Background: Infection is a major contributor to morbidity and mortality in sickle cell disease (SCD). Together with hygiene and antibiotics, vaccination led to the elimination of many childhood infectious diseases and contributed to the increase in disability-free life expectancy that in Western societies rose from 50 to 78-85 years. Though it has been shown that individuals with sickle cell disease (SCD) are more susceptible to Salmonella infection, Salmonella vaccine is not included in the routine vaccination schedule for children in Nigeria. The objective of this study therefore is to determine the prevalence of Salmonella infections in SCD children compared to non-SCD children in Abuja with the aim of advocating for the inclusion of Salmonella vaccine to the routine immunization schedule of Nigerian children, especially children with sickle cell disease Methods & Materials: A retrospective study of children enrolled into the Community Acquired Bacteremia among Young Nigerian Children Research(CABSYNC) over a 6 year period was done to determine the Salmonella isolates implicated in bacteremia of sickle cell disease (SCD). Blood culture and sickle cell screening results of a total of 5435 children aged 5 years and below were analyzed. Results: Of the 5435 children, a total number of 370 positive blood cultures were reported, giving a 6.7% prevalence rate of bacteraemia, while 253 cases were SCD, giving a SCD prevalence rate of 4.7%. Of the 370 positive blood cultures, the frequencies of isolates are Salmonella Typhi (121, 32.7%), Non-Typhoidal Salmonella (42, 11.4%), Staphylococcus aureus (31, 8.4%), Pseudomonas spp (24, 6.5%), Streptococcus pneumoniae (17, 4.6%) and Enterococcus faecalis (20, 5.4%). Out of the 253 SCD cases, 16(6.3%) had positive blood cultures, out of which 7(43.8%) were Salmonella Typhi, 5(31.3%) were Non-Typhoidal Salmonella, 2(12.5%) were Enterobacter spp, 1(6.3%) was Streptococcus pneumoniae and 1(6.3%) was non-haemolytic streptococcus. Chi-square test revealed a statistically significant higher proportion of Typhoidal Salmonella within the SCD group compared to the non-SCD group (OR 2.804, p = 0.0613). Conclusion: The result of this study shows that Salmonella is an implicated organism in bacteraemia among children with SCD, hence the need to include Salmonella vaccine into the routine immunization schedule for Nigerian children

BACKGROUND:Etiologic agents of childhood bacteremia remain poorly defined in Nigeria. The absence of such data promotes indiscriminate use of antibiotics and delays implementation of appropriate preventive strategies.METHODS:We established diagnostic laboratories for bacteremia surveillance at regional sites in central and northwest Nigeria. Acutely ill children aged <5 years with clinically suspected bacteremia were evaluated at rural and urban clinical facilities in the Federal Capital Territory, central region and in Kano, northwest Nigeria. Blood was cultured using the automated Bactec incubator system.RESULTS:Between September 2008 and April 2015, we screened 10,133 children. Clinically significant bacteremia was detected in 609 of 4051 (15%) in the northwest and 457 of 6082 (7.5%) in the central region. Across both regions, Salmonella species account for 24%-59.8% of bacteremias and are the commonest cause of childhood bacteremia, with a predominance of Salmonella enterica serovar Typhi. The prevalence of resistance to ampicillin, chloramphenicol, and cotrimoxazole was 38.11%, with regional differences in susceptibility to different antibiotics but high prevalence of resistance to readily available oral antibiotics.CONCLUSIONS:Salmonella Typhi is the leading cause of childhood bacteremia in central Nigeria. Expanded surveillance is planned to define the dynamics of transmission. The high prevalence of multidrug-resistant strains calls for improvement in environmental sanitation in the long term and vaccination in the short term.

BACKGROUND:Reports of the etiology of bacteremia in children from Nigeria are sparse and have been confounded by wide spread non-prescription antibiotic use and suboptimal laboratory culture techniques. We aimed to determine causative agents and underlying predisposing conditions of bacteremia in Nigerian children using data arising during the introduction of an automated blood culture system accessed by 7 hospitals and clinics in the Abuja area.METHODS:Between September 2008 and November 2009, we enrolled children with clinically suspected bacteremia at rural and urban clinical facilities in Abuja or within the Federal Capital Territory of Nigeria. Blood was cultured using an automated system with antibiotic removing device. We documented clinical features in all children and tested for prior antibiotic use in a random sample of sera from children from each site.RESULTS:969 children aged 2 months-5 years were evaluated. Mean age was 21±15.2 months. All children were not systematically screened but there were 59 (6%) children with established diagnosis of sickle cell disease and 42 (4.3%) with HIV infection. Overall, 212 (20.7%) had a positive blood culture but in only 105 (10.8%) were these considered to be clinically significant. Three agents, Staphylococcus aureus (20.9%), Salmonella typhi (20.9%) and Acinetobacter (12.3%) accounted for over half of the positive cultures. Streptococcus pneumoniae and non-typhi Salmonellae each accounted for 7.6%. Although not the leading cause of bacteremia, Streptococcus pneumoniae was the single leading cause of all deaths that occurred during hospitalization and after hospital discharge.CONCLUSION:S. typhi is a significant cause of vaccine-preventable morbidity while S. pneumoniae may be a leading cause of mortality in this setting. This observation contrasts with reports from most other African countries where non-typhi Salmonellae are predominant in young children. Expanded surveillance is required to confirm the preliminary observations from this pilot study to inform implementation of appropriate public health control measures.

Background: Drug resistant tuberculosis (TB) has lately emerged and it represents a serious public health problem. We set out to determine drug resistance among TB patients. Methods: Using automated BACTEC cultures, multidrug resistant-tuberculosis (MDR-TB) was investigated in 117 diagnosed cases in Abuja, Nigeria. Results: Ten (31%) of 32 culture-positive patients were resistant to at least one and four (13%) to all of the four drugs tested. No association between drug resistance and human immunodeficiency virus (HIV) infection was found. Conclusions: MDR-TB is present in Nigeria and larger studies are urgently required. TB clinical management and control efforts should be improved.