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A molecular epidemiological and genetic diversity study of tuberculosis in Ibadan, Nnewi and Abuja, Nigeria.

ABSTRACT: BACKGROUND: Nigeria has the tenth highest burden of tuberculosis (TB) among the 22 TB high-burden countries in the world. This study describes the biodiversity and epidemiology of drug-susceptible and drug-resistant TB in Ibadan, Nnewi and Abuja, using 409 DNAs extracted from culture positive TB isolates. METHODOLOGY/PRINCIPAL FINDINGS: DNAs extracted from clinical isolates of Mycobacterium tuberculosis complex were studied by spoligotyping and 24 VNTR typing. The Cameroon clade (CAM) was predominant followed by the M. africanum (West African 1) and T (mainly T2) clades. By using a smooth definition of clusters, 32 likely epi-linked clusters related to the Cameroon genotype family and 15 likely epi-linked clusters related to other "modern" genotypes were detected. Eight clusters concerned M. africanum West African 1. The recent transmission rate of TB was 38%. This large study shows that the recent transmission of TB in Nigeria is high, without major regional differences, with MDR-TB clusters. Improvement in the TB control programme is imperative to address the TB control problem in Nigeria.

SUBMITTER: Lawson L

PROVIDER: S-EPMC3377642 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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A molecular epidemiological and genetic diversity study of tuberculosis in Ibadan, Nnewi and Abuja, Nigeria.

Lawson Lovett L Zhang Jian J Gomgnimbou Michel K MK Abdurrahman Saddiq T ST Le Moullec Stéphanie S Mohamed Fatima F Uzoewulu Gertrude N GN Sogaolu Olumide M OM Goh Khye Seng KS Emenyonu Nnamdi N Refrégier Guislaine G Cuevas Luis E LE Sola Christophe C

PloS one 20120618 6

<h4>Background</h4>Nigeria has the tenth highest burden of tuberculosis (TB) among the 22 TB high-burden countries in the world. This study describes the biodiversity and epidemiology of drug-susceptible and drug-resistant TB in Ibadan, Nnewi and Abuja, using 409 DNAs extracted from culture positive TB isolates.<h4>Methodology/principal findings</h4>DNAs extracted from clinical isolates of Mycobacterium tuberculosis complex were studied by spoligotyping and 24 VNTR typing. The Cameroon clade (CA ...[more]

PMID: 22723859

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Project description:BACKGROUND:Nurses are particularly vulnerable to nosocomial tuberculosis (TB) infection because, being in the frontline of healthcare provision, they are frequently exposed to patients with infectious TB disease. Although cost-effective measures are available for TB infection control (TBIC), they are often poorly implemented. Knowledge of TBIC is known to positively influence the practice of the measures. There is, however, paucity of data on the knowledge and practices regarding TBIC among nurses in Nigeria. This study was aimed at determining the levels of TBIC-related knowledge and practices of nurses in Ibadan, and their associated socio-demographic factors. METHODS:This cross-sectional study utilized a self-administered questionnaire to collect data from 200 nurses in two secondary health facilities, in May 2014. The mean knowledge and practice scores of the nurses were determined and logistic regression was utilized to explore the association between the scores and socio-demographic characteristics. RESULTS:The respondents had mean knowledge and practice scores of 68.2 and 79.9% respectively. Using cut-off points of 80 and 100% for good knowledge and practice scores respectively, small proportions of the nurses had good scores - knowledge (10.5%) and practice (6%). Knowledge was not significantly associated with the socio-demographic characteristics of the nurses. Work experience was the only factor that was significantly associated with practices, with the more experienced nurses (> 18 years of work experience) having lower odds of obtaining good practice scores (OR 0.25, 95% CI 0.06-0.94). There was also no significant association between knowledge and practice scores (the nurses were yet to be trained on the newly-introduced TBIC package at the time of the study). CONCLUSIONS:The study revealed that small proportions of the nurses had good knowledge and practice scores. Its findings will be useful for the designing of interventions to improve TBIC among nurses and other healthcare workers, and to benchmark evaluation of the interventions. It is recommended that nurses should be trained on TBIC to equip them with necessary knowledge and skills. This, together with appropriate policy directives, and adequate monitoring and supervision will contribute to optimal implementation of TB preventive measures.

Project description:Malaria remains a global public health challenge. The disease has a great impact in sub-Saharan Africa among children under five years of age and pregnant women. Malaria control programs targeting the parasite and mosquitoes vectors with combinational therapy and insecticide-treated bednets are becoming obsolete due to the phenomenon of resistance, which is a challenge for reducing morbidity and mortality. Malaria vaccines would be effective alternative to the problem of parasite and insecticide resistance, but focal reports of polymorphisms in malaria candidate antigens have made it difficult to design an effective malaria vaccine. Therefore, studies geared towards elucidating the polymorphic pattern and how genes targeted for vaccine design evolve are imperative. We have carried out molecular and genetic analysis of two genes encoding vaccine candidates-the Plasmodium falciparum cell traversal ookinetes and sporozoites (Pfceltos) and P. falciparum reticulocyte binding protein 5 (Pfrh5) in parasite isolates from malaria-infected children in Ibadan, Nigeria to evaluate their genetic diversity, relatedness and pattern of molecular evolution. Pfceltos and Pfrh5 genes were amplified from P. falciparum positive samples. Amplified fragments were purified and sequenced using the chain termination method. Post-sequence edit of fragments and application of various population genetic analyses was done. We observed a higher number of segregating sites and haplotypes in the Pfceltos than in Pfrh5 gene, the former also presenting higher haplotype (0.942) and nucleotide diversity (θ = 0.01219 and π = 0.01148). In contrast, a lower haplotype (0.426) and nucleotide diversity (θ = 0.00125; π = 0.00095) was observed in the Pfrh5 gene. Neutrality tests do not show deviation from neutral expectations for Pfceltos, with the circulation of multiple low frequency haplotypes (Tajima's D = -0.21637; Fu and Li's D = -0.08164; Fu and Li's F = -0.14051). Strong linkage disequilibrium was observed between variable sites, in each of the genes studied. We postulate that the high diversity and circulation of multiple haplotypes has the potential of making a Pfceltos-subunit vaccine ineffective, while the low genetic diversity of Pfrh5 gene substantiates its evolutionary conservation and potential as a malaria vaccine candidate.

Project description:BackgroundNurses are particularly vulnerable to acquiring tuberculosis (TB) because they are in the frontline of patient care. There is inadequate implementation of cost-effective TB infection control (TBIC) measures in most health facilities. Training has been shown to be effective in improving the knowledge and work practices of nurses. This study sought to utilize a multi-method educational intervention to improve the TBIC-related knowledge and practices of nurses in two secondary health facilities in Ibadan, South-West Nigeria.MethodsThis quasi-experimental study involved 200 nurses (100 each in the intervention and comparison groups). Baseline data were collected in May 2014. This was followed by training of the nurses in the intervention group. After 6 months, the second wave of data was collected and the nurses in the comparison group also received the training thereafter. The final wave of data collection took place 12 months after the commencement of the study. The mean scores of the nurses were determined and comparison was made between both groups at different time points using independent t-test.ResultsThe nurses in both groups were statistically comparable in their socio-demographic characteristics, and baseline mean knowledge (68.6 and 67.7%) and practice scores (79.1 and 80.6%) respectively. After the intervention group received the intervention, there were appreciable improvements in the scores at 6 months (knowledge - 85.9%, practice - 98.5%), which were significantly different from those of the comparison group (knowledge - 69.5%, practice - 78.8%). A large effect size was demonstrated in the improvement in knowledge score in the intervention group at 6 months compared with the other group (Cohen's d = 1.7). Similarly, there were improvements in the scores of the nurses in the comparison group at 12 months after the group had also received the intervention (knowledge - 88.2%, practice - 93.5%). At this point, the mean scores between both groups were no longer significantly different.ConclusionsThe improvement in post-intervention scores implies that the educational intervention adopted for this study was effective in improving TBIC among the nurses. It also underscores the importance of continuous training/retraining of nurses and other healthcare workers in improving and sustaining TBIC at health facilities.

Dataset Information

A molecular epidemiological and genetic diversity study of tuberculosis in Ibadan, Nnewi and Abuja, Nigeria.

Publications

A molecular epidemiological and genetic diversity study of tuberculosis in Ibadan, Nnewi and Abuja, Nigeria.

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