Influenza, Malaria parasitaemia and Typhoid fever Coinfection in Children: Seroepidemiologic Investigation in Four Healthcare Centres in Lagos, Nigeria

Abstract Background : According to WHO, out of about one billion individuals usually infected with influenza virus, children from developing countries account for 99% of deaths due to related infections. There is dearth of clinical-epidemiological information on the trio of influenza, malaria, and typhoid fever co-infection in Nigeria. Similarity of their clinical symptoms coupled with lack of vaccine and all year-round circulation in sub-Saharan Africa cause serious paediatric morbidity and mortality. This study therefore investigated influenza, malaria and typhoid fever coinfection among children in Lagos, Nigeria. Methods : A sero-epidemiologic hospital-based study was designed. Blood from 364 children tested by RDT for malaria HRP-II/pLDH (Accessbio or Medicon BioCheck, USA) and typhoid (CTKBiotech, USA or Omega, UK) were screened by ELISA (Demeditec, Germany) for influenza virus specific IgM antibody. Descriptive statistics was used and p-values were determined with Chi-square. Results : Demographic data showed median age of 3 (mean 3.8, mode 2, range 0-14) years. Out of the 364 samples tested, 76/364 (20.9%) were seropositive for influenza A virus. Of the 76 seropositive patients, 47/76 (61.8%) had malaria parasitaemia, 42/76 (55.3%) had typhoid, and 21/76 (27.6%) were co-infected with malaria parasitaemia and typhoid fever. Furthermore, 2/76 (2.6%) children having underlying health condition of sickle cell anaemia recorded influenza seropositivity. Ojo primary healthcare centre had the highest seroprevalence of 48.7% (37/76), age group 1-4 years recorded the highest seroprevalence of 55.3% (42/76), the highest serologic evidence of 61.8% (47/76) was detected among male children, while fever 27.6% (21/76) was the most common of all the clinical symptoms recorded. Although, the month of March had the highest seroprevalence of 20/76 (26.3%), seropositivity was recorded in all other months considered for this study. Conclusions : We hereby report the first paediatric co-infection of influenza, malaria and typhoid fever with a percentage seroprevalence of 27.6% among all age group round the months. Low co-infection was however recorded in children having sickle cell anaemia. Annual vaccination is strongly recommended for children of all ages in order to prevent co-infection of influenza with other deadly diseases.

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Incidence of Sickle Cell Anaemia among Children Attending Maryam Abacha Women and Children Hospital, Sokoto

Journal of Scientific Research and Reports ◽

10.9734/jsrr/2020/v26i330237 ◽

2020 ◽

pp. 66-71

Author(s):

S. Y. Lema ◽

J. Suleiman ◽

J. Ibrahim

Keyword(s):

Sickle Cell ◽

Sickle Cell Anaemia ◽

Sub Saharan Africa ◽

Age Group ◽

The World ◽

Genotype Test ◽

Women And Children ◽

Sub Saharan ◽

Male Subjects

Sickle Cell Anaemia is still considered the most common genetic disease worldwide, causing morbidity and mortality in Sub-Saharan Africa, Mediterranean areas, Middle East and India. Nigeria, being the most populous black nation in the world, bears its greatest burden in Sub-Saharan Africa. This study was conducted to determine the incidence of Sickle Cell Anaemia among children attending Maryam Abacha Women and Children Hospital, Sokoto. A total of one hundred (100) blood samples were examined for the disease. Out of the 100 children tested for the disease. (59%) were normal (HbAA), (35%) were carrier (HbAS) and (6%) were Sicklers (HbSS). The result based on gender showed that female has the highest percentage of the disease (5%) against male subjects with only (1%). A child between the age group 6-10 years has the highest rate of sickle cell anaemia (3%) while age group 11-15 years had the lowest rate of the infection. Improved knowledge regarding Sickle cell anaemia disease and its comprehensive care among Nigerian physicians will enhance quality of care for affected childrens and policy for regular genotype test by government and other stakeholders before marriage among Nigerians will help to prevent the disease.

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Dual and Triple Infections With Influenza A and B Viruses: A Case-Control Study in Southern Brazil

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz221 ◽

2019 ◽

Vol 220 (6) ◽

pp. 961-968 ◽

Cited By ~ 6

Author(s):

Tatiana Schäffer Gregianini ◽

Ivana R Santos Varella ◽

Patricia Fisch ◽

Letícia Garay Martins ◽

Ana B G Veiga

Keyword(s):

Influenza Virus ◽

Influenza A ◽

Clinical Symptoms ◽

Antiviral Treatment ◽

Influenza Virus Infection ◽

H3n2 Virus ◽

Influenza Surveillance ◽

Influenza B Virus ◽

Influenza B ◽

Influenza A H1n1

Abstract Influenza surveillance is important for disease control and should consider possible coinfection with different viruses, which can be associated with disease severity. This study analyzed 34 459 patients with respiratory infection from 2009 to 2018, of whom 8011 were positive for influenza A virus (IAV) or influenza B virus (IBV). We found 18 cases of dual influenza virus infection, including coinfection with 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09) and influenza A(H3N2) virus (1 case), A(H1N1)pdm09 and IBV (6 cases), A(H3N2) and IBV (8 cases), and nonsubtyped IAV and IBV (3 cases); and 1 case of triple infection with A(H3N2), A(H1N1)pdm09, and IBV. Compared with 76 monoinfected patients, coinfection was significantly associated with cardiopathy and death. Besides demographic characteristics and clinical symptoms, we assessed vaccination status, antiviral treatment, timeliness of antiviral use, hospitalization, and intensive care unit admission, but no significant differences were found between coinfected and monoinfected cases. Our findings indicate that influenza virus coinfection occurs more often than previously reported and that it can lead to a worse disease outcome.

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Lung function in children with sickle cell disease from Central Africa

Thorax ◽

10.1136/thoraxjnl-2018-212720 ◽

2019 ◽

Vol 74 (6) ◽

pp. 604-606 ◽

Cited By ~ 3

Author(s):

Michele Arigliani ◽

Robert Kitenge ◽

Luigi Castriotta ◽

Pathy Ndjule ◽

Vincenzo Barbato ◽

...

Keyword(s):

Lung Function ◽

Sickle Cell ◽

Sickle Cell Anaemia ◽

Democratic Republic ◽

Central Africa ◽

Sub Saharan Africa ◽

Increased Risk ◽

Republic Of The Congo ◽

Sub Saharan ◽

Restrictive Pattern

Lung function in patients with sickle cell anaemia (SCA) living in sub-Saharan Africa is largely unknown. Anthropometry and spirometry were cross-sectionally evaluated in patients with SCA (HbSS) aged 6–18 years and in schoolchildren from the Democratic Republic of the Congo. The Global Lung Initiative 2012 spirometry reference values were used. A total of 112 patients and 377 controls were included. Twenty-six per cent of patients with SCA had spirometry findings suggestive of a restrictive pattern and 41% had a FEV1 z-score <5th percentile. Wasting, increasing age and female sex were independently associated with increased risk of restrictive spirometry pattern in patients with SCA. Longitudinal studies could clarify the prognostic meaning of these findings.

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Initiation of prenatal genetic diagnosis of sickle cell anaemia in Cameroon (sub-Saharan Africa)

Prenatal Diagnosis ◽

10.1002/pd.2896 ◽

2011 ◽

Vol 31 (12) ◽

pp. 1210-1212 ◽

Cited By ~ 5

Author(s):

Ambroise Wonkam ◽

Cedrik Ngongang Tekendo ◽

Huguette Zambo ◽

Michael A. Morris

Keyword(s):

Sickle Cell ◽

Sickle Cell Anaemia ◽

Genetic Diagnosis ◽

Sub Saharan Africa ◽

Prenatal Genetic Diagnosis ◽

Sub Saharan

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Prevalence of sickle cell disease and sickle cell trait among children admitted to Al Fashir Teaching Hospital North Darfur State, Sudan

BMC Research Notes ◽

10.1186/s13104-019-4682-5 ◽

2019 ◽

Vol 12 (1) ◽

Author(s):

Mudathir A. Adam ◽

Nassreldeen K. Adam ◽

Babiker A. Mohamed

Keyword(s):

Sickle Cell Disease ◽

Sickle Cell ◽

Teaching Hospital ◽

Sickle Cell Anaemia ◽

Sickle Cell Trait ◽

Sub Saharan Africa ◽

Cell Disease ◽

Normal Individuals ◽

Sub Saharan ◽

Hb Concentration

Abstract Objective It is estimated that 50% to 90% of infants born with (SCA) in sub-Saharan Africa die before 5 years old. Northern Darfur State at western Sudan region has a multiethnic population with a high frequency of sickle cell anaemia, but little about it is published. This study aimed to determine the prevalence of sickle cell anaemia among children admitted to Al Fashir Teaching Hospital in Al Fashir, Northern Darfur State, Sudan. Results The prevalence of sickle cell disease by haemoglobin electrophoresis among these 400 children patients was 59 (14.8%). Sickle cell trait patients were 11.3% and Sickle cell disease positive patients were 3.5%. Individuals with SCA have consistently low blood Hb concentration, normal MCV and high mean WBC’s. Individuals with sickle cell trait had haematological parameters near to those of normal individuals.

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Establishing Sickle Cell Diagnostics and Characterizing a Pediatric Sickle Cell Disease Cohort in Malawi

Blood ◽

10.1182/blood.v126.23.2070.2070 ◽

2015 ◽

Vol 126 (23) ◽

pp. 2070-2070

Author(s):

Jonathan Brett Heimlich ◽

Godwin Chipoka ◽

Portia Kamthunzi ◽

Yuri D. Fedoriw ◽

Nigel S. Key ◽

...

Keyword(s):

Blood Pressure ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Joint Pain ◽

Clinical Care ◽

Diagnostic Methods ◽

Sub Saharan Africa ◽

Age Group ◽

Cell Disease ◽

Sub Saharan

Abstract Sickle cell disease (SCD) is highly prevalent in sub-Saharan Africa; however, there are relatively few studies describing the clinical profile for children with laboratory-confirmed SCD. Prior to December 2014, neither neonatal screening nor standardized methods for SCD diagnosis were routinely available in Malawi, as hemoglobin electrophoresis and alternative diagnostic methods were absent. We describe implementation of hemoglobin electrophoresis for children with clinically suspected SCD at Kamuzu Central Hospital, one of two national teaching hospitals in Malawi. Children with clinically suspected SCD were recruited January - May 2015 and underwent comprehensive clinical and laboratory characterization. 137 total patients were recruited and 117 were confirmed to have HbSS disease. Among children who were being cared for as SCD prior to enrollment, 86% had HbSS suggesting generally accurate clinical diagnosis by local providers. Baseline clinical parameters and self-reported SCD complications for the study population are displayed in Table 1. Of those with confirmed SCD, median age was 7.3 years (IQR 2.7-10.4) with 53% males. Prior malaria was reported by 39% of patients, and was higher in the 0-5 age group compared with the over 5 age group (46% vs. 31%, p=0.03). The most commonly reported SCD complications were anemia (72%), joint pain (56%), jaundice (52%), and acute pain episodes (50%). Children with confirmed SCD had median hemoglobin of 7.3 g/dL (IQR 6.9-7.9), total bilirubin of 1.7 mg/dL (IQR 1.1-2.6) and lactate dehydrogenase of 658 IU/L (IQR 527-773). Urinalysis demonstrated 26% of patients with blood and 7% with proteinuria by dipstick. As of May 2015, more than 250 samples for enrolled children as well as routine clinical care had been batch-processed weekly with an average turn-around time of 36 hours for results. Three Malawian laboratory technicians were trained to perform hemoglobin electrophoresis, all of whom have been performing the test independently since April 2015. Our findings highlight a need for wider implementation of resource-appropriate diagnostics as an essential foundation for care and research. Children had substantial clinical and laboratory evidence of SCD-related morbidity. Earlier diagnosis can improve care for this population by facilitating earlier therapeutic interventions, as well as providing a basis for research to better understand SCD-related morbidity in sub-Saharan Africa. These efforts can ultimately inform management strategies to improve outcomes and increase life expectancy among children with SCD in Malawi. Table 1. All (n=117) Male (n= 62) Female (n=55) p value Age years, median (IQR) 7.3 (2.7-10.4) 5.3 (2.3-9.4) 8.9 (4.2-11.9) 0.004 Height cm, median (IQR, n) 115 (88-131, 60) 111 (89-128, 36) 119.5 (93-140, 24) 0.21 Weight kg, median (IQR, n) 19 (13-27, 108) 16.5 (12-23.6, 58) 21 (14-30, 50) 0.01 Blood Pressure Systolic mmHg, median (IQR, n) 103 (98-110, 83) 101 (94-108, 43) 103 (99-110, 40) 0.37 Blood Pressure Diastolic mmHg, median (IQR, n) 60 (55-65, 83) 58 (53-65, 43) 61 (56-68, 40) 0.13 Heart Rate BPM, median (IQR, n) 104 (91-118, 114) 105 (94-123, 61) 104 (88-112, 53) 0.15 O2 Saturation %, median (IQR, n) 93 (88-97, 108) 91 (85-96, 59) 95 (91-98, 49) 0.004 % Hypoxemic (SPO2 < 90%), n (%) 36 (30.7) 26 (41.9) 10 (18.2) 0.005 Body Temperature Celsius, median (IQR, n) 37 (36.7-37.4, 91) 37 (36.7-37, 46) 37 (36.4-37.2, 45) 0.22 Positive History of: Malaria, n (%) 45 (38.5) 22 23 0.34 0-5 years, n (%) 25 (46.3) - - 0.03 6-18 years, n (%) 20 (31.7) - - Pneumonia, n (%) 29 (24.8) 10 (16.1) 19 (34.5) 0.02 HIV, n (%) 0 0 0 - Anemia, n (%) 84 (71.8) 49 (79.0) 35 (63.6) 0.06 Pallor, n (%) 16 (13.7) 7 (11.3) 9 (16.4) 0.43 Jaundice, n (%) 61 (52.1) 33 (53.2) 28 (50.9) 0.82 Received Blood Transfusion, n (%) 87 (74.4) 47 (75.8) 40 (72.7) 0.47 Days since last transfusion, median (IQR) 316 (133-1144) 240 (111-410) 577 (180-1784) 0.03 Pain episodes, n (%) 58 (49.6) 27 (43.5) 31 (56.4) 0.16 Joint pain, n (%) 66 (56.4) 33 (53.2) 33 (60.0) 0.34 Dactylitis, n (%) 41 (35.0) 19 (30.6) 22 (40.0) 0.29 Leg ulcers, n (%) 5 (4.3) 5 (8.1) 0 0.03 Stroke, n (%) 10 (8.5) 5 (8.1) 5 (9.1) 0.84 Nocturnal Enuresis, n (%) 24 (20.5) 12 (19.4) 12 (21.8) 0.74 Disclosures No relevant conflicts of interest to declare.

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Influenza, malaria parasitemia, and typhoid fever coinfection in children: Seroepidemiological investigation in four Health-care Centers in Lagos, Nigeria

10.25259/jpats_2_2020 ◽

2020 ◽

Vol 1 ◽

pp. 26-34

Author(s):

Abdul-Azeez Adeyemi Anjorin ◽

Shola Rachael Babalola ◽

Oluwaseun Paul Iyiade

Keyword(s):

Typhoid Fever ◽

Influenza A ◽

Clinical Symptoms ◽

Epidemiological Data ◽

Health Centers ◽

Chi Square ◽

Cross Sectional ◽

Malaria Parasitemia ◽

Rapid Diagnostic Method ◽

Health Care Centers

Objectives: There are similarities in the presentation of influenza-A infection, malaria, and typhoid fever which include their overlapping clinical symptoms such as fever and myalgia. Coinfection may be easily missed and may lead to more severe associated morbidity. This study, therefore, investigated the prevalence of coinfection of influenza A, malaria, and typhoid fever in children in four locations in Lagos and determined their age, gender, and location-related prevalence. Materials and Methods: A cross-sectional hospital-based study was conducted between March and October 2018. Children less than 15 years attending four health centers in Festac, Amuwo, Ojo, and Shibiri were recruited consecutively. Demographic and epidemiological data were obtained using structured questionnaires, to ascertain children with influenza-like symptoms. Their blood samples were then tested with rapid diagnostic method for malaria and typhoid fever. The children were further screened for influenza-A-specific IgM using ELISA method. Descriptive statistics were reported while p-values were determined for comparable parameters using Chi-square. Results: There were 364 children aged <1–14 years including 207 (56.9%) males. Of the 364 children tested, 76/364 (20.9%) were seropositive for influenza-A virus out of which 47/76 (61.8%) had malaria parasitemia, 42/76 (55.3%) had typhoid fever, and 21/76 (27.6%) were coinfected with both malaria parasites and Salmonella enteric Typhi. Children coinfected with influenza-A and malaria were found with a higher frequency of chest pain and cold/chill symptom respectively compared to children having influenza alone (P = 0.0001). Seropositivity for influenza was recorded in all the months studied with the month of March recording the highest influenza-A seropositivity of 20/76 (26.3%) (P = 0.02). Conclusion: This study detected 27.6% trio coinfection seroprevalence of influenza Type-A, malaria, and typhoid fever among children population. The finding is unique being the first of such report, to the best of our knowledge. Children coinfected with influenza-A and malaria had greater morbidity.

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Pulmonary Hypertension in Adults with Sickle Cell Anaemia: A Prevalence Study in the Niger Delta Region of Nigeria

Asian Journal of Medicine and Health ◽

10.9734/ajmah/2019/v17i130158 ◽

2019 ◽

pp. 1-6

Author(s):

A. N. Mbakamma ◽

C. A. Alikor

Keyword(s):

Pulmonary Hypertension ◽

Sickle Cell ◽

Niger Delta ◽

Sickle Cell Anaemia ◽

Sub Saharan Africa ◽

Prevalence Study ◽

Study Cohort ◽

Delta Region ◽

Niger Delta Region ◽

Port Harcourt

Introduction: Sickle cell anaemia (SCA) is a lifelong multisystem disease endemic in sub Saharan Africa. As the population of patients living with SCA into adulthood continues to increase, pulmonary hypertension has emerged as one of the foremost complications with severe implications on the quality of life and a risk factor for premature mortality. Aims: The present investigation is a prevalence study in the Niger Delta region regarding pulmonary hypertension in adults with sickle cell anaemia. Methods: One hundred and six adults were recruite; fifty-three sickle cell anaemia patients recruited from the outpatient clinic of the haematology department of the University of Port Harcourt teaching hospital, Port Harcourt and 53 genotype AA adults recruited as control. Transthoracic echocardiography was performed on all 106 subjects. The prevalence of pulmonary hypertension was assessed based on tricuspid regurgitation jet of velocity ≥2.5 m/s (estimated SPAP≥30 mmHg). Results: The mean age of the SCA patients was 25.94±6.47 years, (range 18-45 years) while the age group with the highest representation was those within 18–27 years. The proportion of males (52.8%) was slightly higher than that of the females. Pulmonary hypertension was observed in 5.7% while high normal pulmonary artery pressure was observed in 1.9% of the SCA patients studied. Conclusion: The prevalence of pulmonary hypertension in adults living with Sickle Cell Anaemia in this study is 5.7% and it is significantly influenced by the age of the study cohort and the method used in assessing this parameter.

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Gene Therapy : The New Weapon Against Diseases Until There Difficult To Overcome: Some Current Facts Of Gene Therapy And Cases Of Sickle Cell Anaemia

Journal of Clinical Research and Reports ◽

10.31579/2690-1919/075 ◽

2020 ◽

Vol 4 (3) ◽

pp. 01-07

Author(s):

Carolle Kpoumie

Keyword(s):

Gene Therapy ◽

Sickle Cell ◽

Genetic Disease ◽

Sickle Cell Anaemia ◽

Black People ◽

The Body ◽

Sub Saharan Africa ◽

Cell Disease ◽

Mass Migration ◽

Sub Saharan

Sickle cell anaemia is an inherited genetic disease that affects the hemoglobin chains of red blood cell hemoglobin, carrying oxygen less well through the body. It is a rare disease, however, it is the most widespread genetic disease in the world and especially widespread in sub-Saharan Africa. It causes anemia, painful seizures that affect several organs, it is also called sickle cell anemia, this disease results in a deformation of red blood cells in the form of sickle or a crescent moon, which prevents normal circulation in the blood vessels. This will cause blood flow to be blocked. It is a disease that is geographically concentrated in certain areas such as Africa, India, Brazil, the Mediterranean Basin, but it is currently found everywhere because of mass migration and has been considered since 2008 by United Nations as a public health priority. Sickle cell disease affects black people and accounts for 50% of deaths in childhood.

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Increased memory phenotypes of CD4+ and CD8+ T cells in children with sickle cell anaemia in Tanzania

Tanzania Journal of Health Research ◽

10.4314/thrb.v19i2.3 ◽

2017 ◽

Vol 19 (2) ◽

Author(s):

Emmanuel Balandya ◽

Teri Reynolds ◽

Said Aboud ◽

Stephen Obaro ◽

Julie Makani

Keyword(s):

T Cells ◽

B Cells ◽

Sickle Cell ◽

Cd8 T Cells ◽

Sickle Cell Anaemia ◽

Sub Saharan Africa ◽

Effector Memory ◽

Absolute Increase ◽

Memory Cd8 T Cells ◽

Activation Status

Background: Infection is an important cause of morbidity in children with sickle cell anaemia (SCA). However, little is currently known regarding the spectrum of adaptive immune derangement in SCA, especially of populations in Sub-Saharan Africa. In this study, we investigated the phenotype and activation status of T and B lymphocytes among children with SCA in Tanzania.Methods: We compared 30 children with SCA aged 1–6 years in steady-state with 10 age-matched controls. We assessed white blood cell count, T and B lymphocyte phenotype and activation status using an automated haematology analyser and multiparameter Flow Cytometry.Results: In children with SCA, the absolute lymphocyte, monocyte and granulocyte counts were all increased. There was also an increase in proportion of central/transitional memory (42.4% vs. 33.3%, p = 0.0100), effector memory (7.8% vs. 5.4%, p = 0.0086) and terminally differentiated (2.3% vs. 1.3%, p = 0.0355) CD4+ T cells as well as effector memory CD8+ T cells (21.3% vs. 11.5%, p = 0.0060) in children with SCA. In contrast, there was no difference in naïve, classical memory, atypical memory and IgM memory B-cells between the two groups. The level of activation of both T and B cells were comparable between children with and without SCA. Furthermore, we observed a significant inverse correlation between frequency of the effector memory CD8+ T cells and haematocrit (Spearman rho = -0.3859, p = 0.0352). Conclusions: Children with SCA in Tanzania show an absolute increase in all leukocyte types, including lymphocytes, with skewing of both CD4+ and CD8+ T cells towards the memory phenotypes. These findings provide insights on the development of adaptive immunity which may have implications on vaccine responsiveness, allo-immunisation, auto-immune diseases and transplant immunology in children with SCA.

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