BackgroundActivation of immune cells by malaria infection induces the secretion of cytokines and the synthesis of other inflammatory mediators. This study compared the cytokine levels and leukocyte count between malaria-infected peripheral and placental blood of pregnant women before delivery and postpartum. The cytokines assessed include interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin-4 (IL-4), interleukin-6 (IL-6) and interleukin-10 (IL-10).Materials and methodsThe subjects comprised 144 malaria-infected pregnant women and 60 malaria-infected women at post-partum stage (for placental blood collection). Others were 60 malaria-uninfected pregnant women and 40 malaria-uninfected women at postpartum stage (for placental blood collection). Forty malaria-infected and 40 malaria-uninfected nonpregnant women served as control subjects. The test groups were asymptomatic, and the control groups were apparently healthy subjects. All were aged between 17 and 44 years. Ethical approval for the study was obtained at Abia State University Teaching Hospital and Living Word Mission Hospital, Aba. Informed consent was obtained from the participants. Blood samples were aseptically collected initially from the maternal peripheral circulation and from the placenta on delivery, and tested for HIV and malaria using standard methods. IFN-γ, TNF-α, IL-4, IL-6 and IL-10 were measured by enzyme-linked immunosorbent assay technique. Kruskal–Wallis test was used for comparison of the groups.ResultsIFN-γ was significantly higher in the peripheral than in placental blood (P=0.001). IL-4 and IL-10 were significantly lower in the peripheral than in placental blood (P=0.001 and P=0.004, respectively). The total leukocytes, neutrophils and lymphocyte counts were significantly higher in the placenta than in peripheral blood (P=0.001), and the mixed differential count was significantly higher in the placenta than in peripheral blood (P=0.012).ConclusionThis study has shown that the cytokine levels and leukocyte counts may differ between the peripheral and placental blood of the same women. Therefore, measurement of parameters in the peripheral circulation may not always reflect the levels in the placental blood for the assessment of immune cellular response at the materno–fetal interface.
The study was undertaken to determine transmission of Mycobacterium tuberculosis within the prison environment. In total, 168 Aba Federal prison inmates in Nigeria were evaluated for tuberculosis (TB) by sputum-smear microscopy and sputum culture, simultaneously, and for HIV status by serology. They were subsequently followed up for one year for fresh Mycobacterium-associated infection by tuberculin skin testing or for development of TB and for HIV infection or AIDS. Ninety-one (54.2%) of the 168 prison inmates had infection due to Mycobacterium, and three (3.3%) of them were sputum-smear-and culture-positive while 41 (24.4%), including one (2.4%) with concomitant TB, were HIV-infected. In a one-year follow-up study, 11 (19.3%) of 57 tuberculin skin test (TST)-and HIV-negative inmates became TST-positive and one (1.8%) HIV-positive, eight (13.8%) of the 58 TST-positive but HIV-negative inmates developed TB, and one (1.7%) became HIV-infected: six (24.0%) of 25 TST-and HIV-positive inmates developed TB while five (33.3%) of 15 TST-negative but HIV-positive inmates became TST-positive, and one (6.7%) progressed to AIDS. The duration of imprisonment did not influence the rates of infection, and the transmission of Mycobacterium tuberculosis did not necessarily require sharing a cell with a TB case.
Contacts of tuberculosis (TB) cases in households orsharing space in hospitals, classrooms, offices, market stalls or other, were evaluated by tuberculin skin test (TST), sputum-smear microscopy or sputum culture method for Mycobacterium tuberculosis and by serology for HIV infections. Of the 633 contacts, 47.4% were TST-positive and 18.2% HIV-infected. Household contacts were 174 and 51.2% of them were TST-positive and 8.0% HIV-positive. Spouse (TB-case)-spouse contacts gave 83.3% TSTpositive rate followed by mother (TB-case)-child contact (65.5%); father (TB-case)-child contact (35.0%) and other relationships (51.2%). In a three-year cohort study, 46.2% contacts, initially TST-and HIVpositive, developed TB compared with 16.7% among those TST-positive but HIV-negative. For those TB and HIV positive, 52.4% developed AIDS and 42.9% died compared with 22.3% AIDS rate and 18.2% deaths among those testing TST-negative but HIV-positive. This confirms interaction between HIV and TB; and the liaison of the two resulted in higher mortality.
We report a case of primary amoebic meningoencephalitis in Nigeria in a 7-year old boy from a rural area. The clinical course was classically that of meningoencephalitis and laboratory diagnosis was from the cerebrospinal fluid and pond water specimen which showed free-living structures of amoeba of Naegleria species. Methods available could not differentiate the Naegleria species. Investigation revealed that the boy played and swam in a village pond for many years before his death and the pond was infested with free living amoebae. Despite the worldwide nature of the disease, the reporting of the cases had been very rare. The apparent rarity of the reporting worldwide and in particular in developing countries result in ignorance of people of the disease.
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