Infections: HIV and related-diseases, anti-microbial resistance and neglected tropical diseases

In this infectious disease section of the June issue of African Health Sciences, we begin with papers on ‘the usual suspect’ HIV; which contributes a significant portion of disability adjusted life years lost in low and middle-income countries. Howlett reviews HIV neurological disorders in Africa, and characterizes them based on their aetiology into: HIV infection, auto immune, and opportunistic process related disorders¹. Nigerian authors report on adrenocortical deficiency² and Hepatitis B virus³, among HIV patients. Viruses have unexpected effects, which are often ignored by clinicians. Bal et al report on reduced pulmonary function among participants with high Hepatitis C viremia⁴. Ugandan authors classify and describe chronic pain among HIV patients. They report that 1/5^th of all HIV patients had chronic pain and this was associated with poor quality of life⁵.

From HIV and related diseases, we turn to anti-microbial resistance:

Anti-microbial resistance is a growing threat world wide, and in this issue, we offer some insight into the subject in the Africa context. Tunisian authors report high prevalence of Extended Spectrum Beta-Lactamase (ESBL) producing bacteria⁶ and on carbapenem resistance mechanisms in Klebsiella Pneumoniae isolates⁷. Crossing over to gram-positive bacteria, Nigerian authors⁸ report on the phenotypes of methicillin resistant Staphylococcus aureus. Out of Africa, Chinese authors report on multidrug resistant bacteria among patients re-admitted with acute exacerbations of chronic obstructive pulmonary disease (COPD). They found that the commonest potentially pathogenic organism isolated from patients with acute exacerbation of COPD as Pseudomonas aeroginosa⁹. Saleh et al give us insight into how we can tackle Pseudomonas aeruginosa¹⁰. Ugandan authors report that 9% of culture confirmed TB patients developed recurrent TB, and they determined predictors of recurrence¹¹.

Neglected tropical diseases:

Nigerian authors report that Dengue is a growing public health problem in their country¹², and that levels of stigma against Buruli ulcer disease are high¹³. On the surgical front, Salako et al report that 10% of patients who underwent prostatectomy in a Nigerian Teaching Hospital suffered from a surgical site infection¹⁴, while Omorogiuwa et al report that Cymbopogoncitratus Stapf leaf is a potential treatment of male reproductive related infections¹⁵.

Gastrointestinal infections are a major cause of morbidity and mortality in under-5 year olds. One of the greatest public health advances in the last century was the development of vaccines. However the failure to maintain a cold chain renders the efficacy of most vaccines uncertain. Osaretin et al report that a monovalent rotavirus vaccine remained potent after exposure to different temperatures in South Africa¹⁶, which is good news. Subbaram et al recommend immune magnetic polymerase chain reaction for the molecular identification of diarrheal Aeromonas from clinical specimens¹⁷. Babatola et al report that one third of asymptomatic under-five children at a tertiary hospital in South West Nigeria had anti H.Pylori Ig G in their blood; and they determine the risk factors for this sero-positivity¹⁸, this is scary news given that H. Pylori is a group 1 carcinogen.

Enjoy the section!