Open Access Review Article

The Martyrdom of St. Julia: On Microbial Strategies to Evade the Immune System

Thuc Anh Nguyen, Angkarina Angkasuwan, Claudia Rossi, Frans J. Van Overveld, Ger T. Rijkers

Asian Journal of Immunology, Page 1-13

Bacteria and viruses use an array of evasion mechanisms to escape from the host immune system. Due to antigenic variation, pathogenic micro-organisms can escape the immune system. Micro-organisms can occur in different types, such as the 97 serotypes of Streptococcus pneumoniae. Influenza viruses change their antigenic make-up, in particular, the hemagglutinin molecule by antigenic drift and antigenic shift. Trypanosomes and malaria parasites use DNA programmed expression of highly variable surface antigens. Micro-organisms can also produce proteins that degrade (IgA protease) or inactivate antibody molecules (protein A and protein G). Some bacteria and viruses produce proteins that inhibit complement activation. Virus can become invisible for recognition by T-lymphocytes by interference with antigen presentation. Antiviral immunity can be suppressed by viral homologues of cytokines and cytokine receptors and other proteins. Despite the extensive immune evasion strategies used by viruses, bacteria and other micro-organisms, the immune system in most cases is ultimately able to control an infection.

Open Access Original Research Article

Missed Immunisation and Immunisation Drop-outs among Infants in Rural Health Facilities in Abakaliki, Nigeria

N. C. Eze

Asian Journal of Immunology, Page 1-6

Background: Missed immunisation, immunisation drop-out and coverage rates at primary health care (PHC) level indicate the level at which communities utilise the preventive services and thus serve as a measure of the strength of the public health system. They also measure the effectiveness of the immunisation programme. The extent of missed immunisation and immunisation drop-out is not well known in the study area. This study, therefore, determined the extent of missed immunisation and immunisation drop-outs in Abakaliki.

Materials and Methods: Descriptive cross-sectional analytical study design was used for the survey. Total number of infants in the health facilities was used as a sample size in this study (406 infants at Mile-Four hospital and 281 infants at St. Vincent hospital). Data were extracted from the existing immunisation registers in the two health facilities studied. Statistical Package for Social Sciences (SPSS) version 22 was used for data analysis. Ethical approval for this study was obtained from the Research and Ethics Committee (REC) of the Federal Teaching Hospital Abakaliki (FETHA).

Results: Showed significant differences in the proportion of missed immunisations (39.7% in Mile-Four and 48.4% in St. Vincent respectively, p=0.02) and immunisation drop-outs (35.7% in Mile-Four and 47.7% in St.Vincent respectively, p=0.02).  The drop-out rate is 64.3% in Mile-Four and 52.3% in St. Vincent. It also showed that 36.6% of male infants when compared to 34.8% of female infants dropped-out of the 3rd dose of pentavalent vaccines in Mile-Four while 44.5% of male infants and 51.1% of female infants dropped-out 3rd dose of pentavalent vaccines in St.Vincent hospital. There was no significant difference in the immunisation drop-out rates between male and female infants in the study groups (p>0.05).

Conclusion: A higher proportion of infants missed immunisation and dropped out of vaccination at St.Vincent than Mile-Four. This calls for an aggressive public campaign on the need to ensure immunisation timeliness for effective immunisation in such rural areas.

Open Access Original Research Article

A Cross-sectional Study on Awareness, Attitude and Utilisation of Immunisation Services by Mothers of Under-five in Elele, Rivers State, Nigeria

Kenechi A. Uwakwe, Uche R. Oluoha, Anthony C. Iwu, Chukwuma B. Duru, Ernest Nwaigbo, Ijeoma N. Alex-Okedo

Asian Journal of Immunology, Page 1-10

Introduction: Approximately 6.2 million under-five children die globally on annual basis and immunisation having been recognised as the most successful and cost-effective public health intervention of the 20thcentury regarding the number of deaths averted can help to prevent approximately 2 million of these deaths if coverage is optimal.

Objectives: To assess the awareness and attitude of mothers towards utilisation of immunisation services in Elele, Rivers State.

Methodology: It was a descriptive cross-sectional study conducted between April and July 2015. The study population comprised of mothers with at least one under-five-year-old child. Stratified sampling technique was used, and data collection was with a pre-tested, semi-structured, interviewer-administered questionnaire. Data analysis was done using IBM SPSS version 20. Level of statistical significance was set at p-value ≤ 0.05.

Results: The average age of the respondents was 28.6 ± 5.3 years. Most (89.3%) had at least a secondary level of education. Respondents level of awareness of childhood immunisation was high (95.0%) and the major sources of information on immunisation were antenatal clinic (61.0%) and health workers (20.0%). Respondents' knowledge of vaccine-preventable diseases (VPD) was highest with poliomyelitis (76.0%) while diphtheria at 34.4% was the least known. Approximately seven percent (7.3%) of the respondents' children were unimmunized while 18.1% were partially immunised. Tetanus toxoid utilisation was significantly associated with respondents' level of education (χ= 9.44, p-value = 0.0240) while the odds of completing their children immunisation was higher if done in a hospital setting compared to home service {OR (95% CI): 4.03 (1.09 – 14.95)}.

Conclusion: Health education on some of the VPDs by healthcare personnel is advocated for the community. Greater efforts should be placed on strengthening routine immunisation as against supplemental immunisation since the former has a better immunisation completion rate.

Open Access Original Research Article

Reasons for Childhood Immunisation Drop-out in Rural Health Facilities in Abakaliki, Nigeria

N. C. Eze

Asian Journal of Immunology, Page 1-6

Background: High rate of childhood vaccination drop-outs is a significant public health problem in rural areas of developing countries especially in NigeriaThe reasons for immunisation drop-out are poorly understood and little or no data is available to explain the phenomenon that could support the decision making. This study, therefore, determined the reasons for immunisation drop-out in the rural areas of Abakaliki, Nigeria.

Materials and Methods: Descriptive analytical cross- sectional study design was used for the survey. Data were collected using pretested, semi-structured interviewer administered questionnaire from 290 mothers/caregivers accessing childhood immunisation services in Mile Four and St. Vincent hospitals selected using systematic random sampling technique. Reasons for immunisation drop-out were gotten from caregivers when they brought their children for immunisation in subsequent immunisation dates after the drop-out interval. Analysis was done using SPSS version 22 and level of statistical significance set at p< 0.05 and confidence level at 95%. Ethical approval was obtained from the Research and Ethics Committee (REC) of the Federal Teaching Hospital Abakaliki (FETHA), Ebonyi State, Nigeria.

Results: The mean age of respondents in Mile Four hospital was 26.6 ±4.9 years while 27.1±4.2 years in the St.Vincent hospital. The reasons for immunisation drop-out in Mile Four were no money for transport (2.1%), caregiver travelled (1.4%), baby was sick (1.4%), far distance to health facility (0.7%). In St.Vincent reasons cited were- Far distance to health facility (6.2%), no money for transport (4.8%), Mother was sick (2.8%), caregiver travelled (2.1%) and baby was sick (2.1%).Far distance to health facility was a predictor of immunisation drop-out in St. Vincent group. It is 2.8 times more likely to cause immunisation drop-out than near distance to health facility.

Conclusion: High rate of immunisation drop-outs need to be addressed collectively both by individuals and government in order to achieve the targeted 95% immunisation coverage necessary for the sustained control of vaccine preventable diseases.

Open Access Original Research Article

Antifungal and Immunomodulatory Activity of Bryophyllum pinnatum Leaf Extracts

Jacinta Edesiri Okpoho, Lucky Evbuomwan, Fortune Itojie Ebiala

Asian Journal of Immunology, Page 1-8

This study was carried out to investigate the antifungal and immunomodulatory activities of Bryophylum pinnatum. Both aqueous and ethanol solvents were used for extraction. Five fungal species including Aspergillus niger, Aspergillus flavus, Cladosporium herbarium, Candida albicans and Penicillium italicum were obtained from the University of Benin Teaching Hospital and they were preliminarily identified using standard microbiological methods. Wistar rat models for the study were purchased and acclimatized for a period of two weeks. The rats were divided into five groups and orally administered with the ethanol extract of the plant while one group served as control. Antimicrobial and hematological parameters including packed cell volume (PCV), hemoglobin, white blood cell counts, platelets and CD4 count were assayed using standard methods. The only fungus sensitive to aqueous extract was Aspergillus niger, with zone of inhibition ranging from 6.00±0.58-11.33±0.33 mm at concentration range of 50-100 mg/ml. Mean zones of inhibition of ethanolic extract ranged from 11.67±0.67-20.33±0.33 mm against Cladosporium herbarium at concentration range of 6.25-100 mg/ml. Minimum inhibitory concentrations (MIC) of ethanol extract ranged from 6.25- 50 mg/ml against fungal isolates. While MIC of aqueous extract was 50 mg/ml against susceptible fungal isolate. Minimum fungicidal concentrations of ethanol and aqueous were 25- 100 mg/ml and 100 mg/ml respectively. Significant difference was observed between the treatment and control groups in platelet counts (range: 95.40±1.86-126.20±5.40% and control: 108.60±4.19%), PCV (range: 39.00±0.71-44.20±0.58%; control: 39.00±0.71%) and hemoglobin (range:12.94±0.21-14.62±0.24 g/dl; control: 12.94±0.21 g/dl). There was no significant difference between the treatment and control groups in CD4 counts (75.40±19.32-99.00±6.33cells/ml and control 75.4±19.32 cells/ml). Bryophylum pinnatum has been shown in this work to possess both antimicrobial and hematological properties.