A total of 2,570 apparently healthy human immunodeficiency virus-negative adults from the six geopolitical zones in the country were enrolled in our study in 2006. The samples were assayed using the Cyflow technique. Data were analyzed using the Statistical Package for Social Scientists (SPSS). The majority (64%) of the participants had CD4 counts within the range of 501 to 1,000 cells/l. The reference range for CD4 was 365 to 1,571 cells/l, while the reference range for CD8 was 145 to 884 cells/l.In Nigeria, although country-specific reference ranges for some hematological measures have been determined (3,5,6), national data for CD4 reference values are still not available. Prior to a few recent monocenter studies carried out among defined populations of healthy Nigerians (2, 13), CD4 reference range values from literature based on studies in western countries were largely employed for clinical decision making.However, as the access to treatment increased in Nigeria, it became critically necessary to determine on a national level the reference values for CD4 cell counts and the factors that may affect it. This was necessary to inform the clinicians of the required minimal range for the initiation of antiretroviral therapy, and also for accurate monitoring of responses to therapy and other treatment outcomes.The national study reported in this document was a multicenter study conducted among healthy human immunodeficiency virus (HIV)-negative adult Nigerians, in eight sites across the six geopolitical zones of the country. Therefore, the objective of this study was to establish the normal reference values of CD4 and CD8, as well as CD4/CD8 lymphocyte ratios, indigenous to Nigeria.This project was carried out as a cross-sectional study among apparently healthy Nigerians aged 18 years and older who tested HIV negative at voluntary counseling and testing site sites. Exclusion criteria included pregnancy, sickle cell anemia, or clinical illness.A 5-ml sample of blood was collected from each participant by venipuncture into a Vacutainer EDTA bottle. These samples were retested using the Genie II kit (Bio-Rad), which is a rapid HIV serology test kit. Only samples that were confirmed negative were assayed for CD4 and CD8 cell counts concurrently using the Cyflow technique, with an instrument known as the Cyflow counter (Partec). This instrument is for counting and analyzing particles and cells. The first step in the measurement of cells is staining with a fluorescent dye. The fluorescent molecules are taken up by the cells. The cells are individually illuminated by light of a defined wavelength. The light activates the fluorescent molecules so that they emit light of a characteristic color (wavelength). This fluorescent light is filtered out, and its intensity is measured by a ploidy analyzer for each single cell. The fluorescence light intensity emitted by a labeled cell is proportional to its CD4 or CD8 content. For cell counting or concentration determination, the sample volume detector measures exactly 0.2 ml of th...

BACKGROUND: Toxoplasmosis is an infection caused by the protozoan Toxoplasma gondii. It is common in severely immunecompromised persons. OBJECTIVE: To determine the seroprevalence of T. gondii infection and the risk factors associated with the infection and to investigate the association between T. gondii infection and CD4 cell count. METHODS: Sera collected from 242 HIV positive HAART-naïve patients were tested for T. gondii specific immunoglobulin G antibodies. Information was obtained using a structured questionnaire. Baseline CD4 cell counts were obtained from patients' case files. Data was managed using SPSS version 20 software and Microsoft Excel worksheet. RESULTS: One hundred and sixty eight (69.4%) subjects were females while 74(30.6%) were males. One hundred (41.3%) of study participants were Toxoplasma IgG antibody positive. Thirty two(32) HIV positive pregnant women were among this group studied with 12(37.5%) being Toxo IgG antibody positive. Toxoplasma seropositivity was higher in females (42.8%) than in males (39.2%), P= 0.60. CD4 cell count level of < 200 was negatively associated with Toxoplasma seropositivity than CD4 count ≥ 200 by logistic regression (OR= 0.6; 95% CI 0.3-1.0). Living in proximity with cat was positively associated with T. gondii infection (P= 0.01). CONCLUSION: T. gondii infection is common in pregnant women indicating greater probability of congenital transmission of T. gondii. This could form a basis for recommending intensifying health education and prophylactic treatment for all HIV positive pregnant women. Measures should be taken to prevent stray cats from entering homes.

Lagos metropolis, southwestern Nigeria, is faced with environmental problems ranging from slums and informal settlements, to crime and delinquency. The aim of the study was to explore the demographic characteristics, migration history and living conditions of 2,434 residents of Ajegunle, Ijora Oloye and Makoko in Lagos metropolis. A cross-sectional survey was conducted between June 2010 and October 2012 using a semi-structured questionnaire. Units of analysis used were households. Many of the respondents are low-income earners working in the informal service sectors, and living in unhygienic conditions. The communities are densely populated, with more than five people living in a room. Residents make use of poor and overstressed facilities and inadequate water and electricity supplies. They also lack appropriate garbage disposal facilities and good drainage. Personal hygiene habits are very poor; open defecation in ditches and the lagoon is widely practiced. Respondents are faced with perennial flooding due to blocked drainage systems resulting in a number of diseases, such as malaria, diarrhea, cold and cough. Migration has led to uncontrolled and unplanned developments of slums in metropolitan Lagos. This in turn has led to poverty, unemployment, illiteracy, polluted environment, uncontrolled population growth and health problems in the slums as are observed in this study. There is an urgent need for comprehensive interventions from the government and other organizations to strengthen existing programs to improve the health and quality of life of this vulnerable population.

This study focuses on the identification of aetiological agents of vaginitis in Nigerian women. Study subjects are drawn from patients presenting with lower abdominal pain, vaginal discharge and itching at the gynaecology clinic of Lagos University Teaching Hospital and at the Clinical Centre of the Nigerian Institute of Medical Research, Yaba, Lagos, between January 2001 and July 2002. A total of 250 patients gave informed consent to participate in the study. The patients also had pre- and post-test human immunodeficiency virus (HIV) counselling. Each patient completed a questionnaire in order to provide biographical data, past clinical history and socio-economic background information. A cervical swab (CS) and a high-vaginal swab (HVS) were obtained from each patient. Swab samples were examined for pH and under light microscopy by Gram's stain and as wet preparations in 10% potassium hydroxide. Subsequently, samples were cultured on appropriate media at optimal conditions and a drug sensitivity profile for all isolates was determined by standard methods. Blood samples were screened and confirmed for HIV antibodies. Bacterial, fungal and parasitic pathogens were identified or isolated in samples from 241 (96.4%) of the women. Bacterial agents (Neisseria, Streptococcus and Staphylococcus species) were predominant in 128 (51.2%) patients, followed by fungi in 108 (43.2%) and parasites (Trichomonas vaginalis) in five (2.0%). Sensitivity to ciprofloxacin was seen in 40% of Staphylococcus species and in 90% of Neisseria species. Positive HIV serology was seen in 25 (10%) of the 250 women studied, 20 (80%) of which had concurrent microbial infections. Overall, a broad spectrum of microbial agents were shown to be responsible for vaginitis in the group of patients studied.

Displaced people are faced with over-crowded conditions in camps with children being the most vulnerable. This is because they are faced with myriad of challenges such as poor nutrition, breakdown of health infrastructure, disease epidemics, looting and violence. Others include unprotected sex especially when separated from their families. Displaced persons are prey to a host of diseases, most of which could be prevented. In this study the socio-economic and health impacts among internally displaced persons (IDPs) following floods in Nigeria were identified. Information on social, economic and health issues obtained from 432 household heads, nursing mothers and pregnant women from 17 IDP camps in three states was analyzed using SPSS version 20.0. Majority (58%) of IDPs had their occupation as farming and as a result of the flood, 299 (69.2%) people lost their means of livelihood with a concomitant decrease in income to a mean of $35.2. Victims' nutrition was affected, resulting 63.3 % having less to eat. Though the major source of water to the IDPs before the flood was rivers/streams and wells, there was no statistical significance (p=0.99) between the major source of water to the community even when they had access to pipe-borne water after the disaster.