S M Agwale

Nasarawa State University, Keffi, Nassarawa State, Nigeria

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Publications (11)6.57 Total impact

  • Source
    Article: CD4- and CD3-T lymphocyte reference values of immunocompetent urban and rural subjects in an African nation.
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    ABSTRACT: Studies on the reference values of CD4 and CD3 T cells in healthy individuals have continued to gain significance because of the importance of these immunological markers in the initiation of combination antiretroviral therapy (cART). The aim of the present study was to determine and compare the reference values of CD4 and CD3 T cells in urban and rural Nigerians who were human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) negative. After ethical clearance and informed consent, 1123 subjects who met the inclusion criteria [mean age = 24.4 (± 11.2) years] were recruited in this study. Blood samples were analysed using the BD FACScount cytometer according to the manufacturer's instructions. Of the overall 1123 subjects, reference means of CD4, CD3 and CD4/CD3 ratio were 1030 ± 367, 1757 ± 609 cells/μl and 0.59 ± 0.08, respectively. Five hundred and fifty-one (49.1%) were an urban population with the mean CD4, CD3 and CD4/CD3 T cell ratio of 1032 ± 369, 1761 ± 612 cells/μl and 0.59 (±0.08), respectively. The remaining 572 (50.9%) were of a rural population with the mean CD4, CD3 and CD4/CD3 T cell ratio of 1028 ± 459, 1753 ± 958 cells/μl and 0.59 ± 0.13, respectively. Subjects with higher CD4 and CD3 T cells were more likely to be female than male (P < 0.05). There was no significant difference between the T cell values of the two populations (P > 0.05). Our findings provide new insight in the CD4 and CD3 T cell reference values of Nigerians.
    Scandinavian Journal of Immunology 07/2012; 76(1):33-8. · 2.23 Impact Factor
  • Article: Quantification of human immunodeficiency virus-1 viral load using nucleic acid sequence-based amplification (NASBA) in north central Nigeria.
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    ABSTRACT: Viral load (VL) quantification is considered an integral part of the standard care in human immunodeficiency virus (HIV) infected individuals but in Nigeria as in most of sub-Saharan Africa, this has not reached the majority ofpatients. We report the first field application of the NucliSens EasyQ HIV-1 platform for the real time quantification of HIV-1 VL combining NASBA amplification and real time detection with molecular beacons among HIV-1 infected individuals in north central Nigeria where the predominant HIV-1 subtypes are CRF02_AG and G. CD4+ counts were enumerated using a fluorescence-activated cell sorter system. Of one hundred and forty nine (n=149) plasma sample from patients with mean age of 32 years and made up of 77 males and 72 females, fifty {n=50 (37.9%); 28 males and 22 females} had VLs below the lower detection limit (LDL=25 IU/ml) set by the assay while eighty-two {n=82 (62.1%); 39 males and 43 females} had VL levels above the LDL. Furthermore, 13 of 82 (15.9%) patients with viral loads above the LDL had VLs between 26-1000 IU/ml while 69 (84.1%) had VLs of 1001-2,400,000 IU/ml. 17 (11.4%) of the samples could not be analyzed due to poor viral amplification. Among individuals with both CD4+ and VL results (n=56), those with CD4+ of 1-418 cell/microl presented with higher VL usually above 45,000 IU/ml when compared with those with CD4+ of over 500 cell/microl. Our findings highlight the pattern, usefulness and feasibility ofVL quantification by NucliSens EasyQ in monitoring HIV-1 patients in Nigeria.
    Nigerian journal of clinical practice 09/2010; 13(3):284-7. · 0.19 Impact Factor
  • Conference Proceeding: Sero-prevalence and Co-infection of HIV and HBV in a Nigerian Rural Community
    M.P. Adoga, G. Pennap, S.D. Agya, S.M. Agwale
    5th National Conference of HIV/AIDS, May 2nd -5th,, Abuja, Nigeria; 01/2010
  • Conference Proceeding: High Prevalence of HIV/TB Co-infection in a Cohort of Nigerian TB Patients and Evaluation of a Rapid TB Serological Assay
    XVIII International AIDS Conference., Vienna, Austria.; 01/2010
  • Article: Inverted CD4+/CD8+ ratio associated with AIDS event and death in HIV-1 infected individuals in Nasarawa State, Nigeria.
    J C Forbi, S M Agwale
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    ABSTRACT: The current guidelines for the use of antiretroviral therapy in Nigeria places emphasis on the use of CD4+ enumeration to take decision of initiating antiretroviral therapy and HIV disease monitoring. CD4+ counts are known to be inherently inconsistent and therefore could be misleading. This study was undertaken to analyze the CD4+/CD8+ ratio vis-à-vis CD4+ in HIV-1 infected individual in North Central Nigeria and to correlate these immunological parameters to AIDS event and death in relation to gender and age of patients. Cell counts were carried out using a Fluorescence Activated Cell Sorter (FACS) that quantifies CD4+ and CD8+ T lymphocytes as absolute numbers of lymphocytes per microL of blood and the CD4+/CD8+ T lymphocyte ratio recorded in an automated fashion. A total of 290 HIV-1 positive persons were enrolled for this study. The median CD4+/CD8+ ratio were 0.05, 0.27, 0.64 in patients with CD4+ counts of < 50, 51-200, > 350 respectively. CD4+/ CD8+ of 0.05 and 0.27 were corresponding predictors of AIDS-related event and death. Patients with > 0.64 are predictive of better disease prognosis and low progression to AIDS. The CD4+/CD8+ were minimally higher in female patients with a median CD4+/CD8 ratio of 0.27. The age distribution of our patients at point of first entry was not found to influence CD4+/CD8+ ratios. These findings provide basic and critical CD4+/CD8+ cut-off values in predicting HIV disease progression and an alternative to absolute CD4+ counts at predicting the onset of HIV related disease. These data are useful to determine when intervention with antiretroviral therapy is needed and to determine the likelihood of virological failure.
    Tanzania journal of health research 07/2009; 11(3):144-8.
  • Article: A review of the disease burden, impact and prevention of typhoid fever in Nigeria.
    O H Iperepolu, P E Entonu, S M Agwale
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    ABSTRACT: Typhoid fever is still a common infection in many parts of the world, especially in developing countries where sanitation and water supply are a common problem. A recent study placed the disease burden at 21650 974 illnesses and 216510 deaths during 2000. The infection is a major cause of morbidity and mortality in Nigeria. This review set out to present in one concise volume a review of the major findings from published articles on the burden and impact of typhoid fever in Nigeria to aid easy reference for researchers. It highlights the disease burden, the different diagnostic methods and their sensitivities, complications, treatment methods as well as the various preventive measures including the use of typhoid vaccine in the control of the disease. Several published articles covering a period of 40 years were accessed different journals and reviewed, and their major findings presented in this review. The disease burden from typhoid fever in Nigeria is still high with associated serious complications, which in most cases have been managed effectively with the use of potent antibiotics and surgical intervention. However, the typhoid problem has been compounded by the emergence and circulation of multi-drug resistant strains of the organism being sensitive only to the newer generation antibiotics. Typhoid fever remains a major public health problem in Nigeria. The infection however can be prevented by good sanitation, improving good water supply, the provision of proper sewage disposal system, as well as the effective use of the available typhoid vaccines. The government and people of Nigeria should rise up to the challenge of stamping out this ugly trend.
    West African journal of medicine 08/2008; 27(3):127-33.
  • Article: A review of the epidemiology, prevention and treatment of human immunodeficiency virus infection in Nigeria.
    P E Entonu, S M Agwale
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    ABSTRACT: In order to amalgamate research findings on HIV/AIDS in Nigeria as well as the trend of the infection in a concise manner, we reviewed published articles on the HIV/AIDS situation in Nigeria. We categorized this review into several subheadings. The HIV prevalence rate has continued to rise steadily from less than 0.1% in 1987, to 5.8% in 2001, with a slight decrease in 2003 to 5.0%. Although the knowledge about HIV and its mode of transmission is widespread, it is however disheartening to note that this did not result into appreciable attitudinal change and behavior modification among Nigerians. Both HIV-1 and HIV-2 have been identified in Nigeria, with HIV-1 being the predominant type. Furthermore, several subtypes like subtypes A, B, C, G and J have been identified in Nigeria, with several recombinant forms like the CRF02_AG; the major ones being A, G and CRF02_AG. HIV-infected patients in Nigeria are also co-infected with other viral and bacterial infections, the commonly reported ones being co infections with hepatitis B and C. Although treatment of infected patients has increased recently, more effort is needed, especially in the area of patients monitoring, to maximize the benefits of ART in Nigeria. Finally, Nigeria has made appreciable efforts in vaccine development and candidate HIV DNA vaccines have been developed utilizing the sequences from predominant subtypes, and these candidates have been shown to be immunogenic in animal models. It is therefore clear that only the integration of prevention and antiretroviral research programmes into a coherent programme that is needed to address the public health needs that HIV/AIDS crisis represents for Nigeria.
    Brazilian Journal of Infectious Diseases 01/2008; 11(6):579-90. · 1.00 Impact Factor
  • Conference Proceeding: Human immunodeficiency virus, hepatitis B virus and hepatitis C virus: sero-prevalence, co-infection and risk factors, among prison inmates in Nasarawa State, Nigeria
    AIDS 2008 - XVII International AIDS Conference, Mexico; 01/2008
  • Article: The role of triple infection with hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV) type-1 on CD4+ lymphocyte levels in the highly HIV infected population of North-Central Nigeria.
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    ABSTRACT: We set out to determine the seroprevalence of hepatitis B and C among human immunodeficiency virus type-1 (HIV-1) infected individuals in North-Central Nigeria to define the influence of these infections on CD4+ lymphocytes cells among our patients as access to antiretroviral therapy improves across the Nigerian nation. The CD4+ values of 180 confirmed HIV-1 infected individuals were enumerated using a superior fluorescence-activated cell sorter system. These patients were tested for the presence of hepatitis B surface antigen and anti-hepatitis C virus (HCV) using third generation enzyme-linked immunosorbent assays. Fifty (27.8%) patients had active hepatitis B virus (HBV) infection while 33 (18.3%) tested positive for anti-HCV antibody. Of these infections, 110 (61.1%), 37 (20.6%), and 20 (11.1%) had HIV only, HBV/HIV-only, and HCV/HIV-only respectively. A HBV/HCV/HIV coinfection prevalence of 7.2% (13 patients) was recorded. Patients coinfected with HIV/HBV/HCV appeared to have lower CD4+ counts (mean = 107 cells/microl; AIDS defining) when compared to HBV/HIV-only (mean = 377 cells/microl), HCV/HIV-only (mean = 373 cells/microl) and patients with mono HIV infection (mean = 478 cells/microl). Coinfection with HBV or HCV is relatively common among HIV-infected patients in Nigeria and should be a big consideration in the initiation and choice of therapy.
    Memórias do Instituto Oswaldo Cruz 07/2007; 102(4):535-7. · 2.15 Impact Factor
  • Article: High prevalence of hepatitis B virus among female sex workers in Nigeria.
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    ABSTRACT: Hepatitis B virus (HBV) infection is endemic in Nigeria and constitutes a public health menace. The prevalence of HBV infection in many professional groups has been described in Nigeria. However, literature on HBV infection among female sex workers (FSW) in Nigeria is scanty. FSW in Nigeria are not subjected to a preventive control of HBV infection. This study assesses the extent of spread of HBV among FSW in Nigeria. Seven hundred and twenty (n = 720) FSW (mean age = 26.7 years) were tested for hepatitis B surface antigen (HBsAg) by a double antibody sandwich ELISA method. The overall HBV prevalence among the FSW was 17.1%. FSWs between the ages of 31-35 year (20.5%) and those with 'age-at-first-sex' below 10 years of age (28%) were most affected. This high prevalence of a vaccine preventable disease is unacceptable, therefore, vaccination of this high risk HBV reservoir group should be considered worthwhile.
    Revista do Instituto de Medicina Tropical de São Paulo 50(4):219-21. · 1.00 Impact Factor
  • Article: Inverted CD4+/CD8+ ratio associated with AIDS event and death in HIV- 1 infected individuals in Nasarawa State, Nigeria
    J C Forbi, S M Agwale
    [show abstract] [hide abstract]
    ABSTRACT: The current guidelines for the use of antiretroviral therapy in Nigeria places emphasis on the use of CD4+ enumeration to take decision of initiating antiretroviral therapy and HIV disease monitoring. CD4+ counts are known to be inherently inconsistent and therefore could be misleading. This study was undertaken to analyze the CD4+/CD8+ ratio vis-à-vis CD4+ in HIV-1 infected individual in North Central Nigeria and to correlate these immunological parameters to AIDS event and death in relation to gender and age of patients.Cell counts were carried out using a Fluorescence Activated Cell Sorter (FACS) that quantifies CD4+ and CD8+ T lymphocytes as absolute numbers of lymphocytes per mL of blood and the CD4+/CD8+ T lymphocyte ratio recorded in an automated fashion.A total of 290 HIV-1 positive persons were enrolled for this study. The median CD4+/CD8+ ratio were 0.05, 0.27, 0.64 in patients with CD4+ counts of <50, 51-200, >350 respectively. CD4+/CD8+ of 0.05 and 0.27were corresponding predictors of AIDS-related event and death. Patients with >0.64 are predictive of better disease prognosis and low progression to AIDS. The CD4+/CD8+ were minimally higher in female patients with a median CD4+/CD8 ratio of 0.27. The age distribution of our patients at point of first entry was not found to influence CD4+/CD8+ ratios.These findings provide basic and critical CD4+/CD8+ cut-off values in predicting HIV disease progression and an alternative to absolute CD4+ counts at predicting the onset of HIV related disease. These data are useful to determine when intervention with antiretroviral therapy is needed and to determine the likelihood of virological failure.
    Tanzania Journal of Health Research (ISSN: 1821-6404) Vol 11 Num 3.