Evaluation of nutritional status using body fat, physiological and biochemical parameters in some Nigerian women

Some nutritional parameters were investigated in 62 healthy Nigerian female subjects of low socio-economic status. The percentage body fat (% BF) and some biochemical parameters, High and Low Density Lipoprotein Cholesterol (HDL-C and LDL-C), Total Plasma Cholesterol (TC), Triglyceride (TG), Uric Acid (UA), Urinary Creatinine (U-Cr), Creatinine in plasma (P-Cr) and Creatinine clearance (Cr-CI), were evaluated. Also determined were the Body Mass Index (BMI), Packed Cell Volume, Systolic and Diastolic Blood Pressure (BP-I, BP-2), various skin-fold measurements and body circumferences. Reference values were then established for these various parameters and the correlation between the various variables determined. When the subjects were stratified into four groups (underweight, normal, overweight, and obese) based on their BMI, significant differences (ANOVA, p < 0.05) were observed in LDL-C, Cr-CI, BP-I, as well as 10 out of the 13 anthropometric parameters. These differences could possibly provide diagnostic/prognostic insight for the four groups and the many important diseases associated with them. The hip circumference, in particular, has such a high correlation with both BMI and % BF that it is being suggested as a substitute for these two important parameters in Nigerian women of low socio-economic background.

Bacteriologic features and antimicrobial resistance of organisms associated with extracted teeth: findings from a Nigerian university teaching hospital

BACKGROUND

Empirically prescribed antibiotics are widely employed in the management of odontogenic infections.

OBJECTIVE

To characterise the infections associated with extracted teeth and assess effectiveness of the antibiotics prescribed empirically following tooth extraction.

METHODS

The study was cross-sectional and consisted of 41 consecutively recruited subjects who required extraction for infections associated with the tooth. Appropriate clinical specimens were collected aseptically from each patient and transported in Stuart's transport medium for processing in the laboratory. Isolation, identification, and susceptibility pattern of anaerobic and facultative organisms were done employing standard bacteriologic techniques. Antimicrobial susceptibility testing was performed by the disc diffusion technique.

RESULTS

There were positive cultures for 37 patients. Twenty-eight aerobic (45.9%) bacteria and 32 anaerobic (54.1%) bacteria were isolated, an approximation of two microorganisms per patient. Staphylococcus was the most predominant aerobe (25.0%) whereas Bacteroides fragilis was the most predominant anaerobe (34.2%). All the bacteria isolated showed in vitro resistance to cephalexin, cloxacillin and metronidazole. Eighteen (64.3%) different aerobic bacteria and 13 (40.6%) different anaerobic bacteria were sensitive to ciprofloxacillin and these included staphylococcus and Bacteroides fragilis. Sensitivity pattern for amoxycillin was very poor with 3.6% and 6.3% for aerobes and anaerobes respectively.

CONCLUSION

Odontogenic infections from our centre are polymicrobial in nature with anaerobes predominating. High resistance to most of the antibiotics routinely prescribed in our centre is common. Ciprofloxacillin demonstrated the highest sensitivity pattern.

Hepatitis B viral markers in surface antigen negative blood donors: the need to look beyond antibody negativity

BACKGROUND

The presence of Hepatitis B Virus (HBV) in blood that is Hepatitis B Surface Antigen (HBsAg) negative is considered a potential risk for transmission of hepatitis B virus infection.

OBJECTIVE

To determine prevalence of antibodies to markers of hepatitis B virus infection in HBsAg negative prospective blood donors.

METHODS

A structured questionnaire to assess prospective donor's demographic data and past medical history was administered to 457 consenting HBsAg negative subjects. All the subjects were also negative for antibodies to hepatitis C virus (HCV), human immunodeficiency virus (HIV) and syphilis. Their serum samples were tested for the presence of anti-HBc, anti-HBe, anti-HBs and HBeAg.

RESULTS

Of the 457 samples tested, 20 (4.37%), 58 (12.69%), 1 (0.22%), and 1 (0.22%) were positive to anti-HBc, anti-HBs, anti-HBe, and HBeAg antibodies, respectively. Ten (50%) of those who were positive for HBc antibody were also positive to anti-HBe and anti-HBs. Similarly, two (3.4%) donors who were positive for anti-HBs were also positive for HBeAg and anti-HBe. Of the 20 who were anti-HBc positive, seven had tattoo/traditional marks on their body and one had previous history of blood transfusion.

CONCLUSION

This study has shown that some potential blood units containing HBV are being transfused to patients unknowingly by screening for HBsAg only. Screening for other markers of hepatitis B virus may increase the rejection rate, but will reduce HBV transmission.

Seroprevalence of hepatitis C virus infection in Nigerians with type 2 diabetes mellitus

BACKGROUND

Several studies have suggested a strong epidemiologic association between Diabetes Mellitus (DM) and Hepatitis C Virus (HCV) infection in some populations. However, the reasons why chronic HCV infection is prevalent in DM remain unknown. Our aims were to determine the prevalence of HCV infection in a population of Nigerian diabetics compared with the general population as well as assess the influence of sex and age on HCV infection in the same diabetic population.

DESIGN AND METHODS

A total of 115 diabetic patients were compared with 2,301 blood donors matched by recognized risk factors to acquire HCV infection. Serologic testing for anti HCV was done using a commercial enzyme-linked immunosorbent assay (ELISA) kits.

RESULTS

Sixty (60) type 2 diabetic patients were males while fifty-five (55) were females. Their mean age was 55.4 +/- 9 years and mean blood glucose level was 8.5mmol/l. One subject tested positive for HCV infection. The control group consisted of 2,031 adults recruited from the blood donor's clinic. Forty five of them (2.2%) tested positive for HCV.

CONCLUSION

Our preliminary results suggest a low sero-prevalence of HCV infection among our patients with type 2 diabetes. Presently, routine screening for HCV infection in persons with diabetes may not be necessary.

Asymptomatic bacteriuria in patients with diabetes mellitus in Ile-Ife, South-West, Nigeria

OBJECTIVES

To investigate the prevalence and associates of asymptomatic bacteriuria (ASB) in a sample of Nigerian diabetic patients.

DESIGN

Cross-sectional descriptive and analytic study.

SETTING

The Wesley Guild Hospital and Ife State Hospital, both units of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.

SUBJECTS

One hundred and thirty five diabetic patients and 57 non-diabetic patients as controls.

MAIN OUTCOME MEASURES

Demographic parameters of participants were recorded. Significant bacteriuria was determined for each of the mid-stream urine specimen obtained from all the subjects. Organisms isolated were identified and evaluated for antibiotic susceptibility patterns.

RESULTS

There was a significant difference in the prevalence of ASB in the two groups. Prevalence of ASB was 16% and 3.5% in the diabetic patients and control respectively (p=0.03). Demographic parameters except age were not related to the presence of ASB. ASB was found in 54.4% of diabetic patients with poor glycaemia control compared with 2.9% in diabetics with good glycaemia control (p = 0.006). Organisms associated with ASB were Staphylococcus aureus, Klebsiella sp, Escherichia coli and Enterococcus faecalis, however the most predominant was Staphylococcus aureus. These organisms were largely resistant to the common antibiotics tested such as cotrimoxazole and gentamicin but susceptible to nitrofurantoin.

CONCLUSIONS

The prevalence of ASB is high in diabetic patients and poor glucose control can be considered a predisposing factor.

The pattern of malaria infection in under-fives in Ile-Ife, Nigeria

Over 90% of the burden of malaria occurs in sub-Saharan Africa. Children, especially under-fives, are the most vulnerable. In Nigeria, Africa's most populous nation, it accounts for 25 and 30% of infant and childhood deaths, respectively. One hundred and seventy-six children who fulfilled clinical and parasitological criteria for the diagnosis of malaria, 26.4% of all under-fives, who presented to the Seventh Day Adventist Hospital in Ile-Ife during the months of May to September 2005 were studied to identify the factors that were associated with severe malaria in the target population. The proportion of children with severe malaria in the study was 17%, while the case-fatality rate was 3.5%. Of the 17 variables examined, high malaria parasite density, non-use of mosquito-bite preventive measures and poverty remained independently and significantly associated with an increased risk for severe malaria. Progress in stemming the burden of malaria depends on accurate knowledge and understanding of the epidemiology and control of the disease in the affected populations.

Campylobacter enteritis in Ilorin, Nigeria

BACKGROUND

Campylobacterje junilcoli is one of the most commonly identified bacterial causes of acute gastroenteritis worldwide. In Nigeria, it has been reported in the northern part of the country, extensive work has also been done in the south-west leaving behind the middle-belt of the country.

OBJECTIVE

To determine the role of Campylobacter jejunilcoli as an agent of diarrhoea in the middle-belt of Nigeria.

DESIGN

A prospective case control study.

SETTING

University of Ilorin Teaching Hospital (UITH), private hospitals and primary health centers all in Ilorin, Nigeria.

SUBJECTS

Three hundred and six children with diarrhoea and 100 without diarrhoea were randomly selected.

MAIN OUTCOME MEASURES

Isolation of Campylobacter jejuni/coli from stool samples. Biological characteristics of the isolates.

RESULTS

Twenty five (8.2%) of the patients and none of the controls had the organism. Campylobacter jejuni and C. coli were 56% and 44% respectively. All the isolates were susceptible to erythromycin and ciprofloxacin. None of the isolates harboured plasmids.

CONCLUSION

C. jejunil coli is an important diarrhoea agent in our geographic environment, further characterisation is desired of these local strains.

Determination of trace elements status of Nigerians with sickle cell anaemia using INAA and PIXE

The clinical application of trace elements in the management of Sickle Cell Anaemia (SCA) has not become standard recommended practice despite decades of research. A major reason for this is the ambivalence in published results as to the relative importance of some of these elements in the disease. An attempt has been made in this work to correct some of the various factors that could contribute to such inconsistencies. Results from separate investigations carried out on Nigerian subjects by our group, using both INAA and PIXE methods have been holistically evaluated and compared. Trace and minor elements were determined in wholeblood, erythrocytes, plasma, headhair and nail obtained from SCA patients in steady state and compared with identical samples from normal controls. Twelve elements were determined in blood while 20 and 30 elements were analysed in nail and hair samples respectively from the total 225 subjects. The results indicate a general mild zinc deficiency, more serious for males, in Nigerian SCA patients. It is clear that the elements Na, K, Rb and Br play key roles in maintaining homeostasis in the steady-state SCA patients. Possible gender influence in the utilization of K, Br and Fe in SCA is also suggested.

Microbial isolates in early swabs of open musculoskeletal injuries

BACKGROUND

Infections of open musculoskeletal injuries, especially open fractures, continue to pose a challenge to the Orthopaedic and Trauma surgeons. There is a dearth of information on the early bacterial contaminants of these open wounds and their antibiotic sensitivity patterns in our environment.

OBJECTIVE

To determine the bacteriology of open wounds of the musculoskeletal system at initial presentation in hospital and their antibiotic susceptibility profile in Ile-Ife, Nigeria.

MATERIALS AND METHODS

A prospective study of 86 consecutive patients over an eight-month period (March to October 2002). Eighty-six patients with 96 open wounds of the musculoskeletal system admitted to the Accident and Emergency unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. Bacteria were isolated from swabs taken from the depth of the wounds and their antibiotic susceptibility determined.

RESULTS

A total of 126 bacterial isolates were recovered from 96 wounds in 86 patients (61 males and 25 females) with mean age of 31.4 years +/- SD. About 73.3% of the wounds were from road traffic accidents and 72.3% of the wounds were severe open fractures (Grades IIIA to C). Staphylococcus aureus constituted 22.2% while coagulase negative Staphylococci (CONS) accounted for 21.4% with Staphylococcus. epidermidis leading the group with 13.5%. Gram negative rods constituted 40.5% of the isolates with Pseudomonas aeruginosa accounting for 11.1%. Antibiotic sensitivity profile revealed that many of the isolates were multiply resistant to the antimicrobials employed but were sensitive to Ofloxacin.

CONCLUSION

This study has shown that open wounds of the musculoskeletal system are usually contaminated at presentation with pathogenic organisms. The antibiotic sensitivity pattern of the isolates shows that the quinolones, represented by Ofloxacin, is the most effective antibiotic.

Effect of socio-economic status, age and sex on antibody titre profile to Salmonella typhi/paratyphi in Ile-Ife, Nigeria

BACKGROUND

Typhoid fever remains a great socio-medical problem in many poor and underdeveloped countries, with an estimated 16 million cases and 600,000 deaths occurring each year. Although it has a world wide distribution, typhoid fever is endemic where sanitary controls are inadequate. The distribution of the infection in relation to age and sex has shown that typhoid fever is more prevalent in males than in females with out satisfactory explanation. Also, those in their second and third decades are more susceptible. The aim of the study is to evaluate the effect of socio-economic status, age and sex on antibody titre profile to Salmonella typhi and praratyphi in Ile-Ife, using both healthy individuals with immunological scar to Salmonella typhi/paratyphi and enteric fever patients.

METHOD

Healthy volunteers (310) were recruited into the study and clinically diagnosed/culture proven cases (48) were used as control. Widal text was performed on each serum. Slide agglutination was first done, then positive samples were further subjected to tube agglutination for quantitative titration.

RESULTS

The relationship between age and antibody titres in both healthy subjects and enteric fever patients is not statistically significant, (P values > 0.05). From the study also, sex and social status do not influence antibody titres to salmonella typhi/paratyphi (P value > 0.05).

CONCLUSION

The study has shown that age, sex and social class do not statistically influence antibody titre profile to S. typhi/paratyphi in Ile-Ife, south western Nigeria.

Determination of baseline antibody titre to S. typhi/paratyphi in Ile-Ife, Nigeria

The aim of the study is to determine the baseline antibody titres to Salmonella typhi/paratyphi in healthy individuals with a view to establishing the significant titre for Widal agglutination test in Ile-Ife, Western Nigeria. Three hundred and ten healthy volunteers were admitted into the study and forty-eight clinically diagnosed and culture positive cases of Enteric fever were used as purposeful controls. Widal test was performed on each serum. Slide agglutination test was first done, then positive samples were further subjected to tube agglutination for quantitative titration. Of the 310 healthy volunteers, 274 (97.2%) had reciprocal antibody titre of < or = 80 to O antigen and 265 (95.0%) had reciprocal antibody titre of < or = 80 to H. antigen of S. typhi. On the other hand, in 48 control cases, 43 (89.6%) had reciprocal antibody titre of > or = 160 to O antigen and 38 (78.2%) had reciprocal titre of > or = 160 to H. antigen. The sensitivity and specificity of the test were 89.9% and 94.2% for O antibody, and 79.2% and 92.3% for H. antibody respectively. The baseline titre to S. typhi/paratyphi for both O & H antibody is 1:80 whilst the significant titre for O & H antibodies is 1:160 and above in Ile-Ife, Nigeria.

Role of Campylobacter jejuni/coli in diarrhoea in Ile-Ife, Nigeria

BACKGROUND

Campylobacter jejuni/coli are well established causative agents of diarrhoea. In Nigeria, gastroenteritis due to C. jejuni was first reported in northern part of the country in 1981 and the South-Western part in Ile-Ife in 1983.

OBJECTIVE

To re-examine the role of C. jejuni as an agent of diarrhoea after more than a decade at Ile-Ife, Nigeria and to determine the biological characteristics of local strains.

DESIGN

A prospective case control study.

SETTING

Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) Ile-Ife, Nigeria.

SUBJECTS

Three hundred and three children with diarrhoea and 100 children with other medical conditions other than diarrhoea were randomly selected.

MAIN OUTCOME MEASURES

Isolation of C. jejuni/coli from stool samples collected from the patients and controls. Biological characteristics of the isolates.

RESULTS

Fifty eight (19.1%) and 6% of the patients and controls, had the organism respectively. Campylobacter coli accounts for 53.3% of isolates. All the isolates were susceptible to erythromycin and there was no evidence of beta-lactamase production.

CONCLUSION

Campylobacter jejuni is an important diarrhoea agent in our environment and should be considered strongly in children with diarrhoea. Complete characterization of local, strains is necessary.

Sero-prevalence of HIV antibodies in tuberculosis patients in Ile-Ife, Nigeria

BACKGROUND

The acquired immunodeficiency syndrome (AIDS) is of major public health concern worldwide more so in sub-Saharan Africa where there is an upsurge in the incidence of the disease. Reports from developed countries have shown that a close link exists between the human immunodeficiency virus (HIV) and pulmonary tuberculosis. No such study has ever been carried out in Ile-Ife, Nigeria.

OBJECTIVE

The study was designed to determine the prevalence of HIV infection among randomly selected tuberculosis patients seen in a Nigerian chest clinic using third generation ELISA kits that detect HIV-1 and HIV-2 strains.

RESULTS

Of the 79 subjects with confirmed active tuberculosis, 12.7% tested positive for HIV antibodies compared with 2.0% of subjects without tuberculosis designated as the control group--a value that is statistically significant (p < 0.05). Farmers, artisans and students contributed a large proportion of the seropositive sera. Although the seroprevalence rate of 12.7% is low compared with the rates from eastern and southern African countries, this value was threefold higher than 5.2% value reported in metropolitan Lagos--suggesting concern about the spread of HIV in a semi-urban centre such as Ile-Ife.

CONCLUSION

This study suggests that a close link exists between active tuberculosis and HIV infection in Ile-Ife, Nigeria which underscores the urgent need to monitor tuberculosis patients as the increase in the rate of new cases may indicate the spread of HIV infection. The study also recommends that an aggressive public awareness programme be undertaken to enlighten communities about the risk of TB/HIV infection.