Introduction: Neonatal sepsis is a major cause of mortality in developing countries. Accurate and quick diagnosis are difficult because clinical presentation are non-specific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. Serum procalcitonin (PCT) has been proposed as an early marker of infections in neonates. Objectives: This study investigated the value of PCT in the diagnosis of Neonatal Sepsis. Methods: Neonates undergoing sepsis evaluation at the Special Baby Care Unit, Federal Medical Centre, Abeokuta, Nigeria between January and April 2013 were included. Blood samples were obtained for white cell count, blood cultures, serum CRP and PCT analysis. Neonates were categorised into Proven Sepsis, Suspected Sepsis and Clinical Sepsis groups on the basis of laboratory findings and risk factors. A control group with no clinical and biological data of infection was also included. Predictive values and area under the receiver operating characteristic curve (AUC) of PCT were evaluated. Result: Of the 85 neonates, 19 (22.4%) had positive blood culture. PCT level was significantly higher in neonates in all sepsis groups in comparison with those in the control group (P< 0.05). At a cut-off of 0.5 ng/ml, the negative predictive value (NPV) of PCT was 80% and the positive predictive value (PPV) 39%. There were no significant statistical difference between the AUC values of PCT in Early onset and Late onset sepsis, as well between AUC in Preterm and term cases. A higher percentage of neonates who died (96%) had elevated PCT levels compared to those who survived (46%). Conclusion: These findings support the usefulness of the PCT in diagnosis of Neonatal sepsis. Keywords: Neonatal Sepsis, Diagnosis, Procalcitonin, Receiver Operating Characteristic Curve

The bottom ash produced during incineration contains toxic heavy metals that can persist for a long time in the environment and accumulate in the food chain; when indiscriminately disposed of, it can adversely affect public health. The study aimed at assessing the level of heavy metals in the bottom ashes produced during the incineration of sharp medical waste. Bottom ash samples were collected from the ash pit of the incinerator twice a month for four months (two months in the rainy and two months in the dry season) in triplicates. Five grams of the sieved samples were analyzed for cadmium (Cd), chromium (Cr), Nickel (Ni), iron (Fe), lead (Pb), Copper (Cu), and zinc (Zn) using atomic absorption spectrophotometer. The mean concentrations of these heavy metals during the study period in decreasing order were Fe (18,504.66) > Zn (16,292.11) > Cr (374.47) > Pb (179.78) > Cu (128.91) > Cd (1.28) > Ni (0.50) mg/kg. The concentrations of the assessed heavy metals in the bottom ash samples obtained were compared with notable international guidelines, and it was deduced that the concentrations of all the heavy metals were above the acceptable limits except for Nickel, whose concentration was below the limit set for it.

INTRODUCTION:Zika virus (ZIKV) infection during pregnancy can result in severe outcomes for both the pregnant woman and the developing fetus. The objective of this study was to investigate the prevalence of Zika virus infection among pregnant women who sought healthcare services at Ahmadu Bello University Teaching Hospital.MATERIALS AND METHODS:Serum samples were collected and analyzed using Enzyme Linked Immunoassay and RT-qPCR methods, while a structured questionnaire was used to gather relevant information about the participants.RESULTS:The results showed that 53 out of the 180 pregnant women tested positive for Anti-Zika IgM antibodies, which represents a 29.4% prevalence rate. Subsequent RT-qPCR analysis found that only 6 out of the 53 positive samples contained Zika virus RNA. Fever and headache were the most commonly reported symptoms related to the infection.CONCLUSION:These findings indicate a potential outbreak of Zika fever in Northern Nigeria emphasizing the importance for pregnant women to take precautions to avoid getting infected.

Prior to the discovery of Human Immunodeficiency Virus (HIV), the pattern of tuberculosis (TB) prevalence witnessed a gradual drawdown and the mode of presentation was usually pulmonary. This study assesses the mortality rates of TB and HIV co-infected patients in a directly observed therapy (DOT) centre in Nigeria. The retrospective study retrieved 18 months of data from 197 patients on the TB register of a centralized DOT centre in the Ogun State, Nigeria. Data collected included age, sex, and HIV status, with TB results obtained from Genexpert. The data obtained from 197 TB patients were analyzed using descriptive statistics and chi-square. Out of the 197 TB patients, 67.0% were males and 33.0% were females. A majority of the patients (41.6%) were within the age category of 43 years and above. This was followed by 35 – 42 years (25.4%) and 27 – 34 years (19.8%), while the lowest proportion of patients (0.5%) falls within the age brackets of 3 - 10 years. Furthermore, 92.9% of the patients were HIV negative. Using Chi-squared test, no significant difference was seen in TB occurrence to sex (p>0.05) while age contribute significantly to mortality. Co-infection of HIV/TB was 7.1% while mortality rate in this group was 28.6%. as observed in the age group 43 and above. Overall, the mortality rate in the TB patients was 2.0%. Results showed that the age was a significant contributor (p<0.05) to HIV TB co-infection among the patients. Age regressed positively with TB infection in the study population. The study concludes that the co-infection of TB and HIV was significantly associated with high mortality.

: The increase in the occurrence of carbapenemase-producing Enterobacteriaceae constitutes a threat not only to treatment of bacterial infection but also to public health problems. Resistance to carbapenems is mostly due to the production of carbapenemases, which are capable of hydrolyzing not only carbapenems but also other groups of antibiotics like penicillins, cephalosporins, quinolones, etc. The most common carbapenemases include veronica integron Metallo-β-lactamases types (VIM), imipenemase (IMP) types, Klebsiella pneumoniae carbapenemase (KPC), oxacillinase-48 (OXA-48), and New Delhi metallo-β-lactamase-1 (NDM-1), encoded by carbapenem resistant determining genes bla VIM, bla IMP, bla KPC, bla OXA-48, and bla NDM, respectively. Carbapenemase activity can be investigated by phenotypic assay however carbapenemase encoding genes can also be part of the routine assay for diagnosis of bacterial infection. In Africa, there is limited data on the prevalence and distribution of carbapenem resistant enterobacteriaceae in clinical studies except in East Africa where a few studies have been done in Kenya and Tanzania.

Statement of the Problem: Tuberculosis remains a serious public-health threat in developing countries though it has been eradicated in some advanced countries. This disease constitutes a significant threat to global health, being the second highest cause of morbidity and mortality resulting from infectious agents. Prompt diagnosis of active TB facilitates timely therapeutic intervention and minimizes community transmission. Aim: This study aimed at determining a ‘Point of Care’ diagnostic tool for pulmonary tuberculosis (PTB) by comparing the efficiency of four different PTB diagnostic tools for different age groups. Methodology: Zeihl Nelson (ZN) staining, culture, Gene xpert (GX) and Lipoarabinomanan (LAM) assay were employed in this study The culture method was used for confirmation. Sputum and urine samples were collected from each of 100 patients symptomatically diagnosed of PTB. Findings: Fifty-seven percent of the population was male while 43% were female. Mycobacterium tuberculosis was isolated from 9 (9%) of 100 patients. Similarly, GX detected Mycobacterium tuberculosis in 9 (9%) of the patients while the rate of detection using LAM was 10% and with ZN it was 7%. Gene xpert produced no true or false positive and negative result, LAM had one false positive result and ZN had two false negative results. The maximum time frame to generate result was 25 minutes for LAM, two hours for Gene xpert, eight weeks for culture and two days for ZN. Two positive isolates were observed at the same frequency for age group 21-30 and 31- 40 while age groups 1-10, 10-20, 41-50, 50-60 and above has 1 positive result each. Gene xpert had 98.11% sensitivity while LAM had 96.23% and ZN had 86.79%. The choice of ‘Point of Care’ diagnostic tool is of great concern to clinicians and the general public. Conclusion & Significance: This study identified LAM assay as suitable ‘Point of Care’ diagnostic and an add-on tool for PTB diagnosis because of its relatively high sensitivity and short maximum time frame to generate result compare to other three diagnostic techniques.

Objectives: UTIs could be wrongly diagnosed by chromogenic dipsticks especially in the case of early infection. Hence, the need to evaluate the sensitivity of the dipstick in comparisms to conventional method, microscopy. Methods: Sample size was obtained using standard normal distribution within 95% CI. Three hundred and seventy urine samples were collected after obtaining consent and ethical approval. WBCs and RBCs were counted after staining the slide and view at high-power microscope. All the positive samples were subjected to urinalysis using chromogenic dipsticks with ten biomarkers. The data was processed using descriptive statistics and represented with Graph Pad Prism version 6.01. Results: The gender distribution 33.5% and 66.5% for male and female respectively while age ranges from less than 1 year to greater than 60 years. Only two hundred (200) had WBCs by microscopy with 0-4 cells (73.5%), 5-9 (9.5%) and 10+(17%). These positive samples were subjected to urinalysis. Among other biomarkers, protein and nitrite are 49.5% and 36% respectively. High alkalinity (pH 9) was observed in the 18% of the urine sample investigated. Out of the positive samples to microscopy, only 27.5% were confirmed positive by chromogenic dipsticks. Conclusion: The sensitivity of the dipstick cannot be absolutely relying upon because of undetectable level of some enzymes required for the colour change. This can result into false negative in the diagnosis of UTIs.

Polyparasitism is widespread in many communities in Sub-Saharan Africa. However, there is paucity of data on polyparasitism in infants and preschool-aged children (IPSAC), to inform policy developments. Therefore, a survey of 1110 consented IPSAC was undertaken in Egbedore Local Government Area (LGA), Osun State, Nigeria, to determine the prevalence of polyparasitism in IPSAC in ten randomly selected rural communities. Fresh stool and blood samples were collected and processed for intestinal parasites and malaria infection. Mothers/caregivers were interviewed using a structured questionnaire to obtain demographic data of their IPSAC and to document knowledge, attitude, and practice (KAP) on parasitic infections. Data obtained through the questionnaire were analyzed using EpiData version 3.1, while parasitological data were analyzed using Statistical Package for Social Sciences (version 20.0). Descriptive statistics were computed for demographic data and association which were tested using bivariate analysis at a 95% confidence level while significance was set at p < 0.05. The results showed that 349 (46.29%) were infected with a single parasite. Infants and preschool-aged children infected with double, triple, and quadruple parasites are 268 (35.54%), 122 (16.18%), and 15 (1.99%), respectively. The prevalence of polyparasitism is 405 (53.71%). Although females (54.07%) were more infected than males (45.93%), there was no significant difference (p > 0.05) observed. Significantly (p < 0.05) more preschool children (65.93%) harbour more infections than the infants do (34.07%). Ara community (14.81%) had the highest cases of polyparasitized IPSAC, but no significant difference (p > 0.05) was observed across the communities. Double parasitic infection of Plasmodium falciparum and Ascaris lumbricoides (30.12%) and triple parasitic infection of P. falciparum, A. lumbricoides, and T. trichiura (14.81%) were the most common forms of polyparasitism encountered in the study. This study showed that polyparasitism is a burden in IPSAC and needs further investigation.

Increase in plasma free fatty acids (FFAs) concentrations may cause cellular damage via the induction of oxidative stress. The aim of this present study was to investigate FFAs and oxidative stress in hypertension co-morbidly occurring with Type 2 Diabetes Mellitus (T2DM). Age and sex matched control subjects (n=150) and patients (n=470) [hypertensive nondiabetics (HND, n=179), normotensive diabetics (ND, n=132), hypertensive diabetics (HD, n=159)] presenting at the Medical Out-Patient Clinic of the State Hospital, Abeokuta, Nigeria were recruited. Fasting plasma glucose, creatinine, urea, FFAs, thiobarbituric acid reactive substances (TBARS) were determined spectrophotometrically. The presence of either or both diseases resulted in significant increase (p<0.05) in the plasma FFAs and oxidative stress marker-TBARS in different compartments (plasma, erythrocytes andlipoproteins) for both male and female patients when compared with their control counterparts. The increase in FFAs was more marked in comorbidity female when compared with other female patients. There was significant (p<0.05) difference in gender FFAs concentrations. In both controls and patients, FFAs in plasma are significantly (p<0.05) higher in male when compared with their female counterparts. This research revealed biochemical variations in hypertension co-morbidly occurring with T2DMcharacterised by gender-related elevation in FFAs and enhanced oxidative stress. Plasma FFAs might be a good biomarker predicting the occurrence and development of hypertension and/or T2DM.

Neonatal sepsis, a bacterial infection of blood in the first month of life is a common cause of morbidity and mortality in developing countries and factors associated with positive blood culture and perinatal deaths among neonates are rarely described. This study was conducted at the Special Baby Care Unit of Federal Medical Centre, Abeokuta (FMCA), Southwest Nigeria, to identify the predictors of positive blood culture and deaths due to neonatal sepsis among neonates admitted with clinical diagnosis of septicemia between January and April 2013. Data on socio-demographic characteristics, peripatal events and clinical characteristics of neonates were collected on proforma designed for the study. Blood culture was done on Brain Heart Infusion broth and Thioglycolate broth followed by identification of isolates using conventional methods. Serum Procalcitonin (PCT) and Serum C reactive protein (CRP) Levels were determined by immunochromatographic and immuno-turnidimetric assay respec-tively. The neonates were monitored until discharge from the hospital. Among 180 neonates admitted during the study period, there were 85 cases of clinically suspected sepsis. Forty (47.1%) were males and 45(52.9%) were females while 55 (63.5%) neonates and 30 (36.5%) neonates presented with early and late onset sepsis respectively. Positive blood culture was found in 19 (22.4%) of the neo-nates; 14 (73.7%) of neonates with positive blood cultures had early onset neonatal sepsis and 5 (26.3%) had late onset sepsis. Factors that predicted positive blood culture in both early and late onset neonatal sepsis were mode of delivery (p=0.033), estimated gestational age (p=0.039), and CRP (p=0.000). None of the clinical characteristics was found to be statistically significant with positive blood culture. Deaths occurred in 27 (36%) of neonates. The case-fatality rate was 29%. Predictors of death were booking status (p=0.011), birth after prolonged labour (p=0.014), place of delivery (p=0.001), place of antenatal care (p=0.021), respiratory distress (p=0.034), poor cry (p=0.040), con-vulsion (p=0.011) and PCT (p=0.001). Our findings suggest that mode of delivery and estimated ges-tational age are significantly associated with positive blood culture in both early and late onset neona-tal sepsis. Mortality from neonatal sepsis is high in this study. Booking status, place of delivery, place of antenatal care significantly contributed to mortality suggesting that antenatal and perinatal care remains associated with neonatal mortality.

Absolute methanol extract leaf of Costus afer was comprehensively investigated for free radical scavenging activities and antioxidant activities using battery of testing: 1, 1-diphenyl-2-picrylhydrazyl (DPPH) scavenging, hydroxyl radical scavenging, hydrogen peroxide radical scavenging, 2, 2′-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) scavenging, nitric oxide inhibition, anti-lipid peroxidation, ferrous chelating potential, reducing power potential, total antioxidant capacity, cupric reducing antioxidant capacity CUPRAC and ferric reducing antioxidant power (FRAP). The content of phenol, flavonoid, cupric, anthocyanin were also investigated. The results suggest that the antioxidant potentials of the extract may be responsible for its medicinal potentials. Cell viability assay revealed that up to12 μg/ml of the extract is safe for Chang liver cell and no sign of toxicity was observed after the extract treatment of 2000 mg/kg in albino rats.

The growing burden of hypertension and type 2 diabetes mellitus (T2DM) in Nigeria and related cardiovascular complications is becoming a public health concern. Cardiovascular risk factors were evaluated in control subjects (n=150) and patients (n=470) [hypertensive nondiabetics (n=179), normotensive diabetics (n=132), hypertensive diabetics (n=159)] attending at the Medical Out-Patient Clinic of the State Hospital, Abeokuta, Nigeria. Cholesterol, triacylglycerols and phospholipids were determined spectrophotometrically in plasma, erythrocytes and lipoproteins. The presence of either or both diseases resulted in significant (p<0.05) perturbations in blood lipids of the male and female patients. Dyslipidemia was characterised by increased concentrations of cholesterol and triacylglycerols in plasma, erythrocytes, low density lipoprotein (LDL) and very low-density lipoprotein (VLDL). The increase was more pronounced in hypertensive diabetics. High density lipoprotein (HDL) cholesterol values of the male and female patients were between 35% to 43% and 37% to 43% respectively lower than their control counterparts, while that of HDL triacylglycerols was between 8% to 10% and 6% to 23% respectively lower than their control counterparts. Plasma and erythrocyte phospholipid content increased significantly (p<0.05) in all the patients when compared with their control counterparts except in the erythrocytes of the normotensive diabetic male, where significant decrease was observed. Our findings suggest that enhanced hypercholesterolemia, hypertriacylglycerolemia and hyperphospholipidemia in plasma and erythrocytes may be responsible for increased cardiovascular complications in the comorbidity since the combined dyslipidemia are more pronounced in comorbidity of hypertension and T2DM than when either of the two conditions occurs in isolation.Bangladesh J Med Biochem 2017; 10(2): 45-57

BACKGROUND:Multi-drug resistant Escherichia coli has become a major threat and cause of many urinary tract infections (UTIs) in Abeokuta, Nigeria.OBJECTIVES:This study was carried out to determine the resistant plasmids of multidrug resistant Escherichia coli isolated from (Urinary tract infections)UTIs in Abeokuta.METHODS:A total of 120 Escherichia coli isolates were obtained from urine samples collected from patients attending inpatient and outpatient clinics presenting UTI; with their biodata. Antibiotics susceptibility was performed and multi-drug resistant isolates were selected for plasmid profiling. Plasmids were extracted by the alkaline lysis method, electrophoresed on 0.8% agarose gel and profiled using a gel-photo documentation system gel.RESULTS:Escherichia coli isolates obtained shows high resistance to cloxacillin (92.5%), amoxicillin (90.8%), ampicillin (90.8%), erythromycin (75.8%), cotrimoxazole (70.0%), streptomycin (70.0%) and tetracycline (68.3%) while 85.8% and 84.2% were susceptible to gentamycin and ceftazidime respectively. Sixteen Escherichia coli strains were observed to be resistant to more than two classes of antibiotics. The resistant plasmid DNA was detectable in 6(37.5%) of the 16 multidrug resistant Escherichia coli having single sized plasmids of the same weight 854bp and were all resistant to erythromycin, cefuroxime, cloxacillin, amoxicillin, ampicillin and cotrimoxazole.CONCLUSION:This study has highlighted the emergence of multidrug resistant R-plasmids among Escherichia coli causing urinary tract infections in Abeokuta, Nigeria. There is a high level of resistance to many antimicrobials that are frequently used in Abeokuta, Nigeria.

Typhoid fever, a systemic disease caused by Salmonella enterica serovar typhi (S. typhi) remains a major public health problem in many parts of the world. Widal test appears to be the only laboratory means employed in the diagnosis of typhoid fever among suspected patients and the test continues to suffer from serious cross-reactivity with other infectious agents. This project was designed to confirm the diagnosis of typhoid fever from stool culture of Widal test positive patients using molecular method. Prospective study on stool samples of Widal test positive patients was conducted. Patients with Widal test results of titre value ≥ 1:80 were enrolled. Socio-demographic data of the respondents were obtained with open-ended questionnaire. Stool samples were collected and cultured from a total of 200 patients for isolation of Salmonella enterica serovar typhi. Isolates were identified and confirmed using cultural, morphological and biochemical tests. Further identification was done by molecular method using 16S rRNA gene amplification and sequencing. DNA sequences obtained were used for similarity search by Basic Local Alignment Search Tools (BLAST) on National Centre for Biotechnology Information (NCBI) database to identify the isolates molecularly. Phylogenetic tree of relationship among isolates and those on NCBI database was drawn using Molecular Evolutionary Genetic Analysis (MEGA) version 5.0. Antimicrobial susceptibility test for the isolates was determined using disc diffusion method. Descriptive statistics were computed for data analysis using Statistical Package for the Social Sciences (SPSS) version 17.0. Seven (7) isolates of Salmonella enterica serovar typhi was cultured from the 200 stool samples given a prevalence of 3.5 %. Five (71.4%) of the positive samples were isolated from patients age 0-18 while 2 (28.6%) were isolated from patients above 18 years. Also, 2(28.6%) of the isolates were from male and 5(71.4%) from female. The phylogenic analysis showed that six of the isolates formed separate clusters with the isolates from NCBI database. The isolates showed 90% sensitivity to ciprofloxacin, 80% to ofloxacin and 60% to sparfloxacin and pefloxacin. All the isolates were resistant to azithromycin and ceftazidine while 80% of the isolates were resistant to both augumentin and gentamycin. This study demonstrated that stool culture and molecular identification of Salmonella enterica serovar typhi should be part of standard methods for the diagnosis of typhoid fever in humans.

Malaria in Nigeria is treated blindly in most cases and where diagnostic measures exist, efficacies of several are still in doubt. This study evaluated performance of microscopy and rapid (RDT) methods in confirming prevalence of malaria parasites (MP),parasite species and percent parasitized red blood cells in 384 persons systematically selected from seven primary healthcare facilities in Ogun State, Nigeria from October to December 2012. Giemsa thin and thick film techniques and RDT (SD Bioline Ag P.f/Pan kit) were employed on the blood samples. Data were analysed using SPSS version 16. Demographic results showed that females were 61% and males 39%,but of varying age groups. Seventy-one percent of the blood samples were positive for MP by microscopic blood films, and only 24% samples were positive by RDT. Paired sample T-test showed a significant difference (P=0.000)between microscopy and RDT methods. Of the 273 positive blood samples,95.6%were P. falciparum,3.3% were P. malariae, 0.7% was P. ovale and P. vivax (0.4%). For RDT, P. falciparum was 74% while mixed infections were 26%. Prevalence in risk groups 0–10 and 11–20 age groups was observed to be higher with significant differences (p=0.011, p=0.023) for both microscopy and RDT respectively. RDT sensitivity and specificity were 23.4% and 74.7% compared to microscopy. Positive Predictive Value and Negative Predictive Value were 69.6% and 28.4%. The efficiency of the RDT was 38.3%. The low sensitivity of RDT observed means that malaria diagnosis by microscopy method remains the gold standard

ABO blood groups, Rhesus factors and haemoglobin genotypes are all inherited blood characters. This this study was aimed at investigating the relative incidence of hypertension comorbidly occurring with type 2 diabetes mellitus (T2DM) in ABO/Rhesus blood groups and haemoglobin genotypes in some residents of Abeokuta, South-Western Nigeria. Age and sex matched control subjects (n=150) and patients (n=470) [hypertensive nondiabetics (HND, n=179), normotensive diabetics (ND, n=132), hypertensive diabetics (HD, n=159)] presenting at the Medical Out-Patient Clinic of the State Hospital, Abeokuta, Nigeria were recruited. Standard electrophoretic and haemagglutination techniques were employed in testing the blood samples. Fasting plasma glucose, haemoglobin, plasma creatinine and plasma urea were determined spectrophotometrically. Blood pressure and its component were also determined. Prevalence of hypertension and/or T2DM was observed in subjects with blood O followed by A. The phenotype frequencies of ABO blood group in both hypertensive and diabetic patients and controls (both sexes) are in the order O>A>B>AB. The RhD+ and RhD- distribution were similar in patients and their control counterparts (p > 0.05). The spectrum of haemoglobin electrophoresis among the controls and patients can be shown with a general formula HbAA>HbAS>HbAC>HbSS>HbSC>HbCC except in control female and HD female. The results obtained suggest that there is a strong positive relationship between blood group O and hypertension and/or T2DM. Large studies in other ethnic groups are needed to confirm these results.