This prospective study of parturients at a tertiary health institution in south-western Nigeria aims to identify the incidence, severity and obstetric factors predisposing to feto - maternal haemorrhage (FMH) in our population. The exclusion criteria were haemoglobinopathy and patient's refusal of consent to participate in the study. The prepared slide was processed as in the acid elution test described by Kleihauer - Betke. The FMH was calculated using Mollison formula (Mollison 1972). Baseline data included maternal biodata, blood group, RhD and haemoglobin electrophoresis, route/mode of delivery, duration of labour, obstetric interventions, fetal blood group and birth weight. Data generated were analysed with Statistical Package for Social Scientists (SPSS) version 11 software. Frequency tables, cross-tabulations and correlations were performed. Pearson's correlation was applied to continuous variables, while Spearman's correlation was utilised for discrete variables. Level of statistical significance was set at p < 0.05. A total of 163 parturients were studied, of which eight were multifetal gestations. There were no significant differences in maternal age, parity, estimated gestational age at delivery and birth weight, in both groups of parturients with and without FMH. A total of 17 parturients (10.43%), four of which were multifetal gestations (2.45%), had demonstrable FMH. Large FMH (>15 ml fetal cells) were noted in 10 (6.14%) parturients, of which, four were RhD-negative mothers. A total of 9.8% and 11.5% parturients in the vaginal and caesarean delivery groups, respectively, had significant FMH (p = 0.736). Incidence of large FMH was similar with each of the routes of delivery. Antepartum complications of pregnancy, delivery manoeuvres and episiotomy were not significant determinants of FMH. Multiple gestations, fetal birth weight and complications in labour were significantly associated with risk of FMH. Risk-based approach to management, in RhD negative pregnant women, might lead to under-treatment, with attendant increased incidence of isoimmunisation. At least in all RhD-negative women, the cord blood should be tested to determine the baby's blood group and if RhD-positive, Kleihauer - Betke test should be done to determine the degree of FMH and anti-D immunoglobulin dose administered appropriately. Further studies are necessary to establish the determinants/risk factors for FMH.

Human immunodeficiency virus-positive individuals are at increased risk of both asymptomatic and symptomatic urinary tract infections. The aim of this study was to determine the prevalence of asymptomatic bacteriuria (ASB) in HIV-positive individuals, its associated factors including any correlation with the CD4 count of the patient, and the antibiotic susceptibility pattern of the isolated organisms. Midstream urine and blood samples were collected from 242 consenting HIV-positive patients who were attending routine follow-up clinic during the six-month period of the study. Microscopy, culture, and antibiotic susceptibility testing of the samples were carried out following standard protocols, and CD4 counts were also determined. Fifty one (21.1%) of the 242 individuals had significant bacteriuria. The predominant organism was Klebsiella spp. (35%) followed by Escherichia coli (31%). Prevalence of bacteriuria was higher in the women. Low CD4 counts and young age were significantly associated with the presence of bacteriuria. ASB prevalence is high in this population and related to the CD4 count level.

BackgroundPlasmodium falciparum and soil transmitted helminth (STHs) infection are widespread in sub-Sahara Africa, where co-infection is also common. This study assessed the prevalence of these infections and their risk factors among pregnant women in Osogbo, Nigeria.MethodsA total of 200 pregnant women attending the antenatal clinic were recruited. Plasmodium falciparum was detected using thick and thin film methods, while formol ether concentration method was used for STHs detection. A questionnaire was used to investigate the possible risk factors associated with acquisition of malaria and helminth infections.ResultsThe prevalence of P. falciparum, STHs and their co-infection was 29.5%, 12% and 5% respectively. P. falciparum, STHs and P. falciparum + STHs co-infection was significantly higher in primigravidae (52.5% vs 58.3% vs 80%) than in secongravidae (18.6% vs 25.0% vs 20%) and multigravidae (28.8% vs 16.7% vs 0%) (p=0.02). Prevalence associated factors identified for P. falciparum was age (p=0.0001) while gravidity (p=0.02) was identified for P. falciparum + STHs co-infection.ConclusionHigh prevalence of P. falciparum and helminth infections was observed among the pregnant women with primigravidae being the most susceptible to co-infection. There is an urgent need to implement an effective malaria and STHs preventive method for this high risk population.

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The association of the HIV p24 antigen with blood donation was highly significant (p = 0.000) and pose a great risk to recipients if screening of blood donor is only carried out by HIV antibody detection.

ABSTRACT

Background Individuals of African descent are at higher risk of developing kidney disease than their European counterparts, and HIV infection is associated with increased risk of nephropathy. Despite a safe renal profile in the clinical trials, long-term use of tenofovir disoproxil fumarate (TDF) has been associated with proximal renal tubulopathy although the underlying mechanisms remain undetermined. We aim to establish the prevalence of and risk factors for TDF-induced kidney tubular dysfunction (KTD) among HIV-I and II individuals treated with TDF in south-west Nigeria. Association between TDF-induced KTD and genetic polymorphisms in renal drug transporter genes and the APOL1 (Apolipoprotein L1) gene will be examined. Methods This study has two phases. An initial cross-sectional study will screen 3000 individuals attending the HIV clinics in south-west Nigeria for KTD to determine the prevalence and risk factors. This will be followed by a case-control study of 400 KTD cases and 400 matched controls to evaluate single nucleotide polymorphism (SNP) associations. Data on socio-demographics, risk factors for kidney dysfunction and HIV history will be collected by questionnaire. Blood and urine samples for measurements of severity of HIV disease (CD4 count, viral load) and renal function (creatinine, eGFR, phosphate, uric acid, glucose) will also be collected. Utility of urinary retinol binding protein (RBP) and N-acetyl-beta-D-glucosaminidase (NAG) levels as surrogate markers of KTD will be evaluated. Genomic DNA will be extracted from whole blood and SNP analyses performed using the rhAMP SNP genotyping assays. Statistical analysis including univariate and multivariate logistic regression analyses will be performed to identify factors associated with KTD. Discussion In spite of TDF being the most commonly used antiretroviral agent and a key component of many HIV treatment regimens, it has potential detrimental effects on the kidneys. This study will establish the burden and risk factors for TDF-induced KTD in Nigerians, and explore associations between KTD and polymorphisms in renal transporter genes as well as APOL1 risk variants. This study may potentially engender an approach for prevention as well as stemming the burden of CKD in sub-Saharan Africa where GDP per capita is low and budgetary allocation for health is inadequate.