BackgroundThe objective of this trial was to determine the effectiveness of 1.0% C31G (SAVVY) in preventing male-to-female vaginal transmission of HIV infection among women at high risk.Methodology/Principal FindingsThis was a Phase 3, double-blind, randomized, placebo-controlled trial. Participants made up to 12 monthly follow-up visits for HIV testing, adverse event reporting, and study product supply. The study was conducted between September 2004 and December 2006 in Lagos and Ibadan, Nigeria, where we enrolled 2153 HIV-negative women at high risk of HIV infection. Participants were randomized 1∶1 to SAVVY or placebo. The effectiveness endpoint was incidence of HIV infection as indicated by detection of HIV antibodies in oral mucosal transudate (rapid test) or blood (ELISA), and confirmed by Western blot or PCR testing. We observed 33 seroconversions (21 in the SAVVY group, 12 in the placebo group). The Kaplan-Meier estimates of the cumulative probability of HIV infection at 12 months were 0.028 in the SAVVY group and 0.015 in the placebo group (2-sided p-value for the log-rank test of treatment effect 0.121). The point estimate of the hazard ratio was 1.7 for SAVVY versus placebo (95% confidence interval 0.9, 3.5). Because of lower-than-expected HIV incidence, we did not observe the required number of HIV infections (66) for adequate power to detect an effect of SAVVY. Follow-up frequencies of adverse events, reproductive tract adverse events, abnormal pelvic examination findings, chlamydial infections and vaginal infections were similar in the study arms. No serious adverse event was attributable to SAVVY use.Conclusions/SignificanceSAVVY did not reduce the incidence of HIV infection. Although the hazard ratio was higher in the SAVVY than the placebo group, we cannot conclude that there was a harmful treatment effect of SAVVY.Trial RegistrationClinicalTrials.gov NCT00130078

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This study was designed to assess the seroconversion rate of measles vaccine among infants receiving measles immunization in Ilorin, Nigeria. The pre- and post-measles vaccination sera of the children were tested using the Haemagglutination Inhibition test. The measles vaccines administered at the immunization centre were also tested for their potency using in-vitro titration method. Only 286 (71.5%) of the vacinees returned to give post-vaccination samples. All the infants screened had low pre-vaccination measles antibody titers. Thirty one (8.0%) of the infants had measles prior to vaccination. The seroconversion pattern showed that 196 (68.6%) of the infants developed protective antibody titers. Low seroconversion rate reported in this study was due to low vaccine potency. The titers of vaccines with low potency ranged between log10(-1.0)-log10(-2.25) TCID/per dose. This was beside other non specific antiviral substances exhibited virus neutralizing activity. Only 3 (50%) of the 6 vaccine vials tested had virus titers of log10(-3.25) to log10(-3.5), which fell above the cut-off point recommended by the World Health Organization for measles vaccines. The sero-conversion rate of 68.6% observed among vaccinees is far lower than the immunity level of 95% required stopping measles transmission in an endemic community. Failure of 31.4% of these infants to sero-convert post vaccination can be attributed partly to administration of sub-potent vaccines. There is need for improvement and maintenance of effective vaccine cold chain system in Nigeria. There is need also for periodic monitoring of post-vaccination antibody titers as well as vaccine potency status in order to ensure development of protective seroconversion rates.

BackgroundCandidaemia is a widely-studied and reviewed topic in the developed world; however, there is a dearth of information on nosocomial candidaemia in Nigeria, despite the increasing use of more invasive therapeutic modalities, immunosuppressive agents and increasing incidence of immunosuppression as a result of malignancies and HIV.ObjectivesTo determine the hospital-based frequency of candidaemia in a tertiary hospital in Ibadan, Nigeria.MethodThis was a prospective descriptive study which included 230 immunosuppressed patients. All isolates were identified to the species level using both conventional and automated methods. Thereafter, all Candida species isolated were tested for antifungal susceptibility using the broth microdilution method.ResultsCandidaemia occurred in 12 (5.21%) of the 230 study patients, with C. tropicalis accounting for 50% of the infections. Four patients (33.3%) presented with C. parapsilosis, one (8.3%) with C. albicans and one (8.3%) with a mixed infection of C. albicans and C. tropicalis. All 12 isolates were sensitive to fluconazole (minimal inhibitory concentration < 8 mg/mL). Univariate analysis revealed that old age, multiple surgeries and long-term hospitalisation were significant contributing factors for the occurrence of candidaemia. Eleven (91.7%) of the 12 patients with candidaemia had Candida colonisation of other sterile sites including the bladder, peritoneum and trachea. Furthermore, bivariate analysis revealed that mucositis (p = 0.019) and diarrhoea (p = 0.017) were significantly associated with an increased risk of candidaemia. The crude mortality rate of candidaemia was 91.7%.ConclusionThis study highlights the significance of nosocomial candidaemia and the need for proactive laboratory investigation and clinical management of this life-threatening disease.

also been documented among youth (school going and out of school). The weak government response coupled with the extremely distressing social demographics of this South-Asian republic also helps to compound the problem. The time is ripe now to prepare in advance, to take the appropriate measures to curtail further spread of the disease. If this opportunity is not utilised right now, little if at all could be done later. Islamic charities provide health, education and social services to millions of people in Pakistan. But in Pakistan still sexuality is a taboo topic. Strong hold of religious leaders on socio cultural pattern of community (attitude with extremism). Prevailing concepts to talk about sex considered as act of vulgarity and immoral activity. Word STIs and HIV/AIDS conceived as symbol of sexual delinquencies. Method Through a Questionnaire data on knowledge, attitude, behaviour and practices related to STIs/HIV/AIDS was collected from 1200 male religious students and religious scholars from randomly selected Islamic religious centers. Baseline knowledge, attitude, acceptability of the concept were assessed. Results According to KABP study 70% students have friends of opposite sex and due to strong religious values and restriction 30% have no friendship with opposite sex. Regarding nature of sex, 40% had kissing and only 18% had intercourse. During intercourse only 3% used condoms. 42% consider that condom is used only for family planning purpose. 56% answered that during intercourse use of condoms reduce sexual pleasure and enjoyment. 32% youth use drugs and 38% did not know about STIs and HIV/AIDS. General discussions were also started with four Maderssas students and their teachers. These meetings addressed the sensitisation of religious scholars to the issue of HIV/AIDS and highlight the role of Maderssas in STIs and HIV prevention. Conclusions Training of adolescent as peer educators is recommended. Ours being an Islamic society, such information should be given to youth in a way that does not challenge local norms and values. Problem-based learning and participatory education for improving knowledge and condom use and community-based interventions should be considered for STIs/HIV/AIDS prevention.