"Long COVID": A case report of persistent symptoms in a patient with prolonged SARS-CoV-2 shedding for over 110 days.

Coronavirus disease 2019 is a novel disease currently ravaging the world as a pandemic. More emphasis has been focused on the acute disease, with less attention on the detection and management of long-term sequelae which develop in some patients, variously termed "Long COVID," Post-coronavirus disease 2019 syndrome, or ongoing coronavirus disease. There are also various reports in the literature on the duration of viral shedding, with the longest known recorded being about 70 days, and whether this duration has an effect on prognosis or patients remaining infectious is still unknown. We report the case of a 22-year-old health care worker with prolonged multi-systemic features of coronavirus disease 2019 including cardiovascular, respiratory, central nervous system, and musculoskeletal symptoms lasting about 18 weeks from symptom onset, though never hospitalized, and persistent detection of severe acute respiratory syndrome coronavirus 2 attributed to viral shedding for over 110 days, which is the longest duration recorded to our knowledge.

Prevalence of Group B Streptococcus Colonisation and Antimicrobial Susceptibility Pattern among Pregnant Women Attending a Tertiary Health Facility in Ogun State, Southwest Nigeria.

Background: Genital colonisation by group B Streptococcus (GBS) in pregnant women in their third trimester has been shown to be a known risk factor for morbidity and mortality among newborns. Aim: The aim of the study was to determine the prevalence of GBS colonisation among pregnant women in Abeokuta, its associated sociodemographic factors, and the neonatal outcome among exposed babies. Design: Longitudinal cohort study. Setting: Department of Obstetrics and Gynaecology, Federal Medical Centre, Abeokuta, Ogun State. Methodology: One hundred sixty pregnant women presenting for routine antenatal care between 35 and 41 weeks were recruited consecutively. Swabs were taken from the vagina and then the rectum using a single swab. The samples were processed at the hospital's Medical Microbiology Laboratory using standard microbiological methods. Babies whose mothers were positive had their bodies swabbed and the samples sent for GBS isolates. They were also screened for early-onset neonatal sepsis with C-reactive protein. Results: Prevalence of GBS vaginal colonisation was 4.3%. There was no significant association between GBS colonisation status and age, level of education, or occupation; however, women of parity ≤1 had significantly higher prevalence of GBS colonisation than those of parity ≥2. There was no incidence of GBS infection observed in the babies. The GBS isolates were 100% sensitive to cefuroxime and 83.3% resistant to ampicillin. Conclusion: The prevalence of GBS is low in our environment. The organisms were highly sensitive to cefuroxime, erythromycin, and ceftriaxone. Routine screening of all pregnant women may be unnecessary. However, women at risk of GBS who present in labour without a recent GBS screening should be offered intrapartum prophylactic cefuroxime.

Contexte: La colonisation génitale par le streptocoque du groupe B (SGB) chez les femmes enceintes au cours de leur troisième trimestre s'est avérée être un facteur de risque connu de morbidité et de mortalité chez les nouveau-nés. Objectif: Déterminer la prévalence de la colonisation par le SGB chez les femmes enceintes à Abeokuta, ses facteurs sociodémographiques associés et l'issue néonatale chez les bébés exposés. Conception: Étude de cohorte longitudinale. Cadre: Département d'obstétrique et de gynécologie, Centre médical fédéral, Abeokuta, État d'Ogun. Méthodologie: Cent soixante femmes enceintes se présentant pour des soins prénatals de routine entre 35 et 41 semaines ont été recrutées consécutivement. Des écouvillons ont été prélevés du vagin puis du rectum à l'aide d'un seul écouvillon. Les échantillons ont été traités au laboratoire de microbiologie médicale de l'hôpital à l'aide de méthodes microbiologiques standard. Les bébés dont les mères étaient positives ont eu leur corps écouvillonné et les échantillons envoyés pour les isolats de SGB. Ils ont également été dépistés pour une septicémie néonatale d'apparition précoce avec la protéine C-réactive. Résultats: La prévalence de la colonisation vaginale par SGB était de 4,3%. Il n'y avait pas d'association significative entre le statut de colonisation par SGB et l'âge, le niveau d'éducation ou la profession; cependant, les femmes de parité ≤1 avaient une prévalence significativement plus élevée de colonisation par le SGB que celles de parité ≥2. Aucune incidence d'infection à SGB n'a été observée chez les bébés. Les isolats de SGB étaient 100% sensibles au céfuroxime et 83,3% résistants à l'ampicilline. Conclusion: La prévalence du SGB est faible dans notre environnement. Les organismes étaient très sensibles à la céfuroxime, à l'érythromycine et à la ceftriaxone. Le dépistage systématique de toutes les femmes enceintes peut être inutile. Cependant, les femmes à risque de SGB qui se présentent pendant le travail sans dépistage récent du SGB devraient se voir proposer du céfuroxime prophylactique intrapartum.

Assessment of Serological Markers of Genital Chlamydia trachomatis Infection Among the Gynaecology Patients attending Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria.

Genital Chlamydia trachomatis infection causes significant morbidity and mortality in women. A number of epidemiologic studies have suggested that Polymerase Chain Reaction (PCR) is more accurate as a diagnostic tool for Chlamydia trachomatis. However, the use of serological markers may be cost effective and practical in diagnosing and estimating the burden of the disease in resource limited countries.This study was aimed at determining the serological markers (IgG, IgM and IgA) of Chlamydia trachomatis, evaluate the association between Chlamydia trachomatis infection and the sociodemographic characteristics and clinical diagnosis of the participants. This was a cross sectional hospital-based study in which blood samples from 145 consenting participants were tested for IgG, IgM and IgA antibodies against Chlamydia trachomatis using enzyme linked immunosorbent assay and their clinical diagnosis, retrieved from their case notes. The cumulative prevalence of seropositivity for Chlamydia trachomatis (IgG, IgM, IgA) was 112 (77.2%) while 33 (22.8%) were seronegative. The overall predominant seromarker was IgG 91(62.8%) while IgM and IgA accounted for 85(58.6%) and 54(37.2%) respectively. A statistically significant association was found between Chlamydia trachomatis infection and PID (p value = 0.031), primary infertility (p value 0.011) and level of income (p value= (0,045).

Assessment of seminal biomarker of lipid peroxidation among male partners of infertile couples at the university of ilorin teaching hospital, Nigeria.

BACKGROUND: Seminal fluid analysis (SFA) is the most important investigation of infertile males. It is however limited in revealing the aetiologies of the various spermatozoa abnormalities observed on microscopy. Increasing prevalence of male infertility and the challenges of diagnosis require biochemical investigations, such as assay of seminal malondialdehyde (MDA), a marker of sperm peroxidation and to support SFA in investigation of infertile males. AIMS: The aim of this study was to determine the seminal level of biomarker of lipid peroxidation by measuring seminal MDA levels among infertile males in Ilorin. SETTINGS AND DESIGN: This was a descriptive cross-sectional study. SUBJECTS AND METHODS: One hundred and thirty infertile males served as patients and 50 fertile males as controls. Seminal MDA was assayed using ELISA method. STATISTICAL ANALYSIS USED: Statistical Package for the Social Sciences (SPSS) version 20.0 (SPSS Inc., Chicago, IL, USA) was used. Normally distributed data were expressed as mean ± standard deviation. RESULTS: The mean age of the patients who were mainly civil servants was 38.6 ± 6.6 years compared to 37.0 ± 5.8 years among controls. Seminal MDA was significantly higher among infertile males in this study (P < 0.05) indicating higher degree of lipid peroxidation in their semen. Seminal MDA concentrations were found to be significantly higher among infertile males with a history of alcohol consumption (P < 0.05), cigarette smoking (P < 0.001) and sexually transmitted infections (P < 0.001) when compared to control with similar history. CONCLUSIONS: There is significant lipid peroxidation of spermatozoa among infertile males with lifestyle playing a significant role. Evaluation of infertile males should include assessment of seminal MDA. Prophylactic administration of antioxidants to this group of patients may be beneficial.

Patterns of sexually transmitted infections in patients presenting in special treatment clinic in Ibadan south western Nigeria.

INTRODUCTION: Sexually transmitted infections (STIs) are infections that are often transferred from one person to another during sexual activity. In developing countries, an increase in the incidence of STIs is attributed to increasing urbanization, modernization, travel, education and exposure to Western media which has led to increased sexual activity, especially among young people. METHODS: This is a retrospective study carried out in the University College Hospital (UCH) Ibadan, Nigeria. The records of a total of 506 patients who attended the clinic between Jan 2010-Dec 2011 were retrieved. The records of the patients' complaints were taken. Detailed demographic data and history of genital symptoms was taken. RESULTS: The records of 506 patients were used 43.7% (221) were males and 56.3% (285) were females. The patient's age ranged from one to eighty, the 1-10 age groups and the 71-80 ages were the least represented age group. Age, sex, level of education, presenting complaints, presence of yeast cells, VDRL positivity were variables that were looked at. Of these only sex and occupation were risk factors for transmission of STI. CONCLUSION: Good clinical care for patients with STIs should extend beyond therapy and include help to avoid future infections. Control activities should focus on the primary prevention of infection through safer sexual practices. Strategies for improving secondary prevention (health care-seeking behavior and case management) should include identification of people at risk and targeting them for intervention.

Age and sex prevalence of infectious dermatoses among primary school children in a rural South-Eastern Nigerian community.

INTRODUCTION: Various dermatoses, due to their morbidity characteristics, have been shown to negatively impact on learning. The most epidemiologically important seem to be the infectious types because of their transmissibility and amenability to simple school-health measures. The aim of this study was to assess the prevalence and sex/age correlates of infectious dermatoses in a rural South-eastern Nigerian community. METHODS: The pupils were proportionately recruited from the three primary schools based on school population. Stratified simple random sampling method was adopted and a table of random numbers was used to select required pupils from each arm. Clinical and laboratory examination was done to establish diagnoses of infectious skin disease. Data collected were analyzed using SPSS version 16. RESULTS: The 400 pupils consisted of 153 males and 247 females. Age range was between 6 and 12 years. The prevalence of infectious dermatoses was 72.3%. The five most prevalent clinical forms of infectious dermatoses, in order of decreasing prevalence, were tinea capitis (35.2%), scabies (10.5%), tinea corporis (5.8%), tinea pedis (5.5%), and impetigo (5.0%). More cases, generally, occurred among males than females (80.4% vs 67.2%)); while some specific clinical types, pediculosis and seborrheic dermatitis, exhibited predilection for females. Pyodermas and scabies were significantly more prevalent in the 7-9 age-group; while tinea capitis, tinea corporis, seborrheic dermatitis and pediculosis were more associated with ≥10 age-group. CONCLUSION: Infectious dermatoses were highly prevalent in the surveyed population. Many of the clinical types exhibited sex- and age-specificity.

PATTERNS OF SEMINAL FLUID ANALYSIS IN MALE PARTNERS OF INFERTILE COUPLES ATTENDING GYNAECOLOGY CLINIC AT FEDERAL MEDICAL CENTRE, ABEOKUTA.

BACKGROUND: Infertility affects 19% of the general population I, and this constitutes a reproductive health concern for the affected couples. The contribution of male factors as cause of infertility is increasingly being noted in the recent times and has become a source of concern to the affected couples with its attendant social and psychological effects and with the potential of threatening relationships. OBJECTIVES: To assess the seminal fluid analysis parameters in male partners of infertile couples presenting at gynaecological clinic of Federal Medical Centre, Abeokuta and to determine the patterns of seminal fluid abnormalities in the seminalysis results. METHODOLOGY: The study is a 3 year retrospective review of seminal fluid analysis results of male partners in infertility cases at the Federal Medical Centre Abeokuta. Analysis was done using the WHO laboratory manual for the examination and processing of human semen revised fifth edition. RESULTS: During this study period, a total of 214 semen samples were analysed for semen quality over a 3 year period. Sixty four (30%) of the men had normal semen parameters, while one hundred and fifty (70%) had abnormal semen parameters. The abnormal semen parameters consists of low volume (12.6%), prolonged liquefaction time (9.8%), oligospermia (28%), azoospermia (8%), asthenozoospermia (25%), teratozoospermia (9%), combined defects of oligo-asthenozoospermia (23.8%), oligo-teratozoospermia (9.8%), asthenoteratozoospermia (12.60%) and oligoasthenoteratozoospermia (11.20%). CONCLUSION: This study has confirmed that male factor infertility remains a significant contributor to infertility in our environment. Efforts should be made in enlightening men on the common aetiologies of abnormal semen and options of treatment of likely causes.

Sexual behavioral correlates with HSV-2 seroprevalence among pregnant women in Nigeria.

INTRODUCTION: The burden of HSV-2 infection, the cause of most cases of genital herpes in Nigeria, varies from region to region; and so are the associated factors. This infection is known to be responsible for several negative pregnancy outcomes. There is currently no documented data on sexual behavioral factors associated with the occurrence of HSV-2 infection or seroprevalence among pregnant women in Nigeria. This study aimed at identifying the sexual behavioral correlates of HSV-2 seroprevalence among pregnant women in Benin City, Nigeria. METHODOLOGY: The cross-sectional study design was adopted and the study took place between November 2011 and June 2012. Four hundred and ten consenting ante-natal clinic patients in two major tertiary hospitals in Benin City were consecutively and prospectively included. Data sources were represented by questionnaires, the patient's case records and laboratory investigations. Each patient's serum was analyzed for HSV-2 antibody detection. Data analysis was performed using SPSS version 16. RESULTS: Four hundred and ten patients were enrolled with average age 30.6 years. Seroprevalence of HSV-2 antibody was 47.3%. Sexual behavioral factors that were significantly associated with HSV-2 seroprevalence included early exposure to sexual intercourse, number of sex partners, involvement in polygamous marriages, involvement of husband in extra-marital affairs and hormonal contraceptive use. CONCLUSION: The prevalence of HSV-2 among pregnant women in Benin City is high. Public health campaigns aimed at: delaying onset of sexual activity; encouraging monogamous relationships; and emphasizing that hormonal contraceptives do not protect from STI's, are recommended.

Multidrug resistant acinetobacter infection and their antimicrobial susceptibility pattern in a nigerian tertiary hospital ICU.

BACKGROUND: Acinetobacter baumannii, a non-glucose fermenting Gram negative bacillus, has emerged in the last three decades as a major etiological agent of hospital-associated infections giving rise to significant morbidity and mortality particularly in immunocompromised patients. Multidrug resistant A. baumannii (MDR-AB) is fast becoming a global threat, having developed resistance to major classes of antibiotics and carbapenem-resistant isolates have increasingly been reported worldwide as a cause of nosocomial outbreaks. Despite intensive efforts, nosocomial acquisition of MDR-AB is still a problem due to the organism's great ability to colonize human and environmental reservoirs. OBJECTIVES: This study was aimed to determine the prevalence of (MDR) AB and their antibiotic susceptibility pattern. METHODOLOGY: A total of 400 specimens which include tracheal aspirates, catheter specimens of urine, wound biopsies and blood culture collected from 100 patients admitted at the Intensive Care Unit of our hospital over a period of nine months were processed following standard microbiologic procedure. RESULTS: A total of 155 non-lactose fermenters were isolated out of which 14 (9.0%) were Acinetobacter spp. Eleven (79.0%) out of the 14 Acinetobacter spp were A. Baumanii, while 2 (14.0%) were A. lwoffi and 1(7.0%) A.calcoaceticus. All the isolates were resistant to Amoxicillin-clavulanate, Ceftriaxone, Ciprofloxacin, Ofloxacin, gentamicin and Ampicillin-sulbactam; while susceptibility to Meropenem, Amikacin and Levofloxacin were 64.3%, 50.0% and 35.7% respectively. CONCLUSION: The high rate of antibiotic resistance shown by Acintobacter isolates in this study demonstrates the need for antibiotic stewardship protocols to be set up in health facilities to prevent outbreaks of multi-resistant bacterial infections.

Multidrug resistant acinetobacter infection and their antimicrobial susceptibility pattern in a Nigerian tertiary hospital Icu

Background: Pelvic inflammatory disease refers to any infection in the female lower reproductive tract that spreads to the upper reproductive tract. The disease comprises a spectrum of inflammatory disorders of the upper female genital tract; including any combination of endometritis; salpingitis; tubo-ovarian abscess and pelvic peritonitis. PID is not a notifiable disease in most countries; so accurate statistics are not available. This situation is not in any way different here in Nigeria and more so in the Federal Capital Territory; Abuja where this research was conducted; there had never been any published report so far on PID. It therefore became pertinent that such studies be carried out to evaluate the bacterial organisms which may be associated with the disease in this part of Nigeria so that health care providers could take a better look at this affliction in women. Materials and Methods: Endocervical swabs totalling 100 were aseptically collected from patients with confirmed Pelvic Inflammatory Disease (PID); attending some hospitals in Abuja; Nigeria for detection of bacterial pathogens based on cultural and biochemical characterisation tests. Antibiogram was also conducted on the identified bacterial isolates. Results: Out of the 100 samples analysed; 43 yielded pure cultures of bacterial isolates; 2 yielded mixed cultures while no bacterial growths were recorded from the remaining 55 samples. Organisms encountered were Staphylococcus aureus (16); Escherichia coli (10); Streptococcus faecalis (8); Pseudomonas aeruginosa (4); Streptococcus pyogenes (3); Klebsiella pneumoniae (3); Proteus rettgeri (2) and Proteus mirabilis (1). The highest percentage occurrence of pathogenic isolates was observed in polygamous married patients (90). The age group most affected falls within the mean age 30.5 years (68) while the least affected group falls within the mean age 40.5 years (5). There was a significant difference in the acquisition of PID in relation to marital status (P 0.05). However there was no significant difference in the acquisition of the disease with respect to age (P 0.05). Antibiogram patterns of pathogenic isolates revealed varied resistance to most of the antibiotics employed. Cefotaxime (a new generation cephalosporin antibiotic) was established in this study as the best antimicrobial agent for treatment of PID due to Gram-positive and Gram-negative bacteria isolated from the women examined. Conclusion: In conclusion; Pelvic inflammatory disease is a major health problem in developed or developing countries of the world. PID is not a notifiable disease; as accurate statistics on disease prevalence are rarely available. There is therefore no doubt thousands of young women have salpingitis every year and their sheer number makes it an important health problem. PID hence can be said to be a very serious complication of sexually transmitted disease which should be critically and promptly handled by healthcare providers. The right type sample should be aseptically collected and be appropriately handled for laboratory investigation. Treatment of PID should be initiated as soon as the presumptive diagnosis has been made. Immediate administration of antibiotics has been effective in the long-term sequelae associated with PID; especially new generation antibiotics; such as cefotaxime as recorded in this study