Introduction There is a paucity of prospective data on the performance of the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening in sub-Saharan Africa. The aim of this exploratory analysis was to evaluate the feasibility and performance of FIT in Nigeria. Methods This was a prospective, single-arm study. A convenience sample of asymptomatic, average-risk individuals between 40–75 years of age were enrolled at Obafemi Awolowo University Teaching Hospital. Study participants returned in 48 hours with a specimen for ova and parasite (O&P) and qualitative FIT (50ug/g) testing. Participants with a positive FIT had follow-up colonoscopy and those with intestinal parasites were provided treatment. Results Between May-June 2019, 379 individuals enrolled with a median age of 51 years (IQR 46–58). In total, 87.6% (n = 332) returned for FIT testing. FIT positivity was 20.5% (95% CI = 16.3%-25.2%). Sixty-one (89.7%) of participants with a positive FIT had a follow-up colonoscopy (n = 61), of whom 9.8% (95%CI:3.7–20.2%) had an adenoma and 4.9% (95%CI:1.0–13.7%) had advanced adenomas. Presence of intestinal parasites was inversely related to FIT positivity (6.5% with vs. 21.1% without parasites, p = 0.05). Eighty-two percent of participants found the FIT easy to use and 100% would recommend the test to eligible family or friends if available. Conclusions Asymptomatic, FIT-based CRC screening was feasible and well tolerated in this exploratory analysis. However, the high FIT positivity and low positive predictive value for advanced neoplasia raises concerns about its practicality and cost effectiveness in a low-resource setting such as Nigeria.
Background: Gastrointestinal infection is one of the most common infections among HIV patients. Candida spp have been implicated in the aetiology of chronic diarrhoea in HIV patients, but little is known about this in Nigeria. Objectives: We determined the prevalence of faecal candidiasis in HIV patients in relation to diarrhoea, CD4 counts, and other socio-demographic factors and the spectrum of Candida isolates involved. Methods: One hundred and fifty four HIV patients were investigated. Candida species were identified by standard techniques. Socio-demographic and clinical information was obtained from the patients using a structured questionnaire. The CD4 count was estimated using a single platform flow cytometer.
RNAs are a class of molecules and the majority in eukaryotes are arbitrarily termed non- coding transcripts which are broadly classified as short and long non-coding RNAs. Recently, knowledge of the identification and functions of long non-coding RNAs have continued to accumulate and they are being recognized as important molecules that regulate parasite-host interface, parasite differentiation, host responses, and disease progression. Herein, we present and integrate the functions of host and parasite long non-coding RNAs during infections within the context of epigenetic re-programming and molecular crosstalk in the course of host-parasite interactions. Also, the modular range of parasite and host long non-coding RNAs in coordinated parasite developmental changes and host immune dynamic landscapes are discussed. We equally canvass the prospects of long non-coding RNAs in disease diagnosis and prognosis. Hindsight and suggestions are offered with the aim that it will bolster our understanding for future works on host and parasite long non-coding RNAs.
The indwelling urinary catheter (IUC) is the most significant risk factor for developing nosocomial urinary tract infections (UTIs). In order to determine the spectrum of bacterial etiology and antibiotic resistance pattern of uropathogens causing catheter associated UTI, a convenient sample size of ninety-two (92) patients on urethral catheter was investigated. Ethical approval for the study was obtained from the OAUTHC research and ethical committee. Catheter stream urine samples were obtained from all patients and cultured on appropriate culture media. Suspected isolates were identified by a combination of standard tests and using MICROBACT GNA12A/B/E. Susceptibility of the isolates against thirteen (13) antibiotics was performed by the disc diffusion method. Significant bacteriuria was observed in 60.9% (56) catheter specimen urine (CSU) received, while 39.1% (36) were culture negative. Of the 56 positive culture, the predominant organisms were Klebsiella oxytoca, 28.6 %( 16), Proteus vulgaris, 23.2% (13) and Staphylococcus aureus, 12.5% (7). Overall, the antimicrobial susceptibility results showed that all the isolates were highly resistant to the antibiotics tested. Over 50% resistance was recorded for trimethoprim/sulfamethoxazole, gentamicin and amoxicillin/clavulanic acid. More than 25% of the isolates were resistant to nitrofurantoin. This study indicates that catheter stream UTI caused by multiply resistant bacteria are common in our hospital. There is a need to establish standard guidelines on the care of catheter for all units in the hospital with a view to preventing nosocomial infections associated with the use of the catheter in patients. We also advocated prudent use of antibiotics. Key words: Antibiotic resistance, Urinary catheter, Uropathogens, Urinary tract infection Received 27 March 2010/ Accepted 1 June 2010 INTRODUCTIONUrinary tract infections (UTIs) are the most common infections found in the hospital as well as long-term care setting. The indwelling urinary catheter (IUC) is the most significant risk factor for developing catheter-associated urinary tract infections (CAUTIs). The risk of acquiring a urinary tract infection depends on the method and duration of catheterisation, the quality of catheter care, and host susceptibility among others. Several studies have indicated that between 75 and 80% of all healthcare associated UTIs follow the insertion of a urinary catheter (Bryan and
Introduction The fecal immunochemical test (FIT) for hemoglobin is recommended for colorectal cancer (CRC) screening in resource‐limited environments. However, there are several unique variables that may alter FIT performance in this setting, including endemic intestinal parasites and high ambient temperature. This prospective study evaluated the performance of FIT in asymptomatic, average‐risk individuals of screening age in rural Nigeria. Methods Three hundred and twenty‐four community volunteers completed a questionnaire and provided stool specimens for parasitology and microbiome analysis. Specimens were frozen and stored at −80 °C. Of 324 subjects, 139 met criteria for average‐risk CRC screening and had a stool sample for analysis. These were thawed and tested with a qualitative FIT. Specimens positive for occult blood were retested every two days to evaluate the impact of time and temperature on test performance. Results Of 139 individuals, 69 (49.6%) were positive for intestinal parasites and 10 (7.2%) were positive for occult blood. The most common pathogen was Cryptosporidium (40.6%). Among patients with intestinal parasites, 10.1% (7/69) had a positive FIT. Only 4.3% (3/70) of patients without parasites had a positive FIT (p = 0.208). On bivariate analysis, sociodemographic variables were not associated with a positive FIT result. Thirty percent (3/10) of the FIT‐positive specimens became FIT‐negative with routine storage. Conclusion Although a positive FIT result was more common in those with parasitic infection, the relationship was not significant in this small cohort. The impact of high ambient temperature on test positivity may necessitate shorter processing time guidelines for equatorial countries. Additional prospective studies are needed to validate FIT performance in Nigeria.
Background: There is no consensus on the preferred time to remove urethral catheter post caesarean section. Aim: To compare rate of significant bacteriuria and urinary retention following 8-h (study) and 24-h urethral catheter removal (control) post elective caesarean section. Methods: A randomized controlled trial of eligible participants that underwent elective caesarean section under spinal anaesthesia between March 2019 and November 2019 was conducted. Participants (150 in each arm) were randomly assigned (1:1 ratio) to either 8-h or 24-h group. Primary outcome measures included rates of significant bacteriuria 48-h post-operatively and acute urine retention 6-h post urethral catheter removal. Analysis was by Intention-to-treat. ( www.pactr.org:PACTR202105874744483 ) Results: There were 150 participants randomized into each arm and data collection was complete. Significant bacteriuria was less in 8-h group (3% versus 6.0%; risk ratio (RR): 0.85 CI: 0.60 to 5.66; p = 0.274), though not significant. Acute urinary retention requiring repeat catheterisation was significantly higher in 8-h group (11(7.3%) versus 0(0.0%); RR: 0.07; CI: 0.87 to 0.97; p = 0.001). Mean time until first voiding was slightly higher in 8-h group (211.4 ± 14.3 min versus 190.0 ± 18.3 min; mean difference (MD): 21.36; CI: −24.36 to 67.08; p = 0.203); but patient in this group had a lower mean time until ambulation (770.0 ± 26.1 min versus 809 ± 26.2 min; MD: −38.8; CI: −111.6 to 34.0; p = 0.300). The 8-h group were significantly more satisfied (82/150 (54.7%) versus 54/150 (36.0%); p = 0.001) Conclusions: An 8-h group was associated with significant clinical satisfaction and acute urine retention compared to 24-h removal. The timing of urethral catheter removal did not affect rate of significant bacteriuria and other outcomes
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