Abimbola Olaitan

To investigate epidemiology of and risk factors for laboratory-confirmed mpox during the 2022 outbreak in Nigeria, we enrolled 265 persons with suspected mpox. A total of 163 (61.5%) were confirmed to have mpox; 137 (84.0%) were adults, 112 (68.7%) male, 143 (87.7%) urban/semi-urban dwellers, 12 (7.4%) self-reported gay men, and 3 (1.8%) female sex workers. Significant risk factors for adults were sexual and nonsexual contact with persons who had mpox, as well as risky sexual behavior. For children, risk factors were close contact with an mpox-positive person and prior animal exposure. Odds of being mpox positive were higher for adults with HIV and lower for those co-infected with varicella zoster virus (VZV). No children were HIV-seropositive; odds of being mpox positive were higher for children with VZV infection. Our findings indicate mpox affects primarily adults in Nigeria, partially driven by sexual activity; childhood cases were driven by close contact, animal exposure, and VZV co-infection.

Background and objectives: The optimal iron hypothesis (OIH) posits that risk for infection is lowest at a mild level of iron deficiency. The extent to which this protection results from arms race dynamics in the evolution of iron acquisition and sequestration mechanisms is unclear. We evaluated the OIH with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an emerging infectious agent. Methodology: We tested 304 healthcare workers at baseline for iron deficiency (zinc protoporphyrin:heme), anemia (hemoglobin), and SARS-CoV-2 (salivary PCR), and followed them for ~3 months with biweekly SARS-CoV-2 tests. We fit logistic regression models based on Akaike Information Criterion. Results: Adequate data were available for 199 participants. Iron replete (OR: 2.87, 95% CI: 0.85, 9.75) and anemia (OR: 2.48; 95% CI: 0.82, 7.85) were associated with higher risk for SARS-CoV-2 infection after control for covariates. Logistic regression and Cox proportional hazards models of the SARS-CoV-2 outcome were similar. Anemia (OR: 1.81; 95% CI: 0.88, 3.71) was associated with respiratory symptoms regardless of SARS-CoV-2 infection. Conclusions and implications: These findings provide partial support for the OIH: SARS-CoV-2 infection risk was elevated at the high end of the range of iron availability; however, the elevated risk among those with anemia was not, as expected, specific to severe iron deficiency. Narrowly, for COVID-19 epidemiology, these findings accord with evidence that SARS-CoV-2's ability to establish infection is enhanced by access to iron. More broadly, these findings suggest that the OIH does not hinge on a long history of evolutionary arms race dynamics in access to host iron.

A bstract Persons living with human immunodeficiency virus (HIV) are susceptible to intracranial lesions. A 54-year-old woman with HIV presented with a 6-month history of severe headaches and left-sided weakness of 2 months. Her condition deteriorated with seizures, speech difficulties, and mood changes. She reported infrequent headaches in the last 6 years. At presentation, she had left hemiplegia, hypertonia, and hyperreflexia. Circulating HIV load was <40 copies/mL, CD 4 count; 902 cells∕mm 3 , Serum toxoplasmosis IgG was positive: 300 IU/L. Brain tissue histology showed refractile funv cocci of variable diameter and thick walls existing singly and in small chains with cystic cavities, granulomatous inflammation with areas of calcific changes, and inflammation suggestive of brain cryptococcoma. Magnetic resonance imaging suggested glioblastoma, cryptococcoma, and radiation necrosis. She failed to respond to liposomal amphotericin-B and high-dose cotrimoxazole, and serial imaging demonstrated progressive typical lesions, leading to definitive diagnosis of glioblastoma. Complexities of patient evaluation in resource-limited settings call for enhanced diagnostics for timely intervention.

Objective: Despite the end of the pandemic, COVID-19 remains a disease of global concern. This study aimed to describe the clinical characteristics, outcomes, and survival analysis of hospitalised COVID-19 patients in Ogun State, Nigeria, with a view to providing evidence on the survival of hospitalised COVID-19 patients. Methods: The study examined the medical records of COVID-19 patients at the Olabisi Onabanjo University Teaching Hospital COVID-19 Isolation Centre in Sagamu, Ogun State, between March and December 2020. Data was analysed using SPSS version 22, with chi-square tests for association and logistic regression for mortality predictors. Kaplan-Meier curves and Log-rank tests were used for survival analysis. Results: The study involved 273 patients, with a mean age of 45.33±16.9 years. The majority were males, had symptoms (51.6%), and had SPO2 ≥ 94% (82.4%) at presentation. Most were discharged (94.1%), while 5.1% died. Over half presented with fever (55.3%) and cough (51.8%), and one-third had comorbidities. Most of those with comorbidities had hypertension (73.3%). The presence of two or more comorbid conditions (AOR 9.5, 95% CI 1.8 – 50.6; p = 0.008) and oxygen saturation less than 94% at admission (AOR 19.5, 95%CI 3.0 – 128.0; p = 0.002) were predictors of mortality. A significant difference was observed in the Kaplan-Meier curve regarding age group, symptom presence, comorbid conditions, and oxygen saturation at admission. Conclusion: The study found higher mortality rates due to co-morbidities and low oxygen saturation at admission, emphasising the need for early diagnosis, prompt referral, and management of patients with co-morbidities.