BackgroundSub-Saharan countries including Nigeria have the highest burden of Human Papillomavirus (HPV) infection in the world. Most studies on HPV surveillance in Nigeria were done in the southern part of the country. Geographical and socio-cultural diversity of Nigeria makes these data unlikely to be universally representative for the entire country. Northern Nigeria especially the North-East carries a higher prevalence of cervical cancer and many of its risk factors. The region may be harbouring a higher prevalence of HPV infection with a possibility of different genotypic distribution. This study was carried out to determine the burden and confirm the predominant HPV genotypes among women presenting for cervical cancer screening at the Federal Teaching Hospital Gombe (FTHG), North-eastern, Nigeria.MethodsThe study was an observational hospital based cross sectional study among women who presented for cervical cancer screening in FTHG. A total of 209 consenting women were tested for cervical HPV infection using PCR. DNA sequencing was carried out on positive samples to determine the prevalent HPV genotypes.ResultsThe prevalence of cervical HPV infection among the participants with mean age of 39.6 ± 10.4 years was 48.1 %. The five most predominant genotypes were 18, 16, 33, 31 and 35, with prevalence of 44.7 %, 13.2 %, 7.9 %, 5.3 % and 5.3 % respectively. Other genotypes observed were 38, 45, 56, 58, 82 and KC5. Multiple HPV infections were detected among 7.9 % of participants. Risk factors such as level of education (X2 = 15.897; p = 0.007), age at sexual debut (X2 = 6.916; p = 0.009), parity (X2 = 23.767; p = 0.000), number of life time sexual partners (X2 = 7.805; p = 0.005), age at first pregnancy (X2 = 10.554; p = 0.005) and history of other malignancies (X2 = 7.325; p = 0.007) were found to have a statistically significant association with HPV infection.ConclusionThis study identified a high burden of HPV infection in Northern Nigeria while also confirming HPV 18 and 16 as the most predominant genotypes. It further justifies the potential benefit of the currently available HPV vaccines in the area. A larger and community based study is however recommended for better representation of the area.Electronic supplementary materialThe online version of this article (doi:10.1186/s13027-015-0035-8) contains supplementary material, which is available to authorized users.

IntroductionPersistent high-risk HPV (hrHPV) infection is higher among women living with HIV/AIDS thus increasing their risk for cervical cancer. We evaluated the virological and immunological correlates of cervical dysplasia in HIV-infected women.MethodsA cohort of 220 consenting women attending the antiretroviral clinic of the Federal Medical Centre, Keffi, Nigeria was tested for cervical human papilloma virus (HPV) infection using PCR. The prevalent HPV genotypes were determined by DNA sequencing. CD4+T count and type specific HPV was correlated with cervical cytology. Descriptive and inferential statistical analysis of the data was done using the statistical package for social sciences (SPSS) version 20 (SPSS Inc, Illinois, USA) for analysis after validationResultsOverall HPV prevalence was 54.1% while the hrHPV prevalence was 35.9%. Premalignant and malignant lesions were observed among participants with CD4+T counts between 200-300/mm3. A statistically significant association was observed between cervical premalignant lesions and CD4+ count (X2=24.747, P value=0.001) as well as hrHPV infections (X2=46.800, P<0.001).ConclusionRisk stratification with HPV screening among HIV-infected women will help in early case management of cervical precancerous lesions.

Background: Antimicrobial resistance (AMR) is a major clinical challenge globally. It is mainly a consequence of inappropriate prescribing and use of antibiotics. Antimicrobial stewardship (AMS) ensures that antibiotics are prescribed and used appropriately. This study assessed AMS practice in selected Nigerian hospitals.Methodology: This was a cross sectional survey of 20 Federal, State and Private tertiary hospitals randomly selected from the six geopolitical zones of Nigeria. Using an adapted WHO tool on AMS, data were collected from each hospital as regard the existence of AMS committee, Accountability and Responsibility, AMS actions, Education and Training, Monitoring and Evaluation, Infection Prevention and Control (IPC) practice, facilities to support AMS, and challenges to AMS implementation. Gaps and challenges to the implementation of the AMS among the hospitals were identified.Results: Only 6 (30%) of the 20 hospitals had AMS committees while 2 (10%) had any evidence of leadership commitment to AMS. All the hospitals had laboratory facilities to support culture and sensitivity testing. There were no regular AMS-related education or training, monitoring, evaluation or reporting activities in the hospitals, except in 7 (25%) that had participated in the global point prevalence survey (Global-PPS) of antimicrobial use and resistance being hosted by the University of Antwerp, Belgium. Challenges impeding AMS activities included lack of human and financial resources, prescribers’ opposition, lack of awareness and absence of AMS committees. Most of the gaps and challenges bordered on seeming lack of knowledge and inadequate communication among prescribers and other stakeholders.Conclusion: There is need for intense education and training activities for prescribers and other stakeholders, including but not limited to hospital administrators. Keywords: Survey, Antimicrobial Stewardship, Antimicrobial Resistance; Nigeria   French title: Mise en œuvre de la gestion des antimicrobiens dans les hôpitaux Nigérians: lacunes et défis Contexte: La résistance aux antimicrobiens (RAM) est un défi clinique majeur à l'échelle mondiale. C'estprincipalement une conséquence d'une prescription et d'une utilisation inappropriées d'antibiotiques. La gestion des antimicrobiens (AMS) garantit que les antibiotiques sont prescrits et utilisés de manière appropriée. Cette étude a évalué la pratique de l'AMS dans certains hôpitaux Nigérians. Méthodologie: Il s'agissait d'une enquête transversale de 20 hôpitaux tertiaires fédéraux, d'État et privéssélectionnés au hasard dans les six zones géopolitiques du Nigéria. À l'aide d'un outil OMS adapté sur l'AMS, des données ont été collectées auprès de chaque hôpital en ce qui concerne l'existence d'un comité AMS, la responsabilité et la responsabilité, les actions AMS, l'éducation et la formation, le suivi et l'évaluation, la  pratique de prévention et de contrôle des infections (IPC), les installations pour soutenir l'AMS. et les défis de la mise en œuvre de l'AMS. Les lacunes et les défis liés à la mise en œuvre de l'AMS parmi les hôpitaux ont été identifiés. Résultats: Seuls 6 (30%) des 20 hôpitaux avaient des comités AMS tandis que 2 (10%) avaient des preuves d'engagement du leadership envers l'AMS. Tous les hôpitaux disposaient d'installations de laboratoire pour soutenir la culture et les tests de sensibilité. Il n'y avait pas d'activités régulières d'éducation ou de formation, de suivi, d'évaluation ou de rapportage liées à la MGS dans les hôpitaux, sauf dans 7 (25%) qui avaient participé à l'enquête mondiale sur la prévalence ponctuelle (Global-PPS) de l'utilisation et de la résistance aux  antimicrobiens organisée par l'Université d'Anvers, Belgique. Les défis entravant les activités de l'AMS  comprenaient le manque de ressources humaines et financières, l'opposition des prescripteurs, le manque de sensibilisation et l'absence de comités AMS. La plupart des lacunes et des défis se limitaient à un manque apparent de connaissances et à une communication inadéquate entre les prescripteurs et les autres intervenants.Conclusion: Des activités d'éducation et de formation intensives sont nécessaires pour les prescripteurs et autres intervenants, y compris, mais sans s'y limiter, les administrateurs d'hôpitaux. Mots clés: enquête, gestion des antimicrobiens, résistance aux antimicrobiens; Nigeria  

Background: Pseudomonas species are responsible for different healthcare-associated infections and are inherently resistant to many commonly used antibiotics. Hospital antibiograms are either absent or not regularly available in most healthcare facilities in Nigeria. The objective of this study is to present the antibiogram of Pseudomonas isolates in Federal Teaching Hospital Gombe (FTHG) in order to guide antibiotic prescription for better patient safety in the hospital.Methodology: The is a hospital-based cross-sectional study. A total of 4309 bacterial isolates were recovered from aerobic cultures of routine clinical specimens including urine, sputum, blood, swabs, aspirates, biopsies, seminal fluids and cerebrospinal fluids at the Medical Microbiology laboratory of the hospital between January and December 2019. Pseudomonas species were identified by colony morphology, Gram-reaction and conventional biochemical tests. Antibiotic susceptibility testing was performed on each Pseudomonas isolate using the modified Kirby-Bauer disk diffusion method on Mueller-Hinton agar and results interpreted according to the guideline of the Clinical and Laboratory Standards Institute (CLSI). Data were analysed using the Statistical Package for Social Sciences (SPSSTM) software version 23.0.Results: Of the total 4309 bacterial isolates, 436 (10.1%) Pseudomonas species were identified, with majority (49.8%) from urine specimens. Antibiotic susceptibility test results revealed average susceptibility rates of 73.8%, 70.1%, 66.2%, 59.5%, and 34.3% to ciprofloxacin, gentamicin, levofloxacin ceftazidime, and carbenicillin respectively. These rates fluctuate only slightly for each of the antibiotic during the 12 months period of survey.Conclusion: Pseudomonas species were most sensitive to ciprofloxacin and gentamicin among the first line antibiotics in FTHG in 2019. Regular updates and presentation of hospital antibiogram especially for intrinsically resistant bacteria such as Pseudomonas involved in healthcare associated infections, is an important tool in combating antimicrobial resistance and ensuring patient safety. Keywords: antibiogram, Pseudomonas, antimicrobial resistance, antimicrobial stewardship, patient safety

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