Malaria an opportunistic infection in HIV/AIDS patients? - A Nigerian experience.

Background: HIV and malaria interact at the level of the host's susceptibility to infection, but little is known about the effect of HIV on malaria infection in Nigeria. Objective: This study estimated the prevalence of malaria parasitaemia and its relationship with HIV immunodeficiency. Methods: This cross-sectional study was conducted in two hospitals in Abuja, Nigeria between October 2012 and March 2013 among 600 respondents, comprising 200 HIV-negative controls, 200 HIV-positive patients on antiretroviral therapy (ART), and 200 HIV-positive patients not on ART. Malaria parasites, malaria density and absolute CD4 counts were carried out on all three groups. Participants with CD4 counts below 350 cells/mm3 were considered immunocompromised and likely to develop opportunistic infections. Results: Most study participants were aged 21-40 years (65.2%). The mean CD4 counts of HIV-positive patients not on ART (300 ± 211 cells/mm3) and those on ART (354 cells/mm3) were significantly lower than among controls (834 cells/mm3) (p < 0.001). Malaria prevalence was not statistically different between the controls (44.5%), patients on ART (40.5%), and those not on ART (39.5%) (p = 0.562). Compared to 7% immunodeficiency among controls, 56% of patients on ART and 65.5% of those not on ART had a CD4 count < 350 cells/mm3 (p < 0.001). The prevalence of malaria parasitaemia among immunodeficient individuals (42.4%) was similar to prevalence among those with CD4 counts > 350 cells/mm3 (40.8%; p = 0.695). Conclusion: These findings suggest that malaria parasitaemia is not an opportunistic infection among HIV-positive individuals in Nigeria.

Fighting Cancer around the World: A Framework for Action.

Tackling cancer is a major challenge right on the global level. Europe is only the tip of an iceberg of cancer around the world. Prosperous developed countries share the same problems besetting Europe-and the countries and regions with fewer resources and less propitious conditions are in many cases struggling often heroically against a growing tide of disease. This paper offers a view on these geographically wider, but essentially similar, challenges, and on the prospects for and barriers to better results in this ceaseless battle. A series of panels have been organized by the European Alliance for Personalised Medicine (EAPM) to identify different aspects of cancer care around the globe. There is significant diversity in key issues such as NGS, RWE, molecular diagnostics, and reimbursement in different regions. In all, it leads to disparities in access and diagnostics, patients' engagement, and efforts for a better understanding of cancer.

Effects of malaria parasitaemia on some haemostatic parameters among pregnant women of African descent in Specialist Hospital Sokoto, Nigeria.

BACKGROUND: Malaria in pregnancy is a major contributor to adverse maternal and prenatal outcome. In hyper endemic areas like ours, it is a common cause of anaemia in pregnancy and is aggravated by poor socioeconomic circumstance. This study evaluated the prothrombin time and activated partial thromboplastin time of malaria parasitized pregnant women. METHOD: A total of 90 pregnant women participated in the study, 60 of which were malaria positive and 30 of which were malaria negative. Participants were recruited from the antenatal Clinic of Specialist Hospital Sokoto, Nigeria. A structured interviewer-administered questionnaire was used to obtain some socio-demographic characteristics of subjects. Blood samples were collected in ethylene diamine tetra acetic acid and examined for malaria parasite and platelet count while citrated samples were used for the determination of some haemostatic parameters (prothrombin time and activated partial thromboplastin time). Data generated was analyzed using SPSS 25.0 statistical package. A p-value ⩽ 0.05 was considered significant in all statistical comparisons. RESULT: There was a statistically significant decrease (p= 0.000) in the platelet counts of the parasitized subjects compared to the non-parasitized controls. We observed a significant prolongation on both the prothrombin time and activated partial thromboplastin time among the parasitized subjects compared to the non-parasitized controls (p= 0.000). CONCLUSION: This study has shown that malaria in pregnancy causes a significant decrease in the platelet count and prolongation in the prothrombin (PT) and the activated partial thromboplastin time (APTT). There is need for the malaria and haemostatic parameters to be assayed routinely on pregnant women particularly those presenting to antenatal clinic with febrile illness.

Menstrual cycle-associated effects on some acute phase reactants parameters of Students in Usmanu Danfodiyo University Sokoto, North Western Nigeria.

BACKGROUND: The menstrual cycle is the cycle of natural variations that occurs in the uterus and ovary as an essential part of making sexual reproduction possible. It is characterized by hormonal changes but the changes that occur in some active phase reactants (APR) parameters have not been fully elucidated. OBJECTIVE: The aim of this study was to compare the serum albumin, ESR, and C-reactive protein levels in follicular and luteal phases of menstruation. METHODS: A total of 90 healthy regularly menstruating women where used for this study. Forty-five of the study participants were in their follicular phase while the other 45 where in their luteal phase. Four milliliters of blood were withdrawn from each patient under aseptic condition and two milliliters was dispensed into EDTA container while the other two milliliters were dispensed into a plane container. The EDTA anticoagulated blood was used for ESR and full blood count while the serum from the plain tubes was used for analysis of C-reactive protein and Serum Albumin. Sysmex K-3 auto-analyser (Sysmex, Kobe Japan) was used for te determination of full blood count, the Westergren method was used for ESR estimation, Bromo Cresyl Green method was used for serum albumin and ELISA method was used for CRP determination. Data analysis was carried out using SPSS version 23. RESULTS: This study showed a statistically significant difference in the ESR (p= 0.03) among menstruating women in the follicular and luteal phases of menstruation. Sociodemographic factors had no statistically significant effect on the APR parameters of menstruating women in the follicular and luteal phases of menstruation (p> 0.05). There were no statistically significant differences between acute phase proteins of menstruating women in the follicular phase and luteal phases (p> 0.05). Also, age and marital status did not affect the acute phase proteins among menstruating women in the follicular phase and luteal phases (p> 0.05). CONCLUSIONS: There is need to generate data on menstrual disorders and their impact on women's health status, quality of life and social integration. It is vital that evaluation and treatment of menstrual complaints should be given a higher priority in primary care programs. There is need to invest in public enlightenment program to increase awareness in secondary schools to increase the level of awareness among adolescents as well as young females.

Some haematological parameters, copper and selenium level among children of African descent with sickle cell disease in Specialist Hospital Sokoto, Nigeria.

BACKGROUND: Sickle cell disease is a genetic disorder of haemoglobin causing myriad of pathology including anaemia. OBJECTIVES: The aim of this study was to evaluate some haematological parameters and trace elements of total of forty-five (45) children with Sickle cell disease attending Specialist Hospital Sokoto. METHOD: Twenty-five (25) apparently healthy children which were assessed as controls. The haematological parameters were determined using automated method and trace elements (copper and selenium) were determined using colorimetric and atomic absorption spectrophotometry method respectively. RESULTS: The Mean WBC and PLT was significantly higher among sickle cell disease subjects when compared to controls individuals (p< 0.05). The Mean RBC, HCT, HGB, MCV, MCH and MCHC was significantly lower among Sickle cell disease patients when compared to controls (p< 0.05). The Mean Copper and Selenium value was significantly lower (40.4 ± 1.44 µg/dl and 54.6 ± 1.60 ng/ml) among Sickle cell disease subjects compared to controls (75.6 ± 1.30 µg/dl and 86.3 ± 2.30 ng/ml) (p< 0.05). The WBC, HGB, HGT and Copper values of Sickle cell disease subjects shows a weak positive put non-statistically significant correlation with age (p> 0.05). The RBC, MCV, MCH, MCHC, PLT, and Selenium values of sickle cell disease patients shows a negative non-statistically significant correlation indicating that the selenium level decreases as the age increases (p< 0.05). CONCLUSION: This study shows that the WBC and platelet count was significantly higher among sickle cell disease subjects compared to controls. The RBC, HCT, HGB, MCV, MCH and MCHC were significantly lower among sickle cell disease patients compared to controls. The serum copper and selenium levels were significantly lower among sickle cell subjects compared to controls. We recommend that trace elements (copper and selenium) and haematological parameters be monitored routinely among sickle cell disease children to optimize the care offered to these individuals.