A systematic review of the current status of carbapenem resistance in Nigeria: Its public health implication for national intervention.

Carbapenem antibiotics are considered one of the most effective and the last-resort antibiotics for the treatment of infections caused by multidrug-resistant Gram-negative bacteria. However, with the advent of carbapenem resistance, it becomes obvious that quality health-care delivery will be hampered if adequate measure is not put in place. This review assessed the prevalence of carbapenem-resistant Gram-negative bacteria (CR-GNB) and also provided an up-to-date position on carbapenem resistance (CR) in Nigeria. Three electronic databases (Google Scholar, PubMed and African Journal online) were searched for relevant literatures, and 38 articles published between January 2013 and June 2022 that met the criteria for inclusion were recruited into the study. The mean prevalence of CR in Nigeria stands at 21.3%, with the southern and northern regions documenting a mean prevalence of 22.0% and 20.9%, respectively. Most of the reviewed articles were from clinical settings (81.6%), with urine samples (38.7%) constituting the most prevalent clinical sample in which CR-GNB were detected. The preponderance of phenotypic methods (55.3%) over molecular method (44.7%), particularly the use of disk diffusion test breakpoint and Modified Hodge test was documented. The most prevalent carbapenem-resistant bacteria were Escherichia coli (50.0%) and Klebsiella pneumoniae (26.3%). The blaNDM and blaVIM were the major reported carbapenemase-encoded genes, particularly among E. coli, K. pneumoniae and Pseudomonas species. This systematic review revealed a mean prevalence of CR-GNB in Nigeria that required urgent attention. Furthermore, the detection of clinically and epidemiologically important carbapenemase coding genes is of public health importance.

Current trends of immunization in Nigeria: prospect and challenges.

Immunization is aimed at the prevention of infectious diseases. In Nigeria, the National Programme on Immunization (NPI) suffers recurrent setbacks due to many factors including ethnicity and religious beliefs. Nigeria is made up of 36 states with its federal capital in Abuja. The country is divided into six geo-political zones; north central, north west, north east, south east, south west and south south. The population is unevenly distributed across the country. The average population density in 2006 was estimated at 150 people per square kilometres with Lagos, Anambra, Imo, Abia, and Akwa Ibom being the most densely populated states. Most of the densely populated states are found in the south east. Kano with an average density of 442 persons per square kilometre, is the most densely populated state in the northern part of the country. This study presents a review on the current immunization programme and the many challenges affecting its success in the eradication of childhood diseases in Nigeria.

Seroprevalence of syphilis in apparently healthy students from a tertiary institution in Benin City, Nigeria.

The seroprevalence of syphilis in students from a tertiary institution in Benin City, Nigeria was investigated. Venous blood samples (5 mL) were collected from 214 apparently healthy students aged 19-38 years (118 males and 96 females) between February and October 2009 and the serostatus of syphilis determined qualitatively using the rapid plasma reagin test. Seropositive sera were confirmed using the Treponema pallidum hemagglutination test. The total seropositivity for syphilis was 15.4%, with a prevalence in males and females of 18.6 and 11.4%, respectively. This difference was statistically significant (P<0.05). The highest prevalence was found for the 24-28-year-old age group, while the lowest prevalence was found for the 19-23-year-old age group, where no female tested positive. The results of this study show that the prevalence of syphilis infection among students in Benin City was high and is a public health concern. All persons, including voluntary blood donors, patients with sexually transmitted diseases, or those attending for routine medical checkups, should therefore be thoroughly screened for syphilis infection.

Asymptomatic bacteriuria among pregnant women.

BACKGROUND: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. AIM: This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. MATERIALS AND METHODS: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. RESULT: A total of 556 (45.3%) were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001). Trimester did not show any significant difference (P = 0.2006) in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. CONCLUSION: Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.