Open Access Review Article

A Review on Laboratory Diagnosis of Mycobacterium tuberculosis

Mercy Okon Ekong

Asian Journal of Research in Infectious Diseases, Page 1-7
DOI: 10.9734/ajrid/2019/v2i430110

Tuberculosis remains the major public health concern worldwide responsible for about 1.6 million deaths and 0.3 million co-infected with Human immunodeficiency virus (HIV) annually. Mycobacterium is the causative agent of tuberculosis infection and is transmitted principally through air when an infected person coughs, talks, sneezes etc. This infection can be diagnosed using different Microbiological, Molecular and Immunological techniques including, sputum smear microscopy, sputum culture, nucleic-acid amplification test (NAAT), genotyping assay, tuberculin skin test (TST), interferon-gamma release assay (IGRAs) etc. These techniques vary in sensitivity and specificity as well as the ease with which they are carried out. World Health Organisation (WHO) encourages the use of techniques that are sensitive, patient-friendly, and those which produce accurate results in any clinical setting world-wide. Hence, this review highlights smear microscopy and incorporation of more rapid and sensitive diagnostic techniques such as Gene Xpert, IGRAs and urinary antigen analysis in clinical setting in the detection of Mycobacterium. These techniques show high sensitivity, are less time consuming do not require a repeat for a single result,  some are able to differentiate latent and active TB infections, and have the capacity to be  used to screen people unable to expectorate. This review encourages the incorporation of smear microscopy, GeneXpert, IGRAs, urinary antigen analysis into routine laboratory diagnosis especially in high TB burden countries. It is believed that high level of sensitivity and less time used in producing results display by these techniques will yield reduction in mortality rate, decline in static nature of TB status and possibly zero TB 2020 proposed by WHO.

Open Access Original Research Article

Activities of Some Ethnobotanicals from North East Nigeria, against Culicine Mosquitoes

J. S. Ngwamah, R. S. Naphtali

Asian Journal of Research in Infectious Diseases, Page 1-11
DOI: 10.9734/ajrid/2019/v2i430108

Mosquito borne diseases are the major cause of economic loss due to high morbidity and mortality in Africa. Elimination of culicine vectors using ethnobotanical extracts is one of the best methods for controlling mosquito-borne diseases. The methanolic and petroleum ether extracts of five plants, Azadirachta indica (neem), Hyptis suaveolens (bush tea), Eucarlyptus globulus (pole wire), Citrus senensis (orange), and Ocimumkilimanscharicum (bush scent leaf), were investigated for their effectiveness in control of subfamilies Culicidae mosquitoes’ larvae from June 2017 to October 2017. The results showed that the mortality is concentration dependent. Mortality was recorded for both methanol and petroleum ether extracts. Higher mortalities were observed in the methanolic extracts than petroleum ether extracts. The different plant extracts showed high significant differences (p< 0.05) to each other. Hyptis suaveolens proved to be the most effective treatment agent with 100% mortality observed at both 150 ppm and 200 ppm. The present study has demonstrated larvicidal effects, and the effects were extended pupae emerged from the different treatment which led to the low adult emergence as compared to the control.

Open Access Original Research Article

Assessing Five Years of Management of Accidental Exposure to Blood at Gao Hospital, Mali

Y. Cissoko, L. N. Sidibé, J. P. Dembele, A. A. Oumar, A. Traoré, A. Samaké, A. A. Maïga, L. Diabira, D. Diarra, S. Dao

Asian Journal of Research in Infectious Diseases, Page 1-7
DOI: 10.9734/ajrid/2019/v2i430111

Accidental exposure to blood (AEB) constitutes a risk of transmission of blood-borne viruses including HIV, hepatitis B and hepatitis C virus especially amongst health workers. This study aims to describe accidental exposure to blood and post exposure management five years after it begin at the Hospital of Gao, since 2012 there is insurrection in this area making difficult to maintain health care system. This study will help to identify gaps to fill in order to improve the prevention of blood borne pathogen infection in this hospital.

All cases of AEB declared at the Hospital from January 1st 2007 to December 31, 2011 have been enrolled. The sociodemographic profile of victims, the circumstances of the accident, the post exposure management and the follow up of subject have been registered. Data were entered and analyzed with the SPSS software. Chi square test was used with the level of significance p<0.05.

During the 60 months of the study, an average of 124 workers were employed at the Hospital of Gao and 15 cases of accidental blood exposure were declared equal to an incidence density of 4.2 cases per 100 persons per year. Males were the most affected (60%). Nurses and lab technicians represent the majority of victims (53.3%). The most frequent type of accident was the injury by cannula needle sticks during intravenous injections (73.3%). Most of the cases received High Activity Antiretroviral Therapy (HAART) within a mean delay of 25 Hours from the accident, and the regiment (AZT/3TC/LPV/r) is predominantly used. HIV serology was done in 53.3% of subjects and revealed 1 positive case. Initial blood tests in all victims were normal. The HAART observance was worst among medical doctors (p < 0.001). No contaminations by HIV were detected after 6 months of follow up.

The frequency of declared accidental exposures to blood at the Hospital of Gao is low. The post exposure management is facing a problem of observance of the treatment whenever it shows efficacy in all cases.

Open Access Original Research Article

Seasonal Influenza Incidence in India: A Retrospective Study Based on Multiple Indian Hospital and Diagnostic Laboratory Centre

Dinesh Jain, Manmohan Singh, Sandeep Budhiraja, Bansidhar Tarai, Sukanya Ghildiyal

Asian Journal of Research in Infectious Diseases, Page 1-12
DOI: 10.9734/ajrid/2019/v2i430112

The objective of the study is to understand the seasonal variation in influenza incidence across multiple Indian states by using diagnostic laboratories data of influenza.

Materials and Methods: Diagnostic laboratory-based data of subjects who were tested for influenza between 1st January April 2014 to December 2017 across seven Indian states were analysed. In diagnostic laboratories of Maharashtra, Delhi, Uttar Pradesh, Haryana, and Rajasthan RT-PCR was used for detection of H1N1 and laboratories of Tamil Nadu used GeneXpert along with RT-PCR. A total sample size of 10,755 was used in the descriptive observational retrospective study.

Results: In case of H1N1, sample population had almost equal male and female proportion (5172) with 36.5 years mean age. In majority of states, >3-5 years age group had the highest positivity rate. Paediatric age group (0-18 years) contributed 25% of total H1N1 burden, while older adults (>60 years) contributed 15% of the total sample. The yearly trends showed a higher incidence rate of H1N1 in 2015, followed by a decline during 2016 and a surge in 2017. Monthly trends showed consistent rise in H1N1 positivity rate during early months (January, February, and March) of 2015, 2016 and 2017. For influenza B, paediatric age group (0-18 years) showed the highest positivity rate and contributed almost 40% of total influenza ‘B’ burden.

Conclusion: This study highlights the importance of big data-based analytics and its use in understanding the epidemiological behaviour of diseases like influenza. Insight by leveraging laboratories data, like in the case of current research study, gives demographic patterns of influenza in terms of age, gender, seasons, and regions/states.

Open Access Original Research Article

Prevalence of Mycobacterium tuberculosis and Its Rifampicin Resistance among Patients Attending General Hospital Mararaba as a Case Study

B. A. Ajide, M. M. Igbabul, O. I. Kanyi

Asian Journal of Research in Infectious Diseases, Page 1-10
DOI: 10.9734/ajrid/2019/v2i430113

Aims: To determine the prevalence of Mycobacterium tuberculosis and its Rifampicin resistance among patients attending General Hospital, Mararaba.

Study Design: This was a descriptive health-based research that involved clinically suspected tuberculosis patients whose sputum samples were referred to General Hospital Mararaba for diagnosis.

Place and Duration of Study: Department of tuberculosis, General Hospital Mararaba Nasarawa state between May to July 2019.

Methodology: A total of 100 suspected TB patients of both male and female were included in the study. Two sputum samples from each patient were collected from these patients with sputum containers and samples were processed under level 3 biosafety cabinet by mixing with the reagent that was provided with the assay following manufacturer’s manual and thereafter, the cartridge containing this mixture was placed in the Gene Xpert machine. The processing of the sample is fully automated and takes less than two hours.

Results: An overall prevalence of 21.5% was recorded for Mycobacterium tuberculosis with a rifampicin resistance rate of 65.11% among positive patients. The highest prevalence of infection was observed among the age group of above 40 years (40.0%), males (23.9%), self-employed people (25.6%), those living in a rural environment (31.8%) and those with informal education (35.7%). There was no statistically significant relationship between the prevalence of MTB to sex, marital status, education, employment and ethnicity (P>0.05). Environment factor was however significant (p<0.05). Highest frequency for rifampicin resistance was recorded in the age group 20-29(39.2%), (64.28%) in males, rural areas (57.14%), self-employed persons (57.14%) and single people (50.0%). Age about rifampicin resistance was significant (p<0.05) while sex, occupation, environment and rural areas were not significant (p>0.05).

Conclusion: It was concluded that Mycobacterium tuberculosis and its Rif-resistance amongst patients attending General Hospital, Mararaba is comparatively high and indicative of the rate at which tuberculosis and drug resistance is still resilient despite various methods put in place to control it.

Open Access Original Research Article

Eosinopenia Associated with Infection is an Independent Risk Factor for 28-day Mortality in Staphylococcus aureus Bloodstream Infection

Chunxia Zhou, Jing Sun, Fengqin Xu, Shanping Jiang

Asian Journal of Research in Infectious Diseases, Page 1-9
DOI: 10.9734/ajrid/2019/v2i430114

Aims: This retrospective study aimed to evaluate the impact of eosinopenia on 28-day mortality in Staphylococcus aureus bloodstream infection (SABSI). 

Methods:  A retrospective study was designed to evaluate the impact of eosinopenia on 28-day mortality in SABSI.

Results: Patients who were ≥16 years old with SABSI at Sun Yat-Sen Memorial Hospital between January 1st 2014 and December 31st 2018 were included. The overall 28-day mortality of all patients was 14.3% (44 out of 307). Patients with eosinopenia in the onset of SABSI had a significantly higher 28-day mortality than those without eosinopenia (22.4% vs 6.5%; P<0.01). For patients who developed SABSI after the first 48 hours in the hospital, eosinophils decreased significantly from the baseline (P<0.01). Kaplan–Meier survival curve showed that patients with eosinopenia had a lower survival rate than those without eosinopenia (P<0.01). Multivariate Cox regression analysis revealed that eosinophils in the onset of SABSI were associated independently with 28-day mortality (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.36–5.91; P<0.01).

Conclusion: Eosinopenia associated with infection might be an independent risk factor for 28-day mortality in SABSI.

Open Access Minireview Article

Newly Emerging Candida Specie: Should Clinicians and Mycologist be Concerned?

O. F. Ashcroft, A. S. Kumurya, K. Mohammed, M. U. Iduh, A. A. Yusuf, N. M. Bunza, S. U. Nataala

Asian Journal of Research in Infectious Diseases, Page 1-7
DOI: 10.9734/ajrid/2019/v2i430109

The emergence of C. auris as a global nosocomial pathogen associated with multidrug resistance and high mortality rates has been recently discovered. This emerging pathogen appears to be far more able to induce systemic infection and mortality than other potential multi drug resistance (MDR) yeast pathogens even though it is found to have reduced virulence factors compared to C. albicans. There are issues with regard to the identification of C. auris using both phenotypic and molecular techniques; this has raised concerns about detecting the true scale of the problem. This mini- review elucidates on the literature available on C. auris and highlights the mechanism of pathogenesis and antifungal resistance, which will give further direction to extensive research in this field.

Open Access Case Study

Corynebacterium Diphtheriae: A Case Report of Some Isolates in National Ear Care Centre Kaduna

Maryam Ibrahim Rimi, Isaac Agyigraa, Kelechi N. Nkwazema, Abubakar Yakubu Jajere, Astaharam Ardo Jabbo, Sumayya Ibrahim Ango, Muhammad Kabir

Asian Journal of Research in Infectious Diseases, Page 1-15
DOI: 10.9734/ajrid/2019/v2i430115

This is a case study of the incidence of diphtheria in National Ear Care Centre Kaduna. Samples included all patients presented with diphtheria symptoms referred to the hospital from October to December; 2018. A total of 8 patients were referred and several samples taken for laboratory investigations. 8 throat swabs were collected for organism isolation by inoculation on some certain agars, incubation, secondary gram and microscopy; colonies appeared to be biconcave, large and whitish. Microscopy revealed characteristic Chinese lettered, pleomorphic bacillus which are features of Corynebacterium diphtheriae. Blood samples were used for urea and creatinine estimation which yielded abnormal high values in all except the creatinine of one of the samples indicating kidney impairment which could be attributed to presence of the tox gene. To further confirm the incidence of the disease; one throat swab was saved at 4°C for molecular confirmation and characterisation of the gene. It was then transported to Molecular laboratory and the DNA extracted using the phenol/chloroform extraction method. Both the A and B subunits of the tox gene were amplified from the DNA extract at 248bp and 297bp respectively. Sanger’s Dye Terminator Cycle Sequencing (DTCS) of both the subunits of the tox gene was carried out and the sequences were obtained and converted to the fasta format using a Finch TV for bioinformatics analyses using the NCBI blast tool. The A and B subunits showed a percentage identity of 99.59% and 95.57% to Corynebacterium diphtheriae mitis strain NCTC 3529 genome assembly, chromosome: 1 respectively. The A subunit also showed 99.59% identity to Corynebacterium diphtheriae strain BQ11 chromosome; complete genome while the B subunit also showed 95.57% identity to Corynebacterium diphtheriae mitis strain NCTC 7838 genome assembly chromosome: 1. A mutation was also discovered in the tox genes as indicated by the E-value of 3e-84 and 2e-121 for A and B subunits respectively which are values that are less than 1. This is also confirmed by 5 gaps noticed from the blast results (4 gaps from A and 1 from B) indicating the presence of indels. In conclusion; there are confirmed incidences and sporadic cases of diphtheria in Kaduna State and the organism is said to have mutated.