Mpox (monkeypox) risk and mortality associated with HIV infection: a national case-control study in Nigeria.

INTRODUCTION: Recent outbreaks of mpox are characterised by changes in the natural history of the disease, the demographic and clinical characteristics of the cases, and widening geographical distribution. We investigated the role of HIV and other sexually transmitted infections (STIs) coinfection among cases in the re-emergence of mpox to inform national and global response. METHODS: We conducted a national descriptive and case-control study on cases in the 2017-2019 Nigerian mpox outbreak. Mpox cases were age, sex and geographical area matched each with two randomly selected controls from a representative national HIV/AIDS survey. Logistic regression was used to investigate the association between HIV infection and the risk of mpox acquisition and death. RESULTS: Among 204 suspected mpox cases, 86 were confirmed (median age 31 years (IQR 27-38 years), mostly males (61 cases, 70.9%). Three-fifths of mpox cases had serological evidence of one or more STIs with 27.9% (24/86) coinfected with HIV. The case fatality rate was 9.4% (8/86) and 20.8% (5/24) overall and in HIV positive cases respectively. Mpox cases were more likely to have HIV coinfection compared with an age, gender and geography-matched control group drawn from the general population (OR 45 (95% CI 6.1 to 333.5, p=0.002) and when compared with non mpox rash cases (7.29 (95% CI 2.6 to 20.5, p<0.0001)). HIV coinfection and young age were associated with mortality among mpox cases (aOR 13.66 (95% CI 1.88 to 98.95, p=0.010) and aOR 0.90 (0.82-0.97, p=0.008), respectively). CONCLUSION: HIV infection was associated with a higher risk of contracting and dying from mpox. Children are also at high risk of death. STIs in mpox cases may be suggestive of high-risk sexual behaviours among these individuals.

Targeting Retinol-Binding Protein 4 (RBP4) in the Management of Cardiometabolic Diseases.

The ancient use of herbs for the treatment of various human diseases have been documented, with several scientific literatures supporting the use of medicinal plants. There is however a major concern about the phyto-constituents in the plants that performs the healing function and the mechanism by which it works for different ailments are still a research prospect. Cardiometabolic disease (CMD) is no doubt becoming more frequent globally and this is due to poor approach in therapy, contrary effects linked with intensive control, inept strategies with old drugs, inadequate control of some risk factors and lack of knowledge of the pathophysiological mechanisms that lead to this malaise. Retinol-binding protein 4 (RBP4) are predominantly secreted in the liver and adipose tissues and several researches have observed that elevation in serum levels of RBP4 often observed in obese experimental animals and human subjects causes CMD (obesity, insulin resistance, hyperlipidemia, etc.). RBP4 has gained special attention in the last 20 years in the field of metabolism research. This review aims to show research interaction of some medicinal plants targeting RBP4 in treating CMD and to encourage researchers, who are interested in CMD drug design, to focus on medicinal plants that inhibit the secretion of serum RBP4 in the adipose tissue for therapeutic approach to CMD. It also aims to identify the major bioactive compounds of plants that serves as a better and cheaper drug candidate for CMD and also study the signaling pathway which the plant material uses to regulate the metabolic consequences.

Trend and enhanced surveillance of Monkeypox during COVID-19 pandemic in Nigeria.

Monkeypox (MPX) is a viral zoonosis with lesions like smallpox. Though rare in Nigeria, sporadic outbreaks have been reported in 17 states since September 2017. Unfortunately, the COVID-19 pandemic has further reduced surveillance and reporting of MPX disease. This study seeks to assess the effect of an enhanced surveillance approach to detect MPX cases and measure the cumulative incidence of MPX in priority states in Nigeria. We identified three priority states (Rivers, Delta and Bayelsa) and their Local Government Areas (LGAs) based on previous disease incidence. We also identified, trained, and incentivized community volunteers to conduct active case searches over three months (January to March 2021). We supported case investigation of suspected cases and followed up on cases in addition to routine active surveillance for MPX in health facilities and communities. Weekly and monthly follow-up was carried out during the same period. Out of the three states, 30 hotspots LGAs out of the 56 LGAs (54%) were engaged for enhanced surveillance. We trained three state supervisors, 30 LGA surveillance facilitators and 600 Community informants across the three priority states. Overall, twenty-five (25) suspected cases of MPX were identified. Out of these, three (12%) were confirmed as positive. Enhanced surveillance improved reporting of MPX diseases in hotspots LGAs across the priority states. Extension of this surveillance approach alongside tailored technical support is critical intra and post-pandemic.

Pathogens that Cause Illness Clinically Indistinguishable from Lassa Fever, Nigeria, 2018.

During the 2018 Lassa fever outbreak in Nigeria, samples from patients with suspected Lassa fever but negative Lassa virus PCR results were processed through custom gene expression array cards and metagenomic sequencing. Results demonstrated no single etiology, but bacterial and viral pathogens (including mixed co-infections) were detected.