A ten year study of malaria amongst paediatric patients was carried out in the Federal Capital Territory, Nigeria, West Africa from 2000 to 2010. Giemsa staining methodology was used. Of the 24 289 blood samples analyzed (comprising of 13 435 male children and 10 854 female children), 8668 (35•7%) were positive for malaria parasites. 267 (3•1%) had parasite density of > 5000 parasites/µl of blood; 382 (4•4%) had between 500-5000 parasites/µl of blood; 1262 (14•6%) had between 50-500 parasites/µl of blood; while 6757 (77•9%) had between 5-50 parasites/µl of blood. The 11-15 years age group had the highest prevalence of 40•6%, while neonates (<1-28 days), 1 month-5 years, and 6-10 years age groups recorded 27•2%, 34.5% and 36•5% respectively. Of the 13 435 male children, 4845 (36•1%) had positive malaria result as against 35•2% (3823) of positive cases recorded among the 10854 female children. There is need to enhance parasitological diagnosis by way of providing diagnostic tolls at all levels of health care-primary (rural settings), secondary and tertiary. There are negative implications associated with the continued use of malaria rapid diagnostic tests (M-RDTs) methodologies which includes underdiagnosis, misdiagnosis of malaria and mismanagement of non-malarial fever, which wastes limited resources, erodes confidence in the health care system, and contributes to drug resistance. Finally, appropriate antimalarial drugs for treatment should be given free to all malaria positive children.
Background: Following an increase in the practice of starting antimicrobial therapy prior to clinical sample collection, the ability to confirm pathogenic microorganisms of bacterial meningitis has decreased by approximately 30%. Culture results may be false negative when fastidious or culture-resistant bacteria are involved or when patient samples are obtained after antimicrobial therapy has started. Molecular diagnosis using PCR can be performed directly on clinical samples after metagenomic DNA (mDNA) extraction not requiring live organisms for a positive result. The specific objectives of this study are to perform mDNA extraction directly from cerebrospinal fluids (CSF) using appropriate spin column method, and to determine the quality of the mDNA elute.Methodology: Cerebrospinal fluid specimens were collected from 210 patients with suspected acute cerebrospinal meningitis (CSM) in the Federal Capital Territory and some States in Northern Nigeria during the 2017 and 2018 outbreak seasons. Metagenomic DNA was extracted from approximately 200µL of CSF specimens using the Qiagen QIAamp(R) DNA Mini kit specific for bacterial agents only. DNA quality check was performed on all DNA elutes using fluorometric, spectrophotometric and agarose gel electrophoresis methods.Results: Of the 210 CSF samples analyzed microbiologically, Gram reaction was positive in 94 cases (44.8 %) but only 17 (8.1 %) were culture positive for two of the three major bacterial causes of meningitis. One hundred and eighty (85.7%) samples had DNA concentrations ≥ 0.005 ng/µL, 55 (30.6 %) of these had DNA purity (A260/A280) of ≥ 1.7, 103 (57.2%) had purity value between 1.0 - 1.69, 14 (7.8%) had value of 0.57 - 0.99, and 8 (4.4%) failed purity evaluation with value of 0.00 at A260/A280.Conclusion: The essence of mDNA extraction is multipurpose. A multiplex PCR can be performed on the extracted mDNA to interrogate the presence of microbial pathogens of interest using specific primers and probes (when applicable). Quality mDNA from CSF samples will ensure successful qPCR results for rapid and accurate detection of bacterial pathogens in meningitis. This will eliminate the challenges associated with traditional culture methods. Keywords: Meningitis, CSF, DNA Quality Check, Fluorometry
Enteric fever is caused by Salmonella enterica serotype typhi, Salmonella paratyphi A, B, C, and Salmonella typhimurium respectively. Of the 2818 blood cultures reviewed, only 90 (3.2%) had positive cultures for Salmonella species while the 10,007 faecal samples cultured, 159 (1.6%) were positive for Salmonella species. Identification of isolates was by usual bacteriological techniques including biochemical and serological methods. Percentage occurrence of Salmonella species in blood and faecal samples show Salmonella enterica serotype typhi (75.6% and 59.8%), Salmonella paratyphi A (4.4% and 9.4%), Salmonella paratyphi B (17.8% and 19.5%), Salmonella paratyphi C (2.2% and 6.3%) and Salmonella typhimurium (0.0% and 5.0%). The susceptibility pattern of all the isolates to the eleven drugs used as listed on table iii is highly revealing. For epidemiological status and proper management of patients, it is necessary that appropriate specimens (blood, bone marrow and faecal cultures) are examined and identification of isolates carried out as well as proper sensitivity testing performed prior to treatment for enteric fever.
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