African Journal of Clinical and Experimental Microbiology

Mpox: lessons learnt from previous viral outbreaks applicable to the ongoing outbreak

A. A. Adelakun — 2024-10-07

Human monkeypox (Mpox) is a zoonotic infection caused by Mpox virus (MPXV) that was first identified in a smallpox suspect in 1970, and presents with smallpox-like symptoms but with less severe manifestations. The infection is initiated through rapid replication at the inoculation site, with early symptoms including fever, chills, and exhaustion. The advent of smallpox vaccines has significantly contributed to its prevention. Due to its zoonotic nature, individuals who consume or handle animals susceptible to the virus are at increased risk and should take appropriate precautions. Both vaccines and non-pharmacological interventions have proven potent in limiting the spread of the infection. This narrative review examines the emergence and spread of Mpox in humans, delving into the epidemiology, clinical manifestations and preventive strategies for Mpox, as well as the transmission dynamics of the two MPXV clades. It also highlights the increase in cases outside Africa, with a particular focus on a UK outbreak linked to travel from Nigeria. The importance of vaccination, especially smallpox vaccines, is underscored, noting recent advancements in vaccine development such as the Vaccinia Ankara vaccine. The review emphasizes the need for robust surveillance, diagnostics, and strategies to control and manage epidemics, drawing lessons from past experiences. It concludes by stressing the clinical similarities between Mpox and smallpox and the growing public health concern posed by Mpox, especially in areas with high human-wildlife interactions.

Evaluation of the antimicrobial activity of chemical and herbal toothpastes on selected clinical microbial oral flora

A. S. Buru — 2024-10-07

Background: Microbes are most commonly found associated with oral diseases. Globally, researchers along with the world Health Organization (WHO) suggested that this could be due to poor oral health and encourage all individuals to practice good oral hygiene using daily oral health products. The study aimed to determine the antimicrobial effects of toothpastes, as acclaimed by the manufacturers, to selected microbial flora involved in oral infections.
Methodology: The antimicrobial activity of 6 toothpastes (3 herbal and 3 chemical) was tested against 3 clinical microbial isolates; Staphylococcus aureus, Escherichia coli and Candida albicans, with minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of each toothpaste determined for each microbial isolate using the broth dilution method.
Results: Colgate exhibited the highest inhibitory activity against S. aureus with respective MIC and MBC of 125mg/ml and 125mg/ml, followed by Oral-B with MIC and MBC of 125mg/ml and 500mg/ml, Dabur herbal with MIC and MBC of 250mg/ml and 500mg/ml, and Longrich with MIC of 500mg/ml and MBC of 1000mg/ml. Colgate and CloseUp exhibited highest inhibitory activity against E. coli with respective MIC and MBC of 125mg/ml and 500mg/ml, followed by Dabur herbal with MIC of 500mg/ml but no MBC. Colgate exhibited the highest inhibitory activity against C. albicans with respective MIC and MBC of 125mg/ml and 500mg/ml, followed by CloseUp with MIC of 500mg/ml, Longrich with MIC of 500mg/ml and MBC of 1000mg/ml, and oral-B with MIC of 500mg/ml but no MBC. Longrich and Oral-B exhibited no MIC/MBC against E. coli while Gavia charcoal exhibited no MIC/MBC against all the 3 microbial isolates at the concentrations used in the assay.
Conclusion: The results obtained showed that chemically formulated toothpastes (Colgate, CloseUp and OralB) had higher inhibitory activity on microbial isolates than herbal toothpastes (Longrich, Dabur herbal and Gavia charcoal). This supports the manufacturers claim for the chemical toothpastes used, however, the herbal toothpastes showed little or no inhibitory effects on the microbial flora.

Co-infection of human papillomavirus and herpes simplex virus-2 with cervical dysplasia among women in Kaduna State, Nigeria

D. S. Adejo — 2024-10-07

Background: The epidemiology of human papillomavirus (HPV) and co-infections with herpes simplex virus type 2 (HSV-2) remains poorly characterized in Africa. High risk HPV (hrHPV) infection is the primary cause of 99.7% all cervical cancer especially in the presence of genital ulcer disease (GUD) which is usually caused by HSV-2. Herpes simplex virus-2 might interact directly with hrHPV to increase the risk of cervical cancer. Co-infection of HPV and HSV-2 in asymptomatic women could provide a clue to early diagnosis of cervical cancer and this could aid in the development of new strategies for effective management and improvement of the quality of life of women who are infected. If the synergy between HPV and HSV-2 can be prevented, there may be significant reduction of the incidence of cervical cancer.
Methodology: This was a descriptive cross-sectional study of 515 randomly selected apparently healthy women of reproductive age whose cervical samples were screened for HPV and HSV-2 in Kaduna State, Nigeria. The cervical samples were collected by liquid-based cytology (LBC) for detection of cervical epithelial cell abnormalities (CEA) and molecular detection of HPV and HSV-2 using conventional polymerase chain reaction (PCR) assay. Extracted viral DNAs from the samples were amplified by convectional PCR using specific hrHPV (HPV 16,18, 31 and 45) primer sets and a broad spectrum MY09/11 and GP5+/6+ primers for a wider range of HPV genotypes while HSV-2 DNA was detected by florescence-based PCR assay with HSV-2 gG primers and probes.
Results: PCR assay revealed that 14.7% (n=76) of the 515 selected women harbored HPV, HSV-2 or both. The prevalence of HPV, hrHPV, HSV-2 and HPV/HSV-2 co-infection among in the study participants are 11.8% (n=61), 9.3% (n=48), 5.6% 4% (n=29) and 2.3% (n=12) respectively. The frequency of HPV detection in HSV-2 infected participants (41.4%, 12/29) was significantly higher (OR=6.295, p<0.0001) than in HSV-2 negative participants (10.1%, 49/437), but only co-infections of HPV-31 (p=0.004) and HPV-18 (p=0.040) with HSV-2 were significantly associated. Cervical cytology reports on the smears revealed prevalence of cervical epithelial abnormalities (CEA) of 16.7% (n=86), with cervical dysplasia prevalence of 6.4% (n=33), consisting of high grade squamous intraepithelial lesion (HGSIL) of 1.6% (n=8), low grade squamous intraepithelial lesion (LGSIL) of 4.1% (n=21) and atypical squamous cells of uncertain significance (ASCUS) of 0.8% (n=4). The frequency of HPV detection in women with cervical dysplasia (93.9%, 31/33) was significantly higher (OR=14.22, p<0.0001) than in women without cervical dysplasia (6.2%, 30/482), and all HPV genotypes were significantly associated (p<0.05) with cervical dysplasia except HPV 16 (p=0.051). Also, the frequency of HPV/HSV-2 co-infection among women with cervical dysplasia (15.2%, 5/33) was significantly higher than among women without cervical dysplasia (1.5%, 7/482) (OR=12.12, p<0.0001). Comparing women with cervical inflammatory and atrophic changes (n=53), women with cervical dysplasia (HGSIL, LGSIL and ASC-US) had significantly higher frequency of HPV infection (χ²=42.829, p=0.000), HSV-2 infection (χ²=25.140, p=0.001) and HPV/HSV-2 co-infections (χ²=66.602, p=0.000).
Conclusion: Co-infection rate of hrHPV and HSV-2 among women in Kaduna State is 2.3%. Demographic factors significantly influencing the rate of co-infections included age and marital status. In spite of the screening method using the traditional Pap smear, GUD and cervical cancer continues to be a major public health problem, thus more sensitive and specific methods such as liquid based cytology technique and polymerase chain reaction for early detection of cervical dysplasia and hrHPV or HSV-2 in asymptomatic women should be adopted for routine use

Hepatitis B and C viral infections and correlates among pregnant women in Ilorin, Nigeria: a cross-sectional study

A. O. Udeze — 2024-10-07

Background: Hepatitis B and C are significant viral infections in pregnancy with high risk of maternal and neonatal complications. This study was conducted to determine the prevalence of hepatitis B and C viral infections and correlates among pregnant women who attended antenatal care (ANC) unit of General and Civil Service Hospitals, Ilorin, Nigeria.
Methodology: This was a descriptive cross-sectional study of 282 consented pregnant women randomly selected from the ANC units of two hospitals in Ilorin. Blood samples were collected from the pregnant women and tested for hepatitis B virus (HBV) surface antigen (HBsAg) and anti-hepatitis C virus (HCV) antibody using Enzyme Linked Immunosorbent Assay (ELISA) technique. Socio-demographic and obstetrics information of the pregnant women and potential risk factors for HBV and HCV infections were collected using a pretested structured questionnaire. Statistical analysis was done using SPSS version 22.0
Results: Majority of the women were married (78.4%), from monogamous families (57.8%), do not share sharp objects (65.6%), have not received blood transfusion (65.3%), have no history of organ transplantation (91.1%), and multigravida (61.4%,) in their first (36.9%), second (37.2%) and third (25.9%) trimesters of pregnancy. Overall, 22.3% and 1.4% tested positive for HBsAg and anti-HCV respectively. Family background of the study participants showed significant (p˂0.05) association with HBsAg positivity. None of the other analysed variables showed any significant association with both HBsAg and anti-HCV positivity.
Conclusion: This result showed high prevalence of HBV but low prevalence of HCV infections among pregnant women in the study setting. Improved surveillance and routine screening for HBV and HCV for women attending ANC is recommended to reduce disease burden and help achieve WHO goal of eliminating viral hepatitis as a major public health threat by 2030.

Seroprevalence and risk factors of Toxoplasmosis in HIV positive and negative patients attending the Bamenda Regional Hospital, North West Region, Cameroon

E. E. J. Eyong — 2024-10-07

Background: Toxoplasmosis, caused by Toxoplasma gondii, can infect almost all warm-blooded animals including humans. T. gondii is regarded as an important opportunistic pathogen that can cause infection in HIV/AIDS patients associated with high mortality. The objective of this study is to determine the prevalence and risk factors of T. gondii infection in HIV-positive and negative patients and establish the relationship between HIV viral load and active toxoplasmosis in the Bamenda Regional Hospital Cameroon.
Methodology: Three hundred and three (201 HIV-positive and 102 HIV-negative) participants attending the Bamenda Regional Hospital, Cameroon, were randomly recruited into the study. Well-structured questionnaires were used to obtain information on demographic characteristics and potential risk factors from each participant. Venous blood samples were collected for serological detection of toxoplasmosis using One-Step Toxo IgG/IgM rapid diagnostic test (RDT) kits, followed by confirmation of all positive samples by Toxoplasma IgM ELISA test. Data were analysed on SPSS version 23.0. Association of potential risk factors with seroprevalence of toxoplasmosis was done using Chi square test, and comparison of means HIV loads between participant categories was done using Mann-Whitney U-test and Kruskal-Wallis as applicable, with p<0.05 considered as significant level.
Results: Of the 303 participants, 93 were positive for Toxoplasma IgG, giving latent toxoplasmosis seroprevalence rate of 30.7%, while 2 of the 303 participants were seropositive for Toxoplasma IgM, indicating active toxoplasmosis in 0.7%. The seroprevalence of latent toxoplasmosis was 28.9% (n=58/201) in HIV-positive compared to 34.3% (n=35/102) in HIV-negative participants (χ²=0.948, OR=0.775, p=0.330), while the seroprevalence of active toxoplasmosis was 1.0% (n=2/201) in HIV-positive compared to 0% (n=0/102) in HIV-negative participants (χ²=0.068, OR=2.568, p=0.552). Viral load was detectable (≥ 42 viral copies/ml) in 54 of the 201 HIV-positive participants, giving an overall detectable viral load rate of 26.9%. The seroprevalence of latent toxoplasmosis was higher in HIV-positive participants with detectable viral load than those with non-detectable viral load, and the two HIV-positive patients with active toxoplasmosis had detectable viral loads. The risk factors significantly associated (p<0.05) with the latent toxoplasmosis were owning a cat, presence of stray cats, playing with cats, and eating soya.
Conclusion: Latent toxoplasmosis is prevalent among HIV-positive and negative patients attending the Bamenda Regional Hospital in Cameroon, with active infection only among HIV-infected patients.

Association of umbilical cord care practices with neonatal infection in Katsina, northwest Nigeria

H. K. Obaro — 2024-10-07

Background: Significant numbers of neonatal deaths occurring each year are caused by infections that can be directly associated with improper and unhygienic umbilical cord care practices. The objectives of this study were to describe the umbilical cord care practices among mothers whose babies were admitted for suspected sepsis at the Federal Teaching Hospital and Turai Umaru Yar’adua Maternal and Children Hospital Katsina, Nigeria, assess the relationship between umbilical cord care practices and neonatal sepsis, and the influence of home delivery on this relationship.
Methodology: This was a hospital-based descriptive observational study of 60 selected neonates with clinical features of sepsis admitted into the special care baby unit (SCBU) of the two hospitals between July and December 2022. The study involved the collection and microbiological analysis of blood samples using the BacT/Alert microbial detection system, and the administration of a structured questionnaire on the mother of each enrollee to collect relevant information about cord care practices. Data were analyzed using SPSS version 22.0. The Chisquare (x²) test and Odds ratio (with 95% confidence interval) were used to determine the association of risk factors with culture-confirmed sepsis, and a p value less than 0.05 was considered statistically significant.
Results: Of the 60 neonates blood samples, 31 (51.7%) were culture-positive for neonatal sepsis while 29 (48.3%) were culture-negative. There was no statistically significant association between risk factors such as application of traditional materials for cord care and place of delivery, and culture-confirmed neonatal sepsis (p>0.05). However, neonates whose mothers use traditional materials for cord care were more likely to develop sepsis than those who do not (OR=2.027, 95% CI=0.716-5.736). Concerning place of delivery, which is an important determinant of umbilical cord hygiene, babies delivered at home were almost 3 times more likely to have culture-confirmed sepsis than those delivered in the hospital (OR=2.975, 95% CI=1.040-8.510). A total of 26 out of the 60 (45.3%) mothers of the neonates agreed to have used unhygienic and traditional materials for cord care, with charcoal (39.0%), local herbs (27.0%), cow dung/urine concoction (19.0%), and others (15.0%), such as lubricants, ash, and balm, being the most commonly used materials for cord care.
Conclusion: Neonatal infection is common among newborns in Federal Teaching Hospital and Turai Umaru Yar’adua Maternal and Children Hospital (TUYMCH), Katsina, northwest Nigeria, with a prevalence of culture confirmed neonatal sepsis of 51.7%. Although there was no statistically significant association between unhygienic cord practices and neonatal sepsis in this study, babies whose mothers use traditional materials for cord care were more likely to develop sepsis. There is a high rate of use of harmful and unhygienic traditional materials for cord care in our environment. This habit can be discouraged through health education using the mass media and health talks in health facilities. The use of chlorhexidine, the recommended antiseptic for cord care by the World Health Organization and the Nigeria Federal Ministry of Health, should be encouraged.

Diabetes and tuberculosis comorbidity: a cross-sectional study of patients attending diabetes clinic in Accra, Ghana

H. K. Hackman — 2024-10-07

Background: Diabetes and tuberculosis have significantly increased health-related and socioeconomic implications on individuals, families, health systems, and the global economy at large, making them a serious global health concern. The objective of this study is to determine the prevalence of diabetes-tuberculosis comorbidity and the socio-demographic, behavioral and clinical factors associated with this comorbidity.
Methodology: This was a cross-sectional study of selected diabetic patients at the diabetic clinic of the Shai Osudoku District Hospital-Dodowa in the Greater Accra Region, Ghana. Sputum samples from confirmed diabetics were screened for tuberculosis using GeneXpert MTB/RIF Test and Ziehl-Neelsen AFB Microscopy. The patients’ awareness of their susceptibility to diabetes-tuberculosis, treatment compliance and care manager attentiveness, were assessed through semi-structured questionnaire. Statistical analyses of data were performed using Microsoft Analysis Tool Pak.
Results: The prevalence of diabetes-tuberculosis comorbidity in the study was 7.0% (7/100). The occurrence of diabetes-tuberculosis comorbidity among the participants seemed to be higher in males (11.1%, 3/27) as compared to female (5.5%, 4/73), with no statistically significant difference (p=0.327). The females with diabetes-tuberculosis comorbidity statistically demonstrated poorer glycaemic control (females: 17.08±0.79 mmol/L and males: 15.95±0.79 mmol/L; 95% Cl; 7.15, p<0.001). Participants in the age group 61-80 years had the highest prevalence of 11.4% (4/35) for diabetics-tuberculosis comorbidity but this was not statistically significant (p=0.509), although their mean blood glucose was significantly higher than other age groups (p=0.0137). The mean of patients with no awareness of their susceptibility to diabetic-tuberculosis co-morbidity was 77±28.97% (95% CI=3.79-46.62, p=0.4648). Treatment compliance was observed in 91.0% of the study participants mainly due to high level of attentiveness by care providers at the diabetic clinic for 69.0% of the participants.
Conclusions: The prevalence of diabetes-tuberculosis comorbidity in this study is 7.0%, with majority of the diabetics not aware of their susceptibility to tuberculosis although there was high treatment compliance. There is the need for the adoption of a collaborative framework and integrated approach in the clinical management and control of diabetes and tuberculosis.

Genetic relatedness of diarrheagenic Escherichia coli pathotypes isolated from children under five years of age and food animals in Kisumu County, Kenya

R. Yeda — 2024-10-07

Background: Diarrheal disease remains one of the leading causes of deaths in children below five years of age. The risk factors associated with diarrhea include poor hygiene practices such as open defecation and consumption of contaminated water and food. However, exposure of domestic animal is equally a potential risk factor for diarrhea disease in children.
Methodology: We characterized animal-related exposures in a subset of households (n=73) by collecting faecal samples from 150 children with diarrhoea and 100 food animals (30 cattle, 30 chicken, 25 goats and 15 pigs). Escherichia coli was isolated from the faecal samples and biochemically confirmed using conventional microbiological techniques. The deoxyribonucleic acid (DNA) of each E. coli isolate was extracted and amplified by multiplex PCR to identify three diarrheagenic E. coli pathotypes. The amplified products were sequenced, and genetic relatedness of the isolates was determined through phylogenetic analysis.
Results: We isolated and identified a total of 32 (12.8%) diarrheagenic E. coli (DEC) from the 250 faecal samples, 26 (17.3%) of which were from the 150 children with diarrhea while 6 (6.0%) were from the 100 food animals (OR=3.285, 95% CI=1.299-8.305, p=0.011). Three DEC pathotypes were confirmed by PCR in 16 DEC strains, with 9 enteroaggregative E. coli (EAEC), 2 enterotoxigenic E. coli (ETEC), 2 enteropathogenic E. coli (EPEC), 1 EAEC/ETEC, 1 EAEC/EPEC and 1 ETEC/EPEC mixed strains. The phylogenetic analysis showed that 6 DEC isolates had genetic similarity ranging between 31% to 90%. Isolates S04 originating from animal and S02 from a child with diarrhoea of the same household were closely related, with 55% similarity. Moreover, isolate S05 from animal origin and S06 of diarrheic child origin were closely related, with similarity degree as high as 82% even though they were not paired. Twenty four of the 26 (92.3%) DEC isolates from diarrhoeic children showed multidrug resistance (MDR) pattern to antibiotics but none of the 6 isolates from food animals was multi-drug resistant.
Conclusion: The high degree of genetic relationship between DEC isolate S04 and S02 from animal and human origin indicated the high potency of zoonotic transmission. Further studies investigating animal husbandry practices and zoonotic transmission of DEC are needed.

In vitro evaluation of Morinda lucida root extracts against multi-drug resistant bacterial pathogens isolated from diabetic foot ulcers

N. O. Achukwu — 2024-10-07

Background: The continuous rise in microbial resistance to orthodox antimicrobial drugs has led to the search for alternative sources with proven efficacy to solve the challenges of antimicrobial resistance (AMR). The preferred alternatives are plant sources, and this has led to the evaluation of constituents and potency of medicinal plants to provide scientific justification for their use.
Methodology: The root of Morinda lucida plant was dug up from the ground, washed clean, and cut into smaller pieces and dried. The root was then ground into fine powder and extracted with water (aqueous), methanol, ethyl acetate and n-hexane. Multi-drug resistant (MDR) Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Pseudomonas aeruginosa were isolated from wound swab samples collected from patients with diabetic foot ulcers using conventional cultures, biochemical identification, and antimicrobial susceptibility tests. The phytochemical and proximate contents of the extracts were assessed by standard technique. The in vitro antimicrobial activities of the extracts were determined at a concentration of 200mg/ml of the extract using the agar well diffusion technique. The minimum inhibitory and bactericidal concentrations were determined by serial doubling dilution. The methanol extract time-kill assay was performed to determine the time of kill of the bactericidal concentration.
Results: The phytochemical analysis showed that M. lucida root contains essential secondary metabolites such as flavonoids, alkaloids, tannin, saponin, glucosides, anthraquinone and quinine. The methanol and aqueous extracts showed higher in vitro antibacterial activity, producing the highest zone of inhibition of 27mm against S. aureus but a lower activity of 18mm with n-hexane extract against all isolates except S. aureus. The MIC ranges from 3.125mg/ ml and 25mg/ml. The time-kill assay of methanol extract at 2x and 3x MIC showed that bactericidal activity occurred within 0-8 hours of incubation, indicating high activity.
Conclusion: The antibacterial potency of M. lucida root extract and the phytochemical components from this study shows that it can serve as a source of alternative antimicrobial agent that may be effective in the treatment MDR bacterial infections.

Synergistic invitro antimicrobial activity of polyherbal combination of Morinda lucida fruit and Pterocarpus santalinoides seed against multi-drug resistant clinical bacterial isolates

N. O. Achukwu — 2024-10-07

Background: Synergistic drug combination has been shown to be a way of bypassing drug resistance and reducing the amounts of antimicrobials consumed. As infections caused by multi-drug resistant organisms (MDROs) continue to pose global threat, it is important to search for new antimicrobial combinations of plant origin that are safe and readily available. The objective of this study is to evaluate the synergistic antimicrobial activity of extracts of Morinda lucida fruit and Pterocarpus santalinoides seed against multi-drug resistant (MDR) bacterial isolates
Methodology: Morinda lucida and P. santalinoides fruits were plucked and washed clean, and the fruits of P. santalinoides were deseeded to remove the seeds. They were cut into smaller pieces and dried under shade before being milled into smooth powder and extracted with methanol. The clinical bacterial isolates used were MDR Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus. The phytochemical constituents of the extracts were determined using the standard method. The invitro antimicrobial assay of the extracts was done at a concentration of 50 to 400 mg/ml using the agar well diffusion technique. The minimum inhibitory concentration (MIC) and fractional inhibitory concentration (FIC) of each extract were determined using the Checker-board micro-titration method, and the FIC result obtained for each isolate was used to calculate the fractional inhibitory concentration index (FICI) of the combined extracts. The time kill assay was performed to confirm the synergistic and bactericidal activities from the MIC values obtained.
Results: The phytochemical analysis revealed that the extracts of both herbal plants contained alkaloids, phenol, tannin, saponin, glycosides, and terpenoids. The antimicrobial assay results showed that the polyherbal combination of the extracts was active against all the MDR bacterial isolates tested with varying zones of inhibition. The mean inhibition zone diameters of individual M. lucida and P. santalinoides ranged from 18.0±0.9mm to 26.0±1.4mm and 17.0±0.1mm to 24.0±0.2mm respectively, while the MIC ranged from 6.25mg/ml to 12.5mg/ml for M. lucida and 12.5 mg/ml for P. santalinoides. The mean inhibition zone diameter of the polyherbal combination of the two plant extracts ranged from 25.00±00mm to 34.0±0.4mm, which compared favorably with that of levofloxacin control (28.0±0.0mm to 32.00±0.0mm), while their MIC ranged from 0.39mg/ml to 1.56mg/ml. The FIC of M. lucida extract ranged from 0.06mg/ml to 0.25mg/ml while that of P. santalinoides ranged from 0.03mg/ml to 0.13mg/ml. The FICI of combined extracts ranged from 0.09mg/ml to 0.38 mg/ml for all the MDR isolates, which is less than 0.5mg/ml, indicating synergism against all the isolates. The time of kill assay confirmed the synergistic and bactericidal activities with a 3log10 CFU/ml decrease in the number of viable cells within 6 hours of incubation.
Conclusion: Our findings showed synergistic antibacterial actions of extracts of M. lucida fruit and P. santalinoides seed against MDR clinical bacterial isolates, comparable to levofloxacin. Combination of these herbal plants may serve as alternative sources of antimicrobial agents for the treatment of infections caused by MDR bacterial pathogens.

Suspected epidermolysis bullosa simplex with anonychia and sepsis in a malnourished 7-month-old infant in Katsina, northwest Nigeria: A case report.

O. B. Ajide — 2024-10-07

Epidermolysis bullosa (EB) is an uncommon hereditary cutaneous disorder inherited largely in an autosomal dominant manner. Epidermolysis bullosa simplex (EBS) typically presents at birth or early childhood, and common presenting complaints include blistering, skin fragility, and non-healing wounds inconsistent with mechanical trauma. It is associated with several complications such as sepsis, malnutrition, malignancy, and so on. The management of EBS is mainly supportive. The prognosis is good with early detection, wound care, infection control, nutritional support, and counseling. We present a case of suspected EBS-Dowling Meara type with acquired anonychia and sepsis in a malnourished 7-month-old infant in Katsina, and to the best of our knowledge the first reported case in northwest Nigeria