Phenotypic profile and antibiogram of biofilm-producing bacteria isolates from diabetic foot ulcers in Zaria, Nigeria

Background

Diabetic foot ulcers (DFUs) present with high morbidity and reduce patient's quality of life. There is a gross paucity of data on biofilm-producing bacteria in DFU Infection in North-Western Nigeria. The study sought to determine the biofilm-forming ability of bacteria isolates from DFUs and determine their antimicrobial susceptibility pattern in Zaria, North-Western Nigeria.

Materials and Methods

This hospital-based cross-sectional study of patients with DFUs was conducted from June 2018 to February 2020. Consecutive biopsies were aseptically collected. Bacteria were isolated and identified using a Microgen kit. Biofilm forming ability and antibiogram of isolates were determined using microtitre plate and disk diffusion methods, respectively.

Results

Of the 225 participants enrolled, males constituted the majority, 144 (64.0%) with 88 (36.0%) females, the median age of participants was 54 (48-60) years, and the age range was 36-77 years. A total of 172 bacteria were isolated, and 123 (71.5%) were biofilm producers. Staphylococcus aureus (26.7%) was the highest biofilm producer, while Citrobacter freundii and Stenotrophomonas maltophilia were the least biofilm producers, 1 (0.6%) each. A disproportionate resistance pattern was demonstrated among the biofilm and non-biofilm producers against the cephalosporins tested, ceftazidime (68% vs. 18%), ceftriaxone (50% vs. 8.0%) and cefotaxime (21% vs. 0.0%). About 46% and 68% of the biofilm producers were resistant to gentamycin and ciprofloxacin, respectively. While only 2% of the non-biofilm producers were resistant to imipenem, 11% of the biofilm producers were resistant to it.

Conclusion

These findings revealed a high proportion of biofilm-producing bacteria and were more resistant than non-biofilm producers.

Seroprevalence and Factors Associated with Risk of Hepatitis B Virus Infection among Antenatal Attendees in ABUTH Zaria, Northwestern Nigeria

Background

Nigeria is one of the sub-Saharan African countries within the World Health Organization's (WHO) hyperendemic region for hepatitis B virus infection with prevalence greater than 8%. In this region, mother-to-child transmission is the major route of infection and approximately 90% of newborns of mothers who are seropositive for HBsAg and HBeAg become chronic carriers with a 25% risk of developing chronic liver diseases. This study aimed to determine the seroprevalence, and factors associated with risk of hepatitis B virus infection among antenatal attendees in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria.

Methodology

A hospital based cross sectional study was conducted among pregnant women Rattending the antenatal booking clinic of ABUTH, Zaria from August 2017 to January 2018. Systematic random sampling was used. An interviewer administered questionnaire was used to obtain data on sociodemographic characteristics and risk factors for HBV infection. Blood samples were collected and tested using the third generation ELISAkit for HBsAg (Monolisa HBsAg ULTRA BIORAD, France) and HBeAg(HBeAg & Ab, DiaPro Diagnostic Bioprobes Milano Italy). Data were analyzed using SPSS version 20 (IBM USA, 2011). Statistical testing was carried out with chi-squareand level of significance set as P<0.05.

Results

The mean age of the respondents was 26 ± 6.1 years, the highest HBV seropositivity occurred in the age group 21-25 years from a total of 192 participants. The seroprevalence of HBV obtained was 15.1%. Only1(3.4%) woman was positive for HBeAg among the 29 HBsAg seropositive women. Past history of unsafe injections was the only risk factor significantly associated with HBV seropositivity (x2= 5.628 p-value= 0.023).

Conclusions

The seropositivity of hepatitis B virus was high among pregnant women. Interventions targeted at injection safety will help reduce the risk of infection.

Distribution of hepatitis B virus-positive individuals in Zaria, Nigeria, according to risk-associated practices

Background:

An estimated 75% of Nigerians are at risk of hepatitis B virus (HBV) exposure. In an attempt to reduce the menace, the assessment of risk factors associated with HBV infection and general perception of infected individuals is a step in that direction.

Aim of the Study:

This study, therefore, identified exposure to risk factors and general perceptions associated with HBV infection in infected individuals in Zaria, Nigeria.

Methodology:

Four milliliters of blood were collected in ethylenediaminetetraacetic acid container from each of 165 HBV surface antigen (HBsAg)-positive participants recruited purposively from the gastroenterology clinic of ABUTH Zaria from May to August 2017. Plasma was separated and used to screen for HBsAg with Fastep® rapid strip. Epi Info® questionnaire database was used to collate data on sociodemographics, risk factors, and perception indices. GraphPad Prism 6 was used for statistical analysis.

Results:

The median interquartile range age of the participants was 31.0 (25.5–39.0) years with 107 (64.8%) male participants. Sharing hair clippers, commercial pedicure, and body piercing among others were some of the risks that the study participants reported to be exposed to. One-quarter of health workers involved in the study had needlestick injury. Less than half of the study participants (47.7%) knew of hepatitis B before testing HBsAg seropositive. Knowledge of the HBV vaccine before testing and adherence was generally poor (38.6% and 44.6%, respectively). There was a significant linear relationship between the level of education and knowledge of hepatitis B.

Conclusion:

Considering the myriads of already established risks of HBV seen in Zaria, massive enlightenment campaigns need to be embarked on continuously through all available media, including social media.

Pattern of prevalent Hepatitis B virus genotypes in Zaria, Nigeria

Background:

Hepatitis B virus (HBV) is hyperendemic in Nigeria. Available literature reveal genotype E as being predominant in West Africa. This study aimed at identifying the current pattern and prevalent genotypes of HBV in Zaria, Nigeria.

Materials and Methods:

Four millilitre of blood was collected in ethylenediaminetetraacetic acid-container from each of 165 HBV surface antigen-positive participants recruited purposively from the gastroenterology clinic from May to August, 2017. Plasma was separated and frozen at −20°C till analysis. Multiplex-nested polymerase chain reaction using type-specific primers was used to identify the various HBV genotypes.

Results:

Median (and interquartile range ) age of the participants was 31.0 (25.5–39.0) years, with males constituting 107 (64.8%). Majority (83.6%) of the samples analysed were HBV-DNA-positive with 82.6% of the HBV-DNA-positive samples being mixed genotype infections. Irrespective of mode of occurrence, five HBV genotypes were identified with HBV/E (97.1%) being the most predominant, followed by HBV/B (82.6%), HBV/A (24.6%), then HBV/C (17.4%), while HBV/D (0.7%) was the least prevalent.

Conclusion:

In most (99.1%) of the mixed-infection were a combination of genotype E, the predominant genotype, with other genotypes predominantly genotype B. HBV genotypes E, B, A, C and D are the prevalent genotypes in Zaria, Nigeria, as they occur in single genotype and in mixed-genotypes pattern.

An Exposure Appraisal of Outdoor Air Pollution on the Respiratory Well-being of a Developing City Population

Zaria is the educational hub of northern Nigeria. It is a developing city with a pollution level high enough to be ranked amongst the World Health Organization’s (WHO) most polluted cities. The study appraised the influence of outdoor air pollution on the respiratory well-being of a population in a limited resource environment. With the approved ethics, the techniques utilized were: portable pollutant monitors, respiratory health records, WHO AirQ+ software, and the American Thoracic Society (ATS) questionnaire. They were utilized to acquire day-time weighted outdoor pollution levels, health respiratory cases, assumed baseline incidence (BI), and exposure respiratory symptoms among selected study participants respectively. The study revealed an average respiratory illness incidence rate of 607 per 100,000 cases. Findings showed that an average of 2648 cases could have been avoided if the theoretical WHO threshold limit for the particulate matter with diameter of <2.5/10 micron (PM_2.5/PM₁₀) were adhered to. Using the questionnaire survey, phlegm was identified as the predominant respiratory symptom. A regression analysis showed that the criteria pollutant PM_2.5, was the most predominant cause of respiratory symptoms among interviewed respondents. The study logistics revealed that outdoor pollution is significantly associated with respiratory well-being of the study population in Zaria, Nigeria.

Haematological and Immunological Parameters in Patients with Chronic Hepatitis B Infection in Zaria, Nigeria

Hepatitis B virus (HBV) is one of the major causes of morbidity and mortality worldwide. The aim of this study was to determine the haematological and immunological parameters in patients with chronic HBV infection in Zaria, Nigeria. Twenty individuals with confirmed chronic HBV (CHB) infection constituted the subjects while 20 non-HBV-infected individuals were monitored as controls. The subjects were enrolled purposively from the Gastroenterology Clinic of the Ahmadu Bello University Teaching Hospital Shika, Zaria Nigeria. Four millilitres of blood samples were collected from each study participants. Full blood count was conducted using the Swelab Alfa Haematology Analyzer, while CD4⁺ T-Cell enumeration was performed using the Sysmex Partec CyFlow® Counter IVD flow cytometer according to the manufacturers' instruction. The mean (and standard deviation) age of the 20 participants with CHB was 32.7 (±10.1) years while that of the 20 HBV negative control participants was 30.0 (±7.8) years. Mann-Whitney test showed no significant difference between the two groups in their total WBC (p=0.6634) and granulocytes (p=0.2386). There was a significant increase in the monocytes count (p=0.0151) and a significant decrease in the lymphocytes count (p=0.0006) of patients with CHB compared to the healthy control. There was no significant difference in the mean CD4+ T-lymphocytes count between subjects and controls (p=0.0633). Unpaired Student t-test showed no significant difference between the two groups in the other haematological parameters. This study showed a significant increase in monocytes and decrease in lymphocytes, a phenomenon that characterize the sustenance of infection by immune evasion mechanism.

Clinical feature and management of immune thrombocytopenic purpura in a tertiary hospital in Northwest Nigeria

Background:

Immune thrombocytopenic purpura (ITP) is a rare bleeding disorder that may remit spontaneously. Life-threatening bleeding may require transfusion support, steroids, and other immunosuppressive therapy or splenectomy.

Objective:

To review the clinical presentation and laboratory features of ITP at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria.

Subjects and Methods:

A retrospective analytic study of case notes and bone marrow (BM) records of patients diagnosed with ITP at Haematology Department, ABUTH, Zaria, from January 1, 2004, to December 31, 2012.

Results:

There were nine cases (six females, three males), aged 6–20 (mean 11.11) years. The presentations were epistaxis 8 (88.9%), purpura 4 (44.4%), gum bleeding 4 (44.4%), menorrhagia 2 (22.2%), and intracranial hemorrhage (ICH) 1 (11.1%). Only 1 (11.1%) had clinical splenomegaly. Platelet count of <20 × 10⁹/L was found in 4 (44.4%) while 6 (66.7%) had packed cell volume of <25%. All the nine cases had BM megakaryocytic hyperplasia. Six patients had blood transfusion support while 7 (77.8%) patients received oral prednisolone therapy with time to cessation of bleeding of 12–16 (mean of 8) weeks. One case had spontaneous remission while another had anti-D due to relapse after steroid therapy; this resulted in transient rise in platelet counts. None had other immunosuppressive therapy or splenectomy. Six (66.7%) cases were lost to follow-up after achieving remission and one died of ICH.

Conclusion:

ITP is not common in our center though its clinical presentations are varied. However, prednisolone and blood transfusion therapy are central to the management of these patients with favorable outcome.

A comparative study of the prevalence and correlates of psychiatric disorders in Almajiris and public primary school pupils in Zaria, Northwest Nigeria

BACKGROUND

'Almajiris' are children and adolescents sent far away from their homes to study in Islamic schools under the care of Muslim scholars. Over the years, there has been a decline in the capacity of the scholars to cater to these pupils. Consequently, Almajiris spend significant periods of time on the streets begging and carrying out menial jobs to earn a living thereby increasing their risk for physical and mental disorders. The aim of this study was to compare the prevalence of psychiatric disorders among Almajiris and public primary school pupils in Zaria.

METHODS

A comparative cross-sectional design was utilized to compare 213 Almajiris and 200 public primary school children and adolescents aged between 5 and 19 years. All participants were administered a Socio-demographic questionnaire and the Schedule for Affective Disorders and Schizophrenia for School-aged Children Present and Lifetime Version (K-SADS-PL). Data were analyzed using Chi square tests and logistic regression.

RESULTS

The current prevalence of psychiatric disorders among Almajiris and public school pupils was 57.7 and 37.0% respectively. After adjusting for age and family characteristics, Almajiris were significantly more likely to have any psychiatric diagnosis, depression, enuresis, substance use, and post traumatic stress disorder but less likely to have separation anxiety disorder than the public school pupils.

CONCLUSION

Psychiatric disorders are more prevalent among Almajiris and public primary school pupils in Northwest Nigeria than found in other prevalence studies with a significantly higher rate among the Almajiris. Joint efforts need to be made by the Government and Civil Society organizations including religious groups towards reforming the Almajiri education system and the provision of programmes aimed at reducing the prevalence of psychiatric disorders in both Almajiris and the school pupils.

Temporomandibular joint dislocation: experiences from Zaria, Nigeria

OBJECTIVES

Dislocation of the temporomandibular joint may occur for various reasons. Although different invasive methods have been advocated for its treatment, this study highlights the value of non-invasive treatment options even in chronic cases in a resource-poor environment.

MATERIALS AND METHODS

A seven-year retrospective analysis of all patients managed for temporomandibular joint dislocation in our department was undertaken. Patient demographics, risk factors associated with temporomandibular joint dislocation and treatment modalities were retrieved from patient records.

RESULTS

In all, 26 patients were managed over a seven-year period. Males accounted for 62% of the patients, and yawning was the most frequent etiological factor. Conservative treatment methods were used successfully in 86.4% of the patients managed. Two (66.7%) of the three patients who needed surgical treatment developed complications, while only one (5.3%) patient who was managed conservatively developed complications.

CONCLUSION

Temporomandibular joint dislocation appears to be associated with male sex, middle age, yawning, and low socio-economic status, although these observed relationships were not statistically significant. Non-invasive methods remain an effective treatment option in this environment in view of the low socio-economic status of the patients affected.

Knowledge, attitude and practice of cervical cancer screening among market women in Zaria, Nigeria

Background:

Cervical cancer is the most common genital cancer and one of the leading causes of death among female population. Fortunately, this cancer is preventable by screening for premalignant lesions but this is rarely provided and hardly utilised. We assessed the knowledge, attitude and utilisation of cervical cancer screening among market women in Sabon Gari, Zaria.

Materials and Methods:

This was a cross-sectional study to evaluate the knowledge, attitude and practice of cervical cancer screening among market women. A total of 260 women were administered with questionnaires which were both self and interviewer administered. These were analysed using SPSS version 11.

Results:

Respondents exhibited a fair knowledge of cervical cancer and cervical cancer screening (43.5%); however, their knowledge of risk factors was poor. There was generally good attitude to cervical cancer screening (80.4%), but their level of practice was low (15.4%).

Conclusions:

There was a fair knowledge of cervical cancer and cervical cancer screening among Nigerian market women in this study, their practice of cervical cancer screening was poor.

Bothersome lower urinary symptoms during pregnancy: a preliminary study using the International Consultation on Incontinence Questionnaire

BACKGROUND

During pregnancy, many women suffer from lower urinary tract symptoms which they hardly report to their care providers. Measuring the prevalence of these symptoms has been difficult because of lack of uniform nomenclature and standardized tool. The updated nomenclature and the new ICIQ-FLUTS questionnaire offer an opportunity for assessment of these symptoms especially in developing countries.

OBJECTIVE

This study aimed to establish the prevalence of bothersome lower urinary symptoms among pregnant women in Zaria, Nigeria.

METHODS

This was a cross-sectional study in which the International Consultation on Incontinence Questionnaire on Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) was administered by trained interviewers to 204 consenting pregnant women aged 15 to 42 years who were attending Antenatal care (ANC) at a tertiary health facility in Zaria, Nigeria.

RESULTS

Storage phase symptoms (nocturia, urgency, daytime frequency and painful bladder) were common among respondents. Of these, nocturia was the commonest with 94.1% of the respondents reporting it. Voiding symptoms (hesitancy, straining to pass urine and interrupted stream) were also found. Interrupted stream was the commonest of these, occurring in 8.3% of respondents. Incontinence; stress (13.7%), urge (9.8%) and enuresis (1%) were found among the respondents.

CONCLUSIONS

These findings show that diverse, bothersome forms of lower urinary tract symptoms are experienced by pregnant women in this environment and the ICIQ-FLUTS questionnaire is a helpful tool in identifying these symptoms.