Knowledge, attitude and practice of ante-natal attendees toward prevention of mother to child transmission (PMTCT) of HIV infection in a tertiary health facility, Northeast-Nigeria.

OBJECTIVE: Knowledge, attitude and practice of pregnant women toward prevention of mother to child transmission of HIV infection have not been evaluated in any tertiary health facility in the Northeast region of Nigeria. METHODS: A structured questionnaire was used to obtain data from 172 women that consecutively attended the antenatal clinic of University of Maiduguri Teaching Hospital to determine their level of knowledge, practice and attitude toward HIV/AIDS issues with respect to PMTCT. RESULTS: The survey revealed a high level of knowledge on modes of transmission, risks behaviours and prevention of HIV and other sexually transmitted infections among the pregnant women. However, the use of breast milk substitute (BMS) by HIV positive nursing mothers and use of condom during sexual intercourse did not receive very encouraging responses from 42 (24.4%) and 58 (33.7%) of the women respectively. Those that do not encourage use of BMS indicated spouse dislike as a major reason and the fact that the community places higher premium on breastfeeding than BMS. Majority of those that discouraged condom use 28 (48.3%), said the practice was against their religions beliefs while a few believes withdrawal before ejaculation and use of antibiotics after sex can equally prevent HIV infection. Majority of the respondents, 106 (61.6%) admit their willingness to support their spouses that tested positive for HIV. CONCLUSION: The pregnant women accepted PMTCT as a veritable means of preventing infants from HIV infection as well as an opportunity to know ones HIV status through voluntary testing. Majority implored greater involvement of their male partners and other significant family members during PMTCT counselling sessions to guard against ejection, stigma and discrimination if tested HIV positive. Staff training, awareness creation and community mobilization were identified as key to success of PMTCT programmes and fight against stigma and discrimination.

Prevalence and antibiotic resistant Shigellae among primary school children in urban Calabar, Nigeria.

In a recent study, involving the examination of 593 stool samples obtained from randomly selected children from three primary schools in Calabar, Shigella spp. were isolated from 123 (20.7%) of the samples. The infection rate was highest among the younger children with (64.2%) 79/123 of the isolates coming from children under 10 years of age. Infection rate was comparable among boys and girls (p = 0.1). Only two species of Shigella were isolated viz: Shigella flexneri 12.0% (71/593) and Shigella sonnei 8.8% (52/593), in this study. The infection rate was highest in the Government Public Primary school, which also had the highest ratio of pupils per toilet. In all, 24 (19.5%) of the isolates were sensitive to all of the nine antimicrobial agents tested while 67 (54.5%) were resistant to two or more antibiotics. The data generated from this study show that there is a high infection rate of shigellosis among primary school children in this study area and calls for better health education, improved and sustainable sanitation and provision of more functional toilets with running water in the primary schools.

Epidemiology and spectrum of vibrio diarrheas in the lower cross river basin of Nigeria.

In 1991 a cholera epidemic occurred in Nigeria. The features of this cholera outbreak in a single hospital in Cross River, Nigeria, were examined. Microbiologic techniques included the use of thiosulphate citrate bile-salts sucrose (TCBS) medium for culture of all stool specimens. Vibrio isolates from diarrheic patients included V. cholerae-O1 (75), V. cholerae non-O1 (10) and V. parahaemolyticus (21). The illnesses were diverse, ranging from mild to severe, and in most instances requiring hospitalization, rehydration as well as antibiotic treatment. Eighty patients were hospitalized and six died mainly from hypovolemic shock and acute renal failure arising from excessive fluid loss. The low vibrio-associated mortality observed in this outbreak may have been influenced by the proximity and easy transit access to the health care facilities offered by the teaching hospital. This contrasts with the high mortality figures reported by Health Centers in the rural areas during the same period. Some features of vibrio diarrheas were comparable with those of other enteric pathogens. Poorly developed water and sewage disposal systems, contact with sea water, consumption of fishery products and leftover foods were the main risk factors identified.

Vibrio-associated gastroenteritis in the lower Cross-River Basin of Nigeria.

A total of 120 Vibrio species were isolated from 588 patients with acute diarrheal disease during an outbreak of gastrointestinal tract infections at different locations in the lower Cross River Basin of Nigeria. Vibrio cholerae O1, biotype El Tor, serotype Ogawa, was the prominent organism isolated from the Vibrio-associated diarrheal cases. During the 3 months of study, V. cholerae non-O1 was recovered from 10 patients while Vibrio parahaemolyticus was recovered from 19 patients. The significance of this study is the recognition that there is an ecological niche which supports V. cholerae non-O1 and V. parahaemolyticus in the Cross River Basin of Nigeria.