BackgroundHepatitis B virus (HBV) transmission through blood transfusion is reduced by screening for hepatitis B surface antigen (HBsAg). However this method cannot detect the presence of occult hepatitis B virus infection. This study sought to determine the prevalence of occult hepatitis B virus infection among blood donors in Ile-Ife, Nigeria. For the first time in Nigeria we employed an automated real-time PCR- method to investigate the prevalence of occult HBV in blood donors.MethodsBlood donors screened with HBsAg immunochromatographic rapid test kits at the blood transfusion units of two hospitals and found to be negative were recruited into the study. Questionnaires to elicit risk factors for HBV infection were administered and then 10 ml of blood was collected from each donor. Plasma samples obtained from these HBsAg negative blood donors were screened again for HBsAg using an enzyme-linked immunosorbent assay (ELISA) method, and those found negative were screened for the presence of total antibody to the HBV core antigen (anti-HBc) using ELISA method. Those positive to anti-HBc were then tested for HBV DNA, using an automated real-time PCR method.ResultsFive hundred and seven blood donors found HBsAg negative by immunochromatographic rapid test kits at both blood transfusion units, were tested for HBsAg using ELISA and 5 (1 %) were HBsAg positive. The 502 found negative were tested for anti-HBc and 354 (70.5 %) were found positive implying previous exposure to HBV and 19 (5.4 %) of the 354 anti-HBc positive had HBV DNA signifying occult HBV infection. No risk factors were found to be associated with the presence of HBV DNA among those who tested positive.ConclusionOccult HBV infection exists in blood donors in Ile-Ife, Nigeria and the use of HBsAg alone for screening prospective donors will not eliminate the risk of HBV transmission in blood transfusion or stem cell transplantation.

We report on an 8-year-old patient with septicaemia unresponsive to therapy for five weeks. Undetected, extended-spectrum β-lactamase (ESBL) production by the infecting Klebsiella strain was regarded as responsible for treatment failure. Intravenously administered imipenem during the sixth week led to sustained resolution of fever. Resource-limited hospitals can incur prohibitive costs from ESBL-producer infections because of diagnostic limitations and consequent treatment failure involving prolonged supportive therapy.

BackgroundTuberculosis (TB) is a cause of high morbidity and mortality across the world but more so in developing countries. A large proportion of patients with tuberculosis present with extra-pulmonary disease which is often misdiagnosed or under-diagnosed. In Southwest Nigeria, there are reports on tuberculosis but only a few focused on extra-pulmonary tuberculosis (EPTB). This study was aimed to determine the burden of EPTB and its associated factors in a tertiary health care centre in Nigeria.MethodsThis was a cross-sectional retrospective study involving all the TB cases seen from 1st January 2015 and 31st December 2019. Relevant information was retrieved from the clinical records of the patients with the use of a well-structured proforma. Data obtained was analysed using the Statistical Package for Social Sciences (SPSS) version 23.0.Results Five hundred and nine subjects were involved with a mean age of 39.8±16.99 years. Three hundred and sixteen (62.1%) were males, 69 (13.6%) participants were HIV positive. Eighty-three (16.3%) had EPTB, of these 32 (38.6%) had spinal tuberculosis while 23 (27.7%) had pleural tuberculosis. Age, new cases of TB, and smear-negative TB were found to be significantly associated with the development of EPTB.ConclusionExtra-pulmonary tuberculosis is a common form of tuberculosis in our community, and the commonest presentation is spinal and pleural tuberculosis. There is a need for an improvement in diagnostic capacity for EPTB especially among the middle-aged and those presenting with TB for the first time. This will aid in the prompt detection and management of patients with EPTB.

Background Tuberculosis is a chronic disease with associated high morbidity and mortality. In recent decades, there has been an increase in resistance to drugs used in treatment of tuberculosis. This is a major stumbling block in the global fight against tuberculosis. This study was to demonstrate the current prevalence of rifampicin-resistant tuberculosis and its associated predisposing factors in a Teaching Hospital in Nigeria.Methods This was a cross-sectional retrospective study involving 359 consecutive patients with bacteriologically confirmed tuberculosis seen between January 2015 and December 2019. Ethical approval was obtained from relevant authority. Drug susceptibility testing was performed for rifampicin using GeneXpert MTB/RIF assay. Relevant information was obtained from the clinical records of the patients with use of a well-structured proforma. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS) version 23.0.Results There were a total of 359 patients out of which majority, 235 (65.5%) were males. The mean age was 39.78+16.31 (range 1 - 90 years). A larger percentage of the subjects were new cases of tuberculosis (n=312, 86.9%), 49(13.6%) were HIV positive. The overall prevalence of rifampicin resistance found was 2.5% (n=9/359). There was significant association between gender (p=0.005) and re-treatment (p=0.003). There was no significant association between rifampicin resistance and other factors including age and HIV.Conclusion Male gender and patients on re-treatment for tuberculosis are more at risk of developing resistance to rifampicin in our environment. There is a need to ensure compliance with all guidelines in the management of tuberculosis to prevent an increase in drug resistance.