Asian Journal of Research in Infectious Diseases

Assessment of Hepatitis B Serological Markers in Patients at the Medical Biology Laboratory of the National Hospital of Niamey

Daou M. — 2025-10-08

Objective: To assess the epidemiological and serological characteristics of hepatitis B among patients attending the Medical Biology Laboratory of the National Hospital of Niamey.

Study Design: This was a cross-sectional descriptive study with an analytical purpose.

Place and Duration of Study: conducted from April 1 to October 1, 2024 at the biology laboratory of the National Hospital of Niamey.

Methodology: All compliant specimens received for a hepatitis B test were included. Serological markers (HBsAg, HBeAg, AcHBc, AcHBe, AcHBs, AcHCV), HBV viral load and HIV status were analyzed. Techniques used included immunochromatography (rapid tests), chemiluminescence (COBAS 6000), and real-time PCR (COBAS 4800). The data was collected via a pre-established sheet, then entered and analysed with Epi Info 7. Ethical authorizations have been obtained, and the anonymity of patients has been respected.

Results: 1252 samples were identified. The patients were mostly male in 59% of cases with a sex ratio of 1.45. The mean age was 31.32 years with extremes ranging from 1 to 98 years. The requests were external in 89.80% of cases, the Chirurgue was the in-house prescribing service in 56.69% of cases. The reason for the request was a preoperative check-up in 44.73% of cases and HBsAg was positive in 17.41% of cases, positive patients were male in 9.89% of cases and the age groups of 21-31, 32-42 years were the most common in 4.64% and 4.28% of cases, respectively. HBsAc and HBeAc were positive in 7.41% and 34.64% of cases, respectively. HBeAg and HBeAg were positive in 7.35% and 75.44% of cases, respectively. The viral load was detectable in 80% of cases, and was less than 2000IU/mL in 56% of cases. HCVAC was positive in 1.61% of cases. HIV serology was positive in 0.85% of cases and in 0.32% of cases, there was an HIV-HBsAg association.

Conclusion: Hepatitis B remains a major public health problem, with a significant prevalence in our context.

Assessment of Knowledge, Attitudes and Practices on Prevention of Accidental Exposure to Blood and Body Fluids in the Context of Infection Prevention and Control in Private Health Facilities in Dakar (Senegal)

Agbogbenkou Tevi Dela-dem Lawson — 2025-09-27

Introduction: Prevention of Accidental exposure to blood and body fluids (AEB) is a key component of infection prevention and control (IPC) strategies. According the World Health Organization (WHO), approximately 3 million healthcare professionals are exposed to needlestick injuries each year, resulting in 37% of hepatitis B cases, 39% of hepatitis C cases and 4.4% of HIV infections among these worked. In Africa figures are likely higher than reported due to probable underreporting. Such incidents pose a significant occupational risk to healthcare workers, particularly in resource-limited settings. This study aimed to evaluate the knowledge, attitudes, and practices of healthcare staff regarding Accidental exposure to blood and body fluids in private Catholic healthcare facilities.

Materials and Methods: We conducted a cross-sectional, observational, descriptive study from March 25 to June 6, 2024, in nine private Catholic healthcare establishments. The study was carried out in two phases: (1) a self-administered questionnaire and (2) an audit through direct observation. Data were entered into Microsoft Excel 2013 and analysed using SPSS version 22. Ethical principles were respected throughout the study.

Results: A total of 64 healthcare workers were surveyed, and 75 were observed. The majority were female (73.4%), with a median age of 38 years (range: 26–67) and a mean professional seniority of 10.2 ± 9.5 years. Nurses (45.3%), nursing assistants (12.5%), and laboratory technicians (10.9%) were the most represented categories.

Overall, 79.7% of respondents were aware of accidental exposure to blood, and 40.6% had experienced at least one accidental exposure to blood and body fluids, with a reporting rate of 42.3%. The most feared infections were HIV (89.1%), hepatitis B (84.3%), and hepatitis C (35.4%). Needle recapping after intravenous or intramuscular injection was reported by 43.8% of respondents.

Of the 48 sharps containers observed, 64.5% were clean, 68.7% were appropriate for use, and 70.8% complied with recommended filling levels.

Conclusion: Although accidental exposure to blood and body fluids is widely recognised among healthcare workers, it remains frequent and underreported. Strengthening preventive measures, improving adherence to safe injection practices, and promoting systematic reporting are essential to reducing the risk of occupational exposure.

Prognostic Assessment of Tetanus in Cases of Bacterial Entry Portal Identified, Bamako, Mali

Traoré Abdoulaye Mamadou — 2025-10-09

Objective: To determine the main types of tetanogenic bacterial portals of entry and assess their involvement in the prognostic and evolutionary factors of tetanus.

Methodology: We carried out a descriptive and analytical cross-sectional study with retrospective data collection at Point-G University Hospital over a period of 22 years. Our study population was made up of tetanus patients whose bacterial portals of entry were sought and found or not found upon admission.

Results: The hospital prevalence of tetanus was 5% of admissions. The portal of entry (POE) was found in 217 cases (84.10%). The most common bacterial portals of entry found (BPOEF) were skin and mucosal wounds (65.4%), open fractures (10.6%), skin lesions (7.8%) and deep wounds (7.4%). The most common anatomical sites were the pelvic limbs (62.2%), thoracic limbs (26.3%), head (5.5%) and uterus (2%). The comorbidities associated with the death were dominated by hypertension (50%), malaria (28.6%), and one case of epilepsy, with (p=0.96) compared to the survivors with comorbidities. The POEs as variable dependent of the Dakar score were: 22 POEs due to open fractures, 6 POEs following surgery, 4 POEs after IM injections, 4 POEs due to uterine invasion, and 2 POEs following burns. Dakar scores 2 and 3 were predominantly recorded in cases of BPOEF respectively 48.8% and 31.8%. Specifically, 41.5% of deaths were recorded in patients with BPOEF versus patients BPOE-NF (46.3%) with p=0.77. The mortality in the group with POEs as variable dependent of tetanus risk factors was 42.1% versus 42.5% in the group with POEs as variable independent of risk factors. The Dakar poor prognosis scores were higher in patients whose BPOEF, with a statistically significant difference (p=0.043).

Conclusion: Tetanus continues to be seen despite the availability of effective preventative measures. Given the multitude of comorbidities and the associated significant mortality rate, there would need to be a review of the prognostic factors for tetanus in healthcare settings.

Factors Influencing Immunological Response in HIV Patients after Twelve Months of Antiretroviral Therapy in Dakar

Ndeye Aissatou Lakhe — 2025-10-13

Introduction: The objective of this study was to examine the factors associated with the immunological response in patients living with HIV (PLHIV) following 12 months of antiretroviral therapy (ART).

Patients and Methods: This was a descriptive-analytical study conducted from 2012 to 2018 in PLHIV followed at SMIT/CRCF of Fann hospital. To identify factors associated with CD4 delta (CD4 at M12 - CD4 at M0), univariate and multivariate linear regression were conducted. A significance threshold of 5% was established.

Results: A total of 213 cases were collected, the mean age of the participants was 38 ± 11 years, and the sex ratio was 0.6. The most common comorbidities were diabetes (0.9%) and high blood pressure hypertension (6.1%). A total of 2.3% of patients were identified as having a history of injecting drug use. Patients were diagnosed with advanced HIV disease in 62.9% of cases. At the time of inclusion, the most common co-infections were hepatitis B (13.14%) and tuberculosis (13.6%). The mean difference between M0 and M12 was 197.8 (95% CI: 174.4; 221.3; p<0.001). In the univariate analysis, younger age (p < 0.02), the absence of HBV co-infection (p = 0.01), and therapeutic adherence (p < 0.01) were found to be associated with an increase in TCD4+ lymphocytes. After multivariate linear regression, age (β=-2.64; p=0.018) and adherence (β=188; p=0.001) were found to be independently associated with CD4 delta.

Conclusion: Advancing age and poor adherence to ART are independent predictors of suboptimal immunological recovery among HIV-infected individuals. Tailored interventions targeting adherence support and age-related factors are needed in our settings to enhance immunological response and long-term prognosis.

Effects of Nigella sativa Aqueous Seed Extract on Larval Stages of Schistosoma haematobium

Ogochukwu L. Obealor — 2025-10-24

Aims: To determine the lethal effect of Nigella sativa seed extract concentrations on the egg viability and cercaria infectivity of Shistosoma haematobium in Nkalagu, Ishielu Local government area of Ebonyi State, Nigeria.

Study Design: The study was carried out using standard parasitological and malacological techniques. Snail hosts were picked from waterbodies in the study sites for cercaria shedding, viability and potency for transmission while urine samples were collected from pupils in sampled schools closely located near the water bodies.

Methodology: The urine samples were screened for the eggs of Schistosoma haematobium. Eggs and viable cercaria of S. haematobium extracted, were tested to determine the lethal effects of Nigella sativa (N. sativa) aqueous seed extract.

Results: The egg viability test for Schistosoma haematobium showed that there was a statistical difference in the number of viable, calcified, and resistant eggs tested (p < 0.05) but recorded a significant difference at different time durations (p > 0.05). High morphological and tegumental changes in eggs of S. haematobium occurred at high concentrations and more extended periods of exposure to N. sativa aqueous seed extract. The reverse was observed at lower concentrations and shorter periods of exposure to the extract. This was the same case with cercaria upon exposure to N. sativa aqueous seed extract. The result also revealed that difference in mortality was statistically significant (p < 0.05) at different concentrations but not with time (p < 0.05) at various percentage dilutions.

Conclusion: The current result on the cercaricidal activity of N. sativa suggests that this plant has a potential inhibitory effect on Schistosoma parasites and intermediate snail hosts. Therefore, there is a need for public awareness programs on the use of N. sativa seed due to its antiparasitic properties and its relevance against urinary schistosomiasis infection in endemic communities.

A Dynamic Clinical Prediction Model to Stratify the Risk of Preventable Drug-related Incidents in Infectious Diseases Ward Patients

Eduardo Corsino Freire — 2025-10-25

Background: Preventable drug-related incidents (PDRIs) remain a major challenge in patient safety, particularly among adults hospitalized with infectious diseases, where complex pharmacotherapy and frequent clinical changes increase the likelihood of harm. This study aimed to develop and validate a clinical prediction model to estimate the risk of PDRIs and support early, pharmacist-led interventions.

Methods: A prospective cohort study was conducted among adult inpatients admitted to the infectious disease ward of a tertiary teaching hospital. Data were collected over nine months, from June 2019 to March 2020, and the study was concluded earlier than planned due to restrictions imposed by the COVID-19 pandemic. Information regarding demographic, clinical, and pharmacotherapeutic characteristics, as well as the quality of medication conciliation, was recorded. The model was developed using multivariate logistic regression and internally validated through cross-validation techniques.

Results: A total of 212 patients were included. The incidence of PDRIs was high, especially among those with prolonged hospitalization and multiple comorbidities. Independent predictors of PDRI included the number of medications, the presence of comorbidities, infectious diagnosis, and the quality of medication conciliation. Notably, conciliation performed by non-pharmacists was associated with a significantly higher risk of PDRI compared with pharmacist-led conciliation.

Conclusion: The proposed model provides a practical and reliable tool to dynamically stratify PDRI risk throughout hospitalization. Its implementation may enhance the ability of clinical pharmacists to prioritize high-risk patients, enabling earlier interventions and contributing to safer and more efficient pharmacotherapy in infectious disease wards.

A Hypercoagulable Triad in a Young Woman: Pulmonary Embolism Revealing Pulmonary Tuberculosis with Triple-Positive Antiphospholipid Syndrome and Protein S Deficiency, Senegal

Mouhamed AlMakhy Niang — 2025-10-07

Introduction: Unprovoked pulmonary embolism (PE) in a young adult mandates a search for prothrombotic etiologies - chief among them acquired thrombophilias, antiphospholipid syndrome (APS), and, in tropical settings, tuberculosis (TB).

Observation: We report a 39-year-old woman with weight loss and fever, presenting with acute basal chest pain on a background of prolonged cough. CT pulmonary angiography diagnosed distal PE, and Xpert MTB/RIF confirmed pulmonary TB. Work-up identified triple-positive APS associated with protein S deficiency. Management combined standard anti-tuberculosis therapy (RHZE) and vitamin K antagonist (VKA) anticoagulation, with close INR monitoring due to drug–drug interactions.

Discussion: TB triples the risk of VTE/PE ; in triple-positive APS, direct oral anticoagulants (DOACs) are discouraged in favor of VKAs per international recommendations. Rifampicin, a strong inducer, reduces the effectiveness of both DOACs and VKAs, necessitating dose adjustments and tight monitoring. Protein S deficiency may be constitutional or acquired (inflammation, TB, pregnancy, VKAs) and must be re-confirmed away from the acute phase and off VKA.

Conclusion: In apparently “unprovoked” PE in TB-endemic regions, TB and APS should be actively sought. In APS receiving rifampicin, VKAs remain the reference strategy with rigorous bio-clinical follow-up.

Cytomegalovirus-induced Severe Aregenerative Autoimmune Hemolytic Anemia in an Immunocompetent Patient

Chaïmaâ Zeroual — 2025-10-14

Background: While cytomegalovirus (CMV) infection is usually benign in immunocompetent adults, it can exceptionally trigger severe hematological autoimmunity.

Case Presentation: We report the case of a 41-year-old immunocompetent woman admitted with profound symptomatic anemia (Hb 1.9 g/dL). Laboratory findings showed positive direct antiglobulin test and marked aregenerative anemia. Bone marrow biopsy excluded malignant or aplastic processes. CMV serology confirmed acute primary infection,and the patient was initially treated with red blood cell transfusions associated with antiviral therapy. Corticosteroids were added afterwards. Clinical evolution was favorable, with complete clinical and hematologic recovery.

Conclusion: CMV-induced anemia, although exceptional in immunocompetent adults, should be recognized as a potential diagnostic challenge in acute severe anemia. This case highlights the need for greater awareness among clinicians and for future research to establish standardized therapeutic strategies and evaluate the long-term autoimmune implications of CMV infection.