IgG avidity, implying past rubella infection or reinfections. Seroprevalence was significantly higher among participants from lower educational and socio-economic classes compared with other participants (P = .035 and P = .023, respectively). There was a negative correlation between age and rubella specific IgG titer (P = .000). Thus rubella specific IgG titer decreases with increasing age. Conclusion: There is need for vaccination of susceptible women of reproductive age in Ilorin as the rubella susceptibility rate was higher than the 5.0% target set by the World Health Organization (WHO) for prevention of congenital rubella syndrome (CRS).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.