Is the COVID-19 pandemic masking the deadlier Lassa fever epidemic in Nigeria?

With the COVID-19 officially declared a pandemic, Nigeria alongside other countries is directing all its resources and manpower to contain this pandemic. However, the existence of Lassa fever (LF), a more severe, zoonotic, endemic and viral haemorrhagic fever caused by Lassa virus with higher case fatality ratio (CFR) rages on across Nigeria while receiving little or no public health attention. The simultaneously increasing cases of COVID-19 and LF across Nigeria would be catastrophic unless infection prevention and control measures toward both LF and COVID-19 outbreaks are considered alongside.

CD4+ T lymphocyte reference values of immunocompetent subjects in an African university.

CD4(+) T cells play critical roles in the immune system and, being primary targets of HIV infection, they are used to measure disease progression and response to combination antiretroviral therapy (cART), alongside other parameters, in HIV/AIDS patients. The aim of this study was to determine the reference values of CD4(+) T cells in a student population that was HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) negative. After ethical clearance and informed consent, 500 subjects (mean age = 26 years) were recruited, of whom 56 (11.2%) had HIV, HBV or HCV and were excluded. Blood samples were collected from the remaining 444 subjects into vacutainer tubes and analysed using the BD FACScount cytometer according to the manufacturer's instructions. Of the 444 subjects, 266 (59.9%) were male and 178 (40.1%) were female. The mean (± standard deviation) CD4(+) T cell count was 987 cells/µL (± 336). The mean counts among males and females were 957 cells/µL (± 306) and 991 cells/µL (± 340), respectively. Values of CD4(+) T cells ranged from 651 cells/µL to 1705 cells/µL. Subjects with higher CD4(+) T Cells were more likely to be female than male. There was no direct correlation between CD4(+) T cell values and age of the participants. Our findings offer the first insight into the CD4(+) T cell reference values of a Nigerian student population and provide useful data that will guide future cART decisions and other immune-based therapies.

Sero-prevalence of HIV infection among tuberculosis patients in a rural tuberculosis referral clinic in northern Nigeria.

Co-infection with Human Immunodeficiency virus (HIV) and Mycobacterium tuberculosis the causative agent of Tuberculosis (TB), has been referred to as the "cursed duet" as a result of the attendant morbidity and mortality due to their synergistic actions. This study was carried out to determine the prevalence of HIV infection among Tuberculosis (TB) confirmed patients on admission at a TB referral centre. The association of HIV prevalence with gender and age as risk factors was also determined. Blood samples were collected by venipuncture from 257 TB patients and their HIV status determined. Viral antibody detection was carried out using ELISA kits which detected both HIV-1 and HIV-2 and confirmed by Western blot. Of the 257 patients screened, 44.20% (106) were HIV positive. The prevalence of co-infection was higher among the female (44.82%) than the male (38.30%) patients and highest among those aged 21-40 years old (45.30%). Co-infection was found to be statistically highly associated with gender and age (p<0.05). A very high prevalence of HIV infection was reported in this study among patients that were on admission on the grounds that they had only TB. It is therefore important to screen for HIV among all TB patients.

Urban-rural estimation of hepatitis C virus infection sero-prevalence in north Central Nigeria.

BACKGROUND/OBJECTIVE: The epidemiology of hepatitis C virus (HCV) infection has been partially described for at risk groups in urban communities in Nigeria. On the other hand, literature on the possible spread of the virus in rural Nigeria remains extremely scanty. The objective of this study was to estimate the prevalence of HCV in a rural and urban community in Nigeria. METHODS: Four hundred and twenty four (n = 424) plasma samples belonging to 238 rural inhabitants and 186 urban dwellers in North Central Nigeria were tested for anti-HCV markers using a third generation quantitative enzyme-linked immunosorbent assay (ELISA) that uses recombinant proteins and synthetic peptides derived from core and non-structural regions. RESULTS: 29(12.2%, CI = 0.17-0.86) of the rural samples and 5(2.7%, CI = 0.01-0.06) of urban samples were positive for HCV infection. The highest number of infections was in the 21-40 years age category. Our preliminary findings indicates that the number of HCV infection in rural was higher (p = 0.03) when compared with urban settings in Nigeria. CONCLUSION: Our results suggest a higher prevalence of HCV infection in rural than urban Nigeria in the region studied and possibly in Nigeria as a whole. HCV transmission is active in rural Nigeria and large scale studies to understand the dynamics of the infection are required so as to plan targeted preventive measures.

Evaluation of a recombinant DNA hepatitis B vaccine in a vaccinated Nigerian population.

INTRODUCTION: Recombinant hepatitis B vaccine was introduced in 1986 and has gradually replaced the plasma-derived hepatitis B vaccine. No published data are available on the immunogenicity of hepatitis B vaccines in Nigerians. The current study aimed to evaluate protective sero-conversion rates after vaccination with Shanvac-B rDNA hepatitis B vaccine in Nigerian subjects between January and September 2009. METHODOLOGY:   After having obtained informed consent and ethical clearance, 2 mL of blood were aseptically collected from each participant aged ≤50 years, one month after the first, second and third doses of the vaccine. Sera were separated into cryovials and frozen at -21oC until analysed for the detection of the protective antibody titre induction. Protective antibody titre was defined as a titre of ≥10 mIU/mL. RESULTS: Of the 376 participants, 192 (51.1%) were males and 184 (48.9%) were females. A total of 144 subjects participated in the first-dose group, nine (6.3%) of whom developed protective antibody titre (8.3% of males and 4.2% of females). Of the 121 participants in the second-dose group, 108 (89.3%) developed protective antibody titre (98.3% of males and 80.3% of females), while of the 111 participants in the third-dose group, 100% protectively sero-converted. Males were more likely to develop protective antibody titre than females after the second dose (P < 0.05). CONCLUSION: This data provides additional evidence for the efficacy of Shanvac-B rDNA hepatitis B vaccine and the need to adhere to the recommended three-dose schedule to achieve full and lasting sero-protection among Nigerians.

Serological markers and risk factors for hepatitis B and hepatitis C viruses among students in a Nigerian university.

OBJECTIVE: The aim of this cross-sectional study was to estimate the seroprevalence rates of hepatitis B virus and hepatitis C virus infections and to analyze associated risk factors among 400 students in a Nigerian. METHODS: Participants were interviewed in a face-to-face sessions through a short structured questionnaire. Qualitative rapid immuno-chromatography test were used to screen for HBsAg and anti-HCV antibodies and these were confirmed by using third generation quantitative enzyme-linked immunosorbent assay (ELISAs). RESULTS: Seroprevalence rates were: HBV. All these individuals were asymptomatic and unaware of their hepatitis status prior to this study. We did not detect any case of HBV/HCV co-infection. The risk of being infected with HBV or HCV was not associated with marital status or having facial/tribal (p>0.05). A significant association was found between HCV (not HBV) infection and blood transfusion {OR=5.0 (95% CI=0.91-27.47); chi2=4.15; p=0.04}. CONCLUSION: Although the seroprevalence of HBV and HCV is lower among university students when compared to blood donors, HIV/AIDS patients and health workers in Nigeria. We have shown that these viruses circulate among the study population and blood transfusion identified as the factors most associated with HCV infection. Routine donor screening needs to be enforced and it is essential to implement prevention strategies focused on university students and youths in general.

Prevalence of pulmonary tuberculosis (PTB) among people living with HIV/AIDS (PLWHA) in Keffi and its environs.

Coinfection with HIV and Mycobacterium tuberculosis is known to be a lethal combination especially with its attendant mortality and morbidity. The need to have a baseline data in an environment like Keffi with a HIV/AIDS prevalence of 38.6% necessitated this study. Three hundred and ninety people living with HIV/AIDS (PLWHA) were screened for pulmonary tuberculosis. Results of this study showed 16.7% prevalence of coinfection in the population. Gender-related prevalence of coinfection was 19.4% and 14.4% among males and females respectively (P>0.05). Age-related prevalence of coinfection was least among respondents of age below 20 years (13.3%) and highest among those of age above 40 years (20.2%) (P>0.05). Even though statistically insignificant by both parameters, these findings are of public health significance. There is therefore an urgent need for immediate intervention to allow for early TB diagnosis, institution of anti-TB treatment and provision of prophylaxis against TB among TB-negative PLWHA.

Serologic survey of specific rubella virus IgM in the sera of pregnant women in Makurdi, Benue State, Nigeria.

Although a major section of pregnant women in Nigeria are immune to rubella infection, cases of congenital rubella syndrome are still been seen in hospitals. Rubella is not a reportable disease in Nigeria and data of its epidemiology are extremely rare. In this study, we estimate the burden of acute rubella virus infection among pregnant women during their first trimester in Makurdi-Benue State-Nigeria. Anti-rubella IgM were detected using a commercially available quantitative enzyme immunoassay. Of the 534 (mean age = 28.1 +/- 1.7 years) sera sample tested, 21 (3.9%; 95% CI = +/- 1.64%) were positive for Rubella IgM antibodies. We also extrapolated by mathematical modeling that 4.2% represents the actual/real susceptible population in Nigeria. There was no significant correlations between rubella infection and age (p > 0.05). Although the incidence of rubella is low we suggest the antenatal screening and vaccination of all females of child bearing age to eliminate this potentially devastating virus in the county.