Spinal cord schistosomiasis in a 6-year-old child with complete recovery after spine surgery and medical treatment: case report and discussion.

Spinal cord schistosomiasis is a rare and severe form of schistosomiasis. The prognosis is largely conditioned by early diagnosis and treatment. The authors present a case of spinal cord schistosomiasis complicated by spinal cord compression syndrome. This is the case of a 6-year-old patient who presented with febrile gastroenteritis followed by complete paralysis of both lower limbs of sudden onset following a brief stay in a village setting with notion of multiple baths at a stream. Spinal cord MRI revealed an enlarged spinal cord spanning D10 to D12 with heterogeneous contrast enhancement and a syrinx cavity above the lesion. Biological workup revealed an inflammatory syndrome. Treatment consisted of decompressive laminectomy with biopsy of the lesion and a syringo-subarachnoid shunt. Pathological analysis revealed fragments of central nervous system tissues with an infiltrate composed of lymphocytes, plasmocytes, and macrophages producing granulomatous foci lined with areas of necrosis in addition to a large contingent of polynuclear eosinophils, agglutinating around or covering in some places elongated ovoid structures, with relatively thick eosinophilic shells and presenting a terminal spur. Adjuvant treatment consisted of praziquantel and corticotherapy for 1 month. The evolution showed marked improvement in the neurological deficits. She now walks unassisted and has good sphincter control. Spinal cord schistosomiasis is rare in our context; its diagnosis is difficult. The treatment is both medical and surgical.

Behavioral validation of novel high resolution attention decoding method from multi-units & local field potentials.

The ability to access brain information in real-time is crucial both for a better understanding of cognitive functions and for the development of therapeutic applications based on brain-machine interfaces. Great success has been achieved in the field of neural motor prosthesis. Progress is still needed in the real-time decoding of higher-order cognitive processes such as covert attention. Recently, we showed that we can track the location of the attentional spotlight using classification methods applied to prefrontal multi-unit activity (MUA) in the non-human primates. Importantly, we demonstrated that the decoded (x,y) attentional spotlight parametrically correlates with the behavior of the monkeys thus validating our decoding of attention. We also demonstrate that this spotlight is extremely dynamic. Here, in order to get closer to non-invasive decoding applications, we extend our previous work to local field potential signals (LFP). Specifically, we achieve, for the first time, high decoding accuracy of the (x,y) location of the attentional spotlight from prefrontal LFP signals, to a degree comparable to that achieved from MUA signals, and we show that this LFP content is predictive of behavior. This LFP attention-related information is maximal in the gamma band (30-250 Hz), peaking between 60 to 120 Hz. In addition, we introduce a novel two-step decoding procedure based on the labelling of maximally attention-informative trials during the decoding procedure. This procedure strongly improves the correlation between our real-time MUA and LFP based decoding and behavioral performance, thus further refining the functional relevance of this real-time decoding of the (x,y) locus of attention. This improvement is more marked for LFP signals than for MUA signals. Overall, this study demonstrates that the attentional spotlight can be accessed from LFP frequency content, in real-time, and can be used to drive high-information content cognitive brain-machine interfaces for the development of new therapeutic strategies.

Effectiveness of Trichoderma strains isolated from the rhizosphere of citrus tree to control Alternaria alternata, Colletotrichum gloeosporioides and Penicillium digitatum A21 resistant to pyrimethanil in post-harvest oranges (Citrus sinensis L. (Osbeck)).

AIMS: Penicillium digitatum, Alternaria alternata and Colletotrichum gloeosporioides are pathogens responsible for large decays and production losses of citrus. They are commonly controlled by fungicides, whose excessive applications have led to the emergence of resistant P. digitatum strains. Alternative approaches are imperative for sustainable and environmental harmless citrus production, being biological control a promising strategy. The objective was to evaluate the potential of Trichoderma strains native from the rhizosphere of citrus trees to control these pathogens. METHODS AND RESULTS: Seven strains were isolated and identified as Trichoderma harzianum, T. guizhouense, T. atroviride and T. koningiopsis through morphological and molecular analyses. Five of them showed effective antagonist performance in vitro against the pathogens. The strain T. harzianum IC-30 was the best biological control agent in vivo, obtaining a reduction of rot percentage around 80% after 3 weeks of infection of oranges with P. digitatum A21 (resistant to pyrimethanil). This strain also showed the highest chitinase and glucanase activities. CONCLUSIONS: Trichoderma harzianum IC-30 is an optimal antagonist for the control of green mould spreading and other pathogens in post-harvest citrus fruits. SIGNIFICANCE AND IMPACT OF THE STUDY: The strain combined with supplementary practices could lead to sustainable management of citrus fungal diseases, dispensing with synthetic fungicides.

Quality of life of patients operated for lumbar stenosis at the Yaoundé Central Hospital.

Introduction: Several studies have been conducted in many African countries on lumbar stenosis but none on the quality of life of patients after surgery. We conducted this study to evaluate the quality of life of patients following surgery indicated for lumbar stenosis.Methods: A cross-sectional study from January 2010 to December 2015 in the neurosurgery department of the Yaoundé Central Hospital. We included all patients operated for lumbar stenosis, whose post-operative follow-up was at least of one year. Sampling was consecutive using operating room registries and archives of the neurosurgery department. We used the Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) to evaluate patient's quality of life.Results: We recruited 52 patients. The mean age was 58.13 years. Pre-operatively, 67.3% of patients presented with severe pain (mean VAS of 8.9). At 3 months, 59.6% presented with moderate pain (mean VAS = 4.75). At six months following surgery, 92.3% of patients had mild pain (mean VAS = 2.92). At one year, all patients had only mild pain (mean VAS = 1.05). Pre-operatively, 67.30% of patients presented with severe walking disability; the mean ODI was 77.88% and a third were bedridden. Three months after surgery 61.50% presented with moderate disability and the mean ODI was 38.17%. Six months following surgery, 48.10% of patients presented with moderate disability and 42.30% presented with a mild disability (the mean ODI was 24.80%). At one year, 82% of patients presented with mild disability and the mean ODI was 12.67%.Conclusion: Surgery improved the physical condition of patients.

Prevalence of Pre-Diabetes, Diabetes and Associated Cardiovascular Risk Amongst Healthcare Workers in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria using Glycated Haemoglobin.

BACKGROUND: There is a global rise in the prevalence of diabetes mellitus and pre-diabetes is a fore-runner to type-2 diabetes. Pre-diabetes is reversible, therefore, measures should be taken to halt or slow down its progression to frank diabetes. AIM: The study aimed to evaluate the prevalence of pre-diabetes and diabetes amongst staff of ABUTH, Zaria and identify some cardiovascular risks associated with them. METHODS: A cross-sectional analytical study carried out on 377 healthcare workers who presented at the Medical out-patient department of ABUTH, Zaria in response to an invitation for the 2017 World Diabetes Day free medical screening. HbA1c was assessed via Immunofluorescence method. The difference in HbA1c amongst healthcare workers was determined by One-way Analysis of Variance with Post-hoc Bonferroni test. Cardiovascular risk associations were assessed via Multiple Binary Logistic Regression. RESULTS: Pre-diabetes and diabetes prevalence were 19.4% and 6.5% respectively. There were 28.6% undiagnosed diabetic healthcare workers. There was no significant (p=0.35) difference in HbA1c between different categories of healthcare workers, however, random blood glucose was significantly (p=0.042) higher in other healthcare workers than doctors. There was a significant (p<0.01) association between systolic hypertension and risk of developing pre-diabetes and diabetes (OR, 4.11, CI 0.98-17.30). CONCLUSION: There is a high prevalence of pre-diabetes and diabetes amongst healthcare workers in Zaria. The odds of hypertensive healthcare workers developing pre-diabetes and diabetes is high. Efforts should be geared at intensifying health education, increased work physical activity and proper diet.

Visual outcome of surgically managed pituitary adenomas followed-up at the Yaoundé Central Hospital.

INTRODUCTION: Pituitary adenomas are benign brain tumours arising from the adenohypophysis; representing 10-15% of all intra-cranial tumours. Despite improved management, they are still related to high morbidity. Visual impairment is a common presentation and visual field defects representing 37-96%. We aimed at describing the clinical presentation of operated patients and their visual outcome. METHODS: We conducted a cross-sectional study for 6 months at the Yaoundé Central Hospital's Neurosurgery, Endocrinology and Ophthalmology departments. We included all patients with histopathological confirmation, having pre-operative visual assessment and operated from January 2010 to June 2016. RESULTS: Twenty-five participants (50 eyes) were enrolled. Three subtypes of pituitary adenomas were identified: Non-functional pituitary adenomas (64%) > Somatotropinomas (20%) > Prolactinomas (16%). All cases were macroadenomas. The median duration of symptoms was 14 months. All participants presented with vision impairment and 80% with headaches. Craniotomy was used in 88% of cases. The temporal hemifield was the most quantitatively affected; 76% of eyes presented with visual acuity (VA) < 6/12 and 24% of eyes a visual acuity ≥6/12. Thirty percent of eyes presented with optic atrophy; cranial nerve III palsy was the most observed. The Mean deviation (MD), an automated visual field index, improved though non-significant and 16% of eyes had a normal visual field printout after surgery. Left eye mean deviation improved significantly (p = 0.04). After surgery, there was a mild improvement of VA with 62% of eyes having a VA< 6/12 and 38% a VA ≥6/12. There was no ophthalmoplaegia after surgery. Long delay before diagnosis significantly jeopardizes pre-operative and post-operative visual acuity (r = 0.5; p = 0.01). CONCLUSION: Quantitative vision parameters comparison are suggestive of a potential improvement of vision. This conclusion will be better ascertained on a large-scale sample size. Long delay before diagnosis is associated to poor visual outcome.

A community-based surveillance of gastrointestinal helminthiasis among pregnant women in Ibadan, South West Nigeria.

BACKGROUND: : Intestinal helminthiasis is a major public health problem in Africa. Helminthic infection in pregnant women causes loss of appetite, poor nutrient absorption, gastrointestinal impairment, iron deficiency, and iron deficiency anemia resulting in low birth weights and preterm births. The main aim of this study is to assess the prevalence of helminthic infections in pregnant women in rural and peri-urban communities of Ibadan. MATERIALS AND METHODS: : A cross-sectional descriptive study was carried out at the antenatal clinics of 12 selected primary health centers and mission homes in Ibadan, Nigeria. Open- and closed-answer questionnaires were administered to 604 consenting pregnant women, who provided fresh stool samples for microscopy. Helminthic quantification was carried out by the Kato-Katz technique. Proportions were compared using Chi-squared with IBM® SPSS® Statistics 21 for analysis. Statistical significance was set at P < 0.05. RESULTS: : Eighty-nine stool samples (14.7%) were positive for helminthiasis. Most had roundworms (13.6%); 13 (2.2%) had hookworms. The mean arithmetic eggs per gram of feces were 2,124 and 248, respectively. No participant had a heavy intensity infection; nearly all were of low intensity. Participants (P = 0.005) and their husbands (P = 0.005) who had higher education were less likely to have helminthiasis. CONCLUSION: These communities are classified as Category III, having a low prevalence and low intensity infection. Therefore, prophylactic anti-helminthic treatment in pregnancy is not recommended. The inverse relationship with education may be a function of better living conditions. Better hygiene should be advocated.

Athermal operation of multi-section slotted tunable lasers.

Two distinct athermal bias current procedures based on thermal tuning are demonstrated for a low-cost, monotlithic, three section slotted single mode laser, achieving mode-hop free wavelength stability of ± 0.04 nm / 5 GHz over a temperature range of 8-47 °C. This is the first time that athermal performance has been demonstrated for a three-section slotted laser with simple fabrication, and is well within the 50 GHz grid spacing specified for DWDM systems. This performance is similar to experiments on more complex DS-DBR lasers, indicating that strong athermal performance can be achieved using our lower-cost three section devices. An analytical model and thermoreflectance measurements provide further insight into the operation of multi-section lasers and lay the foundation for an accurate predictive tool for optimising such devices for athermal operation.

MATERNAL MORTALITY AUDIT IN A TERTIARY HEALTH INSTITUTION IN NIGERIA: LESSONS FROM DIRECT CAUSES AND ITS DRIVERS.

INTRODUCTION: Nigeria has the second highest number of maternal deaths in the world.The study aimed at determining the causes of and non-obstetric contributors to maternal mortality at a tertiary referral hospital. MATERIALS AND METHODS: It was a prospective audit of all consecutive maternal deaths in the hospital over a three-year period. Immediately after the death, information wvas retrieved via a data collection form. Data were analysed with SPSS-20. RESULTS: Seventy deaths were examined over the study period. Maternal mortality ratio was 1,265/100,000 live births. The annual ratio decreased steadily over the study period. Most of the deaths were of multiparous women who had not received any antenatal care, and were mostly postpartum,within 24 hours of delivery. Most of them were critically ill on admission to the hospital. Major causes of death were haemorrhage (36%), sepsis (17%) and hypertensive disorders (16%).Delays were identified in 34.3% of cases; most (70.1%) were Phase III delays. DISCUSSION: Direct causes of maternal mortality are consistent with those found in literature. Steps which the centre has been taken to counter direct and non-obstetric causes are discussed. Possible strategies to improve health financing and referral system are proffered.

Structurally diverse MDM2-p53 antagonists act as modulators of MDR-1 function in neuroblastoma.

BACKGROUND: A frequent mechanism of acquired multidrug resistance in human cancers is overexpression of ATP-binding cassette transporters such as the Multi-Drug Resistance Protein 1 (MDR-1). Nutlin-3, an MDM2-p53 antagonist, has previously been reported to be a competitive MDR-1 inhibitor. METHODS: This study assessed whether the structurally diverse MDM2-p53 antagonists, MI-63, NDD0005, and RG7388 are also able to modulate MDR-1 function, particularly in p53 mutant neuroblastoma cells, using XTT-based cell viability assays, western blotting, and liquid chromatography-mass spectrometry analysis. RESULTS: Verapamil and the MDM2-p53 antagonists potentiated vincristine-mediated growth inhibition in a concentration-dependent manner when used in combination with high MDR-1-expressing p53 mutant neuroblastoma cell lines at concentrations that did not affect the viability of cells when given alone. Liquid chromatography-mass spectrometry analyses showed that verapamil, Nutlin-3, MI-63 and NDD0005, but not RG7388, led to increased intracellular levels of vincristine in high MDR-1-expressing cell lines. CONCLUSIONS: These results show that in addition to Nutlin-3, other structurally unrelated MDM2-p53 antagonists can also act as MDR-1 inhibitors and reverse MDR-1-mediated multidrug resistance in neuroblastoma cell lines in a p53-independent manner. These findings are important for future clinical trial design with MDM2-p53 antagonists when used in combination with agents that are MDR-1 substrates.

Analysis of the genetic variability and structure of Ochlerotatus taeniorhynchus (Diptera: Culicidae) populations from the Colombian Atlantic coast on the basis of random amplified polymorphic DNA markers.

Ochlerotatus taeniorhynchus (Diptera: Culicidae) is a mosquito, which is an efficient vector of the virus causing epidemic-epizootic Venezuelan equine encephalitis in Colombia. This study used 9 random amplified polymorphic DNA (RAPD) markers to analyze the mosquito's genetic variability and genetic structure of 122 specimens in 7 populations from the Colombian Atlantic coast. Assuming that all loci were in Hardy-Weinberg equilibrium, diversity statistics and analyses were performed. The average number of amplified fragments for each primer was 8.3, and the size of these fragments ranged from 350 to 3600 bp. The expected average heterozygosity was 0.358 ± 0.103. The genetic heterogeneity among the populations studied was small (GST = 0.05 ± 0.01); meanwhile, the gene flow estimates (Nm = 7.32 ± 1.35) were high. In an identical way, the Nei's genetic distances obtained yielded very small values amongst the populations that were studied in this Colombian region. Furthermore, a spatial autocorrelation analysis with Moran's I index revealed a very weak, or inexistent, spatial genetic structure among these populations. The comparison of these results with those performed for other markers (isoenzymes and microsatellites) in populations of this same mosquito from the Colombian Atlantic coast was discussed. The results of our RAPD analysis showed scarce genetic differentiation among the mosquito populations on the Colombian Atlantic coast, which was probably determined by high gene flow levels.

Effectiveness of a structured checklist of risk factors in identifying pregnant women at risk of gestational diabetes mellitus: a cross-sectional study.

BACKGROUND: Gestational diabetes mellitus (GDM) is associated with increased risk of mortality and morbidity for pregnant women and newborns. Identifying pregnant women with risk factors for GDM based on the clinical suspicion is a popular approach. However, the effectiveness of the use of a structured checklist of risk factors is yet to be evaluated. This study assessed the effectiveness of a structured checklist of risk factors in identifying pregnant women at risk of GDM at the University College Hospital, Ibadan. MATERIALS AND METHODS: It was a comparative cross-sectional study implemented in two phases. The first phase (Group A) of the study was a prospective study that involved 530 pregnant women who presented at the booking clinic. A structured checklist containing risk factors was used to identify women at the risk of GDM. The second phase (Group B) was a retrospective study of 530 pregnant women managed 2 years previously who were selected by systematic random technique. RESULTS: The mean age, gestational age at booking, gestational age at delivery and birth weight were 30.2 ± 5.2 years, 21 ± 10.8 weeks, 38.7 ± 2.7 weeks and 3.1 ± 0.7 kg respectively. The prevalence of GDM in Group A and B were 4.9% and 1.6% respectively ( P < 0.05). There was about three fold increase in identification of women at risk of GDM by use of a checklist. CONCLUSION: Identification of women at risk of GDM was approximately 3-4 fold higher with the use of checklist of risk factors. Exhaustive clinical identification with a checklist of risk factors for GDM should be encouraged.

Knowledge and use of emergency contraception by medical doctors on internship in a tertiary healthcare facility in Nigeria.

CONTEXT: Emergency contraception (EC) is widely used to prevent unwanted pregnancy and it is largely adopted in many countries as over the counter drug to improve access. AIMS: To determine and compare the correct knowledge, attitude and current use of EC among newly graduated medical doctors (MDs). SETTINGS AND DESIGN: A cross-sectional study conducted among 255 newly graduated MDs at the University College Hospital, Ibadan, Nigeria. MATERIALS AND METHODS: A pretested self-administered questionnaire was used to obtain data from consenting participants. STATISTICAL ANALYSIS USED: Descriptive, bivariate, and multivariable analyses were performed, and statistical significance was set at 0.05. Statistical Package for Social Science version 15.0 (Chicago, IL, USA) software was used. RESULTS: The mean age of the respondents was 27.2 years (standard deviation = 2.1). The commonest indication for emergency contraceptive use mentioned was rape-96.5%. About 70% support EC in Nigeria, while about a quarter (26.9%) routinely counsel women about ECP use. About 21% of respondents currently use EC. Logistic regression analysis revealed significant results for gender [odds ratio (OR) =3.64; 95% confidence interval (CI) OR = 1.31-10.01), religion (OR = 0.26; 95% CI OR = 0.11-0.630) and marital status (OR = 0.19; 95% CI = 0.07-0.56). CONCLUSION: The correct knowledge and professional disposition toward EC as a form of contraception is low. We recommend that in-service training should focus more on EC to improve the quality of their knowledge and attitude towards it.

Intracranial suppurations in the African child: a severe but preventable complication.

INTRODUCTION: Intracranial suppurations (ICS) are collections of pus of infectious origin in the skull. The authors present their experience. PATIENTS AND METHOD: All children operated for ICS at the Central Hospital of Yaoundé from January 2000 to December 2008 were retrospectively included. RESULTS: Thirty-five patients were recruited: 26 (74.29 %) males and 9 (25.71 %) females. These represent 82.9 % of all ICS operated in our institution. ICS represented 14.3 % of intracranial space-occupying lesions. The mean age was 8.34 years. They presented with headaches (80.77 %), altered consciousness (20 %), convulsions (76 %), vomiting (20 %), unilateral motor deficit (69.23 %), speech disorders (12 %), and fever (89.29 %). Bergman's triad (51.86 %) was frequent. The primary infection was: meningitis, eight cases (22.85 %); sinusitis, six cases (17.14 %); head trauma, five cases (14.28 %); otitis media, one case (2.85 %); suppurations of the face, three cases (8.56 %); cardiopathy, one case (2.85 %); and craniotomy, one case (2.85 %). In seven cases (20 %), the origin was unknown. The lesions were empyema in 23 cases (65.71 %), cerebral abscess in 8 cases (22.85 %) and pyoventriculitis in 2 cases (5.72 %). The surgical procedures were burr holes (88.89 % of empyemas) and trepano-puncture-aspiration (75 % of abscesses). The mortality (21.42 %) and morbidity (42.85 %) were recorded. CONCLUSION: ICS are frequent but preventable (early treatment of the primary infection) pathologies of childhood in developing countries. Burr hole drainage (empyemas) and puncture-aspiration (abscesses) are simple, safe, and effective techniques.

A family of null models to distinguish between environmental filtering and biotic interactions in functional diversity patterns.

QUESTIONS: Traditional null models used to reveal assembly processes from functional diversity patterns are not tailored for comparing different spatial and evolutionary scales. In this study, we present and explore a family of null models that can help disentangling assembly processes at their appropriate scales and thereby elucidate the ecological drivers of community assembly. LOCATION: French Alps. METHODS: Our approach gradually constrains null models by: (1) filtering out species not able to survive in the regional conditions in order to reduce the spatial scale, and (2) shuffling species only within lineages of different ages to reduce the evolutionary scale of the analysis. We first tested and validated this approach using simulated communities. We then applied it to study the functional diversity patterns of the leaf-height-seed strategy of plant communities in the French Alps. RESULTS: Using simulations, we found that reducing the spatial scale correctly detected a signature of competition (functional divergence) even when environmental filtering produced an overlaying signal of functional convergence. However, constraining the evolutionary scale did not change the identified functional diversity patterns. In the case study of alpine plant communities, investigating scale effects revealed that environmental filtering had a strong influence at larger spatial and evolutionary scales and that neutral processes were more important at smaller scales. In contrast to the simulation study results, decreasing the evolutionary scale tended to increase patterns of functional divergence. CONCLUSION: We argue that the traditional null model approach can only identify a single main process at a time and suggest to rather use a family of null models to disentangle intertwined assembly processes acting across spatial and evolutionary scales.

In vitro inhibition of Clostridium difficile and Clostridium perfringens by commercial probiotic strains.

Probiotics have gained importance in human and veterinary medicine to prevent and control clostridial enteric disease. Limited information is available on the ability of different probiotic bacteria used in food products to inhibit Clostridium difficile and Clostridium perfringens. The objective of this study was to examine the in vitro inhibitory effects of selected commercial bacterial strains on pathogenic clostridia and their growth characteristics under simulated gastrointestinal conditions. The inhibitory effects of 17 commercial strains of Lactobacillus (n = 16) and Bifidobacterium (n = 1) on the reference strains of C. difficile and C. perfringens were assessed by an agar well diffusion assay and by a broth culture inhibition assay using cell-free supernatant harvested at different growth phases, with and without pH neutralization. To study growth characteristics, probiotic strains were cultivated in different acid and bile environments, and growth in the modified media was compared to growth in standard medium. In the agar well diffusion assay, supernatant obtained from two probiotic strains inhibited the growth of both reference and clinical strains of C. perfringens. This effect as seen when supernatant was assessed with and without pH neutralization. Supernatants obtained from 10 probiotic strains inhibited C. difficile only when supernatant was added without pH neutralization. In the broth culture inhibition assay, growth of C. perfringens and C. difficile was inhibited by supernatant without pH neutralization from 5 and 10 probiotic strains, respectively. All potential probiotic strains were able to grow at pH 4.0 and in the presence of 0.15% and 0.3% bile but none were able to grow or survive at pH 2.0. Altogether five probiotic strains [Lactobacillus plantarum (n = 2), Lactobacillus rhamnosus (n = 2), Bifidobacterium animalis lactis (n = 1)] were shown to inhibit all strains of C. difficile and C. perfringens. The inhibitory effect was probiotic strain-specific. Two strains showed a pH-independent inhibitory effect likely due to production of either antibiotics or bacteriocins inhibiting C. perfringens only. These strains have favourable growth characteristics for use as probiotics and their efficacy as prophylactic or therapeutic measures against clostridial enteric disease should be further evaluated by clinical trials in animals.

Knowledge of hepatitis B virus infection, access to screening and vaccination among pregnant women in Ibadan, Nigeria.

The knowledge of pregnant women about Hepatitis B virus infection at three different levels of healthcare and their access to screening and vaccination was evaluated by a questionnaire-based cross-sectional study. There were 643 respondents with a mean age of 30.2 ± 5.2 years and mean gestational age of 26.1 ± 8.4 weeks. The distribution of respondents was 55 (8.6%, primary), 204 (31.7%, secondary) and 383 (59.6%, tertiary) women. The majority of respondents were traders (36%) or civil servants/professionals (28.6%). Overall, 76% of all women had inadequate knowledge about hepatitis B infection; 19.5% had been screened, while 9.7% had been vaccinated. There was an increased likelihood of adequate knowledge, previous screening and vaccination among health workers (p = 0.00). Other positive predictors of knowledge and vaccination were tertiary education (p = 0.04) and tertiary care (p = 0.00). There is inadequate knowledge among pregnant women in Ibadan about Hepatitis B infection, with significant differences at the various levels of care, particularly in non-tertiary settings where screening and vaccination is also sub-optimal. Information dissemination, universal screening and vaccination services for pregnant women in Nigeria require urgent consideration.

Viral infections among couples for assisted reproduction in a fertility clinic in Nigeria.

CONTEXT: The risk of laboratory cross-contamination may limit the availability of assisted conception for couples infected with chronic viruses. However, assisted conception is the standard of care for people living with human immunodeficiency virus (HIV) to minimize risk of transmission or reinfection. AIMS: To assess the burden of viral infection among couples that present for assisted reproductive technology (ART) with a view to evaluating implications for their care. SETTINGS AND DESIGN: A cross-sectional descriptive study carried out among 138 couples at a private fertility clinic in Nigeria. MATERIALS AND METHODS: Screening for HIV, hepatitis B virus (HBV) and hepatitis C virus were carried out among these clients. The males' seminal parameters were analyzed according to World Health Organization (WHO) criteria. STATISTICAL ANALYSIS USED: Statistical Package for Social Sciences was employed. Analysis was by Chi-square test; statistical significance was set at 0.05. RESULTS: Viral infections were found in 10/138 women (7.2%) and 15/138 (10.9%) men. The most prevalent infection was HBV. Twenty-one couples were sero-discordant. Two couples had concordant HIV and HBV infections, respectively. There was no significant association between sperm quality and chronic hepatitis infection. CONCLUSION: Nearly a fifth of the couples had at least one partner infected with a chronic virus - a proportion significant enough to demand attention. Apart from separate laboratory and storage facilities, basic principles to minimize transmission are recommended: HBV vaccination in sero-discordant partners of HBV carriers (and immunoprophylaxis for the baby) and antiretroviral therapy for HIV-positive partners to reduce the viral load before fertility treatment is commenced.