Since the eradication of smallpox approximately 39 years ago, monkeypox virus remains the most pathogenic poxvirus, being mainly restricted to Central and West Africa. Before 1970, there were no reports of human monkeypox in Nigeria, while between 1971 and 1978 there were three cases, with none having been reported thereafter. However, in September 2017, a case of contagious skin rash disease, typical of monkeypox, was observed in an 11‐year‐old boy from the southern part of the country and confirmed to be associated with the monkeypox virus. This large outbreak consisted of 262 suspected, 115 confirmed cases, and 7 mortalities across 26 states and the Federal Capital Territory (FCT), Abuja. The aim of this manuscript is to provide an updated, comprehensive, and timely review of monkeypox, an important emerging infection in Nigeria. Monkeypox is now a major threat to global health security, requiring an urgent multidisciplinary approach involving veterinarians, physicians, virologists, and public health experts to fast‐track the development of diagnostic assays, vaccines, antivirals, and other control strategies.
Parechoviruses are emerging pathogens of humans often affecting the pediatric age group, with a growing line of evidence implicating them as agents of a broad spectrum of clinical syndromes in adults. However, because many clinicians are not familiar with the manifestation of the infections, they are not included in the list of diagnostic pathogens. Furthermore, due to the indistinguishable feature of the infection compared with other common pathogens, a large number of cases are likely to go unchecked. Some may develop asymptomatic infection and recover without overt clinical disease. In this manuscript, we reviewed available literature on parechovirus infection in adult and summarized information relating to epidemiology, clinical manifestation, laboratory diagnosis, and therapeutics. The information provided should help in early case detection and support an evidence‐based clinical decision.
Background: Infection with an oncogenic type of human papillomavirus is a prerequisite for the development of precancerous cervical lesions and its subsequent progression to cervical cancer. With an alarming increase in the detection of other suspicious papillomavirus genotypes in both healthy and women with cervical lesions, there is a need for comprehensive data on cervical papillomavirus infection to address cervical cancer and other associated disease burden, especially in Sub-Sarahan Africa, where the bulk of the problem exists. The present study was conducted to develop comprehensive data on the prevalence and circulating genotypes of human papillomavirus in various risk categories in Nigeria. Methods: A systematic review and meta-analysis of peer-reviewed publications on cervical papillomavirus infection were performed. Relevant data were extracted from eligible studies published in PubMed, Web of Science, Embase, Scopus, and Google Scholar, from inception to July 31, 2019. The random-effect model was used to estimate the pooled prevalence. We identified 327 potential studies and pooled data from 18 studies, involving 5697 women aged 15-86 years. Results: The overall pooled prevalence of cervical papillomavirus infection was 42% (95%CI: 30-54%) in the general population and 37% (95%CI: 25-50%) among women living with HIV/AIDS, with the predominance of genotypes 16, 18, 31, 35, 52, 58 and 45. The highest prevalence was observed in teenagers and young adults and the second peak in women 50 years and above. Conclusion: The prevalence of cervical human papillomavirus infection is cumulatively high in Nigeria and HIV is a strong co-factor. We, therefore, strongly recommend the co-screening of human papillomavirus and cervical cancer and integration of the intervention strategy into the existing HIV-care guideline in Nigeria.
Objective: Maggot debridement therapy (MDT) is an emerging procedure involving the application of sterile maggots of the Dipteran species (commonly Lucilia sericata) to effect debridement, disinfection and promote healing in wounds not responding to antimicrobial therapy. Data on MDT in sub-Saharan Africa (including Nigeria) are scarce. This study aimed to use medicinal grade maggots as a complementary method to debride hard-to-heal necrotic ulcers and thereby promote wound healing. Method: In this descriptive study, we reported on the first group of patients who had MDT at Aminu Kano Teaching Hospital (AKTH), a tertiary hospital in northern Nigeria. The first instar larvae of Lucilia sericata were applied using the confinement (free-range) maggot therapy dressing method under aseptic conditions. Results: Diabetic foot ulcer (DFU) grade III–IV constituted more than half of the wounds (53.3%), followed by necrotising fasciitis (30%), and post-traumatic wound infection (10%). Others (6.7%, included pyomyositis, surgical site infection and post traumatic wound infection). The median surface area of the wounds was 56cm 2 . Of the 30 patients, half (50%) had two MDT cycles with a median time of four days. Of the wounds, 22 (73%) were completely debrided using maggots alone while eight (27%) achieved complete debridement together with surgical debridement. Wound culture pre-MDT yielded bacterial growth for all the patients and Staphylococcus aureus was the predominant isolate in 17 wounds (56.7%) while Pseudomonas aeruginosa and Streptococcus pyogenes were predominant in five wounds (16.7%) each. Only four (13.3%) wound cultures yielded bacterial growth after MDT, all Staphylococcus aureus. Conclusion: A good prognosis was achieved post-MDT for various wounds. MDT effectively debrides and significantly disinfects wounds involving different anatomical sites, thus enhancing wound healing and recovery. MDT is recommended in such wounds.
Enteroviruses and Parechoviruses are increasingly recognized as the cause of aseptic meningitis, especially in the paediatric age group. However, because of indistinguishable clinical features with bacterial meningitis, many clinicians cannot make a clear distinction in disease presentation, and a large number of cases go undiagnosed. Although polymerase chain reaction is the current standard diagnostic approach, it takes many hours or days to get a result and these tests are not available at primary and secondary levels of care in many resource-poor countries. Furthermore, diagnosis is often difficult in children due to nonspecific cellular and biochemical cerebrospinal fluid findings. Some affected children may develop neurologic or/and systemic complications, resulting in prolonged hospital admission, increasing the risk of avoidable deaths, and healthcare expenditures. This review focuses on epidemiology, presentation, and diagnosis of Enterovirus and Parechovirus meningitis, highlighting the challenges in diagnosis and the potential roles of on-site CSF virology tests in improving the quality of paediatric patient’s care. The information provided should help early case detection, thereby ensuring avoidance of unnecessary antibiotics, minimal complications, a short period of hospital stays, and a reduction in healthcare-associated costs. Keywords: Aseptic meningitis; Enterovirus; Parechovirus; Diagnostic challenge; On-site virology test; Children FrenchTitle: Méningite à Entérovirus et Parechovirus chez les enfants: un examen de l’épidémiologie, des défis diagnostiques et de l’importance du tests virologique sur site du LCR dans les soins aux patients pédiatriques tropicaux Les entérovirus et les parechovirus sont de plus en plus reconnus comme la cause de la méningite aseptique, en particulier dans le groupe d'âge pédiatrique. Cependant, en raison des caractéristiques cliniques indiscernables de la méningite bactérienne, de nombreux cliniciens ne peuvent pas faire une distinction claire dans la présentation de la maladie, et un grand nombre de cas ne sont pas diagnostiqués. Bien que la réaction en chaîne par polymérase soit l'approche diagnostique standard actuelle, il faut plusieurs heures ou jours pour obtenir un résultat et ces tests ne sont pas disponibles aux niveaux de soins primaires et secondaires dans de nombreux pays pauvres en ressources. En outre, le diagnostic est souvent difficile chez les enfants en raison de découvertes non spécifiques du liquide céphalo-rachidien cellulaire et biochimique. Certains enfants atteints peuvent développer des complications neurologiques ou systémiques, entraînant une hospitalisation prolongée, augmentant le risque de décès évitables et les dépenses de santé. Cette revue se concentre sur l'épidémiologie, la présentation et le diagnostic de la méningite à entérovirus et parechovirus, mettant en évidence les défis du diagnostic et les rôles potentiels des tests virologiques sur place dans le LCR dans l'amélioration de la qualité des soins aux patients pédiatriques. Les informations fournies devraient contribuer à la détection précoce des cas, garantissant ainsi d'éviter les antibiotiques inutiles, des complications minimales, une courte période d'hospitalisation et une réduction des coûts associés aux soins de santé. Mots clés: méningite aseptique; Entérovirus; Parechovirus; Défi diagnostique; Test de virologie sur place; Enfants
Background: The emergence of widespread resistance of Plasmodium species to most antimalarial drugs has led to a more vigorous and concerted research on traditional medicinal plants for the treatment of malaria. Objective of Study: The study was aimed to investigate the in vitro antiplasmodial activity of crude ethanolic and aqueous extracts of Phyllanthus amarus against clinical isolates of Plasmodium falciparum in Northwestern Nigeria. Materials and Methods: The plant was extracted using two solvents, water and ethanol, where a high yield was obtained from the aqueous extracts (11.9%) as compared to the ethanolic extract (9.64%). The extracts were evaluated in vitro at concentrations of 6.25, 12.5, 25, 50, and 100 μg/ml, and the level of potency in each case was expressed as the concentration of the extract that exhibited a 50% reduction of the parasites relative to control (100%) parasitemia. Artemether-lumefantrine was used as a positive standard in the assay. Results: All extracts showed a significant reduction in parasite growth relative to control ( P ≤ 0.05). Ethanolic extract exhibited a higher antiplasmodial activity of 76.8%, half-maximal inhibitory concentration (IC 50 ) of 5.80 μg/ml, and aqueous extract had an activity of 75.3%, IC 50 of 7.94 μg/ml. Both extracts exhibited very active antiplasmodial activity. Oral acute toxicity test in the doses of 500, 1000, and 1500 mg/kg showed no sign of toxicity on albino mice after 48 h. Conclusion: Although there was an increase in appetite after 24 and 48 h, the findings from this study show that P. amarus possesses a promising antimalarial activity which can be exploited for malaria therapy and justifies the traditional use of the plant in malaria treatment.
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