BackgroundLassa fever is a viral hemorrhagic fever endemic in West Africa. However, none of the hospitals in the endemic areas of Nigeria has the capacity to perform Lassa virus diagnostics. Case identification and management solely relies on non-specific clinical criteria. The Irrua Specialist Teaching Hospital (ISTH) in the central senatorial district of Edo State struggled with this challenge for many years.Methodology/Principal FindingsA laboratory for molecular diagnosis of Lassa fever, complying with basic standards of diagnostic PCR facilities, was established at ISTH in 2008. During 2009 through 2010, samples of 1,650 suspected cases were processed, of which 198 (12%) tested positive by Lassa virus RT-PCR. No remarkable demographic differences were observed between PCR-positive and negative patients. The case fatality rate for Lassa fever was 31%. Nearly two thirds of confirmed cases attended the emergency departments of ISTH. The time window for therapeutic intervention was extremely short, as 50% of the fatal cases died within 2 days of hospitalization—often before ribavirin treatment could be commenced. Fatal Lassa fever cases were older (p = 0.005), had lower body temperature (p<0.0001), and had higher creatinine (p<0.0001) and blood urea levels (p<0.0001) than survivors. Lassa fever incidence in the hospital followed a seasonal pattern with a peak between November and March. Lassa virus sequences obtained from the patients originating from Edo State formed—within lineage II—a separate clade that could be further subdivided into three clusters.Conclusions/SignificanceLassa fever case management was improved at a tertiary health institution in Nigeria through establishment of a laboratory for routine diagnostics of Lassa virus. Data collected in two years of operation demonstrate that Lassa fever is a serious public health problem in Edo State and reveal new insights into the disease in hospitalized patients.

No abstract

The Quinolones inhibit bacteria by interacting with DNA topoisomerases (gyrases) of which four subunits (two A and B monomers) have been identified thus, inhibiting bacterial DNA gyrase. High level resistance to quinolones can be produced by serial exposure of bacteria to subinhibitory concentration. A Total of 408 suspected UTI and high vagina swab (HVS) samples were examined for bacteria and the isolates obtained tested against the newer quinolones. Prevalence of Bacterial isolates revealed Escherichia coli 110(92%) as the most isolated organism from urine, while Staphylococcus aureus 31(32%) was the most isolated species from HVS samples. Bacterial species such as coliforms 55(70%) and Klebsiella spp 42(84%), equally had high prevalence rate in urine samples. Pseudomonas aeroginosa 19(66%) was next to Staphylococcus aureus in terms of prevalence of isolated strains from HVS samples.The resistance pattern observed for these isolates, showed that the strains were least resistant to Ciprofloxacin, followed by Ofloxacin and Perfloxacin, while they were most resistant to Nalidixic acid. There was however no statistical significance (P<0.001) between the use of Ofloxacin and Perfloxacin, however, ANOVA showed a significant difference (P<0.05) between the pattern of Klebsiella spp resistance against Perfloxacin when compared to Proteus vulgaris.

Colorectal cancer is a common malignant neoplasm in adults, with a peak incidence of 60–79 years. About 1 million cases of the disease and half a million deaths associated with it are reported world-wide each year. Colorectal cancer, however, is very uncommon in children and adolescents. This is a presentation of 3 cases of colon cancer in Nigerians aged 17 and 19 years. Two of them were adenocarcinoma and the other leiomyosarcoma. The pathogenesis and aspects of management are discussed.

This study sought to analyze the effect of three remedial measures, namely, hiring more pathologists, increasing the frequency of clinicopathologic conferences, and stepwise increase in the level of rejection criteria, on the adequacy of laboratory request form completion by clinicians. Based on the findings, recommendations were made that may reduce rejection rate of specimens and facilitate histopathology investigations. Methods: This is a retrospective study covering a period of 7 years (2004-2010). Data were retrieved from histopathology laboratory request forms submitted to three laboratories in Eastern Nigeria. These data were entered in SPSS statistical software and were analyzed using simple linear regression analysis. Results: A total of 8573 completed and submitted forms were analyzed, out of which 74.7% were found to be inadequately completed. The effect of increasing the number of pathologists in the employ on the adequacy of laboratory request form completion was found not to be statistically significant. Similarly, change in the frequency of clinicopathologic conferences was also found not to significantly affect the adequacy of laboratory form completion. However, change in the aggregated level of rejection criteria used by the laboratories was found to significantly affect the clinician's compliance to laboratory request form completion. For every 1 unit increase (or decrease) in the level of rejection criteria used there was, on the average, a 4.7% increase (or decrease) in the proportion of adequately completed laboratory request forms submitted. Conclusion: The findings highlight the need to enforce and implement policies that would possibly enhance compliance with the requirements of laboratory request form completion.