Medical Microbiology and Immunology

Dengue Hemorrhagic Fever (DHF) is a severe form of dengue fever (DF), which can be life-threatening. The first recorded epidemic of dengue was reported in the
late 18th century and affected Asia, Africa, and North America. Female mosquitoes, predominantly of the species Aedes aegypti and less commonly, Aedes albopictus, are responsible for the transmission of the dengue virus. As the most dangerous and widespread mosquito-borne viral infection, the dengue virus affects more than 100 countries worldwide. Increasing 30-fold in the last 50 years, the social and economic effects of dengue are far-reaching and of worldwide concern.
The disease is widespread throughout the tropics with local variations in risk influenced by rainfall, temperature, and unplanned rapid urbanization. Up to
400 million people are infected each year. Currently, vaccines are still under development for DHF; therefore, prevention is of utmost importance in lessening
the impact of dengue on a global scale. This review article summarizes the global epidemiology of Dengue Hemorrhagic fever by utilizing the most recent and
available information on the topic.

Although microbiology and immunology are fundamentally separate areas of biology and medicine, they combine to provide a powerful understanding of human health and disease -- especially with regard to infectious disease, disease prevention, and tragically, of the growing awareness that bioterrorism is a real and present worldwide danger...

Throughout history, microorganisms have spread deadly diseases and caused widespread epidemics that threatened and altered human civilization. In the modern era, civic sanitation, water purification, immunization, and antibiotics have dramatically reduced the overall morbidity and the mortality of disease in advanced nations. Yet, much of the world is still ravaged by disease and epidemics, and new threats constantly appear to challenge the most advanced medical and public health systems. For all our science and technology, we are far from mastering the microbial world.  (download to read more) K. Lee Lerner & Brenda Wilmoth Lerner, editors. St. Remy, France. June, 2002.

This extract presents 100 pages from the newly revised and enlarged Fourth Edition of 'AVD: The Anti-Viral Diet', which shares the results from the most recent, cutting-edge scientific research into the anti-viral properties of widely available foods - as well as of some rarer ingredients. Most significantly, that report confirms - among other conclusions - that good nutritional status increases vaccine efficacy and decreases the probability of suffering the dangerous side effects of some vaccines.

This extract includes copious evidence regarding eight dietary ingredients from the 'Anti-Viral Diet' and a key extract on the project's proposal for an 'Anti-Viral Five-a-Day'. This extract includes 16 full-colour photographs.

The 'AVD' publication presents the general theory of an 'Anti-Viral Diet' and also the evidence from over 2000 scientists and medical researchers confirming the anti-viral and immunomodulatory properties of many dietary ingredients. At the core of 'AVD' is a database of 52 Anti-Viral Ingredients  with detailed specifications and 104 colour photographs. Key info is provided on each of the identified ingredients, including against which viruses they have exhibited potent effects, how they 'boost' the Immune System, as well as key data about Recommended Daily Allowances. Citations and extracts from over 1000 research articles enables a broad range of scientists to speak in their own words about key discoveries in nutritional immunology and anti-viral dietetics. Every section includes research findings from at least two dozen articles (mainly from peer-reviewed journals) corroborating anti-viral qualities exhibited by that ingredient.

With kind permission of the publishers LIVING TIME™ Books. Copyright © LTB™ 2020-22.

Autoimmune reactions to vaccinations have been reported since vaccines were introduced into modern
medical technology. Here, we discuss the possible underlying mechanisms of autoimmune reactions following
vaccinations and review cases of autoimmune diseases that have been correlated with vaccination. Molecular
mimicry and bystander activation are reported as possible mechanisms by which vaccines can cause autoimmune
reactions. Idiopathic Thrombocytopenia Purpura, Myopericarditis, Primary Ovarian Failure, Systemic Lupus
Erythematosus (SLE) and Acute Disseminated Encephalomyelitis (ADEM) are all autoimmune conditions
with reported links to vaccinations. Genetic predisposition was a definite risk factor for people experiencing
autoimmune conditions following immunization; thus understanding the genome of patients is vital for both the
development of future generations of vaccines and personalized medicine. Further study is encouraged into the
direct associations between vaccines and autoimmune conditions, and the biological mechanisms behind them.

It is very important to recognize the trends in HIV/AIDS in specific areas such as Asia because it is vital to understanding the effectiveness of current approaches towards diagnosis and treatment. It is also very important to understand the risk factors that greatly predispose people in Asia to contracting HIV/AIDS such as lifestyle, culture, and religion. This review extensively analyzes the current trends of HIV/AIDS in India, China, Thailand, Cambodia and Indonesia. Additionally, cultural diversity carries certain social and religious stigmas associated with the disease. These social stigmas also pose as a significant influence on government involvement with regards to the funding of HIV/AIDS awareness, education, prevention, and the protection of human rights. Lack of education about the methods that help people from the disease and mode of transmission remains a significant hindrance in the prevention of a further rise in epidemiological statistics. Moreover, these factors are attributed to the rising incidence or risk of HIV within several populations amongst these countries. This review also analyzes the clinical presentation, epidemiological statistics, and the financial and socioeconomic impacts of HIV/AIDS in India, China, Thailand, Cambodia and Indonesia. Financial burdens and lack of government infrastructure in the healthcare systems are largely responsible for the rapidly rising prevalence of the disease among these populations, along with the inaccessibility to prevention and treatment methods. Furthermore, the scarcity of available antiretroviral and preventative medications is discussed. Lastly, this review explores various methods of diagnosis, treatment and prevention plans that are implemented in modern medicine with respect to HIV/AIDS.

Purpose of Review Now more than ever, regions other than Africa and Asia, such as the USA, are being affected by the rising epidemic of vector-borne illnesses, specifically Chikungunya, Dengue, and Zika viruses; this has prompted this review aimed at discussing the changing epidemiology of the three diseases as well as the current treatment and vaccines in development to control the diseases. With the viruses being spread through a variety of ways, including, but not limited to, mosquito bites, fetal transmission, sexual contact, breast milk, and saliva, there is no doubt that more preventative measures are required.
Recent Findings The changing epidemiology of the three viruses is already creating an impact, with the spread of Dengue in 2009
in Florida, to the 2013 spread of Chikungunya through the Caribbean, and now, the Zika virus making its mark on the tropics with
major concerns of it spreading to theWestern Hemisphere, including the USA. Although they are all vector-borne illnesses, each
carries its own clinical presentations that sometimes make it hard to diagnose. Collectively, there are no current vaccines or
antiviral drugs against these three viruses, and with no sign of the spread slowing down, more geographic regions are in danger of
being hit by these diseases in the near future.
Summary As the evolving world for the three viruses continues due to changes in epidemiology, there is a dire need to develop
vaccines for each of the three diseases that will target a variety of mechanisms to help fight the transmission and provide succor to
affected communities. Public health preventive strategies need to be employed for proper actions to be taken aimed at preventing
viral transmission and ultimately, helping to fight this changing epidemiology of vector-borne diseases.

A large number of medicinal plants and their purified constituents have been shown to have beneficial therapeutic potentials. In this study, ethanolic extract of Bidens pilosa was evaluated for its invivo activity on haematological parameters in Swiss albino rats orogastrically dosed with Escherichia coli O157:H7. Fifteen Swiss albino rats were used for the study. The animals were divided into five groups of three rats each. The first, second and third group of rats were orogastically dosed with 9.1 × 104 cfu/ml of E. coli O157: H7 to induce infection. The first group was treated with 800 mg/kg Body weight (Bw) of the ethanolic extract of B. pilosa, the second group was treated with Ofloxacin (16mg/kg Bw), while the third group was not treated. The fourth group was given only the plant extract, while the fifth group was given sterile distilled water. The results of the haematological assay indicated that: the infected-untreated rats showed lowest mean values of PCV (34.00±2.50a %), RBC (6.54±0.45a ×106/mm3) and HB (11.50±0.83a g/dL); and highest ESR (4.50±0.50c mm/hr). In the infected-extract-treated group, a significant increase in the PCV (45.00±1.00b %) and HB (15.00±0.33b g/dL) was observed. The group fed with extract alone had the highest mean values of PCV (51.00±1.00b %), RBC (11.10±0.95c ×106/mm3) and HB (17.00±0.33b g/dL). Similar pattern was observed for the results obtained for the white blood cell differential count. The infected-extract-treated group, and the group to which only extract was administered without infection showed significant increase in lymphocyte count (61.00±1.00ab ×103/mm3) and (73.50±2.50c ×103/mm3) respectively. Conversely, the infected�untreated group showed a decline in lymphocyte count (54.50±3.50a ×103/mm3). The results obtained from this study revealed that ethanolic leaf extract of Bidens pilosa exhibited haematopoietic potential and tends to modulate the values of White Blood Cell differential count in Swiss albino rats.

Although colorectal cancer is the third leading cause of death in Morocco, there are no studies of the microbiome changes associated with the disease in the Moroccan population. The aim of our study was to compare the stool microbiome of Moroccan cancer patients with healthy individuals. We analyzed the microbiome composition of samples from 11 CRC patients and 12 healthy individuals by 16S rRNA amplicon sequencing. Principal coordinate analysis of samples revealed defined cancer versus healthy clusters. Our findings showed that cancer samples had higher proportions of Firmicutes (T = 50.5%; N = 28.4%; p = 0.04), specifically of Clostridia (T = 48.3%; N = 19.0%; p = 0.002), and Fusobacteria (T = 0.1%; N = 0.0%; p = 0.02), especially of Fusobacteriia (T = 0.1%; N = 0.0%; p = 0.02), while Bacteroidetes were enriched in healthy samples (T = 35.1%; N = 62.8%; p = 0.06), particularly the class Bacteroidia (T = 35.1%; N = 62.6%; p = 0.06). Porphyromonas, Clostridium, Ruminococcus, Selenom...

As a strong heritability component has recently been identified in a whole exome sequencing study in SARS-CoV-2 infected COVID-19 patients, the ongoing identification of host susceptibility factors appears to be a worthwhile endeavour. In this article, α1-antitrypsin deficiency (A1AT deficiency) is proposed to represent a host susceptibility background in some COVID-19 patients. A1AT possesses general anti-inflammatory and immune-modulating properties in addition to maintaining the protease/antiprotease balance in the lung. A1AT deficiency is a common, underdiagnosed, inherited disorder. Associated immunological and clinical responses show overlap with post infectious residual problems experienced by some COVID patients. Research hypotheses to investigate the possibility of a A1AT deficiency-COVID 19 link include 1) investigating whether there is a causal connection between pathogenic A1AT deficiency alleles and COVID morbidity and mortality based on shared immunopathological features 2) whether altered glycosylation in AIAT deficiency has an effect on viral envelope glycosylation properties/gender glycosylation differences/hyposmia? 3) Is the COVID associated Kawasaki-like multisystem inflammatory syndrome in children (MIS-C) similar to AIAT - associated Kawasaki syndrome? 4) Do post- COVID infection disease states underlie the triggering of ongoing AIAT associated pathogenicity in various ways in specific A1AT pathogenic allele variant carriers? 5) Do international infection hotspots overlap with the geographical distribution of specific A1AT pathogenic allele variants? A1AT deficiency has previously been shown to alter host responses to atypical mycobacteria and HIV infectivity. It appears urgent to clarify whether superimposed COVID-19 infection in A1AT deficiency carriers results in an altered, more severe or prolonged illness. Demonstration of a pathophysiological relationsip between the two conditions will allow consideration of an additional therapeutic option in COVID 19 infection, the FDA-approved medication (Prolastin) (purified A1AT obtained from pooled human serum) is available for the neutrophil - driven immunopathology associated with genetic AIAT deficient disorders.

Diarrhea is a major cause of childhood morbidity and mortality. It results from contaminated food and water sources. Diarrhoea caused by infection is widespread throughout developing countries. This review focuses on diarrhea-related diseases in children worldwide. It looks at the pathogenesis, treatment, prevalence, and mortality rates of the major pathogens which cause diarrhea in children. The major pathogens include Rotavirus, Escherichia coli, Cholera, Shigella, Parasites (Protozoa and Helminthes), and waterborne-specific pathogens. Included are the associations between malnutrition, increased diarrheal prevalence and mortality rates, as well as Human Immunodeficiency Virus’ (HIVs) association with increased mortality rates due to diarrhea. This paper explores the current treatment and prevention methods used to decrease the incidence, prevalence and mortality associated with diarrhea, and can help to promote diarrheal awareness and education

Kundalini (adaptation of Kuṇḍalinī, devanagari) is a Sanskrit term originally used in some texts of the Tantric traditions to indicate that aspect of Śakti (śakti, devanāgarī, "energy", "power", in Hinduism, the power of a God to give place to the phenomenal world and to the conscious plane of creation, its immanent creative capacity), the divine energy personified, present in the human body, present in quiescent form in every individual. The snake is the most used symbol to represent the kuṇḍalini, an association suggested by the same Indian texts belonging to the tradition: "The kuṇḍalinī, when it rests it is like a snake gathered on itself, ready to spring to bite and thus inject its venom; but when it is awakened it is like the snake standing upright on the tip of its tail, stiff as a stick, harmless "(Silburn 1997). In the tantric traditions the liberation from the cycle of rebirths is seen as the "awakening" of Kundalini followed by the relative ascent (śat chakra bedhana) in the subtle body until the last chakra, where it must permanently remain in union with Śiva. At this stage the adept has definitively abandoned his individual ego (ahmakara) to identify himself with the universal Subject (aham). In Yoga Hatha (devanāgarī, also adapted into ioga, ascetic and meditative practice), the management of Kundalini is not possible if the energy channel system of the subtle body, the nāḍī (from Sanskrit, It means tubes, canals or veins) the ways through which the prana (from the Sanskrit, literally "life" and in the second instance breath and spirit) passes, understood as vital energy or breath, identified with the breath, to feed all parts of the body. The adept must first engage in operations aimed to this purpose (nāḍīśodhana), which include specific āsana positions (devanagari, are positions or postures used in some forms of yoga, in particular in Hatha Yoga) accompanied by controlled breathing techniques and recitations of mantras (devanāgarī, thought, or to think a sacred expression") corresponding to verses of the Veda (devanāgarī, a very ancient collection in Sanskrit of sacred texts of the Aryan peoples of the 20th century BC), to a sacred formula

Comparative sequence analysis of a 423-bp segment of the gyrA gene including a region homologous to the quinolone resistance-determining region (QRDR) of other species was evaluated as a novel typing method for Legionella strains. The study was performed with 29 reference strains representing 11 different Legionella species, with various serogroups, and with 13 clinical isolates of L. pneumophila. Pulsed-field gel electrophoresis and serotyping were employed for comparison of the clinical isolates. QRDR sequencing proved to be a highly discriminative tool for typing Legionellae, and permitted identification of species, serogroups and even different strains within serogroup 1. None of the isolates were resistant to quinolones in vitro and this correlated with dissence of mutations in the QRDR region. The data show that comparative sequence analysis of a short fragment of the gyrA gene is a potentially useful tool for typing of Legionella beyond the serogroup level. It is anticipated that mutations of the QRDR may arise in Legionella as a consequence of the introduction of quinolones as the agents of choice for the treatment of infections with this agent in immunocompromised patients. The employment of QRDR-typing maybe helpful in uncovering such mutations.

Two test-kits — API and Oxi Ferm tube — have been compared for accuracy in individual tests and for identification on the genus or species level with conventional biochemical tests on 154 oxidative-fermentative gram-negative rods. The two test systems were found to be reliable and permit identification of the clinically most significant oxidative-fermentative strains.

Background: Diseases caused by opportunistic pathogens are the major clinical signs of HIV infected and AIDS patients with parasitic infection being part of the common causes of morbidity and mortality. Objectives: This was a cross-sectional study to determine the sero-prevalence of serum antibodies to three parasitic infections namely Entamoeba histolytica, Schistosoma sp. and Toxoplasma gondii, which are opportunistic infections among HIV/AIDS patients. Methods: One thousand and eighty patients that attended three healthcare institutions in Lagos were recruited for the study through convenience sampling method. Venous blood was collected from the recruited patients and screened for HIV infection as well as the presence of serum antibodies to three parasitic infections. All positive sera samples were confirmed for HIV infection. Result: The results revealed that 65/1080 (6%) of the recruited patients were HIV sero-positive. In addition, 5/65 (7.7%) of the HIV positive patients had E. histolytica co-infection, 1/65 (1.5%) had Schistosoma sp. co-infection while 2/65 (3.1%) had T. gondii co-infection. The results also indicated that the proportion of patients with E. histolytica was significantly higher among HIV sero-positive patients than the sero-negative patients (P = 0.031). Conclusion: The study showed the opportunistic potential of the three parasitic infections among HIV/AIDS patients in the study area. RÉSUMÉ CONTEXTE : Les maladies causées par les pathogènes opportunistes sont les principaux signes cliniques des patients infectés par le VIH et des Patients infectés par le VIH et le SIDA avec les infections parasitaires faisant partie des causes fréquentes de morbidité et de mortalité.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019. It was first reported in Wuhan, China and has since become a global health concern. Keeping in view, the magnitude of the problem, scientists around the globe are working to develop effective therapeutic strategies. This review focuses on previous findings regarding SARS-CoV, which may prove helpful in future research on SARS-CoV-2. In addition, it also highlights recent developments in medicine and biotechnology toward developing effective drugs and vaccines against SARS-CoV-2. This review will analyze available data on this topic and will help researchers develop new thoughts using information already available as a step toward developing novel therapeutic strategies against SARS-CoV-2.

Background: Infections linked to blood transfusion or tissue transplants prove to be a major challenge globally because of the serological window period (WP) and a latent stage exhibited by most viral infections. The objective of this study was to determine the prevalence of anti-HBc antibodies in HBsAg negative donors at Aga Khan University Hospital Nairobi. Methods: The current project was a cross-sectional study in which 76 donor samples that tested negative for HBsAg marker were reevaluated with an anti-HBc ELIA kit (Elecsys reagent kit) following Cobas 601(Roche, Stuttgart, Germany) machine operation manual. Anti-HBc positive samples were confirmed for positivity using polymerase chain reaction (PCR). Donor demography and risk factors such as age; gender, marital status, employment status, and donor type were reviewed and documented from the archived questionnaires. Results: In total, 76 archived samples were screened during the period of the study. The study population had an average age of 32 ± 8 years which male donors dominating at n=61 (79.2 %) and female n=16 (20.8 %). The prevalence rate of anti-HBc Total was 13 % during the period of the study. On further analysis of the 10 anti-HBc positive samples with PCR, there was no detectable HBV-DNA. The majority (63.6 %) of Anti-HBc positive cases were first-time donors and blood donors aged between 25-45 years being the majority. Conclusions: The introduction of anti-HBc as a routine screening tool is recommended to all potential blood donors and even in other medical procedures such as dialysis. These support the need for a duo approach when screening potential donors to rule out occult infection.

The study investigated the genetic relatedness between bovine and human group A
rotaviruses. Ninety four human stool and calf fecal samples (47, each) were
collected from different localities in Egypt and tested by rotavirus group A enzyme
immunoassay. Only twenty five fecal samples (26.5%) were positive. Viral isolation
and RT-PCR amplification of full length VP7 gene was performed for the reacted
fecal samples. VP7 genes were sequenced for one isolate each from diarrheic
human and calf. Human EGY2012 and bovine EGY2022 rotavirus strains displayed
the strongest identity of their VP7 genes [95.3% nucleotide (nt), 97.6% amino acid
(aa)]. The antigenic regions A, B, and C of its VP7 genes were analogue. The high
homology of two studied strains explained the interspecies transmission and its
zoonotic hazard. Further rotavirus P and G genotyping of human and different
animal species are needed to study genetic diversity of human rotaviruses in Egypt

All Coronal viruses such as SARS and MERS and COVID19 enter cells the same way and translate their RNA using the cells translation tools called Ribosomes into viral blue prints called RdRp (RNA Dependent RNA Polymerase) which after a series of other translations leads to complete viral replication and the infection cycle continues until the immune system clears up the virus or the virus overwhelms the infected human host and the host dies due to complications. Zinc has been proven in countless studies to stop the virus from translating its RNA into RdRp, stopping the virus RNA Polymerase activities (mechanism is still not fully understood) leading to the virus failing to complete its replication cycle and ending the infection. Not any zinc however can enter the cell membrane to complete this crucial task. Only a bio-available type pf zinc such as the types found in certain foods can enter the cell cytoplasm, such lipid soluble zincs complexes are called zinc Ionophores. The most effective of Zinc Ionophores are Zinc Picolinate followed by Zinc Glycinate and Zinc Bisglycinate. Other Co-factors that can further increase Zinc transport into cell cytoplasm are Quercetin, Co-Q10 and EGCG. Bio-available alimentary zinc has long been known for its innate monocyte and macrophages immune response modulator and an intra-cellular antiviral agent. Adults with a daily zinc intake of 30-40mg a day will inhibit any viral Coronal RNA translation inside the cells, slowly stopping the viral infection within 7 to 14 days. The following is the zinc and its transporters needed to inhibit viral replication and infection: Zinc: Alimentary Zinc in any combination: 100g of goat meet contains 50%

Tuberculosis (TB) has scourged humankind for millennia, and latent infection affects nearly one-third of today's world population. The emergence of multidrug-resistant (MDR)-TB is a major global threat and reflects treatment failure of drug-sensitive disease. MDR-TB management is a burden for patients and society; success rates are unacceptably low with prolonged treatment duration. Mycobacterium tuberculosis (Mtb) possesses the ability to transform into a dormant state in which it can persist in the face of antimicrobial treatment and host defense. This sub-population of persisters is largely responsible for lengthy and difficult treatment. Targeting persistent bacilli could eventually improve the treatment success rate (currently 50-65 %) and shorten duration of treatment. A subset of therapies in the pipeline, termed therapeutic vaccines, use the host immune response to attack Mtb. The historical occurrence of an exacerbated host response has resulted in a negative perception of therapeutic vaccines. Thus, a renewed concept of immunotherapy is needed. We review current perspectives of immunotherapy in MDR-TB based on the knowledge of TB immunology and briefly discuss the profiles of several therapeutic vaccine products.

Blood is a fluid tissue present in animals with a circulatory system, humans included, it has a red color (the lighter one is arterial, the darker one is venous) and a ferrous taste, due to the presence of the metal in an oxidized form (+2). It performs many essential functions, first of all, the oxygen and nutrients transportation to the body's cells and the parallel removal of carbon dioxide and other metabolites from them...

Good food hygiene ensures that the preparation and preservation of foods are safe for human consumption. It ensures that food is prevented from microbial contamination at the levels of production to consumption. The aim of this study was to determine the microbial content of ready-to-eat cooked food, ready-to-use serving plates and hands of food handlers in six selected restaurants in Okada, Edo State, Nigeria. The samples were aseptically collected from the restaurants and taken to the microbiology laboratory of Igbinedion University, Okada for analysis. The microbial content of the samples was identified by standard microbiological methods. The microorganisms isolated were Enterobacter species, Streptococcus species, Micrococcus species, Bacillus species, Staphylococcus aureus and Saccharomyces species. The total aerobic viable counts, total coliform counts and total Staphylococcus counts in the ready-to-eat cooked food from the six restaurants were 3.67 ± 0.33 × 102 cfu/g - 2.71 ...

Gram positive Bacteria can cause resistant to the antibiotics which are currently available for treating acute bacterial skin and skin structure infections (ABSSSIs) thereby rendering the antibiotics unsafe to use for treatment. The production of new drugs for the treatment of this infection as well as other infections caused by the resistant gram positive organisms is imperative for public health. MRSA is a resistant pathogen of special importance in the clinical setting as it is difficult to treat and easy to spread both in the healthcare settings as well as in the community. The newest antibiotic, Dalvance, is promising. It is as effective as other drug protocols like the combination of vancomycin and linezolid. So far, no resistance has been produced against the drug with over ten years in clinical trials. This review discusses the drug description, indications and usage, side effects, drug interactions and non-clinical toxicology, clinical pharmacology, mechanism of action, pharmacodynamics, pharmacokinetics, microbial efficacy, studies, dosage and administration information, of the new drug Dalvance and its importance in the health care system for the treatment of ABSSSIs.

Despite high vaccine coverage, whooping cough caused by Bordetella pertussis remains one of the most common vaccine-preventable diseases worldwide. Introduction of whole-cell pertussis (wP) vaccines in the 1940s and acellular pertussis (aP) vaccines in 1990s reduced the mortality due to pertussis. Despite induction of both antibody and cell-mediated immune (CMI) responses by aP and wP vaccines, there has been resurgence of pertussis in many countries in recent years. Possible reasons hypothesised for resurgence have ranged from incompliance with the recommended vaccination programmes with the currently used aP vaccine to infection with a resurged clinical isolates characterised by mutations in the virulence factors, resulting in antigenic divergence with vaccine strain, and increased production of pertussis toxin, resulting in dampening of immune responses. While use of these vaccines provide varying degrees of protection against whooping cough, protection against infection and tran...

Background: There are no robust national prevalence of Human Papillomavirus (HPV) genotypes in Nigerian women despite the high burden of cervical cancer morbidity and mortality. The objective of study: This study aims to determine the pooled prevalence and risk factors of genital HPV infection in Nigeria through a systemic review protocol. Methods: Databases including PubMed, Scopus, Google Scholar and AJOL were searched between 10 April to 28 July 2020. HPV studies on Nigerian females and published from April 1999 to March 2019 were included. GRADE was used to assess the quality of evidence. Results: The pooled prevalence of cervical HPV was 20.65% (95%CI: 19.7-21.7). Genotypes 31 (70.8%), 35 (69.9%) and 16 (52.9%) were the most predominant HPV in circulation. Of the six geopolitical zones in Nigeria, northeast had the highest pooled prevalence of HPV infection (48.1%), while the least was in the northwest (6.8%). After multivariate logistic regression, duration (years) of sexual exposure (OR ¼ 3.24, 95%CI: 1.78-9.23]), history of other malignancies (OR ¼ 1.93, 95%CI: 1.03-2.97]), history of sexually transmitted infection (OR ¼ 2.45, 95% CI: 1.31-3.55]), coital frequency per week (OR ¼ 5.11, 95%CI: 3.86-14.29), the status of circumcision of the sexual partner (OR ¼ 2.71, 95%CI: 1.62-9.05), and marital status (OR ¼ 1.72, 95%CI: 1.16-4.72), were significant risk factors of HPV infection (p < 0.05). Irregular menstruation, postcoital bleeding and abdominal vaginal discharge were significantly associated with HPV infection (p < 0.05). Conclusion: HPV prevalence is high in Nigeria and was significantly associated with several associated risk factors. Rapid screening for high-risk HPV genotypes is recommended and multivalent HPV vaccines should be considered for women.

Disseminated tuberculosis can cause a lot of damage to an individual if there is no early diagnosis. In Africa, about 70% of patients with abdominal tuberculosis present with ascites and most of these cases are missed diagnostic cases. The case in question is of a 40 year old women from one of the rural areas of Zimbabwe who had previously presented with severe coughing but had denied sweating at night and the sputum results were negative on screening. After 2 weeks she presented again at the clinic with a swollen abdomen and the X-ray showed flooding of the lungs and difficulty in breathing. Disseminated  tuberculosis  can  cause  a  lot  of  damage  to  an  individual  if  there  is  no  early  diagnosis.  In  Africa,  about  70%  of  patients  with  abdominal  tuberculosis  present  with  ascites  and  most  of  these  cases  are  missed  diagnostic  cases  [1,2].  The  patient  presents with a swollen abdomen containing many litres of straw-coloured fluid. The fluid accumulates as the result of large numbers of  miliary  tubercles  on  the  peritoneum.  The  only  certain  way  to  make  the  diagnosis  is  to  do  a  minilaparotomy  (‘’minilap’),  which  will also enable you to diagnose cirrhosis, peri portal fibrosis (due to Schistosomiasis mansoni), carcinomatosis of the peritoneum and hepatoma  (usually  with  cirrhosis).  Experts  can  usually  diagnose  miliary  tuberculosis  with  their  naked  eyes;  but  even  they  can  be  wrong, so take a biopsy of his parietal peritoneum and/or his liver. [3] The case in question is 40year old women from one of the rural areas  of  Zimbabwe  who  had  previously  presented  with  severe  coughing but had denied sweating at night and the sputum results were negative on screening.

Entamoeba moshkovskii is species of the big genus Entamoeba. This type of parasite rarely causes disease in humans. However, this has been more changed recently. The purpose of the current study was to review all obtainable published data regarding E. moshkovskii infections around the world and provides essential information on the epidemiology, incidence, diagnosis and microbiological information of E. moshkovskii at present, trying to understand if it can be considered as important risk diarrhoeal pathogen. Only studies that depending on polymerase chain reaction as a definitive diagnosis of E. moshkovskii have been included because E. moshkovskii is undistinguished from E. histolytica and E. depress morphologically, so very little information is available concerning the epidemiology and prevalence of E. moshkovskii because few searches have been used molecular diagnostic techniques to identify it. The ability of E. moshkovskii to grow and adapt to the various environmental hard conditions may make its risk of infection higher than the risk of E. histolytica. Reasons beyond E. moshkovskii differentiation from other Entamoeba complexes for stopping dispensable medications in patients infected with nonpathogenic amoebiasis. All E. moshkovskii infections were gastrointestinal tract diseases associated with infectious diarrhea, From available data in this review, E. moshkovskii considered an important and potential risk pathogen with a high rate of residence and prevalence worldwide.

Non-typhoidal salmonellae (NTS) have been associated with invasive disease, notably meningitis, in immunocompromised individuals. Infections of this nature carry high rates of morbidity and mortality. Colistin resistance in salmonellae is a rare finding, more so in an invasive isolate such as cerebrospinal fluid (CSF). Colistin resistance has important infection control implications and failure to manage this phenomenon may lead to the loss of our last line of defence against multi-drug resistant Gram-negative organisms. To our knowledge, this is the first reported clinical case of colistin-resistant Salmonella Enteritidis meningitis in South Africa.

Case presentation: We report a case of a young male patient with advanced human immunodeficiency virus (HIV) infection who presented to hospital with symptoms of meningitis. Cerebrospinal fluid (CSF) cultured a Salmonella Enteritidis strain. Antimicrobial susceptibility testing (AST) of the isolate, revealed the strain to be colistin resistant. Despite early and aggressive antimicrobial therapy, the patient succumbed to the illness after a short stay in hospital. Subsequent genomic analysis of the isolate showed no presence of the mcr genes or resistance-conferring mutations in phoPQ, pmrAB, pmrHFIJKLME/arnBCADTEF, mgrB, and acrAB genes, suggesting the presence of a novel colistin resistance mechanism. Conclusion: Invasive non-typhoidal salmonellae infection should be suspected in patients with advanced immunosuppression who present with clinical features of meningitis. Despite early and appropriate empiric therapy, these infections are commonly associated with adverse outcomes to the patient. Combination therapy with two active anti- Salmonella agents may be a consideration in the future to overcome the high mortality associated with NTS meningitis. Colistin resistance in clinical Salmonella isolates, although a rare finding at present, has significant public health and infection control implications. The causative mechanism of resistance should be sought in all cases.

Background: This study aimed at comparing results of the rapid test strips and ELISA method in the
detection of HBsAg among HIV infected patients.
Methods: The study was a cross sectional in which 180 treatment naïve adult HIV infected patients were
screened for HBsAg using rapid test strips and these were re-tested for HBsAg with ELISA method. The
CD4+T cell counts was performed with Cyflowcounter machine. Interviewer administered questionnaire
technique was adopted in obtaining information about the study participants.
Results: Eighteen (10%) and thirty seven (20.6 %) patients were positive for HBsAg using HBsAg rapid
test strips and HBsAg ELISA kit respectively. The false positive and false negative of the rapid test strips
with ELISA as a gold standard were 11.11 % and 12.96 % respectively. The sensitivity and specificity of
rapid test strips with ELISA as a gold standard were 43.24 % and 98.60 % respectively. About 22(59.5 %)
of those positive for HBsAg with ELISA method were severely immunosuppressed.
Conclusion: Rapid test strips were inferior compared to ELISA in the detection of HBsAg among HIV
infected patients and severe immunosuppression might impair the performance of rapid test strips.
Manufacturing companies need to improve on their rapid test strips. Validation of rapid test strips prior to
their usages should be ensured. WHO and member states should come up with standard protocol for the
screening and diagnosis of HBV infection and there is need to step up HBV immunization strategies.

In a multicenter study a new, fully automated Roche Diagnostics Elecsys® HBsAg II screening assay with improved sensitivity to HBsAg mutant detection was compared to well-established HBsAg tests: AxSYM HBsAg V2 (Abbott), Architect HBsAg (Abbott), Advia Centaur HBsAg (Bayer) Enzygnost HBsAg 5.0 (Dade-Behring), and Vitros Eci HBsAg (Ortho). A total of 16 seroconversion panels, samples of 60 HBsAg native mutants, and 31 HBsAg recombinant mutants, dilution series of NIBSC and PEI standards, 156 HBV positive samples comprising genotypes A to G, 686 preselected HBsAg positive samples from different stages of infection, 3,593 samples from daily routine, and 6,360 unselected blood donations were tested to evaluate the analytical and clinical sensitivity, the detection of mutants, and the specificity of the new assay. Elecsys® HBsAg II showed a statistically significant better sensitivity in seroconversion panels to the compared tests. Fifty-seven out of 60 native mutants and all recombinant mutants were found positive. Among 156 HBV samples with different genotypes and 696 preselected HBsAg positive samples Elecsys® HBsAg II achieved a sensitivity of 100%. The lower detection limit for NIBSC standard was calculated to be 0.025 IU/ml and for the PEI standards ad and ay it was <0.001 and <0.005 U/ml, respectively. Within 2,724 daily routine specimens and 6.360 unselected blood donations Elecsys® HBsAg II showed a specificity of 99.97 and 99.88%, respectively. In conclusion the new Elecsys HBsAg II shows a high sensitivity for the detection of all stages of HBV infection and HBsAg mutants paired together with a high specificity in blood donors, daily routine samples, and potentially interfering sera.