Chukwudi Umenzekwe

BACKGROUND: We describe clinicoepidemiologic characteristics of mpox-chickenpox coinfection in Nigeria. METHODS: A retrospective cohort analysis was performed of confirmed mpox cases in Nigeria from January 2022 to March 2023. Mpox and chickenpox were confirmed by real-time polymerase chain reaction (RT-PCR). RESULTS: Of 94 (60.0%) suspected cases, 56 had confirmed mpox, of whom 16 (28.6%) had chickenpox coinfection. The median age of confirmed mpox cases was 29 years (interquartile range, 20-37 years), 24 were men (60.7%), 6 (10.7%) were bisexual, and 5 (8.9%) died. Mpox-chickenpox-coinfected patients had more complications than mpox-monoinfected cases (56.3% vs 22.5%, P = .015). CONCLUSIONS: The high frequency of mpox-chickenpox coinfection argues for accelerated access to mpox and chickenpox vaccines in Africa.

Background: Multidrug resistant bacteria have become a major public health concern worldwide. Inappropriate and overuse of antibiotics are known promoters of antibiotic resistance. This study was therefore carried out to assess healthcare workers’ knowledge, attitude, and practice on antibiotic use and resistance. Materials and Methods: A descriptive cross-sectional study was conducted among healthcare workers from University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. A self-administered questionnaire was used to assess the knowledge, attitude, and practice of antibiotic use and resistance. Descriptive and inferential analyses were subjected on the data. Results: A total of 600 healthcare workers were surveyed with male: female ratio of 1:2.2. The mean age of the participants was 39.6±25.6 years. The level of knowledge was 58.8%, followed by attitude (49.1%) and practice (24.3%). The knowledge on super bugs (40.3%) and carbapenem-resistant Enterobacteriaceae (37.3%) was the least on resistant organisms surveyed. The main source of information was internet with the least being television/newspaper. Slightly less than half, (287/600, 47.8%) always do laboratory investigations before commencing antibiotics and (373/600, 62.2%) will stop taking antibiotics when their symptoms improve without completing the dosage. Majority of the participants (91.2%) indicated that healthcare workers are at risk of acquiring the antimicrobial-resistant organisms; however, only 67.7% believed that UNTH has the same problem. Conclusion: The knowledge, attitude, and practice of healthcare workers on antibiotic use and resistance were not encouraging. Greater educational interventions are, therefore, necessary to improve public awareness and develop behavioral measures to curb the spread of the resistant organisms.

A study on malaria infection prevalence and haematological profiles of nursery and primary school pupils aged 0 – 14 years old was conducted in three selected primary schools in Fegge, Onitsha South Local Government Area, Anambra State. Three hundred and sixty (360) pupils were randomly selected from the schools and 2ml of venous blood was collected by venipuncture. Thick and thin blood films were made and stained with Field’s stain A and B. Haematological profiles such as Haemoglobin, White Blood Cell Count, Mean Corpuscular Haemoglobin (Hb) Concentration and Erythrocyte Sedimentation Rate were determined using the anticoagulated blood samples. Of the 360 blood samples examined, 342 (95.0%) comprising 170 (47.22%) males and 172 (47.78%) females were positive for Plasmodium falciparum across the three primary schools. Differences in malaria prevalence among the schools and gender was not statistically significant (P>0.05). Pupils within the age group 3 - 5 and 6 - 8 years recorded the highest infection rate of 118 (96.72%) and 102 (96.22%) respectively which was not statistically significant (P>0.05). The highest percentage of the pupils 10 (55.6%) with heavy malaria intensity had their haemoglobin levels within the lower normal range of 11.0 – 11.9g/dl. There were significant and no significant differences in the haematological profiles of the pupils – Haemoglobin and Packed Cell Volume (P<0.05) indicating mild anaemia, while White Blood Cell Counts (P>0.05) indicates mild leukopenia and for Erythrocyte Sedimentation Rate (P>0.05). The study showed that malaria is holoendemic in Fegge area of Onitsha and poses a significant health problem for the children in the study area. Improved health education in the schools on preventive measures for malaria transmission including integrated vector control to reduce vector-man is recommended.

Introduction Lassa fever (LF) is an acute viral haemorrhagic fever (VHF) endemic to parts of West Africa. Multi-organ failure is a frequent cause of death in patients hospitalized with LF. This study determined the prevalence, types, and determinants of organ failure among adult patients with confirmed LF managed at the Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Ebonyi State, Nigeria. Methods This hospital-based, cross-sectional study enrolled adults (≥ 18 years) with real-time polymerase chain reaction (RT-PCR) confirmed LF from October 2022 to April 2023 at AEFUTHA. Data were collected using a modified Nigeria Centre for Disease Control and Prevention (NCDC) VHF case investigation form, including socio-demographics, medical history, and laboratory tests. Logistic regression models were used to assess the determinants of organ failure and in-hospital all-cause mortality. Results Sixty adult patients were enrolled, with a mean age of 35.2 years (range: 18–62), and 73.3% (44) were males. Organ failure occurred in 50% (30) of cases, with acute kidney injury, AKI (33.3%), central nervous system dysfunction (25%), and liver failure (20%) being most frequent. Multi-organ failure was seen in 33.3% (20) of participants. In-hospital mortality was recorded in 25% (15) of participants. Duration of hospital stay was comparable between patients with organ failure (10 days, IQR=15.00) and those without organ failure (10.5 days, IQR=6.00), p= 0.35. Elevated urea levels (AOR 1.44, 95% C.I.: 1.04 – 2.05) and GCS <13 (AOR: 0.23, 95% C.I.: 0.06 – 0.81) predicted organ failure. In-hospital mortality was independently associated with respiratory failure (AOR 8.88, 95%CI: 1.77 – 44.41) and AKI (AOR 20.00, 95%CI:4.09 – 97.81). Conclusion Our LF cohort experienced a high frequency of organ failure, with respiratory failure and AKI independently predictive of mortality. Treatment outcome of hospitalized LF patients can potentially be improved through early, targeted monitoring and support of organ function.