Ownership of mobile phones and willingness to receive childhood immunisation reminder messages among caregivers of infants in Ondo State, south-western Nigeria

Background. The timely completion of the childhood immunisation schedule for children under the age of 1 year by caregivers is key to reducing the high morbidity and mortality of vaccine-preventable diseases among infantsglobally.Objective. To determine the ownership of mobile phones among caregivers of children under the age of 1 year, their knowledge about immunisation service delivery and willingness to receive childhood immunisation schedule reminder messages in Ondo State, south-western Nigeria.Method. A descriptive cross-sectional study using semi-structured interviewer-administered questionnaires was conducted with 615 caregivers of infants, who brought their children to clinics conducting immunisation in 24 health facilities in rural, semi-urban and urban settlements in Ondo State in December 2014.Results. The mean (standard deviation, SD) age of respondents was 28.49 (6.01) years, 76.7% were Yoruba, 91.4% were married and living with their spouses and 4.2% were single. Mobile phone ownership was 74.5% among rural-based respondents, and 95.8% among urbanbased.Forty-six percent of the respondents had good knowledge of immunisation, vaccine-preventable diseases and vaccination schedules,while 27.5% had poor knowledge. The majority of the respondents (99.7%) were willing to receive childhood immunisation reminder messages on their mobile phones. About 50% of the respondents preferred to receive reminder messages at any time, rather than specific times. The most preferred language for reminders was English (54.5%). Residing in an urban area and having post-secondary education were predictors of mobile phone ownership.Conclusion. The high mobile phone ownership level, and the willingness of caregivers of infants in this study area to receive immunisation schedule reminder messages, is encouraging, and should be optimised to improve routine immunisation uptake. However, caregivers of infants in rural areas need to be provided with mobile phone support, and trained in their usage in order to benefit from such an intervention in childhood immunisation

Accessory genetic content in Campylobacter jejuni ST21CC isolates from feces and blood.

Campylobacter jejuni is an important foodborne pathogen and the most commonly reported bacterial cause of gastroenteritis. C. jejuni is occasionally found in blood, although mechanisms important for invasiveness have remained unclear. C. jejuni is divided into many different lineages, of which the ST21 clonal complex (CC) is widely distributed. Here, we performed comparative genomic and in vitro analyses on 17C. jejuni ST21CC strains derived from human blood and feces in order to identify features associated with isolation site. The ST21CC lineage is divided into two large groups; centered around ST-21 and ST-50. Our clinical strains, typed as ST-50, showed further microevolution into two distinct clusters. These clusters were distinguished by major differences in their capsule loci and the distribution of accessory genetic content, including C. jejuni integrated elements (CJIEs) and plasmids. Accessory genetic content was more common among fecal than blood strains, whereas blood strains contained a hybrid capsule locus which partially consisted of C. jejuni subsp. doylei-like content. In vitro infection assays with human colon cell lines did not show significant differences in adherence and invasion between the blood and fecal strains. Our results showed that CJIEs and plasmid derived genetic material were less common among blood isolates than fecal isolates; in contrast, hybrid capsule loci, especially those containing C. jejuni subsp. doylei-like gene content, were found among many isolates derived from blood. The role of these findings requires more detailed investigation.

Relevance of truncating titin mutations in dilated cardiomyopathy.

Dilated cardiomyopathy (DCM), a genetically heterogeneous cardiac disease characterized by left ventricular dilatation and systolic dysfunction, is caused majorly by truncations of titin (TTN), especially in A-band region. Clinical interpretation of TTN-truncating variants (TTNtv) has been challenged by the existing inaccurate variant assessment strategies and uncertainty in the true frequency of TTNtv across the general population. We aggregated TTNtv identified in 1788 DCM patients and compared the variants with those reported in over 60,000 Exome Aggregation Consortium reference population. We implemented our current variant assessment strategy that prioritizes TTNtv affecting all transcripts of the gene, and observed a decline in the prevalence of TTNtv in DCM. Despite this decline, TTNtv are more prevalent in DCM patients compared with reference population (p = 4.1 × 10(-295) ). Moreover, our extended analyses confirmed the enrichment of TTNtv not only in the A-band but also in the I/A-band junction of TTN. We estimated the probability of pathogenicity of TTNtv affecting all transcripts of TTN, identified in unselected DCM patients to be 97.8% (likelihood ratio (LR) = 42.2). We emphasize that identifying a TTNtv, especially in the A-band region, has a higher risk of being disease-causing than previously anticipated, and recommend prioritizing TTNtv affecting at least five transcripts of the gene.

Comparative genomics and genome biology of invasive Campylobacter jejuni.

Campylobacter jejuni is a major pathogen in bacterial gastroenteritis worldwide and can cause bacteremia in severe cases. C. jejuni is highly structured into clonal lineages of which the ST677CC lineage has been overrepresented among C. jejuni isolates derived from blood. In this study, we characterized the genomes of 31 C. jejuni blood isolates and 24 faecal isolates belonging to ST677CC in order to study the genome biology related to C. jejuni invasiveness. We combined the genome analyses with phenotypical evidence on serum resistance which was associated with phase variation of wcbK; a GDP-mannose 4,6-dehydratase involved in capsular biosynthesis. We also describe the finding of a Type III restriction-modification system unique to the ST-794 sublineage. However, features previously considered to be related to pathogenesis of C. jejuni were either absent or disrupted among our strains. Our results refine the role of capsule features associated with invasive disease and accentuate the possibility of methylation and restriction enzymes in the potential of C. jejuni to establish invasive infections. Our findings underline the importance of studying clinically relevant well-characterized bacterial strains in order to understand pathogenesis mechanisms important in human infections.