Fluoroquinolone Resistance in Relation to Phylogenetic Background and Iron Uptake Associated Virulence Profile among Urinary Escherichia coli Isolates from HIV and Non-HIV Patients | Chapter 9 | Innovations in Medicine and Medical Research Vol.2

Introduction: Urinary tract infection is a major cause of morbidity among HIV patients and is more often underestimated in developing countries. Urinary Escherichia coli isolated from HIV and non-HIV patients in South India were analyzed to determine the virulence profile and phylogenetic distribution and their correlation with fluoroquinolone (FQ) resistance. Methods: This study aimed to assess the difference in the incidence of iron uptake associated virulence genes among urinary E. coli isolated from HIV (n= 76) and non-HIV antenatal patients (n=42). We compared the incidence of virulence associated genes (VAGs) among the E. coli isolates in relation to FQ resistance, phylogeny and host immunocompromise.  Results: fyuA was higher among the isolates from HIV than from non-HIV patients (P=0.00024).              E. coli isolates from HIV, non-HIV patients primarily belonged to the phylogroups D and B2 respectively. Q and FQ resistance were higher among isolates from HIV patients compared to nonHIV patients (P=0.000414, P<0.0001 respectively). PhylogroupB2 strains were predominant among the FQ susceptible than FQ-resistant strains (P=0.000652). fyuA and iutA was higher among the Qresistant isolates than their susceptible counterparts (P<0.0001; P=0.000132). FQ resistant isolates harboured fyuA, iutA than the susceptible isolates (P=0.0063; P=0.000478). Hly+ phenotype was significantly associated with FQ-susceptible isolates (P=0.003253).  Discussion: Our results establish the relative predominance of non-hemolytic, fyuA+, Q, FQ resistant E. coli isolates primarily of phylogroup-D among the HIV patients and there by suggests that non-B2 strains with lower virulence but with increased antibiotic resistance establish infection in HIV patients.

Author(s) Details

Dr. Kesavaram Padmavathy
Department of Microbiology, Research Laboratory for Oral and Systemic Health, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, India and Department of Microbiology, Dr. ALM PGIBMS, University of Madras, Chennai, India.

Dr. Krishnan Padma
Department of Microbiology, Dr. ALM PGIBMS, University of Madras, Chennai, India.

Dr. Sikhamani Rajasekaran
Government Hospital of Thoracic Medicine, Chennai, India.

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Origin of the Viruses and Their Evolutionary History: Recent Advancement | Chapter 4 | Innovations in Medicine and Medical Research Vol.2

The human immunodeficiency virus (HIV) originated via a process of natural evolution, probably emerging from the primate SIV reservoir into the human population via hunting or other behavior involving contact with the blood of these animals. A particular subspecies of chimpanzee, the Pantroglodytes troglodytes, has been recognized as the most probable original source of human infection. Analysis of viral genetic sequences has allowed researchers to estimate that the native strain of HIV originated in 1931. In the West, sexual behavior patterns and injecting drug use subsequently began the epidemic. Polymerase Chain reaction (PCR), is a technique in molecular biology that amplifies a specific region of deoxyribonucleic acid (DNA), and has been useful in the molecular characterization of viruses. The Variola major, the virus that causes the smallpox, lethal virus in the 30% of the cases, was eradicated in 1979 in the human species, thanks to a capillary vaccination on global scale. It has now become a “historical footprint” in two known laboratories, one in the USA and another in Russia, leaving no obvious source for its often-theorized use as a bioterrorist weapon. Nevertheless, mass vaccination against smallpox continues to be a leading initiative in Western countries to guard against bioterrorist attack.

Author(s) Details

Giulio Tarro
Beaumont Bonelli Foundation for Cancer Research, Naples, Italy and Committee on Biotechnologies and Virus Sphere, World Academy of Biomedical Technologies, UNESCO, Paris, France.

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Utilization and Factors Associated with Uptake of Prevention of Mother- to – Child Transmission (PMTCT) of HIV Services among Antenatal Clinic Attendees at a Tertiary Health Facility in Akure, Ondo State | Chapter 2 | Current Trends in Disease and Health Vol. 3

Background: Prevention of mother-to-child transmission of HIV (PMTCT) programmes provide antiretroviral treatment to HIV-positive pregnant women to reduce the likelihood of their infants acquiring the HIV. However despite concerted efforts to scale-up PMTCT services in Nigeria, the coverage and uptake of the service by pregnant women remain low.  

Aim/Objective: This study was carried out to assess the utilization and factors associated with the uptake of PMTCT Services among pregnant women at a tertiary health facility in Akure, Ondo State.

Methodology: This research was an institutional based descriptive cross-sectional study conducted over a period of one month (May 2018). The study population included pregnant women accessing antenatal care at the University of Medical Sciences Teaching Hospital, Akure, Ondo State. Data was collected using interviewer administered questionnaire and analyzed using SPSS Windows 20. The main outcome measured was the utilization of PMTCT services. Factors associated with its utilization was assessed using binary logistic regression. Statistical significance was set at P<0.05.

Results: A total of 400 pregnant women were interviewed with 100% response rate. The mean age of the women was 32 years ± 4.8. The majority of them with their spouses were educated up to the tertiary level. Their mean gestational age was 28 weeks ± 2.2 standard deviation. Among the respondents, 252 (63.2%) had been tested for HIV in the index pregnancy while 148 (36.8%) were not yet tested, those not tested identified lack of counsellors as their main reason. The average time spent before the patients were seen at the clinic was reported to be too long in 287 (71.7%), so 368 (92.5%) of the women were not satisfied with the service. Factors found to be positively associated with PMTCT utilization were the educational level of the women and their partners which could be in favour of their utilizing PMTCT services and inadequate counsellors which may not be in favour of utilization of the service.

Conclusion: All the respondents did not utilize the PMTCT services in the index pregnancy and the main reason being inadequate number of counsellors. There is the need to improve the quality of PMTCT services in the study setting.

Author Details

Dr. (Mrs.) Theresa Azonima Irinyenikan

Department of Obstetrics and Gynaecology, University of Medical Sciences / University of Medical Sciences Teaching Hospital, Akure, Ondo State, Nigeria.

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Liver Protein and Enzymes in HIV Infected Pregnant and Non-pregnant Women on Antiretroviral Therapy | Chapter 08 | Current Trends in Medicine and Medical Research Vol. 5

This in-vivo study was carried out to investigate alterations in the levels of proteins and enzymes produced by the liver of HIV infected pregnant women and HIV infected non pregnant women under different antiretroviral therapy. Forty six human patients (Pregnant patient, n=21, Non pregnant patient, n=25) were recruited during this study from the PEPFAR (President Bush Emergency Plan for Aids Research) clinic in LUTH (Lagos University teaching Hospital), Lagos. The patients were between the ages of 29 – 34 years. All samples were analyzed for Albumin, Transferrin, Urea, Total protein, Total bilirubin, Creatinine and Cholinesterase. Along with it, liver enzymes – Alkaline phosphate, Alanine aminotransferases and Aspartate aminotransferases were also analyzed to confirm proper liver function for each patient. Result showed that total bilirubin and transferrin were statistically higher in the pregnant group while other liver proteins (Albumin, Urea and Total protein) were statistically lower in the pregnant group. Two liver enzymes, Creatinine and Cholinesterase, were statistically lower in the pregnant group. Though, other liver enzymes; aspartate aminotransferases and alanine aminotransferases were also lower in the pregnant group. No significant difference were noted when statistics were applied. Only alkaline phosphatase showed a non significant increase in the pregnant group. Findings in this study suggest that effective antiretroviral therapy stabilizes proteins and enzymes production in both HIV groups, however, slight alterations which were observed in the pregnant HIV group were due to physiological changes during pregnancy.

Author(s) Details

Prof (Mrs) P. I. K. Onyeka
Department of Animal and Environmental Biology, Faculty of Biological Sciences, Imo State University, Owerri, Nigeria.

U. O. Emmanuel
Department of Animal and Environmental Biology, Faculty of Biological Sciences, Imo State University, Owerri, Nigeria.

O. G. Udujih
Department of Public Health Technology, School Of Health Technology, Federal University of Technology, Owerri, Nigeria.

E. U. Nwabueze
Department of Animal and Environmental Biology, Faculty of Biological Sciences, Imo State University, Owerri, Nigeria.

H. I. Udujih
Department of Medical Laboratory Science, Faculty of Health Science, Imo State University, Owerri, Nigeria.

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Cytomegalovirus Retinitis: Current State in People with HIV-AIDS in Peru | Chapter 11 | New Insights into Disease and Pathogen Research Vol. 3

Purpose: To describe the incidence and progression of cytomegalovirus retinitis (CMVR) in public hospital patients from Peru.

Study Design: Prospective study conducted in HIV-AIDS diagnosed patients.

Place and Duration of Study: Department of Ophthalmology and Department of Tropical Medicine, Hospital Nacional Dos de Mayo, from 2004 to 2013.

Methodology: Descriptive statistics were obtained for age, gender, associated disease, CMVR location and ganciclovir treatment. Data were analyzed by the Pearson Chi. Square test, Mann-Whitney test, and the two-tailed exact Fischer’s Exact test. SPSS version 20.0 for Windows software program was used

Results: 2627 patients were evaluated, 75 had CMVR diagnosis. Active CMVR was found in 68 eyes (90.7%). Median age at diagnosis of CMVR was 37 years (IQR 30-41 years). Median CD4 level of 25 cells/μL (IQR 12.2-57.7 cells/μL), viral load > 1000,000 in 39 (52%) patients. Median mortality  rate was 7.1 deaths per 1000 PY and mean survival time from HIV diagnosis to death was 29,5 months (95%  8,7-43,0 months) and from CMVR diagnosis, 6,2 months (95%  IC 2,0-8,0 months). Duration since HIV diagnosis to CMVR onset was 12 months (IQR 3-48 months). Tuberculosis (TB) was present in 23 (30.7%) patients. Incidence rate of HIV patients with CMVR was 28.2 cases per 1000 PY. 51 patients received ganciclovir: endovenous 34 (91.17%), intravitreal 6 (26.5%) and orally 4 (11.8%).

Conclusion: CMVR has a high prevalence in young people with an elevated value of HIV-TB co-infection (30.7%). CMVR diagnosis was a predictor for early mortality, including highly active antiretroviral therapy (ART).

Author(s) Details

Bety Yáñez
Department of Ophthalmology, Hospital Nacional Dos de Mayo, Lima, Peru.

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Use of Condom and Knowledge of Own HIV Status among Undergraduates of Ten Tertiary Schools in Ekiti and Ondo States Southwest, Nigeria | Chapter 16 | Theory and Applications of Microbiology and Biotechnology Vol. 2

Bearing a burden of 66.7% of all global cases, HIV infection has become a major health challenge in Africa in general and sub-Sahara Africa in particular. For this reason, the battle to halt HIV/AIDS’ spread in Africa, particularly in Nigeria is being fought on different fronts, carefully considering all factors that can help bring down prevalence rate and curb the spread of the disease. Two of such fronts are advocacies for the consistent and right use of a condom, as well as voluntary testing to know own HIV status. In this study, 100 undergraduates each were sampled consecutively from ten tertiary schools in Ekiti and Ondo States of Nigeria, so as to evaluate the level of use of condom and knowledge of own HIV status among this group of youths and young adults. The study was conducted through the use of self-administered questionnaires among the enrolled undergraduates. The 1000 subjects comprised 421(42.1%) males and 57.1 (57.1%) females, while 8 (0.8%) did not disclose their gender. Five hundred and twenty-one (52.1%) of the subjects fell within the 21-30 age-bracket, 407 (40.7%) were 20years and below, 22 (2.2%) were within the 31-40 age-bracket, while 12(1.2%) were 40years and above. Thirty-eight (3.8%) did not disclose their age-bracket. Two hundred and four (20.4%) of the subjects always used condom, 169 (16.9%) used it occasionally, 139 (13.9%) never used during sexual intercourse, 403(40.3%) indicated that the use of condom wasn’t applicable to them (this group was presumed to be sexually inactive/inert), while 85 (8.5%) didn’t volunteer information about their sexual activity. Findings also revealed that majority, 564(56.4%) of the subjects did not know their HIV status, 51(5.1%) were indifferent about their HIV status, 25 (2.5%) did not disclose if they knew their HIV status or not. However, 360 (36%) knew their HIV status. With more than half of the study population not knowing their HIV status, it is therefore suggested that health policy-makers should scale-up advocacy activities to persuade the general populace in Nigeria to go for voluntary testing.

Author(s) Details

Dr. G. O. Daramola
Department of Medical Microbiology and Parasitology, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria.

Dr. H. A. Edogun
Department of Medical Microbiology and Parasitology, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria.

A. O. Ojerinde  B.MLS, M.Sc
University Health Centre, Federal University, Oye-Ekiti, Ekiti State, Nigeria.

A. A. Agbaje
Department of Haematology and Blood Transfusion, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria.

O. O. Ogunfolakan
Department of Medical Laboratory Science, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria.

O. O. Ajala
Department of Haematology and Blood Transfusion, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria.

A. Egbebi
College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.

E. F. Akerele
Department of Medical Microbiology and Parasitology, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria.

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Sexually Transmitted Diseases Posing Health Hazards to Women Who Have Sex with Women | Chapter 13 | New Insights into Disease and Pathogen Research Vol. 2

Aims: The aim of this work is to present the findings of various studies relevant to the incidence of sexually transmitted disease (STD) among women who have sex with women (WSW). This being an important issue when considering the numerous and diverse types of infections possible.

Results: The various types of STD, vaginal infections, and abnormalities that are known among WSW includes: herpes simplex virus type 2, Chlamydia trachomatis, Neisseria gonorrhoeae, trichomoniasis, syphilis, hepatitis A, HIV, genital and oral human papillomavirus, pelvic inflammatory disease, allergic vaginitis, genital herpes and genital warts, squamous intraepithelial lesions, and bacterial vaginosis. Risk factors among WSW are the number of sexual partners, minimal use of protected sexual behaviors, and very low levels of knowledge of STD prevention among WSW.  Drug-resistant pathogens have been observed in lesbian patients.

Conclusion: The threat of infection among WSW is significant, with the types and number of viral and bacterial potential pathogens being diverse and numerous. Recognition of risks will assist in correctly identifying the STD and aid in choosing the appropriate clinical care. Further research into the occurrence of STDs among WSW will benefit and contribute to public health.

Author(s) Details

Dr. Ronald Bartzatt
Durham Science Center, University of Nebraska, 6001 Dodge Street, Omaha, Nebraska 68182, USA.

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View Volume: https://doi.org/10.9734/bpi/nidpr/v2

Postpartum Sexual Abstinence and High Risk Sexual Behaviour Trends in African Settings | Chapter 03 | Current Trends in Disease and Health Vol. 1

Aims: To determine the prevalence of high risk sexual behavior and its relationship to the duration of coital sexual abstinence in husbands of postpartum women.

Study Design:  Cross sectional descriptive study.

Place and Duration of Study: Ikenne Local Government Area, in Ogun State, South Western Nigeria between, December 2014 and May 2015.

Methodology: Data were obtained with the aid of semi-structured interviewee administered questionnaire from 771 husbands of postpartum women using the multi-stage sampling technique.

Results: The prevalence of High risk sex in the population was 10.6%. The duration of coital sexual abstinence was the most important risk factor (P<.001), while previous extramarital sexual relationship (P<.001, OR=41.70, 95%CI=18.07-96.07) and husband’s knowledge of his own HIV status (P=.03, OR=1.71) were also significant determinants of this occurrence. Consistent condom use during unsafe sex was 6.1%, while STIs occurred in 3.7% of the participants. Significantly longer durations of coital abstinence (8.30 ± 6.24 months) were observed in men who were rural dwellers than in urban dwelling husbands (7.16 ± 6.01 months), P=.01. Violent behavior against the postpartum wife during the abstinence period was reported by 1.2% of the participants.

Conclusion: High risk male sexual behavior was a consequence of prolonged postpartum sexual abstinence and a predisposition to STIs among husbands of postpartum women.

Author(s) Details

J. O. Imaralu
Department of Obstetrics and Gynaecology, Benjamin Carson (Snr) School of Medicine, Babcock University Teaching Hospital, Babcock University, Ilishan-Remo, Nigeria.

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View Volume: https://doi.org/10.9734/bpi/ctdah/v1