Mpox in Nigeria: Perceptions and knowledge of the disease among critical stakeholders-Global public health consequences

BACKGROUND

The mpox (monkeypox) disease is a re-emerging viral zoonosis of international concern that is endemic in parts of Africa. The mpox virus (MPXV), which was hitherto largely limited to some Central and West African countries, was declared a public health emergency of international concern by the WHO on July 23, 2022 following the rapid spread of the virus to non-endemic countries. Globally, as of March 16, 2023, the WHO had reported 86,496 laboratory-confirmed cases of mpox and 111 deaths in 110 countries. Of the 1,420 cases of mpox reported in Africa as of March 16, 2023, Nigeria alone recorded 57.1% (812) of the confirmed cases and eight fatalities recorded in the continent. To help improve on the understanding of the current situation in Nigeria, the present study assessed the perception and knowledge of mpox among Nigerian healthcare workers, academics and tertiary students. The study also sought to highlight the global public health significance of the MPXV, and recommend a One Health approach to limit exporting of the virus beyond the borders of Nigeria.

METHODS

A web-based cross-sectional survey was conducted between 24 July 2022 and 12 August 2022 to evaluate the perception and knowledge of mpox among 1544 Nigerians, consisted of healthcare workers (n = 832), academics (n = 306) and tertiary students (n = 462). Data on the respondents' socio demographics and their information sources on mpox were also collected. Each correct response was allotted one point while an incorrect response was scored zero. The scores for perception and knowledge were dichotomized into positive (>5.5) and negative (≤5.5) and adequate (>5.8) and inadequate (≤5.8), respectively; using the average scores for perception and knowledge. The average score for perception and knowledge were summarised and presented as the mean and standard deviation (SD). Chi-square tests of association and binary logistic regression were carried out to determine factors associated with the outcome variables.

RESULTS

Of the 1452 respondents that had heard of mpox, 878 (60.5%) and 419 (28.9%) had adequate knowledge and positive perception concerning MPXV infection respectively. Average perception score was 5.5. Mean perception and knowledge scores were 4.5(SD: 2.0) and 5.8 (SD: 1.9), respectively. Factors that were significantly associated with knowledge level were age (p = 0.020) educational qualification attained (p = 0.004), occupation (p<0.001), and geopolitical zone of residency (p = 0.001). There was a positive correlation between perception and knowledge scores (r = 0.4, p<0.001). Positive perceptions were likely among respondents who had tertiary education, and residing in North-west Nigeria. Likewise, adequate knowledge scores were likely among respondents under 30 years of age, with tertiary education or reside in North-west Nigeria. Sources of information were significantly associated with perception (p = 0.004) and knowledge (p<0.001) of the respondents.

CONCLUSION

The findings of this study show that there is disparity in the knowledge and perception of mpox in the study population, and as a result, there is a need to intensify awareness about MPXV infection to enhance positive perception among the respondents. This has potential to safeguard public health and contain the disease thus preventing it from spreading to the global community. A One Health approach involving animal and human health workers is imperative for improved knowledge and a good perception towards the disease among respondents, and enhanced active surveillance and early detection of MPXV in reservoir hosts (rodents and non-human primates); to prevent reverse zoonotic transmission of the virus at the human-animal interface.

Clinico-toxicological effects of ceftriaxone after intramuscular administration of graded doses in Basenji dogs

Purpose: The recent ceftriaxone-induced anaemia and mortalities at the dose of 50 mg/kg in Veterinary Teaching Hospital, University of Nigeria prompted this study which sought to assess the clinicotoxicological effects of ceftriaxone (CFZ) after intramuscular administration of graded doses in Basenji dogs.Methods: The effects of CFZ on the haematological indices, physiological parameters, liver and kidney functions were assessed in 4 group of dogs (n = 4) designated A – D. They were given CFZ intramuscularly for 21 days at doses of 12, 25 and 50 mg/kg for groups A, B, C, respectively, while thecontrol (group D) received the diluent (lignocaine 0.2 mL)Results: The mean pulse and heart rate of dogs in group C were significantly (p < 0.05) higher than those of group A, B and D. Significant (p < 0.05) decrease in red blood cell count (RBC), haemoglobin concentration (Hb) and packed cell volume (PCV) was observed in group C on days 7 and 14, while on day 21, these parameters were significantly (p < 0.05) higher in group D than in the treated groups. On day 14 of CFZ administration, the alanine transaminase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) activities of dogs in group C was significantly (p < 0.05) elevated than the control group.Conclusion: These findings suggest that CFZ, at the doses of 12.5 - 25 mg/kg, appears safe in dogs as most of the adverse effects observed are reversed following the withdrawal of the drug on day 28. However, CFZ at 50 mg/kg causes anaemia, tachycardia and bilateral paralysis of the hind limbs which did not revert to normal after one week; hence, it is not recommended for use in dogs at this dose.

Veterinary clinic surfaces as reservoirs of multi-drug- and biocide-resistant Gram-negative bacteria

This cross-sectional study was carried out to determine the common Gram-negative bacteria (GNB) contaminating veterinary clinic environments, and to evaluate the susceptibility of the isolates to commonly used antibiotics and biocides. A total of 62 swab samples were collected from different frequently touched surfaces in the 4 veterinary clinics visited. The samples were processed for isolation and identification of GNB using standard microbiological procedures. The susceptibility of the isolates to disinfectants and antibiotics was determined using agar dilution and disc diffusion techniques, respectively. A total of 114 GNB were isolated from the 4 clinics with isolation rates of 21.9, 22.8, 23.7 and 31.6% in clinics A, B, C and D, respectively. The surfaces of treatment tables were more contaminated (16.7 %) than receptionist/clinician desks (15.8%), weighing balances (10.5 %), door handles (7.9 %), drip stands (7.9 %), handwashing basins (7.0 %) and client chairs (7.0%). The surface-contaminating isolates were distributed into 20 genera, with members of Enterobacteriaceae predominating (n=97). Fifty-nine per cent of the isolates were resistant to the disinfectant Septol, while 5.3 and 0.9% were resistant to Purit and Dettol disinfectants, respectively. Multiple drug resistance was observed among 99% of the isolates with approximately 100% resistance to beta-lactams. Phenotypic expression of extended-spectrum (3.5 %) and AmpC beta-lactamase (38.6 %) production was detected. These findings highlight the role of clinic environments in serving as reservoirs for potential pathogens and sources for the spread of multi-drug resistant GNB.

Molecular epidemiology, genetic diversity and antimicrobial resistance of Staphylococcus aureus isolated from chicken and pig carcasses, and carcass handlers

The epidemiology of Staphylococcus aureus in food animals, associated products, and their zoonotic potential in Nigeria are poorly understood. This study aimed to provide data on the prevalence, genetic characteristics and antimicrobial resistance of S. aureus isolated from chicken and pig carcasses, and persons in contact with the carcasses at slaughterhouses in Nigeria. Surface swabs were collected randomly from 600 chicken and 600 pig carcasses. Nasal swabs were collected from 45 workers in chicken slaughterhouses and 45 pig slaughterhouse workers. S. aureus isolates were analyzed by spa typing. They were also examined for presence of the Panton-Valentine Leucocidin (PVL) and mecA genes, as well as for antimicrobial resistance phenotype. Overall, 53 S. aureus isolates were recovered (28 from chicken carcasses, 17 from pig carcasses, 5 from chicken carcass handlers and 3 from pig carcass handlers). Among the isolates, 19 (35.8%) were PVL-positive and 12 (22.6%) carried the mecA gene. The 53 isolates belonged to 19 spa types. The Based Upon Repeat Pattern (BURP) algorithm separated the isolates into 2 spa-clonal complexes (spa-CC) and 9 singletons including 2 novel spa types (t18345 and t18346). The clonal complexes (CC) detected were CC1, CC5, CC8, CC15, CC88 and CC152. CC15-related isolates represented by spa type t084 (32.1%) and CC5 represented by spa type t311 (35.3%) predominated among isolates from chicken carcasses/ handlers, and pig carcasses/ handlers, respectively. Multidrug resistance exhibited by all the CC except CC8, was observed among isolates from chicken carcasses (64.3%), pig carcasses (41.2%), handlers of chicken meat (40.0%) and handlers of pork (33.3%). All the CC showed varying degrees of resistance to tetracycline while CC15 and CC5 exhibited the highest resistance to sulphamethoxazole/trimethoprim and erythromycin, respectively. The predominant antimicrobial resistance pattern observed was penicillin-tetracycline-sulphamethoxazole/trimethoprim (PEN-TET-SXT). In conclusion, food animals processed in Enugu State in Southeast Nigeria are potential vehicles for transmission of PVL-positive multiple-drug resistant S. aureus and methicillin-resistant S. aureus from farm to slaughterhouse and potentially to the human population. Public health intervention programs at pre- and post-slaughter stages should be considered in Nigerian slaughterhouses.

Prevalence and risk factors associated with Cryptosporidium spp. infection in local breed of dogs in Enugu State, Nigeria

Aims:

Cryptosporidiosis is an important zoonotic disease of major public and veterinary concern. The disease affects humans and a variety of animal species including the domestic dog. This study aimed to determine the prevalence and risk factors associated with Cryptosporidium spp. infection in local breed of dogs from different homes and those presented at veterinary hospitals and clinics in Enugu State, Nigeria.

Materials and Methods:

A total of 203 fresh fecal samples were collected from domestic dogs in six local government areas in Enugu State from February 2015 to August 2015. All the samples were examined using the formol-ether sedimentation method. Fecal smears were then stained by the modified Ziehl–Neelsen technique and examined under direct light microscopy.

Results:

A total of 74 (36.5%) dogs were infected with Cryptosporidium spp. oocysts. There was a strong association (p<0.05) between the presence of Cryptosporidium spp. oocysts and management practices. However, there was no statistically significant association (p>0.05) between the presence of Cryptosporidium spp. oocysts and age, sex, and fecal consistency.

Conclusion:

The findings of this work suggest that domestic dogs in Enugu State harbor and shed Cryptosporidium spp. oocysts in the environment, especially those managed semi-intensively. Such fecal shedding is particularly so and of greater zoonotic and epidemiological importance in animals that do not show clinical signs and therefore not treated. They, therefore, pose a greater public health risk, especially to immune-compromised humans and animals. Public education on the zoonotic implication of this protozoan infection is of paramount importance in Enugu State, in particular, and Nigeria, in general, considering the closeness of dogs and man.

Prevalence of antimicrobial residues in raw table eggs from farms and retail outlets in Enugu State, Nigeria

The use of antimicrobial agents in poultry production results in their accumulation in the body tissues and products such as milk and egg. The subsequent accumulation of these drugs and their metabolites in body cells is known as drug residue. This study was designed to determine the prevalence of antimicrobial residues in eggs from poultry farms and retail outlets in Enugu State, Nigeria. Eggs from 25 selected commercial farms and ten retail outlets were screened for the prevalence of antimicrobial residue. Also, structured questionnaires were administered to 25 commercial farms in the state to determine the management practices and the most widely used antimicrobial drugs in farms and possible association between the management practices and the occurrence of antimicrobial residues in eggs from these farms. All the 25 farms surveyed use oxytetracycline. Eggs from nine of the surveyed farms tested positive for antimicrobial residue and three of the ten surveyed farms also tested positive for antimicrobial residue. No association was observed (p 0.05; Fisher's exact test) between the occurrence of antibiotic residues in eggs and farm size, feed source and housing systems. This study was able to demonstrate the presence of antimicrobial residues in eggs destined for human consumption. Drugs like nitrofurans which has been banned for use in food animals are still very much in use in Enugu State, Nigeria. Antibiotics given as feed additives may give rise to drug residues in food animals.