In-utero exposure to Zika virus (ZIKV) could lead to miscarriage, preterm birth and congenital Zika syndrome. This study aimed at estimating the burden of ZIKV and Dengue virus (DENV) infections among pregnant women in Bojude, Nigeria. A total of 200 blood samples were collected from pregnant women between February and April 2022. Using the updated CDC guidelines for the diagnosis of ZIKV infections, including ELISA and microneutralization test (MNT), we found that 16.5% of participants were positive for ZIKV IgM, 10% were positive for IgG, and 23% had nAb in their serum. Among the 46 ZIKV nAb-positive women, 52.2% and 10.9% were recent and previous ZIKV infections, respectively, while 6.5% had previous DENV infections. Although no recent DENV infection was detected, recent and previous ZIKV/DENV co-infections were 13.0% and 17.4%, respectively. Two participants had recent secondary ZIKV infections, while 39.1% had prolonged lifelong immunity. Recent ZIKV infection rates were significantly higher among sexually active females aged 20-29 years than other age groups, with the highest risk observed in the first trimester of pregnancy. In addition, the grand-multiparous women are at higher risk of ZIKV infections than other categories. Monotypic recent, secondary and past ZIKV infections, as well as DENV and ZIKV co-infections, were detected in both the asymptomatic and symptomatic pregnant women. These findings highlight that ZIKV infection is prevalent among pregnant women in Nigeria and underscore the associated risk factors, providing evidence-based information on the burden of ZIKV infections in DENV-endemic region.

The presence of neutralizing antibodies is considered a surrogate marker of protection against the three serotypes of poliovirus. The need to use the Microneutralization test in assessing the neutralizing antibodies to the three serotypes of polioviruses among vaccinated children aged 1-15 years informed this study. Of 400 children tested, 309 (77.3 %), 253 (63.3 %), and 308 (77.0 %) had neutralizing antibodies against P1, P2, and P3, respectively. Only 191 (47.8 %) had neutralizing antibodies against P1P2P3 simultaneously, the global target. Whilst 91 (22.8 %) had no neutralizing antibodies against P1, these children were protected against P2 (23.0 %) and P3 (43.9 %). Similarly, 147 (36.8 %) children had no neutralizing antibodies against P2, but were protected against P1 (66.0 %) and P3 (65.3 %). Furthermore, 52(13 %), 51(12.8 %), and 52 (13.0 %) had no neutralizing antibodies against the combination of P1P3, P1P2, and P2P3, respectively. Only 34 (8.5 %) of the children had no nAb to any of the three serotypes. The optimal number of Polio vaccine doses for effective immunity varied depending on the serotype. Also, gender differences may favor the speed at which children achieve the target antibody titers. Higher antibody titers (1:1280) were observed for P2 and P3, with six of the children having a titer of 1:10240 for P3. The combination of supplementary immunization activities and routine immunization generated a robust immune response across all poliovirus serotypes, in contrast to each of the two. The administrative data and population immunity were not commensurate. New strategies to increase immunity against the P1P2P3 simultaneously in all age groups are urgently required.

After a long global battle with wild poliovirus, the virus has been defeated through researches and vaccination using the oral polio vaccine and inactivated polio vaccine as well as sensitization. The issue that is now of global concern is that of vaccine-derived poliovirus which emerged from the unstable oral polio vaccine. Ninety sewage water samples were collected from slums in Maiduguri using grab method, concentrated using two phase separation method and subjected to intratypic differentiation and vaccine-derived poliovirus screening. The result revealed the presence of Sabin 1in 17 samples (61.0%) and Sabin 3 in 22 samples (79.0%), all of which were positive after vaccine-derived poliovirus screening. The presence of strains of Sabin 1 and Sabin 3 in the sewage water samples collected is an indication of virus shedding in individuals which could be as a result of vaccination or contact with the faeces infected or vaccinated individuals.

We report the complete genome sequences of nine double recombinant vaccine-derived novel oral poliovirus type 2 genomes from acute flaccid paralysis (AFP) cases (n = 3), AFP case contacts (n = 4), and environmental surveillance sampling (n = 2) in Nigeria.

Identifying the dissemination patterns and impacts of a virus of economic or health importance during a pandemic is crucial, as it informs the public on policies for containment in order to reduce the spread of the virus. In this study, we integrated genomic and travel data to investigate the emergence and spread of the SARS-CoV-2 B.1.1.318 and B.1.525 (Eta) variants of interest in Nigeria and the wider Africa region. By integrating travel data and phylogeographic reconstructions, we find that these two variants that arose during the second wave in Nigeria emerged from within Africa, with the B.1.525 from Nigeria, and then spread to other parts of the world. Data from this study show how regional connectivity of Nigeria drove the spread of these variants of interest to surrounding countries and those connected by air-traffic. Our findings demonstrate the power of genomic analysis when combined with mobility and epidemiological data to identify the drivers of transmission, as bidirectional transmission within and between African nations are grossly underestimated as seen in our import risk index estimates.

Introduction: Chronic kidney disease (CKD) is a progressive loss of functional nephron characterized by various risk factors. Influenza virus has been found to cause rhabdomyolysis, which is toxic to the kidneys and can initiate or worsen CKD. This study aims to investigate the frequency and molecular detection of Influenza A(H1N1)Pdm09 Virus gene among CKD patients attending University of Maiduguri Teaching Hospital, Nigeria.Materials and Methods: Peripheral blood samples were collected from 150 CKD patients. One-step RT-PCR was performed for detection of influenza virus using the Centers for Disease Control and Prevention protocol. Relevant clinical data were collected in standardized questionnaires from each patient, and medical history was obtained from their hospital records.Results: Conventional PCR analysis revealed that 16% of the CKD patients tested positive for Inf A/Pdm H1N1. The virus frequency was found to be higher among patients in CKD stage 5 (end-stage CKD) and lower in CKD stage 3 (moderate CKD). Additionally, female CKD patients and those in the age group of 55-64 years showed a higher susceptibility to Inf A/Pdm H1N1 infection.Discussion: The study provides evidence of the presence of Inf A/Pdm H1N1 in CKD patients, aligning with previous research showing its involvement in kidney disease aggravation. CKD patients often exhibit immune dysregulation, which might facilitate the virus's invasion and persistence. Conclusion: This study provides evidence of an association between Influenza A(H1N1)Pdm09 viraemia and decreased kidney function among CKD patients. The findings highlight the importance of monitoring and preventing influenza infection in CKD patients to prevent further kidney damage.

Introduction Although environmental and human behavioral factors in countries with Zika virus (ZIKV) outbreaks are also common in Nigeria, such an outbreak has not yet been reported probably due to misdiagnosis. The atypical symptoms of malaria and ZIKV infections at the initial phase could leverage their misdiagnosis. This study randomly recruited 496 malaria-suspected patients who visited selected health institutions in Adamawa, Bauchi, and Borno states for malaria tests. These patients’ sera were analyzed for ZIKV antibodies using ELISA and plaque reduction neutralization tests (PRNT) at 90% endpoint. About 13.8% of Zika virus-neutralizing antibodies (nAb) did not cross-react with dengue, yellow fever, and West Nile viruses suggesting possible monotypic infections. However, 86% of the sera with ZIKV nAb also neutralized other related viruses at varied degrees: dengue viruses (60.7%), West Nile viruses (23.2%), yellow fever virus (7.1%) and 39.3% were co-infections with chikungunya viruses. Notably, the cross-reactions could also reflect co-infections as these viruses are also endemic in the country. The serum dilution that neutralized 90–100% ZIKV infectivity ranged from 1:8 to 1:128. Also, our findings suggest distinct protection against the ZIKV between different collection sites studied. As indicated by nAb, acute ZIKV infection was detected in 1.7% of IgM-positive patients while past infections occurred in 8.5% of IgM-negatives in the three states. In Borno State, 9.4% of IgG neutralized ZIKV denoting past infections while 13.5% were non-neutralizing IgM and IgG indicating other related virus infections. The age, gender, and occupation of the patients and ZIKV nAb were not significantly different. ZIKV nAb from samples collected within 1–7 days after the onset of symptoms was not significantly different from those of 7–10 days. A wider interval with the same techniques in this study may probably give better diagnostic outcomes. ZIKV nAb was significantly distinct among recipients and non-recipients of antibiotic/antimalaria treatments before seeking malaria tests. The inhibiting effect of these drugs on ZIKV infection progression may probably contribute to the absence of neurological disorders associated with the virus despite being endemic in the environment for several decades. Also, protection against ZIKV as marked by the nAb was different among the vaccinated and unvaccinated YF vaccine recipients. Thus, the YF vaccine may be a good alternative to the Zika vaccine in resource-constrained countries. Conclusion The cryptic ZIKV infections underscore the need for differential diagnosis of malaria-suspected febrile patients for arboviruses, especially the Zika virus. The absence of systemic surveillance for the virus is worrisome because of its association with neurological disorders in newborns. Co-infections with other arboviruses may impact adversely on the management of these diseases individually.

We sequenced 109 type 2 Sabin-like poliovirus isolates that had been collected from acute flaccid paralysis patients or healthy children in Nigeria. Understanding the genetic makeup of these viruses may contribute to polio eradication efforts.

Monitoring biological vectors of disease is an indispensable public health and national security endeavor for tropical countries. Older protocols for surveillance involve tedious and resource-demanding programs, but low sequencing costs and advances in metagenomics have brought this within the reach of any country wishing to protect its citizens from emerging or introduced viral pathogens. Vector population density and distribution are usually insufficient for specific risk assessment because actual disease transmission rate is a complex function of the density of infected vectors /fecundity indices and environmental factors. A much bigger problem is that, while epidemiological surveillance systems designed to detect introduction of novel viruses exist, there are no systems that can predict epidemic risk based on pure entomological information. Coping with imported cases of Aedes-borne arboviruses like dengue virus (DENV), chikungunya virus (CHIKV), yellow fever virus (YFV), and Zika virus (ZIKV) presents a daunting challenge since current Nigerian mosquito control generally have limited experience with an Ae. aegypti-borne virus epidemics. The outbreak of ZIKV around the world from imported index cases illustrates the urgency of the need to create a flexible mosquito-arbovirus surveillance system that could be applied to any type of mosquito. Although general environmental baseline biology studies would yield information on prevalence of arthropod vectors in the community, individual mosquito lines surveillance programs will not allow for a rapid response to emerging cases from genetic drifts or imported vector communities. Moreover, a given mosquito genus like the Aedes spp. can transmit several arboviruses (yellow fever virus, ZIKV, and dengue virus), so vector population and distribution statistics are of limited use in tracking specific viral diseases if the viral density is not measured simultaneously. Different mosquito species like Ae aegypti, Ae africanus, and Ae albopictus can spread the ZIKV, emphasizing need for differential / community vector approach. The complex ecology of host range, climate interactions, and multiple transmission routes of these vectors and viruses underscore the vital need to develop a mosquito surveillance protocol that simultaneously identifies the mosquito and the arboviral symbiont using same environmental vector pool. Moreover, the unpredictable trend of zoonotic viral illnesses based on spontaneous mutations can only be mitigated by simple routine biotech surveillance. This chapter discusses viral disease surveillance and argues that it is critically important for countries in the tropics, especially Africa, to establish cutting-edge molecular surveillance systems that proactively capture the introduction or emergence of new virus diseases to its population. The benefits of such an endeavor far outweigh the costs. It has the potential to protect public health, agriculture and food security, and the environment. In an era of systematic release of genetically modified mosquitoes which could become host to unknown virobionts and or promote mutations in extant viruses, establishing such surveillance protocols should be among the highest public health and national security priority of any government.

Urinary tract infection (UTI) is the colonization of the urinary tract by pathogenic microorganisms. There is paucity of data on the development of multidrug resistant uropathogenic strains associated with Diabetes Mellitus (DM). In this cross-sectional study we investigated a total of three hundred and thirty (330) known diabetes mellitus (DM) patients, comprising of 06 (1.8%) Type I DM, 296 (89.7%) Type II DM and 28 (8.5%) Gestational Diabetes patients aged 21 to 80 years. The subjects consisted of 150 males (45.5%) and 180 (54.5%) females. Urine culture was carried out on CLED, MacConkey and blood agar and Kirby Bauer disc diffusion for antimicrobial susceptibility testing was carried out to determine the susceptibility of the isolated organisms to commonly used antimicrobials in the study area. The study revealed that one hundred and twenty-two (37%) yielded significant bacterial growth. The percentage distribution of the organisms isolated are as follows; Staphylococci (10.6%), Klebsiella spp. (13.2%), Coliforms spp. (13.9%), Staphylococcus aureus (24.6%) and Escherichia coli has the highest occurrence of (37.7%). Gram negative bacteria isolated were highly susceptible to Ciprofloxacin (10 μg), tarivid (10 μg) and streptomycin (30 μg); and moderately- to poorly sensitive to the other antibiotics used in the study. In conclusion female diabetics were at a higher risk for UTIs that than males (p=0.000) and low educational level/social class was also a risk factor (p=0.04) when compared to subjects of higher educational level/ social class.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century.

AbstractInvestment in Africa over the past year with regards to SARS-CoV-2 genotyping has led to a massive increase in the number of sequences, exceeding 100,000 genomes generated to track the pandemic on the continent. Our results show an increase in the number of African countries able to sequence within their own borders, coupled with a decrease in sequencing turnaround time. Findings from this genomic surveillance underscores the heterogeneous nature of the pandemic but we observe repeated dissemination of SARS-CoV-2 variants within the continent. Sustained investment for genomic surveillance in Africa is needed as the virus continues to evolve, particularly in the low vaccination landscape. These investments are very crucial for preparedness and response for future pathogen outbreaks.One-Sentence SummaryExpanding Africa SARS-CoV-2 sequencing capacity in a fast evolving pandemic.

Background Hepatitis D virus (HDV) is highly pathogenic, and clinical studies revealed that HDV infection aggravates the natural history of the underlying hepatitis B virus (HBV) infection by progression to cirrhosis that leads to early decompensation of liver function compared with HBV mono-infection. To determine the seroprevalence of HDV among HBsAg-seropositive patients and associated biochemical profiles at Maiduguri, Nigeria, a hospital-based cross-sectional study on 180 sera of patients positive for HBsAg by ELISA were evaluated for anti-HDV, hepatitis B envelop antigen, anti-HBs antibodies and liver enzyme profiles. Results HDV seroprevalence of 3.3% among 180 HBsAg-positive patients. Relatively higher seroprevalence of HDV was observed in males (4.3%) than in females (2.3%). The highest infection rate (20%) was obtained in patients ≥ 56 years. However, no significant association between positive anti-HDV seroprevalence and gender ( p > 0.05). Of the 6 (3.3%) anti-HDV-positive patients, only 1 (16.7%) was positive for HBeAg while all were negative for anti-HBs antibodies. The mean level of liver enzyme level of AST and ALT of the anti-HDV-positive patients significantly differ from that of HBsAg mono-infected patients ( p ˂ 0.05). However, no significant difference ( p < 0.05) between the mean levels of liver enzymes of ALP in anti-HDV-positive and HBsAg mono-infected patients ( p ˃ 0.05) was found. Conclusion This study revealed a relatively low presence of HDV in HBsAg-positive patients. Furthermore, HDV-HBV co-infected patients had somewhat worse liver enzyme upregulation. This underscores the need for rapid HDV testing and treatment in HBV-infected patients.

Poor systematic surveillance for Yellow Fever virus (YFV) is primarily due to lack of affordable diagnostic facilities in resource-constrained countries. This study aimed at providing evidence-based information on immunity against Yellow Fever with a view to assessing the possibility of the recent epidemics persisting in Nigeria. Six hundred patients with febrile illness seeking malaria test in selected hospitals were tested for YFV antibody using three serological assays: ELISA IgM, microneutralization test (MNT) and plaque reduction neutralization test (PRNT). The three assays commonly detected YFV antibody (Ab) in 1.7% patients, MNT: IgM in 8.3%, IgM: PRNT in 7.1%, and MNT: PRNT in 3.2%. Immunity against YF was significantly higher in Bauchi and Borno than Adamawa and children aged 0-9 years compared to 20-29 years. YFV neutralizing antibody (nAb) strongly correlated with the vaccination status of the patients. More unvaccinated patients had nAb compared with the vaccinated. Immunity against YF among treated patients with antibiotic and/or antimalaria before sample collection inversely correlated with the untreated. YVnAb among unvaccinated indicates natural infections. Acute YFV infections were mistaken for malaria and natural infections are ongoing. Individuals aged more than or equal to  20 years should be targeted during mass vaccination campaigns. With low population immunity, repetitive YF epidemics in Nigeria is not yet over. The current policy on Yellow Fever vaccination in Nigeria still leaves a large unimmunized population at the risk of epidemics. Sufficient mass vaccination in combination with National Programme on Immunization remains key to averting YF epidemics.

The progression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Africa has so far been heterogeneous, and the full impact is not yet well understood. In this study, we describe the genomic epidemiology using a dataset of 8746 genomes from 33 African countries and two overseas territories. We show that the epidemics in most countries were initiated by importations predominantly from Europe, which diminished after the early introduction of international travel restrictions. As the pandemic progressed, ongoing transmission in many countries and increasing mobility led to the emergence and spread within the continent of many variants of concern and interest, such as B.1.351, B.1.525, A.23.1, and C.1.1. Although distorted by low sampling numbers and blind spots, the findings highlight that Africa must not be left behind in the global pandemic response, otherwise it could become a source for new variants.

Background: Management and control of the COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus SARS-CoV-2 is critically dependent on quick and reliable identification of the virus in clinical specimens. Detection of viral RNA by a colorimetric reverse transcription loop-mediated isothermal amplification (RT-LAMP) is a simple, reliable and cost-effective assay, deployable in resource-limited settings (RLS). Our objective was to evaluate the intrinsic and extrinsic performances of RT-LAMP in RLS. Methods: This is a multicenter prospective observational study of diagnostic accuracy, conducted from October 2020 to February 2021 in four African Countries: Cameroon, Ethiopia, Kenya and Nigeria; and in Italy. We enroled 1657 individuals who were either COVID-19 suspect cases, or asymptomatic and presented for screening. RNA extracted from pharyngeal swabs was tested in parallel by a colorimetric RT-LAMP and by a standard real time polymerase chain reaction (RT-PCR). Findings: The sensitivity and specificity of index RT LAMP compared to standard RT-PCR on 1657 prospective specimens from infected individuals was determined. For a subset of 1292 specimens, which underwent exactly the same procedures in different countries, we obtained very high specificity (98%) and positive predictive value (PPV = 99%), while the sensitivity was 87%, with a negative predictive value NPV = 70%, Stratification of RT-PCR data showed superior sensitivity achieved with an RT-PCR cycle threshold (Ct) below 35 (97%), which decreased to 60% above 35. Interpretation: In this field trial, RT-LAMP appears to be a reliable assay, comparable to RT-PCR, particularly with medium-high viral loads (Ct < 35). Hence, RT-LAMP can be deployed in RLS for timely management and prevention of COVID-19, without compromising the quality of output. Funding: Bill & Melinda Gates Foundation [Grant No. INV-022,816]. (c) 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Background: Hepatitis E Virus (HEV) is a major public health problem in developing countries and often fatal among pregnant women in the third trimester. Objectives: The study investigated the sero-prevalence and risk factors of HEV infection among pregnant women attendee of University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Methods: The cross-sectional study was carried out between 4th January 2016 to 30th May, 2016. One hundred and eighty blood samples from pregnant women who consented and enrolled for the study were analyzed for anti – HEV IgM using a quality assured commercial Enzyme Linked Immunosorbent Assay (ELISA) kit. Structured questionnaires were used to collate the sociodemographic characteristics and risk factor of study subjects. Results: Out of the 180 pregnant women sampled, the anti-HEV IgM seroprevalence of 13.3% was recorded. The seroprevalence was significantly higher in the age range of 31 – 35 years (26.5%) and least in age range ≤ 20 years (4.9%) (p=0.009). The highest seroprevalence was recorded in the third trimester 14.1% followed by second (p>0.05). After logistic regression, nature of toilet system, and source of water consumption were significant risk factors for active HEV infection (p˂0.05). Conclusion: Based on the 10.8 % pooled national prevalence of HEV infection in Nigeria, this study recorded a significantly high level of anti – HEV IgM seropositivity, an indication of recent and active HEV infection among pregnant women at the study area. Also, these infections are most among the pregnant women in their third trimester. HEV infection was related to personal, water and environmental hygiene.

OBJECTIVES: West Nile virus (WNV) is a re-emerging mosquito-borne viral infection. This study investigated the pooled prevalence pattern and risk factors of WNV infection among humans and animals in Nigeria. METHODS: A systematic review was conducted of eligible studies published in PubMed, Scopus, Google Scholar, and Web of Science from January 1, 1950 to August 30, 2020. Peer-reviewed cross-sectional studies describing WNV infections in humans and animals were systematically reviewed. Heterogeneity was assessed using the Cochrane Q statistic. RESULTS: Eighteen out of 432 available search output were eligible and included for this study. Of which 13 and 5 were WNV studies on humans and animals, respectively. Although 61.5% of the human studies had a low risk of bias, they all had high heterogeneity. The South West geopolitical zone of Nigeria had the highest pooled prevalence of anti-WNV immunoglobulin M (IgM; 7.8% in humans). The pooled seroprevalence of anti-WNV IgM and immunoglobulin G (IgG) was 7.1% (95% confidence interval [CI], 5.9 to 8.3) and 76.5% (95% CI, 74.0 to 78.8), respectively. The WNV RNA prevalence was 1.9% (95% CI, 1.4 to 2.9), while 14.3% (95% CI, 12.9 to 15.8) had WNV-neutralizing antibodies. In animals, the pooled seroprevalence of anti-WNV IgM and IgG was 90.3% (95% CI, 84.3 to 94.6) and 3.5% (95% CI, 1.9 to 5.8), respectively, while 20.0% (95% CI, 12.9 to 21.4) had WNV-neutralizing antibodies. Age (odds ratio [OR], 3.73; 95% CI, 1.87 to 7.45; p<0.001) and level of education (no formal education: OR, 4.31; 95% CI, 1.08 to 17.2; p<0.05; primary: OR, 7.29; 95% CI, 1.80 to 29.6; p<0.01) were significant risk factors for WNV IgM seropositivity in humans. CONCLUSIONS: The findings of this study highlight the endemicity of WNV in animals and humans in Nigeria and underscore the need for the One Health prevention and control approach.