Open Access Original Research Article

Prevalence of Hepatitis B amgonst Asymptomatic Persons Visiting Braithwait Memorial Specialist Hospital (BMSH), Nigeria

B. U. Fajoyomi, C. D. Onwukwe, G. Alukara

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/ajmah/2019/v15i130110

Hepatitis B virus infection is a major public health problem; it infects more than 400 million people worldwide. In recent years, the overall prevalence of this virus has declined due to its vaccine that is now in circulation. Hepatitis B virus causes liver injury by an immune response against the virus-infected liver cells but it’s not directly cytopathic, but immunosuppression enhances replication and can lead to direct cytotoxicity. In this study, A survey was conducted amongst 200 randomly selected general out-patients within the ages of 10-80 years with pregnant women inclusive who are attending the Braithwait Memorial Specialist Hospital (BMSH) Nigeria, in order to ascertain the prevalence of Hepatitis B virus infection among patients attending Braithwait Memorial Specialist Hospital in Rivers State, Nigeria and the general knowledge of the people about this highly infectious disease. Sera collected were screened for the presence of Hepatitis B surface antigen () using Labacon Diagnostic Test Strip (Hangzhou Biotest Biotech Co., Ltd China) and a total of 32 out of the 200 respondents tested positive of Hepatitis B surface antigen, giving a percentage of 16% (32/200).Questionnaires were distributed to the subjects in order to ascertain their perceptions about the disease, and to obtain useful socio-demographic information. There was a poor management and prevention control of the disease and this may have accounted for the prevalence of 16% in the study population.

Open Access Original Research Article

Anaemia in Pregnancy at Booking: Prevalence and Risk Factors among Antenatal Attendees in a Southern Nigeria General Hospital

Victory E. Iyanam, Alphonsus U. Idung, Henry E. Jombo, Ndifreke E. Udonwa

Asian Journal of Medicine and Health, Page 1-11
DOI: 10.9734/ajmah/2019/v15i130112

Background: Despite the fact that anaemia is a preventable morbidity in most cases, its prevalence among pregnant women is still unacceptably high especially in rural and sub-urban settings. This is worrisome considering the enormous contribution of anaemia to maternal and infant morbidity and mortality.

Objective: This study aimed at determining the prevalence of anaemia at booking, identifying and describing its risk factors among pregnant women who attended the antenatal clinic of General Hospital, Etinan, a sub-urban area in Akwa Ibom State, South-South Nigeria.

Methodology:  This was a cross-sectional descriptive study involving 375 pregnant women seen at the antenatal (booking) clinic of General Hospital, Etinan, between April and October 2018, recruited through non-probability consecutive sampling technique. A pretested semi-structured interviewer-administered questionnaire was used to obtain data on socio-demographic, family and nutritional characteristics and obstetric and medical history of the respondents. Blood sample of each respondent was obtained from the median cubital vein, analysed with haemoglobinometer and their haemogloin (Hb) level determined and classified.

Results:  The age of the respondents ranged from 15-49 years with mean and standard deviation of 26.62 + 6.29 years. Results obtained show that out of 375 pregnant women, 265 had Hb <11g/dl giving 70.67% of anaemia among them. While 18.49% had mild anaemia (Hb:10.0-10.9g/dl), 4.15% had severe anaemia(Hb:<7.0g/dl). Anaemia was statistically associated with rural residence (p=0.024), low educational status (p=0.02), low family income (p=0.003), being married (p=0.016), lower parity (p=0.000), late booking (p=0.001), non-use of family planning (p=0.000), non-use of insecticide-treated nets (p=0.000), febrile illness in index pregnancy (p=0.000) and poor nutrition (p=0.000).

Conclusion: The prevalence of anaemia among pregnant women in the study is high. This has far-reaching negative implications on the health status of the women during pregnancy, delivery and puerperum and that of the fetus. The need for preconception  counseling and screening, health and nutrition education, early booking, contraception, treatment and prevention of causes of febrile illness, priority to girl child education and overall poverty eradication measures and recommended.

Open Access Original Research Article

Prevalence and Risk Factors for Pulmonary Mycobacteriosis in Lagos, Nigeria

T. Y. Raheem, B. A. Iwalokun, A. Oluwadun, O. A. Adesesan, N. Tochukwu, M. Nshiogu

Asian Journal of Medicine and Health, Page 1-12
DOI: 10.9734/ajmah/2019/v15i130113

Background: Pulmonary mycobacteriosis has been documented in HIV-infected, diabetics, asthmatics, smokers and alcoholics and its progression and severity are affected by these risk factors. Inappropriate diagnosis of mycobacteriosis could lead to inappropriate treatment with anti- tuberculosis drugs.

Methods: This cross-sectional, prospective study was conducted in patients with TB-like diseases attending six DOTs centres in Lagos, Nigeria, from May 2012 to October 2016. Participants’ informed consent was obtained, structured questionnaires administered to obtain socio-demographic and co-morbid data. Sputum samples collected and processed for microscopy and culture using Lowenstein-Jensen medium with or without pyruvate and MGIT 960 liquid medium. Mycobacteria were identified using MPT64 immunochromatographic, biochemical and molecular methods. This study investigated the presence and prevalence of mycobacteriosis in the participants and assessed the risk factors for the mycobacterial infections.

Results: Of the 1,020 participants, 339 (33.2%) had mycobacteriosis of which 33 (9.7%) were caused by Non-Tuberculosis Mycobacteria (NTM) and 306 (90.3%) caused by Mycobacterium tuberculosis complex (MTBC). Of the isolated 306 MTBC, 247 (80.7%) were M. tuberculosis, 28 (9.2%) were M. africanum, 23 (7.5%) were M. bovis while 8(2.6%) were M. ulcerans [P < 0.0005]. The 33 NTM showed 11 (33.3%), 20 (60.6%) had HIV, 8(24.2%) M. fortuitum, 2 (6.1%) M. abscessus, 2 (6.1%) M. scrofulacium, 6 (18.2%) M. kansasii, 4 (12.1%) M. megateriense and 11 (33.3%) Mycobacterium avium complex (MAC). Sequence analysis of the 16s rRNA of the 11 MAC showed 3 (27.3%) M. avium, 5(45.5%) M. intracellulare, 2(18.2%) M. colombiense and 1(9.1%) M. velneriM. fortuitum and MAC were significantly (P<0.05) associated with HIV infection, while only M. fortuitum relate strongly with diabetes (P <0.05).

Conclusion: The study showed that mycobacteriosis is caused by different species of MTBC and NTM. Relatively high mycobacteriosis were detected during dry season and were significantly associated with gender, age, HIV and diabetes.

Open Access Original Research Article

Use of Performance Status Score for Cytotoxic Chemotherapy among Surgeons in a Tertiary Hospital, Southern Nigeria

Stanley Ukadike Okugbo, Omorodion Irowa

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/ajmah/2019/v15i130114

Introduction: Performance score evaluation is a tool for assessment of patients prior to cytotoxic chemotherapy administration. It has also been used to modify and personalize the dosage, route and types of the various chemotherapeutic agents.

Aim: The present study was aimed at evaluating the use of performance status as assessment tool for patients on cytotoxic chemotherapy.

Study Design: This study is a questionnaire survey involving all doctors in the Department of Surgery of the University of Benin Teaching Hospital, Benin City, Nigeria. The returned questionnaires were individually inspected for clarity of responses and collated. The data was entered into excel sheets. Forms which were incomplete, poorly filled or not returned were not included in the study. All the data entered into the spreadsheets were analysed using the SPSS 20 package.

Results: A total of 64 (70%) doctors where enlisted in the study. Though 73.4% had knowledge about the use of performance status in the assessment of oncology patients, only 62.1% could name any type of performance status. Most respondents agreed that they would reduce the chemotherapeutic dosage in response to a poor PS score. Routine use of PS should be emphasized as it enhances patients’ care, brings measurable objective assessment to bear on the process of both palliative and potential curative measures.

This study focused on the practice amongst doctors, however PS may be routinely measured by nurses both in the clinic or wards when these patients present.

Conclusion: The awareness of performance status score is high however its uptake in clinical practice was low requiring further development and adherence to established protocols.

Open Access Case Study

Association of MnSOD-47C/TGENE Polymorphism (Rs 4880-47C/T) in Sudanese Patient with Diabetic Retinopathy

Naser M. Naser, Saife. El. Babeker, Mayada Abdo, Amar M. Ismail, Sawsan Altoum, Khalid H. Bakheet

Asian Journal of Medicine and Health, Page 1-9
DOI: 10.9734/ajmah/2019/v15i130111

Background: Diabetic retinopathy (DR) is the common micro-vascular complication of diabetes mellitus (DM). It is the main cause of blindness among young adults worldwide. Poor glycemic control in addition to longer diabetic duration is the main risk factors for diabetic retinopathy. Many genes have been postulated as candidates for diabetic retinopathy. Little is known about anti-oxidative enzyme gene polymorphism and its association with diabetic retinopathy, mainly for catalase enzyme and manganese superoxide dismutase and glutathione genes. The study aims to assess the role of manganese superoxide dismutase MnSOD (rs4880) gene polymorphism in diabetic retinopathy Sudanese patients and its relation with MnSOD level. In addition to determine the association of Fasting Blood Glucose (FBS), HbA1c and Lipid in the pathogenesis of diabetic retinopathy.

Methodology: The number of subject involved were 130 which, were classified into (n 60) clinically diagnosed as diabetic retinopathy and (n 70) diabetes mellitus without retinopathy as control group, age ranged from (22 – 80) years old, from Makkah Eye Complex. DNA was extracted and PCR product for MnSOD, gene segment was digested by NgoM enzymes, moreover gene polymorphisms were determined. Serum MnSOD, activity and FBS, TG, CHOL and HbA1c level were analyzed using Cobas Int 400 using absorption photometer and immunoassay methods respectively.

Results: The results revealed that retinopathy is more common in female than male by approximately 2 fold =1.9:1. Type II is more common in our population that type 1. The majority of the patients had type II diabetes (128, 98.5%) and only 2(1.5%) patients were type I diabetes mellitus. The activity of MnSOD, was significantly higher in DNR when compared with DR (p= 0.003). Mean HbA1c and FBG concentration were significantly higher among DR than DNR p=0.001 and p=0.001 respectively. In contrast, mean serum CHOL and TG level revealed insignificant differences when compared DR with Diabetic without retinopathy (DNR).The genotyping for MnSOD-47C/T showed that the frequency of genotype CC was significantly lower in cases compared with control. Theses Associations for SNPs CCs, MnSOD-47C/T SNP rs4880, decreased risk after correction for multiple testing (OR = 0.088, 95% CI = 0.034-0.224 p= 0.001), While the frequency of the CT heterozygote genotype was significantly higher in cases group compare with control, the OR= 3.76(1.41-10.5), P=0.006. While frequency of the TT genotype was significantly higher in cases than controls. Theses Associations for MnSOD 47C/T SNP rs4880, increased risk after correction for multiple testing (OR = 5.31, 95% CI = 1.91-14.75, p= 0.001). The C allele is observed in 47% of the cases while the T allele – risky allele- observed in 73% of the cases, OR= 0.150(0.079-0.285), P=0.001 (Table 6).

Conclusion: The study concludes that there is a significant association between MnSOD-47C/T        (rs 4880) gene polymorphism and the occurrence of diabetic retinopathy in Sudanese population. There is a significant decrease in MnSOD levels and glycemic control in patients with the mutant allele T.