Akaninyene Asuquo Otu

University of Calabar | unical · Department of Internal Medicine

Background:

Introduction: There is a rise in the emergence of multidrug resistant fungal pathogens worldwide, including in Africa. Method: This systematic review summarized the published data on the mechanisms and epidemiology of antifungal resistance in Candida species in Africa between 2000 and early 2024. Result: Seventeen reports from seven African co...

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. This chapter explores the pathogenesis, diagnosis, and management of the various entities of aspergillosis in COPD including chronic pulmonary aspergillosis (CPA) invasive aspergillosis (IA), Aspergillus sensitisation, and community-acquired Aspergillus pneu...

Background Current tuberculosis management algorithm in Nigeria recommends commencement of multi-drug resistant tuberculosis (MDR-TB) treatment on rifampicin resistance detection, following XpertMTB/Rif (Genexpert) test and subsequent re-direction of therapy after phenotypic drug susceptibility testing. With the current dearth of phenotypic drug su...

Background Diabetes can be detected at the primary health-care level, and effective treatments lower the risk of complications. There are insufficient data on the coverage of treatment for diabetes and how it has changed. We estimated trends from 1990 to 2022 in diabetes prevalence and treatment for 200 countries and territories. Methods We used da...

Background Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hyper...

Background Africa has the highest prevalence of hypertension at 46%. Schoolteachers are vulnerable to hypertension due to work-related and general risk factors. Identifying these factors is key to providing interventions. Aim This study aimed to determine the prevalence of hypertension and associated factors among schoolteachers in Calabar, Nigeri...

Background Sepsis is a leading cause of morbidity and mortality especially in low- and middle-income countries such as Nigeria. Training of health workers using digital platforms may improve knowledge and lead to better patient outcomes. Objectives To assess the effectiveness of a digital health educational module on sepsis in improving the knowle...

Summary Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data...

The global increase in the frequency of infectious-disease epidemics has rekindled interest in the role of disruption of the human–animal–environment interface by human activities in propagating disease outbreaks. It is estimated that zoonotic diseases account for >75% of emerging infectious diseases. Human modifications to the environment via agri...

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and de...

Objectives: A novel 'subscription-type' funding model was launched in England in July 2022 for ceftazidime/avibactam and cefiderocol. We explored the views of infection consultants on important aspects of the delinked antimicrobial funding model. Methods: An online survey was sent to all infection consultants in NHS acute hospitals in England....

Cryptococcosis is a neglected tropical disease and the main cause of fungal related deaths in HIV-positive persons in Africa. It is an AIDS-defining illness that has almost surpassed tuberculosis (TB) in mortality despite wide coverage with antiretroviral therapy. What is known about the cryptococcosis burden in Africa is from estimations based on...

Despite the criminalization of the practice by numerous laws and international treaties in most countries concerned, female genital mutilation/cutting (FGM/C), although on the decline overall, is stagnating or tending to increase in some parts Africa. This relative failure in the fight against FGM/C could be explained from an institutional perspect...

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. In this review, we present the clinical spectrum and pathogenesis of syndromes caused by Aspergillus in COPD namely invasive aspergillosis (IA), community-acquired Aspergillus pneumonia, chronic pulmonary Aspergillosis and Aspergillus sensitisation. Some of...

On July 2022, NHS England launched a novel delinked “subscription-type” payment model for ceftazidime/avibactam and cefiderocol. This funding model is intended to allow affordable use of these antimicrobials for patients with drug-resistant infections in individual NHS Trusts. It also aims to align industry financial incentives with good stewardshi...

The COVID-19 pandemic has ushered in high-throughput sequencing technology as an essential public health tool. Scaling up and operationalizing genomics in Africa is crucial as enhanced capacity for genome sequencing could address key health problems relevant to African populations. High-quality genomics research can be leveraged to improve diagnosi...

Invasive fungal infections are a serious concern globally, especially in African settings which are typified by poorly funded and fragile healthcare systems. Low performance diagnostics, limited therapeutics and poor societal awareness of invasive fungal infections are some of the perennial challenges which have contributed to the unacceptably high...

Probiotic-based multi-component preparations refer to a mixture of bioactive agents, containing probiotics or postbiotics as main functional ingredients, and prebiotics, protectants, stabilizers, encapsulating agents, and other compounds as additional constituents.

Following the confirmation on July 21, 2022, of a case of poliomyelitis related to circulating vaccine-derived poliovirus (cVDPV) type 2 in an unvaccinated adult from Rockland County, NY, USA,1 there has been a renewed global drive to strengthen surveillance for the detection of cases and increase vaccination coverage against polio. This is the fir...

Background: Sickle cell anaemia (SCA) is associated with significant morbidity and mortality linked to multi-systemic complications. With recent improvements in healthcare globally, it is expected that SCA patients in Nigeria will live longer. The cardiovascular complications may thus become prevalent. Subjects and methods: Fifty-two patients wi...

Objective To pilot the use of a scalable innovative mobile health (mHealth) non-communicable diseases (NCDs) training application for nurses at the primary care level. Design Mixed methods pilot of mHealth training on NCD care for nurses at primary healthcare (PHC) facilities. We provide a descriptive analysis of mHealth training test scores, with...

Probiotics and related preparations, including synbiotics and postbiotics, are living and non-living microbial-based multi-components, which are now among the most popular bioactive agents. Such interests mainly arise from the wide range and numerous beneficial effects of their use for various hosts. The current minireview article attempts to provi...

Following the confirmation on July 21, 2022, of a case of poliomyelitis related to circulating vaccine-derived poliovirus (cVDPV) type 2 in an unvaccinated adult from Rockland County, NY, USA,1 there has been a renewed global drive to strengthen surveillance for the detection of cases and increase vaccination coverage against polio. This is the fir...

It is unclear how statin-use influences the adoption of healthy lifestyle choices. It is important to understand the nature of this relationship as this could facilitate targeted public health interventions which could help promote a healthy lifestyle, curb the rise of non-communicable diseases, and facilitate overall health. This study aimed to ex...

Introduction Sepsis is a leading cause of morbidity and mortality worldwide. In low- to middle-income countries (LMICs) such as Nigeria, the disproportionately high mortality rate is linked to lack of awareness, poor recognition, and late implementation of sepsis care bundles among health workers. Training of health workers using digital platforms...

Following confirmation of the first case of monkeypox in the UK by the UK Health Security Agency (UKHSA) on May 7, 2022, events have evolved with dizzying rapidity—as of May 21, 2022, 92 laboratory confirmed cases and 28 suspected cases of monkeypox have been reported in 12 non-endemic countries across three WHO regions.1 Monkeypox is a rare viral...

As of 21 May, 92 laboratory confirmed cases, and 28 suspected cases of monkeypox have been reported in 12 non-endemic countries across three WHO regions (See Table 1).1 There are concerns that this outbreak of monkeypox may become the next global pandemic. Complicating the situation is the fact that most of the cases have occurred in gay, bisexual...

We read with keen interest the BMJ report of seven cases of monkeypox that were confirmed in the UK by the 16 May 2022. Since then, 13 more cases of monkeypox have been identified by The UK Health security Agency (UKHSA) bringing the total number of monkeypox cases confirmed in the UK to 20 as of 20 May 2022. Why are these cases generating so much...

Background: Hepatitis D virus (HDV) can cause a chronic infection in the presence of hepatitis B surface antigen and contribute to the burden of chronic liver disease especially in regions where chronic hepatitis B virus (HBV) infection is endemic. Aim: To determine the prevalence and risk factors of HDV among asymptomatic carriers of HBsAg in C...

Dear Editor, We read with keen interest the recent article in The BMJ about cases of idiopathic hepatitis in children around the world. We are concerned that the gains of multi-sectoral mitigation responses to COVID-19 is under threat by this evolving situation. Cases of idiopathic acute hepatitis were first identified in Scotland among 11 childre...

Background The burden of hepatitis B and hepatitis C virus (HBV, HCV) infection is exceptionally high in sub-Saharan Africa (SSA). Many countries in the SSA region are classified as hyperendemic for HBV by the World Health Organization (WHO), with West Africa being most affected. Data from the WHO suggest that Africans infected with hepatitis virus...

Sickle cell disorder (SCD) is a multisystem disease with heterogeneous phenotypes. Although all patients have the mutated hemoglobin (Hb) in the SS phenotype, the severity and frequency of complications are variable. When exposed to low oxygen tension, the Hb molecule becomes dense and forms tactoids, which lead to the peculiar sickled shapes of th...

The increasing global human population is projected to reach 9.7 billion people by 2050. This population growth is currently linked to the trends of world-wide urbanization, growth of megacities and shifting dietary patterns. While humankind faces the daunting challenge of feeding and providing healthy lives for its teeming populations, urban agric...

Feasibility of personalized medical care for patients with sickle cell anaemia using a lab-on-chip microfluidic platform to mimic and unravel components of vaso-occlusive crisis. Abstract: Sickle cell disorder (SCD) is a multisystem disease with heterogeneous phenotypes. Although all patients have the mutated haemoglobin (Hb) in the SS phenotype, t...

The increasing global human population is projected to reach 9.7 billion people by 2050. This population growth is currently linked to the trends of worldwide urbanization, growth of megacities, and shifting dietary patterns. While humankind faces the daunting challenge of feeding and providing healthy lives for its teeming populations, urban agric...

The African Union Bureau of Heads of State and Government endorsed the COVID-19 Vaccine Development and Access Strategy to vaccinate at least 60% of each country’s population with a safe and efficacious vaccine by 2022, to achieve the population-level immunity needed to bring the pandemic under control. Using publicly available, country-level popul...

STIs are infections that result from the transmission of a pathogenic organism by sexual contact. Globally, STIs constitute a major burden and a significant public health challenge, driven by health systems challenges related to inadequately resourced, poor quality services on the one hand and social stigma and discrimination surrounding STIs on th...

Background and objectives Commercial Aspergillus IgG antibody assays have become pivotal in the current diagnosis of chronic pulmonary aspergillosis (CPA). However, diagnostic cutoffs have been found to vary from manufactures’ recommendations in different settings. This study aimed to establish the Aspergillus IgG reference range among Nigerians an...

Aspergillus fumigatus is a species of fungus that is commonly found in the environment, household dust, soil, and decaying plant matter. The fungus produces spores which are inhaled by humans daily, although the host defence mechanisms of most people limit inflammatory responses and promote fungal clearance. Inhalation of the spores of A fumigatus...

Background: Health worker training is an essential component of epidemic control; rapid delivery of such training is possible in low-middle income countries with digital platforms. Methods: Based on prior experience with the Ebola outbreak, we developed and deployed a bespoke InStrat COVID-19 tutorial app, to deliver accurate and regularly updated...

Background and Aims: Patients with chronic pulmonary aspergillosis (CPA) who discontinue antifungal therapy commonly exhibit disease recurrence. We aimed to evaluate the utility of the St. George’s respiratory questionnaire (SGRQ) in predicting the likelihood of clinical recurrence of CPA in patients who come off antifungal therapy. Methods: This a...

Paul Adepoju provides a report on how Africa lags behind in the global race to roll out COVID-19 mass vaccination. This race is unprecedented and characterized by high-income countries adopting strategies such as pre-ordering millions of doses before the COVID-19 vaccines completed clinical trials. Africa has now embarked on the biggest immunisatio...

Abstract Background: As part of the Global Action Plan against antimicrobial resistance (AMR), countries are required to generate local evidence to inform context-specifc implementation of national action plans against AMR (NAPAR). We aimed to evaluate the knowledge, attitude, and practice (KAP) regarding antibiotic prescriptions (APR) and AMR a...

Urbanization, armed confict, and deforestation in African countries have increased the risk of zoonotic infections, which requires a One Health approach focused on the environment, animal health and human health. This approach facilitates the assessment of risks from the human-animal-environment interface. Only by fully implementing One Health appr...

Background: As part of the Global Action Plan against antimicrobial resistance (AMR), countries are required to generate local evidence to inform context-specific implementation of national action plans against AMR (NAPAR). We aimed to evaluate the knowledge, attitude, and practice (KAP) regarding antibiotic prescriptions (APR) and AMR among physi...

Mobile health (mhealth) tools delivered through wireless technology are emerging as effective strategies for delivering quality training, ensuring rapid clinical decision making, and monitoring implementation of simple and effective interventions in under-resourced settings. We share our early experience of developing and deploying the InStrat COVI...

Across Africa, there is some evidence of COVID-19 private sector activities to tackle COVID-19 which include the development of rapid diagnostic kits, deployment of e-health platforms for bespoke health workforce training, disease surveillance, reporting, auto-screening and advisories. Inequities in living and access to care by disadvantaged popula...

Background As part of the Global Action Plan against antimicrobial resistance (AMR), countries are required to generate local evidence to inform context-specific implementation of national action plans against AMR (NAPAR). We aimed to evaluate the knowledge, attitude, and practice (KAP) regarding antibiotic prescriptions (APR) and AMR among physici...

On 3 March 2020, the first case of coronavirus was confirmed in the country, approximately five months after 18 October 2019, one of Chile’s biggest episodes of civil unrest since its return to democracy in the 90s [1]. This social unrest was triggered by deep social inequalities and resulted in massive protests throughout the country. The citizens...

A significant proportion of the world’s population does not have access to essential health services, incurs catastrophic health expenditure, and suffers impoverishment owing to out-of-pocket (OOP) expense. The World Health Organization (WHO) has identified “achieving Universal Health Coverage (UHC), with one billion more people benefitting from th...

Madam, Bloodstream infections (BSI) constitute a significant disease burden and are estimated to affect more than 30 million people worldwide every year resulting in over 6 million deaths [1]. Prompt identification of microorganisms grown in blood cultures facilitates earlier targeted clinical intervention for patients with sepsis. Therefore, reduc...

Isavuconazole is the newest triazole antifungal, and it displays a favorable pharmacokinetic and safety profile. Less is known about its long-term use in immunocompetent hosts. We performed a retrospective service evaluation of isavu-conazole therapeutic drug monitoring in patients with chronic pulmonary aspergillo-sis. Adverse events (AEs) and dos...

There has been mounting evidence of the disproportionate involvement of black, Asian and minority ethnic (BAME) communities by the Covid-19 pandemic. In the UK, this racial disparity was brought to the fore by the fact that the first 11 doctors to die in the UK from Covid-19 were of BAME background. The mortality rate from Covid-19 among people of...

Introduction: it has been estimated that about 11.8% of the Nigerians suffer serious fungal infections annually. A high index of suspicion with early diagnosis and institution of appropriate therapy significantly impacts on the morbidity and mortality of invasive fungal infections (IFIs). Methods: we conducted a cross-sectional multicentre surve...

The coronavirus disease 2019 (COVID-19) is now a pandemic with devastating social and economic consequences. The extent of the spread of COVID-19 within populations is uncertain since diagnostic tests have not been carried out on all eligible persons and doing such diagnostic tests on everyone is much less feasible in developing countries such as N...

Histoplasmosis, caused by the thermally dimorphic fungus Histoplasma capsulatum, is an uncommon multisystem disease with a global distribution. The spectrum of clinical manifestations ranges from an asymptomatic or minimally symptomatic acute pulmonary disease following inhalation of a large inoculum of Histoplasma microconidia to chronic pulmonary...

The COVID-19 pandemic has ushered in a new climate of uncertainty which is fuelling protectionism and playing into nationalist narratives. Globalisation is under significant threat as governments scramble to reduce their vulnerability to the virus by limiting global trade and flows of people. With the imposition of border closures and strict migrat...

With one of the highest testing rates of COVID-19 in Latin America, Chile continues to record low mortality rates from the disease. Several measures such as curfews, cancellation of large gatherings, and closure of schools and businesses have been implemented. Against the backdrop of high levels of alcohol/substance abuse, mental health disorders,...

COVID-19 has further exposed the strong association between race, ethnicity, culture, socioeconomic status and health outcomes and illuminated monumental ethnoracialised differences reflecting the ‘colour of disease’. Racism, segregation and inequality have been invisibly and pervasively embedded in dominant cultures and social institutions for de...

The novel SARS-CoV-2 coronavirus pandemic has emerged as a truly formidable threat to humankind’s existence. In the wake of the massively volatile global situation created by COVID-19, it is vital to recognize that the trauma it causes can affect people in different ways, at the individual and collective levels, resulting in mental health challenge...