In this volume 29, No.3, 2019, we are grateful to our esteemed reviewers who found nine (9) manuscripts worthy of publication. Other manuscripts received from August to December 2019 that are not published in this volume, are either rejected as recommended by the reviewers or still undergoing peer-review Ndiokwere et al from Medical Microbiology Unit, Medical Laboratory Services, University of Benin Teaching Hospital whose article was chosen as a cover page used State-of-the-art sequencing technology, involving 16S rRNA metagenomics to determine bacterial communities present in Seminal fluid samples. Ibeh et al from Department of Medical Laboratory Science, Nnamdi Azikiwe University, Nnewi found a deficiency or lower level in vitamin B12 to be associated with infertility particularly in primary and recurrent abortion cases in women subjects studied. Finally, Omisakin et al from the Department of Haematology, State Specialist Hospital, Abeokuta, Ogun State, established reference values in Abeokuta instead of usin.g Caucasians values, in order to prevent the wrong diagnosis of iron related diseases. Enjoy all the articles and Merry Christmas and more efforts in 2020.

Introduction: Vitamin B12 deficiency is emerging as a growing public health problem in obstetrics. A number of studies show vitamin B12 deficiency to be a risk factor in female infertility. Conventionally hormonal assay has been used in the investigation of infertility; this is without recourse to vitamin B12 assay. This study therefore aims at estimating vitamin B12 level in infertile women attending Obstetrics and Gynecology clinic in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi with the view of determining its role or relationship in female fertility in the study subjects. Method: A total of 165 subjects with different fertility status who were in the child bearing age were recruited into this cross sectional and comparative study through simple random sampling. The enlisted subjects were then grouped into 4 based on their fertility status: group A (35) had primary infertility, group B (22) had secondary infertility, group C (28) had recurrent miscarriages and group D (80) were non pregnant fertile women as control. Fasting blood (5mls) was collected, 2mls was dispensed into EDTA bottles for FBC determination using Procan PE 6800 analyzer and the remaining 3mls dispensed into plain container, the serum was used for batch vitamin B12 estimation by ELISA method. Results: Vitamin B12 (pg/ml) level of the infertile subjects was 232.15±241.13 while the control 406.29±214.58. Comparison using t-test, a statistical difference of (p < 0.05) was observed. The Vitamin B12 for each of the 4 groups based on their fertility status using ANOVA test statistics: group A was 174.33±156.94; group B had 461.84±277.25, while group C and D were 157.15±214.91 and 406.29±214.58 respectively. The Post Hoc intra group comparison of the 4 groups reveals a statistical difference between groups A (10 infertility) & B (20 infertility), A & D(control), B & C(recurrent abortion) and C &D (p < 0.05). No difference was observed for the RBC, PCV, Hb levels between the test and control groups. The case is same for platelet counts, total WBC and its differentials except in neutrophil count. Conclusion: This study suggests that lower level in vitamin B12 may be associated with infertility particularly in primary and recurrent abortion cases in subjects studied.

Objectives: The burden of sickle-cell disease (SCD) in Nigeria is increasing with the increase in population, despite recent high-level interest in SCD, including the adoption of a UN resolution recognizing SCD as a public health problem. The knowledge and attitude of genetic sickle cell screening was assessed on fresh undergraduate students of Ebonyi State University Abakaliki –Nigeria. Method: A descriptive survey designed with the aid of a structured, supervised questionnaire served as an interview schedule for the study on 300 fresh undergraduates’ students, and modified versions of the Sickle Cell Perceptions and Knowledge Survey with SPSS version 20.0 were used to assess their knowledge and attitude towards genetic sickle cell screening using 5point Likert scale. Results; Most respondents demonstrated a moderate level of awareness towards SCD and genetic sickle cell screening with positive mean score values of 3.64±0.70 and 3.62±0.40 respectively. The respondents however rejected the item “that genotype should not be a barrier in marriage if both love each other” (negative mean score 2.11±1.24) while majority believed that genetic screening should only be done for intending couples (mean score 2.38±1.28). Conclusion: The respondents demonstrated adequate knowledge and attitude on SCD and genetic SCD screening. However, similar studies are needed to evaluate the SCD knowledge and control among the less educated or educationally disadvantaged population in same environment. Major benefits in the health and survival of patients with SCD can be achieved through the implementation of a few highly effective evidence-based preventive interventions policies.

Background: Previous studies have relied on culture-dependent methods to determine microbial communities that may be found in the seminal fluids of men seeking reproductive health care. However, understanding the microbiome composition present in seminal fluids with the state-of-art next-generation sequencing technology is more germane than ever before, instead of culture methods which fails to identify over 99% of bacterial organisms present in biological samples. Methods: Forty semen samples were collected and after bacterial DNA extraction, 22 samples that passed quality check were used for amplification of the V4 region of the 16S rRNA using custom bar-coded primers prior to sequencing with Illumina NextSeq 500 platform. Sequencing was performed in a pair-end modality rendering 2 x 150 basepair sequences. Sequence reads were imported into Illumina BaseSpace Metagenomics pipeline for 16S rRNA recognition. Distribution of taxonomic categories at different levels of resolution was done using Greengenes database. Results: The taxonomic categories from the dataset produced phyla that ranges from 6 to 25; Class (9-49), Order (16-99), Family (42-214), Genus (55-555) and Species (56-1156). The taxonomic profiles represented 25 phyla, showing 39.5% of the total sequence reads were categorized to Proteobacteria as the most abundant. This was followed by Firmicutes (33.54%), Actinobacteria (20.77%) and Bacteroidetes (4.77%), Fusobacteria (0.613%), Tenericutes (0.31%) and Verrucomicrobia (0.12. At the species taxonomic level 1841 species were identified among the seminal fluid samples. Serratia marcescens (23.61% sequence reads) was the most abundant species found in 9/22 of the samples followed by Lactobacillus iners (18.22%) 13/22, Serratia entomophila (5.54%) 17/22, Haemophilus parainfluenzae (3.64%) 10/22, Corynebacterium tuberculostearicum (3.29%) 21/22, Gardnerella vaginalis 2.39%) 12/22, Lactobacillus taiwanensis (2.08%) 10/22, Enterobacter amnigenus (1.63%) 15/22, Corynebacterium genitalium (1.29%) 12/22, Neisseria lactamica (1.18%) 8/22, Finegoldia magna (1.17%) 16/22, Prevotella bivia (1.14%) 10/22, Corynebacterium imitans (1.12%) 15/22, Corynebacterium jeikeium (1.02%) 17/22 and Lactobacillus acidophilus (1.01%) found in 6/22 of the samples. Conclusions: We investigated the microbiome compositions from seminal fluids and showed that there are varying bacterial diversities that are unique in each sample in contrast to culture-dependent methods.

Introduction: Differences in lifestyle, access to healthcare and type of food consumed may cause variation in inflammatory biomarkers among persons in different location and ethnic background. There is paucity of data on the effect of location on inflammatory markers in Nigerian population. Aim: This is a cross-sectional study aimed at determining the effect of location on status of some inflammatory markers among residents of Adeyanba village and Egor urban communities of Edo State. Methodology: A total of 200 participants (consisting of 100 from each community) were recruited. Whole blood sample was collected from each participant and analysed for albumin, complete blood count (FBC) and erythrocyte sedimentation rate (ESR). Platelet lymphocyte ratio (PLR), Neutrophil lymphocyte ratio (NLR) were calculated from complete blood count parameters. Serum C-reactive protein (CRP) was determined using enzyme linked immunosorbent assay technique. Data obtained were compared between rural and urban by students’ t- test, using the statistical software INSTAT®. Results: Comparatively, the serum albumin concentration was slightly higher in urban dwellers than in the village dwellers (p=0.5). Whereas there was statistically higher Ferritin concentration (p=0.0001) among Egor urban dwellers than the Adeyanba village dwellers. Adeyanba rural dwellers had a significantly higher total White Blood Cell counts (p=0.001), ESR (p=0.001), PLR (p=0.001), NLR (p=0.001) and CRP (p=0.01) than their urban counterparts. Conclusion: This study suggests that rural residents may have a higher risk for inflammatory conditions than urban population. This underlines the need for regular screening of rural populations for markers of inflammatory disorders and provision of intervention strategies for rural residents of Edo State

Objectives: Toxoplasmosis is a zoonotic infection with worldwide distribution that can have fatal outcomes among HIV/AIDS patients. This study was aimed at determining the prevalence of IgG and IgM antibodies to T. gondii among HIV positive patients as well as their relationship with CD4 count. Methods: Blood specimens were collected from 1500 subjects consisting of 1200 HIV positive patients and 300 apparently healthy non-HIV subjects. The HIV patients comprised 936 on anti-retroviral therapy (Highly Active Antiretroviral Therapy) (HAART) and 264 HAART-naïve HIV patients. The blood specimens were used to determine CD4 counts using flow cytometry as well as the presence of IgG and IgM anti-Toxoplasma antibodies using Immunochromatographic kit Results: Of the 1500 blood specimens, 329 (21.93%) had antibodies to T. gondii (11.13% and 7.53% for IgG and IgM respectively; and 3.27% for both IgG and IgM antibodies). Generally, and among HIV patients on HAART (p<0.0001) and non-HIV subjects (p=0.0890) the prevalence of IgG antibodies was higher, while among HAARTnaïve HIV patients (p=0.0152) the prevalence IgM antibodies to T. gondii was higher. Irrespective of treatment status, the prevalence of antibodies to T. gondii was significantly higher among patients with CD4 count <200 cells/µL compared with those with CD4 count =200 cells/µL (p<0.01). Among HAARTnaïve HIV patients and those on HAART, the prevalence of anti-T. gondii IgM were significantly higher among patients with CD4 count <200 cells/µL (p<0.05) while IgG antibodies to T. gondii were higher in patients with CD4 count =200 cells/µL (p<0.05). Conclusion: Acute toxoplasmosis among HIV patients was associated with immunosuppression. Measures to prevent T. gondii infection and its associated sequalae are advocated.

Objective: Lower respiratory infections (LRTIs) are a persistent threat to quality of life and resistant bacterial strains serve to worsen treatment outcomes. This study aimed at investigating the prevalence of bacteria-producing metallo-ß-lactamase (MBL) among patients with lower respiratory tract infections in a tertiary hospital in Benin City, Nigeria. Methodology: A cross-sectional study was conducted at the University of Benin Teaching Hospital, Benin City. Questionnaires were filled for each study participant presenting with signs and symptoms of LRTI. Sputum specimens were collected from each patient into sterile wide-mouth containers and sent to the Medical Microbiology Laboratory for microbiological processing. Emergent bacterial colonies were identified and antimicrobial susceptibility tests carried out using standard techniques. Result: A total of 185 Gram negative bacterial isolates were recovered from the sputum specimens of patients. These included Enterobacteriaceae (160), Acinetobacter spp (7), Alkaligenes spp (4) and P.aeruginosa (14). A total of 9 (4.7%) isolates were MBL-producing; among them Hafnia alvei was most likely MBL-producing when compared with other isolates (0.0191). Very poor susceptibility was observed for MBL-producing bacteria as 100% multi-drug resistance was observed, non-MBL-producing isolates showed 63.8% MDR. Conclusion: The prevalence of MBL-producing bacteria causing LRTI in this study was 4.7%. The study harps on prudence in the use of antibiotics in order to minimize the emergence and spread of resistant bacterial strains in our setting

INTRODUCTION: This study was carried out to detect the most common resistant-associated mutations and genetic profile of resistance to rifampicin and isoniazid among MDR. M. tuberculosis isolates. METHODS: A total of 20 MDR M. tuberculosis isolates obtained from presumptive MDRTB cases among new and previously treated case TB in Plateau State by conventional Mycobacteriological techniques. Mycobacterium Tuberculosis Drug Resistant plus line probe assay (MTBDR plus) was used to analyzed the isolates. RESULTS: Findings from this analysis indicated that the most frequent mutation at the rpoB gene occurred at codon (H526Y), that of Kat G mutation occurred at codon (S315T1) while that of inh A gene at codon (C15T). Heterogenic genetic profile of resistance (GPR) rate of 31.9% in the rpoB gene of RIF resistant isolates and homogenic (GPR) of 70% in katG gene of INH resistant isolates were reported in this study. Also, One mutation that occurred as a result of loss of WT8 (S531t) band which is an uncommon mutation was discovered. The result suggests a high degree of genetic variability and frequency of resistant conferring mutation involving codon H526Y of the rpoB gene and codon S531T in Kat G gene. CONCLUSIONS: This study found a high level of heterogeneity and homogeneity in the genetic profile of resistance in rifampicin (RIF) and isoniazid (INH) respectively, which probably may have been responsible for high –level of resistance to RIF than INH by the Mycobacterium tuberculosis Isolates in the study population

Background: Studies have shown that there are more incident and severe occurrences of malaria among HIV infected individuals, and markers of HIV disease sequence exacerbate during acute malaria. This study was designed to evaluate the malaria parasites burden on various stages of HIV among infected subjects. Total of 116 co-infected subjects were used and compared with HIV mono-infected and apparently healthy subjects. Method: About 8mls of venous blood sample was drawn from each subject. Malaria parasite density was determined by blood film examination as well as assay of some immunecellular and biochemical parameters using Sysmex Kx-21N automated Haematology Analyzer. Result: The study showed that HIV stage I present the highest prevalence of co-infection (22.4%) whereas stage III had the least prevalence (3.0%) of co-infection. The malaria parasites density was highest in stage III with mean value of 805.00±589.53/µl. This mean value was higher (p<0.05) than the least mean value (307.33±222.65/µl) from stage I subjects. Stages I and II showed that intake of ART reduces parasites burden. However, the reverse was the case for stage III and IV subjects. Stage III proved to have the highest mean granulocytes values (70.45±27.31%) and the least total WBC count (5.05±1.87x109l). ART intake significantly reduced lymphocytes especially in stage I (36.12±21.07%) and III (1.00±0.00%) subjects. Stage III co-infected subjects had significantly low mean PCV (22.50±2.67%). Conclusion: High malaria parasites density and reduced WBCs as well as PCV observed in stage III co-infected subjects could increase the risk of negative disease outcome. Hence, concerted efforts are required to prevent disease progression at this stage

Introduction: The knowledge of laboratory reference values is necessary because most available reference values for laboratory tests are outdated or adopted from the manufacturers of the diagnostic test derived from the populations living in Europe and United States. Objectives: The study is aimed at determining the age-gender specific reference values for iron indices among apparently healthy individuals in Abeokuta, South-Western Nigeria. Methods: A total of 385 subjects which comprised of 180 (46.75%) males and 205 (53.25%) females were enrolled in this study of within aged 18 and 77 years. The subjects for this study were recruited after the informed consent was obtained from every participant. Data were also collected with semi-structured selfadministered questionnaire based on World Health Organization guidelines for students’ substance use survey. The data generated were expressed as Median and 95 percentile (2.5 and 97.5 percentile distribution) and were used to construct the reference ranges. The study reference values were compared with the standard reference values using the one Wilcoxin Signed Ranked Test. Result: The majority (80.78%) of these participants have tertiary education at the time of enrollment. Most of the subjects (88.05%) were Yoruba ethnicity, typically Abeokuta residents. The results showed that all the determined study reference values were significantly different from the standardized reference ranges (P<0.01). Conclusion: The study showed significantly lower values of haemoglobin, red cell count, MCHC, MCH, MCV, haematocrit serum iron, TIBC, and significantly higher values of RDW and ferritin compared with the standardized reference values from the Caucasians. It is recommended to use this established reference values in Abeokuta rather than Caucasians values in order to prevent the wrong diagnosis of iron related diseases.