African Journal of Infectious Diseases <p>The <em>African Journal of Infectious Diseases</em> (AJID), is a peer-reviewed, international journal that publishes papers which make an original contribution to the understanding of infectious diseases. Any paper relating to impact, care, prevention and social planning, will be considered for publication in AJID. Reports of research related to any aspect of the fields of microbiology, parasitology, infection, and host response, whether laboratory, clinical, or epidemiologic, will be considered for publication in the journal. AJID is index by AFrican Index Medicus, African Journals Online (AJOL), Scopus, EBSCO, MEDLINE, etc.</p> <p>All the other links can be found on our site at:&nbsp;<a href=""></a></p> Obafemi Awolowo University en-US African Journal of Infectious Diseases 2006-0165 <strong>Copyright Lic</strong><strong>ense Type (Creative Commons-Attribution </strong><a href=""></a> The license lets others distribute, remix, tweak and build upon your work, even commercially, as long as they credit you for the original creation. This is the most accommodating of all licenses offered. Recommended for maximum dissemination and use of licensed materials. Lipid and lipoprotein levels in HIV-infected adults with sepsis compared to healthy HIV- infected controls <p><strong>Background</strong>: In acute sepsis, reduced lipid and lipoprotein levels occur in HIV negative patients, in particular, low high-density lipoprotein cholesterol (HDL–c) levels are inversely correlated with sepsis severity and increased mortality. However, due to the limited data describing lipid and lipoprotein levels in septic HIV–infected individuals we aimed to investigate the changes in this subgroup.<br><strong>Materials and Methods</strong>: A prospective cross–sectional observational study of HIV–infected patients comparing admitted HIV – infected patients with sepsis to healthy controls from the antiretroviral therapy (ART) clinic. Non fasting - lipograms, ART use, diagnosis of tuberculosis (TB), markers of infection, renal function and mortality outcome to 3 months post discharge were reviewed.<br><strong>Results:</strong> Total cholesterol (TC), low–density lipoprotein (LDL–c) and HDL-c were all significantly lower in the sepsis group (p &lt; 0.001). HDL–c was significantly associated with a higher white cell count (p = 0.018), higher C– reactive protein (p = 0.036) and low serum albumin (p &lt; 0.001). In those with active TB (55%) HDL–c was reduced even further (0.55 vs. 0.72mmol/L, p = 0.013). Acute kidney injury (p = 0.560) and mortality at discharge (p = 0.097) or 3 months follow up (p = 0.953) was not associated with reduced HDL–c.<br><strong>Conclusion:</strong> Septic HIV–infected patients had significantly reduced lipid and lipoprotein levels at admission. Of note<br>however, a low HDL–c was associated with markers of infection and reductions in HDL–c was more marked in those with active TB.</p> <p><strong>Keywords:</strong> Lipid, Lipoprotein, HIV- infected, sepsis, infection.</p> Faheem Seedat Frederick Raal Neil Martinson Ebrahim Variava Copyright (c) 2021-04-29 2021-04-29 14 2 1 9 Outcomes of people living with HIV in two public-sector psychiatric facilities in the eastern cape using efavirenz-containing regimens <p><strong>Background:</strong> People with mental disorders are more vulnerable to human immunodeficiency virus (HIV) infection. A part of first-line treatment for HIV, efavirenz, is routinely avoided in patients with mental illness due to the risk of potential aggravation of the mental illness. This study aimed to determine the outcomes of people living with HIV/AIDS who were mental healthcare users admitted to two public-sector psychiatric facilities and who were prescribed an efavirenz-containing regimen.<br><strong>Materials and Methods:</strong> A retrospective drug utilization study was conducted at two public-sector psychiatric hospitals in the Eastern Cape of South Africa. Patients aged 18 years or older living with HIV were included in the study. Follow-up reviews were conducted at four, 12 and 24 weeks. The patients were seen by doctors at the hospital&nbsp; and notes on progress and medication were recorded in medical records. The files were then reviewed.<br><strong>Results</strong>: A total of 37 patients were enrolled. However, just 26 were reviewed at 24 weeks. A total of 43.2% (n=16) were female patients and the average age of the patients was 39.38±8.76 years. At the baseline, 32.4% (n=12) patients were diagnosed with schizophrenia. A total of 81.08% (n=30) of patients experienced an improvement in psychiatric symptoms after 24 weeks. Of these, 43.3% (n=13) were on an efavirenz-containing regimen.<br><strong>Conclusion</strong>: Majority of the patients demonstrated an improvement in their psychiatric conditions to the extent that they were discharged into the community. This finding suggests that patients with psychiatric disorders on efavirenz can experience stabilisation of their psychiatric symptoms.</p> <p><strong>Keywords:</strong> HIV-positive, efavirenz-containing regimen, neuropsychiatric, psychiatric, outcomes</p> Ilse Truter Razia Gaida Christoffel Grobler Copyright (c) 2021-04-29 2021-04-29 14 2 10 15 Porcine cysticercosis risks: Awareness, attitudes and perceptions on safety practices among farmers, butcher-owners and consumers in western Kenya <p><strong>Background:</strong> The demand for pork is increasing in Africa with the increasing need for animal protein in the household diets. But pork safety and quality remains a pervasive concern that needs intervention to assure consumers of protection from Porcine Cysticercosis (PC) contamination. This study assessed among farmers, butcher-owners and consumers in Western Kenya about their awareness, attitudes and perceptions about safety practices regarding risk of PC.<br><strong>Materials and Methods</strong>: Data were obtained using structured questionnaires in cross-sectional survey interviews with 162 farmers, 26 butcher-owners and 92 consumers from Busia and Kakamega Counties. The data were in binary response, so were analyzed with Chi - square test.<br><strong>Results:</strong> Only two in ten farmers had knowledge of Taenia solium parasite (24.1%), risk factors in PC transmission (21.6%) and could associate pig management system with PC (17.3%). A larger proportion (p&lt;0.01) of the butcher owners perceived pork from slaughter slabs (76.9%) and home slaughters (73.1%) as presenting high risks but considered pork from the butcheries (69.1%) and eateries (61.5%) as presenting no risks. Among the consumers, majority strongly agreed (p&lt;0.05) that pork in the market (85.9%), from slaughter slabs (92.4%) and butchery (81.5%) was safe but a larger proportion strongly disagreed that pork from the eateries exposed them to cysticercosis (64.1%).<br><strong>Conclusion:</strong> The awareness about risks of PC was low among farmers. Butcher-owners and consumers perceived pork safety differently along the value chain. Strengthening public education about PC risks and pork safety among all actors in the pork value chain in Western Kenya is recommended.</p> <p><strong>Keywords:</strong> Pork; quality; safety; T. solium; porcine cysticercosis; value chain actors </p> Marie-Françoise Mwabonimana Anthony Macharia King’ori Charles Muleke Inyagwa Bockline Omedo Bebe Copyright (c) 2021-04-29 2021-04-29 14 2 16 22 In vitro antimalarial activity and toxicity studies of Johar (<i>Cassia siamea</i>) leaves from three different locations <p><strong>Background:</strong> Antimalarial activity of <em>Cassia siamea</em> leaves has been proven by the active compound that has been found, i.e. Cassiarin A. It is known that the quantity of the content of a compound that has the potential as a raw material for medicine can be influenced by various factors including differences in plant origin. This study aims at comparing the antimalarial activity and toxicity of <em>C.siamea</em> leaves from three regions with different meters location values above sea level (asl), i.e Pariaman (1,000 m asl), Palu (60 m asl), and Surabaya (2 m asl).</p> <p><strong>Materials and Methods:</strong> The materials used in this study were Johar leaves from Pariaman, Surabaya, and Palu extracted with n-hexane, and 90% ethanol containing 1% tartaric acid. The antimalarial activity test was done with Plasmodium falciparum 3D7. The toxicity test applied MTT ELISA method.</p> <p><strong>Results</strong>: C.siamea leaf that had highest antimalarial activity came from Pariaman with IC<sub>50</sub> value of 0.006μg/ml, then from Palu was 0.037μg/ml, and the lowest antimalarial activity was from Surabaya that was 0.09μg/ml . In testing the toxicity to get CC<sub>50</sub>, the highest toxicity came from Surabaya with CC<sub>50</sub> value of 135.81μg/ml, Pariaman with CC<sub>50</sub> value of 220.82 μg/ml, and the least toxic came from Palu with CC<sub>50</sub> value of 235.52μg/ml .<br><strong>Conclusion</strong>: <em>C.siamea</em> leaf obtained from Pariaman had a selectivity index value that satisfies the requirements of a promising antimalarial effect.</p> <p><strong>Keywords:</strong> Anti-malarial, Toxicity, <em>Cassia siamea</em>.</p> Ezrani Tasiam Riesta Primaharinastiti Wiwied Ekasari Copyright (c) 2021-04-29 2021-04-29 14 2 23 29 Prevalence of porcine cysticercosis among scavenging pigs in western Kenya <p><strong>Background:</strong> <em>Porcine Cysticercosis</em> (PC) infection is globally classified as a neglected and re-emerging tropical disease. The disease is endemic in Western Kenya yet smallholder farmers continue to practice scavenging pig production, thereby posing public health risk. This study determined the prevalence of PC infection at the farms and slaughter slabs in a cross-sectional survey in two Counties (Busia and Kakamega) of Western Kenya.</p> <p><strong>Materials and Methods</strong>: Two hundred and eighty-seven (287) heparinized blood samples were collected at the farm from 162 households in 9 villages and 113 pigs from 5 slaughter slabs. The prevalence of PC was detected through meat inspection at slaughter slabs, and the prevalence of Taenia solium antigen determined by using the ApDia AgELISA test at the farms and slaughter slabs.</p> <p><strong>Results:</strong> At meat inspection, the PC prevalence was 1.8%, while prevalence of Taenia Species cysts detected with AgELISA test was 3.8% at the farms, and 5.3 % at the slaughter slabs. The Ag-ELISA test had sensitivity of 100% (95% CI: 19.79– 100.00) and specificity of 96.4% (95% CI: 90.49– 98.84).</p> <p><strong>Conclusion</strong>: The PC prevalence levels observed among scavenging pigs in Western Kenya should be a cause of public health risk concern. This observation warrant enforcing mandatory pig confinement, and use of latrines at the farms and meat inspection at local slaughter slabs. Further studies are recommended to identify different Taenia species in cysticercoids pigs in the region, which this study could not differentiate.</p> <p><strong>Keywords</strong>: Pig, Taenia spps, meat inspection, ELISA test, Slaughter slabs, Smallholder farmers.</p> Marie-Françoise Mwabonimana Anthony Macharia King’ori Charles Muleke Inyagwa Eduard Kokan Shakala Bockline Omedo Bebe Copyright (c) 2021-04-29 2021-04-29 14 2 30 35 Ebola virus disease preparedness in countries bordering Democratic Republic of Congo: Lessons from west African outbreak <p><strong>Background</strong>: Ebola virus disease ravaged three West African countries in the wake of 2014 which was seen as the deadliest Ebola Virus Disease (EVD) outbreak in history. Several lessons were taken out of the West African outbreak one of which is the lack of preparedness by countries in the region.<br><strong>Materials and Methods</strong>: This paper looked at the mistakes of the West African outbreak and reports how such mistakes were corrected in the current outbreak going on in the Democratic Republic of Congo (DRC). Preparedness efforts are currently taking place in countries bordering DRC which included quick detection and response to an eventual EVD event.<br><strong>Results</strong>: This paid off on several occasions when cases from DRC to Uganda were quickly detected and response was as quick as possible. Preparedness carried out in Countries bordering DRC included setting up of Rapid Response Team (RRT) and training of these teams both at country and regional level. All members of the RRT were trained in all areas of readiness which included community engagement, laboratory, logistics, surveillance, case management, sample collection, packaging and shipment as well as Infection Prevention and Control (IPC).<br><strong>Conclusion:</strong> These trainings have led to readiness to an eventual EVD event. Countries now have the ability to respond quickly with better Emergency Operation Centre (EOC) for EVD.</p> <p><strong>Keywords</strong>: Ebola, EVD, Preparedness, Response, Infection Prevention and Control. </p> Lawrence Okoror Otridah Kapona Mpanga Kasonde Alice E. Tobin Asogun Danny Ashiat M. Otukoya Copyright (c) 2021-04-29 2021-04-29 14 2 36 41 HIV-associated non Hodgkin lymphoma: A case series study from Turkey <p><strong>Background:</strong> Human immunodeficiency virus (HIV) is a global health concern with major risks for opportunistic infections and&nbsp; predisposition to malignancies including Kaposi sarcoma associated with Human Herpes Virus-8 (HHV8) and non-Hodgkin lymphoma (NHL) commonly associated with Epstein Barr Virus (EBV). Although the exact mechanisms of predisposition to certain malignancies are unclear, HIV (+) cancer patients typically have poorer prognosis.<br><strong>Materials and Methods</strong>: We included all five HIV positive NHL patients receiving antiretroviral therapy (ART) and chemotherapy in our clinic and aim to determine their follow-up outcomes associated with ART.<br><strong>Results</strong>: The use of ART in conjunction with chemotherapy regimens lead to better therapeutic outcome in our cases with no mortality over three years of follow-up despite high rates of poor prognostic factors and studies demonstrating 1-year survival rates of&nbsp; approximately 30% in HIV-associated lymphoma. No significant adverse effect has been recorded.<br><strong>Conclusion</strong>: We recommend use of ART along with chemotherapy regimens in HIV positive lymphoma patients for better treatment&nbsp; response.</p> <p><strong>Keywords:</strong> Human immunodeficiency virus, lymphoma, non-Hodgkin lymphoma, anti-retroviral therapy </p> Kayra Somay Sidar Çöpür Emre Osmanbaşoğlu Helin Masyan Harun Arslan Olga Meltem Akay Süda Tekin Burhan Ferhanoğlu Copyright (c) 2021-04-29 2021-04-29 14 2 42 47 Orbital cellulitis in pulmonary tuberculosis: A case report <p><strong>Background:</strong> Orbital cellulitis in immunocompetent patients with pulmonary tuberculosis (TB) is rare or unheard of. If left untreated, patients might lose their sight and potentially their life. This case describes orbital cellulitis due to extended spectrum β-lactamases (ESBLs)-producing bacteria in a patient with pulmonary tuberculosis.<br><strong>Materials and Methods:</strong> We report the case of a 47-year-old man referred to the emergency room in our hospital with swollen and painful right eye and face for 8 days. On admission, the patient condition was drowsy, pale, and feverish. Visual acuity of the right eye was only light perception with limited eye movement in all directions. The CT scan showed orbital sub-tissue swelling and sub-periosteal abscess on the upper lateral orbital wall. On day 5, pus culture was confirmed as extended spectrum β-lactamases (ESBLs) producing bacteria and Ziehl-Neelson staining test revealed acid fast bacillus with pulmonary inflammation highly pathognomonic of tuberculosis.<br><strong>Results</strong>: The patient showed significant clinical improvement on day 11. The patient was discharged on the day 15 in stable general condition with improved visual acuity on the right eye (capable of capturing hand movement).<br><strong>Conclusion</strong>: ESBL producing bacteria associated orbital cellulitis in tuberculosis patient potentially elevated the morbidity and possibly result in severe loss of visual acuity. Early diagnosis and treatment could reverse this comorbidity and produce a better outcome for affected patients.</p> <p><strong>Key words</strong>: Extended spectrum β-lactamases; orbital cellulitis; pulmonary tuberculosis </p> Ni Made Inten Lestari Susy Fatmariyanti Hendrian D. Soebagjo Neneng Dwi Kurniati Delfitri Lutfi Copyright (c) 2021-04-29 2021-04-29 14 2 48 52 Comparative analysis of qPCR measurement of HIV viral load and Elisa detection of p24 antigen after hyperbaric oxygen exposure <p><strong>Background</strong>: A decrease in the number of viruses or viral nucleic acid components will determine whether a therapy successfully eradicates the virus. Sensitivity and specificity are needed to enable easy, precise and efficient diagnosis and evaluation of therapy. This study examined the sensitivity of quantitative PCR (qPCR) for detecting viral nucleic acids as compared with enzyme-linked immunosorbent assay (ELISA) for detecting the human immunodeficiency virus 1 (HIV-1) p24 antigen after hyperbaric oxygen therapy.<br><strong>Materials and Methods</strong>: In this study, peripheral blood mononuclear cells (PBMCs) from healthy whole blood and inoculated HIV-1/MT4 virus in PBMC cultures were isolated. The cultures were exposed to hyperbaric oxygen at 2.4 ATA with 100% O2 for 3 × 30 minutes for 5 days. ELISA and qPCR were used to measure the p24 antigen and HIV-1 mRNA, respectively, in the treatment and control groups.<br><strong>Result</strong>: The amounts of p24 antigen and HIV-1 mRNA were significantly different (p = 0.001, p &lt; α). The two examination methods were significantly different. Hyperbaric oxygen therapy can reduce virus numbers, as observed from the p24 antigen and HIV-1 mRNA levels. The treatment group had significantly lower virus numbers than the control group. HIV-1 mRNA detection is more sensitive than p24 antigen detection.<br><strong>Conclusion</strong>: Both qPCR and ELISA have their advantages, depending on whether the goal is to establish, diagnose or monitor antiretroviral therapy or to evaluate disease progression.</p> <p><strong>Keywords</strong>: ELISA, HIV-1, hyperbaric oxygen, p24 antigen, PCR </p> Retno Budiarti Kuntaman Kuntaman Guritno Suryokusumo Siti Qamariyah Khairunisa Copyright (c) 2021-04-29 2021-04-29 14 2 53 59