A 15 month longitudinal study of cytomegalovirus (CMV) infection in 178 Gambian mothers and their babies was undertaken. Twenty five (14%) of the babies were congenitally infected despite the fact that 87% of their mothers were antibody positive to the virus. Two of the 25 congenitally infected infants had evidence of severe neurological damage; skin sepsis was also a prominent feature in congenitally infected infants. The other children soon became infected. At 6 months of age, 53% of the infants were shedding virus either in urine or saliva. By the age of 12 months 86% of the infants had serological evidence of CMV infection. Preliminary evidence suggests that sibling to sibling infection in crowded compounds might be a major route of transmission. J Clin Pathol 1991;44:366-369 epidemiology of CMV in Africa. Serological evidence points to frequent and early infection in childhood,2 13 but the incidence of congenital infection and its long term effects on the nervous and immune system in a tropical environment are unknown. The only study in West Africa which involved isolation of the virus was undertaken in Abidjan, the Ivory Coast,'4 where 1-4% of babies born in hospital were congenitally infected. This figure may have been artifically low because difficulties arose during the storage and transportation of specimens to Europe for viral isolation. Routes of infection in Africa have not been charted. In particular, the relative importance of mothers and older siblings in transmission needs to be elucidated.In an attempt to fill these gaps in our knowledge we undertook a community based longitudinal study of CMV in mothers and their babies in The Gambia, West Africa.Cytomegalovirus is the commonest cause of congenital infection in man, and in the West it is known to be a cause of brain damage.' Primary infection in pregnancy, which is common in those of high socioeconomic status, results in congenital infection in half the babies born to mothers in these classes.2 Between 2-7% of these children will sustain neurological damage.
SUMMARYObjectives: To examine sputum specimens from patients with persistent bronchopulmonary disorders for mycobacterium species and to characterize the recovered isolates with a view to determining the extent of involvement of environmental mycobacteria in pulmonary infections. Design: Analytical study using standard microscopy, culture and biochemical test for the identification of mycobacterium species. Setting: Jos University Teaching Hospital (JUTH) and 2 referral hospitals: Plateau Specialist Hospital and Evangelical Churches of West Africa (ECWA) Evangel Hospital in Jos, Nigeria. Participants: Three hundred and twenty nine (329) volunteer new patients seen at the chest clinic and general out patient departments with broncho-pulmonary disorders. Patients already on anti-tuberculosis were excluded from the study. Interventions: Subjects were administered antituberculosis drugs and or other treatment regimes after proper diagnosis Results: Sixty-five (65) mycobacterial isolates were obtained and differentiated into human tubercle bacilli, bovine and or environmental (atypical) mycobacteria on the basis of nine identification tests. Of the 65 mycobacterial isolates subjected to the tests, 40 (61.54%) were identified as mycobacterium tuberculosis, 10 (15.38%) as M. bovis and 15 (23.08%) as environmental mycobacteria. Among the environmental group, 9 (20.69%) were classified as M. avium 3 (3.45%) each as M. kansasi and M. fortuitum. Conclusions:The study confirms the involvement of bovine and environmental mycobacteria in pulmonary infections. This may be related to the rising prevalence of HIV/AIDS globally. The need for adequate bacteriological analysis in current-day diagnosis of pulmonary tuberculosis in indicated.
Our aim was to describe the frequency of HIV infection among patients with tuberculosis and compare their characteristics with patients with TB but not infected with HIV. Patients with cough >3 weeks duration attending 8 hospitals in Abuja, Nigeria were screened with smear microscopy and culture and tested for HIV. Chest X-rays were graded by 2 readers. 731 (62%) of 1186 patients had positive cultures and 353 (48%) of these 731 patients were smear positive. 1002 (85%) patients were tested for HIV and 546 (55%) were positive. 53% (329/625) of the culture positive patients and 58% (217/377) of the culture negative patients were HIV positive. Anorexia, weight loss, low BMI (<18.5), haemoglobin (<11 gm/dl) and albumin and high ESR and liver enzymes were more frequently observed among patients with TB coinfected with HIV than in patients without HIV. Coinfected patients had less cavitations and lung involvement on X-rays than patients without HIV. In conclusion, the prevalence of HIV is very high among patients with TB in Abuja, Nigeria. The presence of HIV decreases the sensitivity of smear microscopy and complicates the diagnosis of TB. Selected clinical and laboratory parameters could be used to identify individuals with TB who are likely to be coinfected with HIV.
The occurrence of fungi was investigated in the gut of 200 common garden lizards (Agama agama). The most important pathogenic fungus isolated was Basidiobolus haptosporus, an aetiological agent of subcutaneous zygomycosis. It was recovered from the intestinal contents of 112 (56%) lizards. Other important fungi isolated included Aspergillus spp. in 24 (12%) lizards, Candida spp. in 12 (6%), Penicillium spp. in 12 (6%) and Fusarium spp. in 12 (6%). Mucor spp. were isolated from eight (4%) male lizards only. Agamid lizards are plentiful in rural and urban areas of Nigeria. As they live in close vicinity to man, they are likely to play an important role in the spread of disease that may be caused by these fungi and its transmission to man. None of the animals investigated that yielded fungal cultures revealed any external fungal infection.
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