International STD Research & Reviews

Comparing the Antibiotic Resistance Profiles of Klebsiella pneumoniae in HIV-positive and HIV-negative Individuals Attending the Bamenda Station Polyclinic, Bamenda, Cameroon

Lem Edith Abongwa — 2025-07-19

The vulnerability of human immunodeficiency virus (HIV) patients to opportunistic pathogens requires measures in monitoring the spread of antibiotic resistance (ABR). ABR to Klebsiella pneumoniae is an urgent threat to human health. This study aimed to determine the prevalence and antimicrobial susceptibility patterns of K. pneumoniae in HIV positive and negative persons in Bamenda III. The study comprised of 333 participants (133 HIV positive and 200 HIV negative persons) recruited from January 2024 to June 2024. K. pneumoniae was isolated from urine samples by culture on selective media. Antibiotic susceptibility testing was done using the Kirby Bauer Disc diffusion method. The prevalence of K. pneumoniae was 23.4% (78/333) and was high 24.0% (48/333) in HIV positive participants though the difference was not significantly (p=0.761). Of the 78 isolates, 77(98.7%) showed resistance to at least one of the antibiotics used. Ampicillin recorded the highest level of resistance (61.05%, 48/77) while Nitrofurantoin was the most active drug 42.3% (28/78). Multidrug resistance (MDR) was reported in 47.4% (37/78) of the participants. Secondary level of education (AOR=6.75, p=0.040), monthly income of less than 50,000frs (AOR=5.53, p=0.025) and HIV positive status (AOR=0.30, p=0.039) were identified as risk factors of MDR. This study reported high prevalence of K. pneumoniae in the urine samples of both HIV positive and negative participants. These isolates demonstrated resistance to most antibiotics with a higher level of antibiotic resistance observed in isolates from HIV positive persons. We recommend the need for controlled administration of ampicillin and gentamycin while encouraging the use of nitrofurantoin and levofloxacin in the treatment of K. pneumoniae especially in HIV patients.

Molecular Epidemiology of HIV-1 Subtypes among HIV-positive individuals in Anambra State, Nigeria

Ndukwu, I, J — 2025-08-19

Aims: The study aimed to describe the molecular epidemiology of HIV-1 Subtypes among HIV- positive individuals in Anambra State.

Study design: Cross sectional study.

Place and Duration of Study: Department of Microbiology, Nasarawa State University, Keffi, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi; St. Charles Borromeo Specialist Hospital (SCBSH), Onitsha; and Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka between February 2023 to March 2024.

Methodology: Samples were collected from 200 HIV/AIDS-positive participants attending Antiretroviral Therapy (ART) clinic at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi; St. Charles Borromeo Specialist Hospital (SCBSH), Onitsha; and Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka. Blood samples were obtained for HIV-1 screening using rapid testing and western blot assays to detect HIV-1-specific antibodies, followed by genotyping and phylogenetic analysis. A structured questionnaire was administered to gather socio-demographic data.

Results: This study found a 96.5% HIV-1 prevalence in Anambra State, with four major HIV-1 subtypes discovered, of which Subtype C (49.7%) and CRF02_AG (26.9%) were predominant. The 40–49 age group showed the highest subtype prevalence, with females comprising the majority of infections. High viral suppression (71.4–96.2%) and preserved immune function (66.7–78.8% with CD4 ≥500 cells/mm³) reflect effective ART. Phylogenetic analysis confirmed Subtype B, C, CRF01_AE, and CRF02_AG circulation, with strong clustering to Belgian reference strains. Targeted interventions are needed to address the high prevalence and sustain epidemic control.

Conclusion: These findings underscore the need for intensified and targeted screening and prevention programs, particularly for women and middle-aged adults. Gender-sensitive interventions and community-based adherence support should also be prioritized to sustain ART success and advance HIV epidemic control in Anambra State.

Implementation and Impact of the Advanced HIV Disease Package of Care in Ekiti State, Nigeria: A Retrospective Cohort Study

Reinnet Awoh — 2025-10-20

Background: Advanced HIV Disease remains a major driver of HIV-related morbidity and mortality in low- and middle-income countries, including Nigeria. Evidence on the real-world impact of the WHO-recommended AHD package of care in Nigeria is limited. This study examined its effect on diagnostics, treatment, and outcomes in Ekiti State.

Methods: We conducted a retrospective cohort study across 15 ART sites using the National Medical Records System data. Patients aged ≥5 years who newly enrolled in HIV care between December 2019 and November 2021(before the implementation of the WHO AHD package of care) and December 2021 and May 2023(implementation period) were included. Data were analyzed using STATA version 16.1.

Results: 892 patients were included in the study with a median age of 35 years (IQR: 28 - 44), and the majority were females (59.3%). Many of the patients were from the key population typology. The study showed an increase in the uptake of CD4 from 83.7% to 99.3%. It also showed an increase in the diagnosis of tuberculosis using TB LAM, although the level of service uptake was generally low. Diagnostic services for cryptococcal meningitis were also seen to be very poor. Clinical outcomes at six months showed a significant difference (p <0.01) in the mortality outcome.

Conclusion: The AHD package improved CD4 testing coverage and reduced mortality, demonstrating its potential to strengthen HIV care in Nigeria. Persistent gaps in Tuberculosis Lipoarabinomannan Assay and cryptococcal antigen testing highlight the need for stronger diagnostic capacity and full adoption of the package. These findings provide early evidence to guide scale-up and optimization of AHD care in similar settings.