International Infectious Diseases

Evaluation of the Rapid Dual HIV and Syphilis Tests in Women Attending Antenatal Clinic at the University Teaching Hospital, Lusaka, Zambia. [Original Research]
Pierre Yassa, MD, PhD1, Rajiv Hira, MBBS, MPH2,3, Charity Sibinda, BSc1, PT Kantenga, MSc4, Ryan Kim, MSc5, Sadik Seeda, BSc5, Valery Mulenga, BSc5, Abdon Mukalay, MD, MPH, PhD6, Davies Glynis,MPH5, Sam Chisela,MD, MMED4,Tamba Tamba, MD7, Grace Tembo, MSc7
1.University of Zambia, Department of Dermatology & Venereology
2. MGM University of Health Sciences, Navi Mumbai, India.
3. Emory University-SPH, Atlanta, USA.
4. University Teaching Hospital Lusaka Zambia
5. Alere, United States of America
6. University of Lubumbashi, School of Medicine, DR of Congo
7. Ministry of Community Development, Mother and Child Health, Zambia.

[emedpub – International Infectious Diseases Vol 1:13] [Date of Publication: 01.03.2015]
ISSN 2231-6019

ABSTRACT:

Objective

The purpose of this study was to evaluate the sensitivity and specificity of SD Bioline Dual Rapid HIV and Syphilis Tests using Uni-gold HIV and Treponema pallidum hemaglutination assay as reference tests in women attending antenatal clinic at the University Teaching Hospital, Lusaka, Zambia.

Methods

To evaluate the sensitivity and specificity of SD Bioline Dual Rapid HIV and Syphilis tests, a  prospective cross-sectional study was conducted at the University Teaching Hospital in Lusaka using previously collected, stored blood samples of antenatal women submitted to cytology laboratory.

Results

The study found that compared with the reference tests, the sensitivity and specificity of the SD BIOLINE HIV and Syphilis Dual test were 100%.

Conclusion

With high laboratory performance of the SD BIOLINE HIV and Syphilis Dual test established in Lusaka, the test is recommended for regular screening in antenatal clinics.

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Quantitative RPR Test as a Guide for the Diagnosis and Treatment of Syphilis in Zambia. [Original Research]
Yassa P,MD PhD*, Bwalya CB,BBS**, Hira RS, MBBS***, Kwenda, PhD*, Kunda M, MD*, Sarenje K,BSc*, Kaswa J,MD****, Skwe H, BSc**, Sheba Ambali C, DipSMM**, Mwika Kabeya M, MD, MPH*, Tembo Mumba G, MOH*, Lumamba R, DipIT*, Makwaza G,DipHR*
*University Teaching Hospital, Lusaka, Zambia.
**University of Zambia.
***Emory University-SPH, Atlanta, USA.

[emedpub – International Infectious Diseases Vol 1:12] [Date of Publication: 08.18.2013]
ISSN 2231-6019

Correspondence: Pr Yassa Pierre, University Teaching Hospital, STI Clinic, Lusaka. Perets31@gmail.com

ABSTRACT:

Introduction:

Syphilis is prevalent in Zambia. A study was designed to determine correlation between the rapid plasma regain (RPR) test and the Treponema Pallidum Hemaglutination Assay (TPHA).

Methods: This was a prospective, cross-sectional study. One hundred seventy seven randomly selected plasma samples that were reactive using qualitative rapid plasma regain (RPR) test were compared with Treponema Pallidum Hemaglutination Assay (TPHA). The samples were collected the Lusaka urban clinics namely, Chawama, Mutendere, Kanyama, Kalingalinga and Chilenje clinics.

Results: The results were tabulated using the SPSS program. Among clinical samples, an increasing trend of syphilis prevalence was observed with increase age groups. Of 177 RPR samples, 108 (61%) were confirmed TPHA . The RPR samples with titres of 1:2 and 1:4 all tested negative on the TPHA and those with 1:16,1:32 and 1:64 all tested positive using TPHA. However, RPR samples with the titre of 1:8 showed mixed frequency of positivity with TPHA.  Co-infection with HIV was established in 118/177 (66.7%) of the samples.

Conclusion:

The quantitative RPR test can be used as a confirmatory test for diagnosis and treatment of syphilis in the absence of TPHA test in resource-limited settings.

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Evaluation of the Rapid Treponemal Point of Care Test introduced in Zambia in 2012. [Original Research]
Yassa Pierre, PhD*, Kwenda SH, PhD*, Hira Rajiv S, MBBS**, Kunda M, MD*, Sarenje K, Bch*, Mwenya D, Msc*, Kantenga, Msc*,Kaswa Jean, MD#, Susan Strasser, PhD***
*University Teaching Hospital, Lusaka, Zambia.
** Emory University-SPH, Atlanta, USA.
*** Country Director, Elizabeth Glaser Pediatric AIDS Foundation.
#CNPP, University of Kinshasa, DR Congo.

[emedpub – International Infectious Diseases: Vol 1:11] [Date of Publication: 07.28.2013]
ISSN 2231-6019

Correspondence:

Pr Yassa Pierre, University Teaching Hospital, STI Clinic, Lusaka, Zambia.

email: perets31@gmail.com

Abstract:

Objective

To evaluate operational characteristics of the rapid treponemal point of care test in terms of its sensitivity and specificity, used among pregnant women attending antenatal clinic in Lusaka, Zambia.

Methodology

A case control study was conducted

Results

Results of the index test (rapid point of care syphilis test) showed that, of the 121 samples tested, 6 (5.0%) were reactive and 115 non-reactive, where as in the reference standard test (chemiluminescent microparticle immunoassay), 8 were reactive and 113 samples non-reactive. Thus, sensitivity of rapid treponemal test was 75%  and  specificity was 100%. Discriminant Ability = (Sensitivity + Specificity) / 2 =( 75% + 100% ) / 2 = 87.5%

Conclusion

The rapid treponemal point of care test presented low sensitivity (75%) and high specificity (100%). This test still remains effective as a routine screening qualitative rapid test for the detection of antibodies against T.pallidum. Screening for syphilis and its treatment is an important strategy for the prevention of adverse pregnancy outcomes of maternal syphilis.

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<font size="2" face="Georgia, Arial" color="Black"> HIGH PREVALENCE OF TRICHOMONAS VAGINALIS AMONG HIV-INFECTED WOMEN ATTENDING HEALTH SERVICES IN LUSAKA, ZAMBIA. </font> <font size="2" face="Georgia, Arial" color="Red"> [Original Research] </font><br /> <font size="2" face="Georgia, Arial" color="blue"> Katakwe Alex BSc1, Yassa Pierre, PhD1/2, Hira Rajiv, MBBS3, Sarenje Kelvin, BSc2, Kantenga MS,MD2, Kaswa J, MD4,Ikembo Janine, BPH5 and Hira Subhash, MD,MPH6 </font><br /> <font size="1" face="Georgia, Arial" color="blue"> 1. University Teaching Hospital (UTH), Department of Dermatology and STIs, Lusaka, Zambia. <br />2.University of Zambia School of Medicine, Dept Biomedical Sciences, Lusaka, Zambia. <br /> 3. Emory University, Rollins School of Public Health, Atlanta, USA.<br /> 4. University of Kinshasa, Congo.<br/> 5.University of East London,UK. <br/> 6. MGM University of Health Sciences, Navi Mumbai, India. </font> <br /> <font size="2" face="Georgia, Arial" color="Black"> [emedpub – International Infectious Diseases: Vol 1:10] [Date of Publication: 07.08.2013] </font> <br /> <font size="3" face="Georgia, Arial" color="Black"> ISSN 2231-6019 </font> </p>

Abstract:

Objective. The prevalence of co-infections of Trichomonas vaginalis (TV) and HIV in women seeking health services in Lusaka, Zambia was determined in order to quantify the prevalence of T.vaginalis in HIV-infected and HIV-negative women, and identify their risk factors.

Methods. A cross-sectional, laboratory based study of women from socially marginalised communities in four peri-urban clinics and one referral hospital in Lusaka was conducted. HIV status was determined as per HIV test protocol after Voluntary Counselling and Testing. Immunological procedure for Rapid TV Test Kit (Device/Cassette) was used to detect the host’s antibodies against T.vaginalis soon after taking self-administered high vaginal swabs. Parasitological procedure was also done using high vaginal swabs and urine for wet mount microscopy.

Results. Among 472 women enrolled, 49.8% were HIV-infected. The prevalence of T.vaginalis in HIV-infected women was 65.5% as compared with 22.8% among HIV-negative women (p< 0.05). A total of 208/472 (44.1%) of women had Trichomonas vaginalis infection. However, yield of T.vaginalis by wet microscopy method was scanty 10%, possibly due to laboratory limitations. There was lack of culture and PCR facilities.

Conclusions. Significantly high prevalence of T. vaginalis was found in HIV positive women in this study. Trichomonad infection was associated with multiple sexual partners, unmarried status, low education level, suburb residency (compound-life), and unemployment. Prompt syndromic management is recommended for all women with vaginal discharges so as to improve their sexual health and reduce transmission of HIV.

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<font size="2" face="Georgia, Arial" color="Black"> PREVENTION OF NOSOCOMIAL INFECTIONS IN THE NEW BORN: THE PRACTICE OF PRIVATE HEALTH FACILITIES IN RURAL COMMUNITIES OF NIGERIA. </font>&nbsp;&nbsp; <font size="2" face="Georgia, Arial" color="Red"> [Original Research] </font><br /> <font size="2" face="Georgia, Arial" color="blue"> SAKA M.J.1,&nbsp; SAKA A.O.2,&nbsp; ADEBARA V.O.3,&nbsp;,&nbsp; </font><br /> <font size="1" face="Georgia, Arial" color="blue"> 1. Department of Epidemiology and Community Health (Health Management Unit), College of Medicine, University of Ilorin, Ilorin, Kwara State, Nigeria <br /> 2. Department of Paediatrics and Child Health, University of Ilorin Teaching Hospital Ilorin, Kwara State Nigeria. <br /> 3. Department of Paediatrics and Child Health Federal Medical Center Ido Ekiti, Ekiti State, Nigeria. <br /> </font> <br /> <font size="2" face="Georgia, Arial" color="Black"> [emedpub – International Infectious Diseases : &nbsp;&nbsp;Vol 1:9]&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; [Date of Publication: 06.19.2011] </font> <br /> <font size="3" face="Georgia, Arial" color="Black"> ISSN 2231-6019 </font> </p>

Abstract

Objectives: Nosocomial infection is defined as an infection acquired in a hospital by a patient who is admitted for a reason other than that infection. The study assessed infection prevention practices among private hospitals in rural community in Nigeria.

Design: The study was carried out using tool on Quality of Care for Integrated Services. A planning meeting was held to plan the modalities for the assessment. The outcome of the planning meeting among others was the determination of composition of the team of assessors to visit each selected health facilities. The tool was administered after its pre-test at Kwali Area Council of Abuja in the north central Nigeria to ascertain the ease of administration of the tools.

Methods: A cross sectional study was carried out on seventeen randomly selected private health facilities in rural community in Nigeria.

Results: The knowledge of hand washing by staff between clients was 64.7%. Barrier to infection prevention practices with the use of linen was 58.8%. More than fifty percent of the hospitals assessed had stocks of 0.5% of the chlorine solution.

Conclusions: Although poor knowledge on infection prevention was observed, disinfectants such as 0.5% chlorine solution was most commonly used in private hospitals. The practice of aseptic hand washing was good. We recommend private healthcare providers to set up hospitals infection control committees and to work in collaboration with the public hospital infection control committees and encourage continuous medial education to develop appropriate policy and programs against hospital acquired infections.

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BACTERIAL ISOLATES FROM CEREBROSPINAL FLUID OF SUSPECTED ACUTE MENINGITIS IN NIGERIAN CHILDREN.    [Original Research]
Nwadioha SI, FMCPath1,  Onwuezube I, FMCPath2,  Egesie J O, FMCPath3,  Kashibu E, FMLS4 ,  Nwokedi EOP, FMCPath1
1. Department of Medical Microbiology, College of Health Sciences, Benue State University, Makurdi, Nigeria
2. Department of Medical Microbiology, University of Uyo Teaching Hospital, Uyo Akwa, Ibom state, Nigeria
3. Department of Haematology, Jos University Teaching Hospital, Jos, Nigeria
4. Department of Microbiology, Aminu Kano Teaching Hospital, Kano, Nigeria.

[emedpub – International Infectious Diseases :   Vol 1:8]                  [Date of Publication: 06.03.2011]
ISSN 2231-6019

Abstract

Objectives: To determine etiology of acute bacterial meningitis in Nigerian children and their antibiotic susceptibility pattern.

Methods: A retrospective study was conducted with a review of cerebrospinal fluid culture reports of suspected acute meningitis in pediatric patients aged 0-15 years between October 2006 and October 2009 in Aminu Kano Teaching Hospital Kano, Nigeria.

Results: A positive culture bacterial isolation rate of 3.3% (n=50/1500) with prevalence of Streptococcus pneumoniae (24%), Neisseria meningitidis(22%), Escherichia coli(16%), Haemophilus  influenzae (14%), Group B streptococci(8%) and Enterococci(8%) which were susceptible to ceftriaxone(96%), cefotaxime(95%) and ciprofloxacin(93%) across  the bacterial isolates. Neonates were 55% (n=6.8/12.4) most at risk.

Conclusion: Neonates are most at risk of acute bacterial meningitis. In the absence of antibiotic susceptibility report, ceftriaxone should be considered as a first choice antibiotic for empirical treatment of acute meningitis among children in Nigeria.

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STUDY OF FIBREOPTIC BRONCHOSCOPY IN ENDOSCOPICALLY VISIBLE BRONCHIAL CARCINOMA.    [Original Research]
SK Verma, MD1,  AN Srivastava, MD2,  R Prasad, MD3 ,  
1. Professor, Department of Pulmonary Medicine
2. Ex-Professor, Department of Pathology
3. Professor & Head, Department of Pulmonary Medicine
Chatrapati Shahuji Maharaj Medical University, Lucknow, India

[emedpub – International Infectious Diseases :   Vol 1:7]                  [Date of Publication: 05.12.2011]
ISSN 2231-6019

Abstract

Flexible fibreoptic bronchoscopy was performed in 60 proved patients with lung cancer. Tumors were endoscopically visible in 38 (63.3%) of patients. Of the endoscopically visible tumors, the primary sites of involvement were: main bronchus in 21 (55.3%), lobar bronchus in 14 (36.8%), and segmental bronchus in 3 (7.9%) of patients. Histopathological examination of bronchial biopsies yielded positive diagnosis in 31 (81.6%) of patients, and a combination of bronchial biopsy, bronchial aspirate cytology and postbronchoscopic sputum smear examination yielded diagnosis in 35 (92.1%) of patients with lung cancer. Squamous cell and small cell carcinoma were the common central tumors found in 60% and 28.5%, respectively. Flexible fiber optic bronchoscopy is a valuable technique for the diagnosis of endoscopically visible bronchial carcinoma.

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PLEURO-PULMONARY CRYPTOCOCCOSIS IN A PATIENT WITH AIDS.   [Case Report]
Jose Orsini, MD1,  Jaswinderpal Sandhu, MD2,  Thomas Aldrich, MD2,  
1. Division of Critical Care Medicine
2. Division of Pulmonary Medicine
Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA

[emedpub – International Infectious Diseases :   Vol 1:6]                  [Date of Publication: 05.02.2011]
ISSN 2231-6019

Abstract:

Invasive pulmonary fungal infections have become a major cause of morbidity and mortality among people with AIDS. Cryptococcus neoformans is an important cause of pulmonary fungal infection in these patients, representing the 4th most common opportunistic infection in patients with HIV/AIDS and one of the most common systemic mycosis among immunocompromised patients. Pulmonary cryptococcosis includes clinical entities ranging from asymptomatic pneumonia to severe acute respiratory distress syndrome (ARDS). While pulmonary cryptococcosis is not an uncommon infection, pleural involvement in the setting of cryptococcal disease has been infrequently reported. We describe a patient with pulmonary Cryptococcus neoformans infection involving the pleura, presenting with pulmonary cavitation and pleural effusion.

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BACTERIAL PATHOGENS AND THEIR ANTIBIOTIC SUSCEPTIBILITY PATTERN IN IDOMA COMMUNITY, BENUE STATE OF NIGERIA [Original Research]
E.E. Okwori, S.I. Nwadioha, E.O.P. Nwokedi, M. Odimayo, G.T.A Jombo
Department of Medical Microbiology & Parasitology, College of Health Sciences, Benue State University, Nigeria
[emedpub – International Infectious Diseases Vol 1:5] [Date of Publication: 04.22.2011]
ISSN 2231-6019

Abstract

Objectives: To isolate bacterial pathogens from a pool of clinical specimens in order to test their antibiotic resistance pattern.

Methods: A total of 20,000 samples were analysed in the laboratory between 1997 and 2000. The specimens were inoculated on the appropriate media for isolation of bacteria. Biochemical and serology tests were conducted to confirm the type of bacteria isolated. Antibiotic resistance test was also performed on each of the bacterial isolate, using the CLSI criteria.

Results: A total of 18,520 bacteria were isolated. The specimens were from nine different clinical sites, i.e from wound 22.8%, urine 31.7%, blood 12.4%, genital 7.7%, sputum 6.8%, stool 6.2%, aspirates 3.8% and ear/throat swabs 2.5%. Gram negative bacteria accounted for 76% of isolates. The main species were Pseudomonas 2238 (12.1%), Escherichia coli 2073 (11.2%), and Staphylococcus aureus 2511 (13.6%) of total isolates. Staphylococcus aureus showed resistance to penicillin (70%), ampicillin (65%) and cloxacillin (40%).  Escherichia coli was resistant to ampicillin (47%) and gentamicin (46%). Also, Salmonella typhi was resistant to chloramphenicol (49%) and Neisseria meningitides was resistant to penicillin (37%).

Conclusion: The rate of bacteria isolated from clinical specimens was high. The antibiotic resistance pattern will be useful for practicing clinicians in Nigeria.

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LYMPHANGITIS CARCINOMATOSIS AS A COMPLICATION OF MALIGNANT PLEURAL EFFUSION    [Case Report]
SK VERMA, MD Professor, Department of Pulmonary Medicine       
Chhatrapati Sahuji Maharaj Medical University, Lucknow, India (erstwhile King George’s Medical University)
[emedpub – International Infectious Diseases :   Vol 1:4]                  [Date of Publication: 04.12.2011]
ISSN 2231-6019

Abstract

Lymphangitis carcinomatosis (LC) is a rare and often fatal form of pulmonary metastases. Author describes this as a case of left sided malignant pleural effusion with unknown primary which after follow up of two months developed lymphangitis carcinomatosis on right side. Despite extensive search of literature author could not find any information to explain the occurrence of lymphangitis carcinomatosis as in this case where the primary could not be traced. There has been literature on the association of lymphangitis carcinomatosis with pleural effusion, but there has been no literature reporting the occurrence of lymphangitis carcinomatosis after or as a complication of malignant pleural effusion.

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