Bassey Ewa Ekeng

Purpose Water deemed fit for consumption ought to conform to minimum standards that pose no significant health risk to the consumers. Bottled and Sachet water constitutes the major source of drinking water in Lagos State Nigeria. We conducted a study to investigate the presence of fungi in the commercially available water brands in the study area. Methods A study collected eleven commercial water brands, including eight bottled and three sachet brands, from retail outlets. Samples with production dates ranging from 24 h to 3 weeks were filtered using membranes inoculated into SDA and incubated at 27 °C and at 37 °C. Pure fungal cultures were identified using microscopic and macroscopic features, using mycology atlas. Results All brands of water (bottled and sachet) analyzed grew at least one fungal isolate thus giving an absolute (100%) rate of contamination in this study. Overall, the predominant fungal pathogen was Aspergillus fumigatus sensu lato (s.l) and Aspergillus niger (n = 6, 30%), followed by Aspergillus terreus (n = 2, 10%). Other isolated fungal species were Aspergillus terreus, A. flavus, Candida albicans, Cladosporium spp. and Penicillium spp. Each of the brands was contaminated with at least one fungal pathogen and at most two. Conclusion The study reveals a high level of fungal contamination in retailed water, particularly in areas with at-risk populations. These fungi can cause allergic reactions or diseases in humans. The study suggests Nigeria’s food and drug regulatory bodies should include routine screening for fungi in commercial water production like their bacteria counterparts.

Background: Human cystic echinococcosis frequently involves the lungs, and colonization of a residual cavity with Aspergillus spores can lead to chronic pulmonary aspergillosis (CPA). Objectives: We pooled and characterized cases of CPA co-existing with pulmonary cystic echinococcosis (PCE) through a systematic review of globally published data. Design: Systematic review. Data sources and methods: Primary literature was identified through searches of various electronic databases, including CINAHL, Ovid MEDLINE, MEDLINE (PubMed), EMBASE, Google Scholar, the Cochrane Database of Systematic Reviews, and African Journal Online. The search encompassed articles from inception to February 2024, using medical subject heading search terms “chronic pulmonary aspergillosis” OR “ Aspergillus ” OR “aspergilloma” OR “aspergillosis” AND “hydatid disease” OR “hydatidosis” OR “echinococcosis” OR “ Echinococcus.” Two reviewers independently assessed titles, abstracts, and full texts for eligibility using the Rayyan web-based software. The eligible studies comprised original observational research, single case reports, and case series that reported on CPA in patients with PCE based on established criteria (microbiological and/or radiological diagnosis of PCE) without language or geographic restrictions. Cochrane Risk of Bias Tools (ROB2 and ROBINS-I) were used to assess study quality and risk of bias, and the quality of the evidence was rated using the Grading of Recommendations, Assessment, Development, and Evaluations tool. The extracted data were summarized using descriptive statistics. Results: A total of 148 studies were initially identified from a literature search, and after the screening, 52 articles were selected for full-text review. We included 41 studies published from 1996 to 2023 that met the eligibility criteria and involved 3035 participants. The studies comprised case reports (75.6%, n = 31), case series (12.2%, n = 5), retrospective cohort studies (7.3%, n = 3), and one (2.4%) each of prospective cohort and cross-sectional study, respectively. More than two-thirds were conducted in India (36.6%, n = 15), followed by Turkey (14.6%, n = 6) and Iran (12.2%, n = 5). Among the 72 CPA cases, 50% were male, and 38.9% were female, with a median age of 38 years. Common comorbidities included pulmonary tuberculosis ( n = 5) and diabetes mellitus ( n = 3). The most frequent symptoms were cough ( n = 32), hemoptysis ( n = 21), and fever ( n = 16). Radiological examinations were conducted in 74.4% of hydatid disease cases, while histological examinations were performed in 82.1% of aspergillosis cases. Cavitary lesions were noted in 21.4% of radiological findings. Treatment involved both surgical and medical management for 43.1% of patients, with antifungals (50%) and anthelminthic drugs (50%) commonly used. Surgical treatments included cystectomy (57.9%) and lobectomy (55.3%). All patients with reported outcomes were cured. Conclusion: CPA complicates PCE and has both similar clinical and radiological features. Diagnostic approaches primarily include radiology and histology, while treatment often involves a combination of surgical and medical management, with antifungals and anthelminthic drugs commonly used. Despite the complexity of CPA, patients generally achieve favorable outcomes with appropriate treatment. Further research is needed to optimize diagnostic and therapeutic strategies for this condition. Trial registration: PROSPERO (CRD42024510441).

Background Data from studies evaluating lung functions in individuals exposed to fumes generated during the preparation of roasted food items is lacking in the Nigerian setting. We aimed to evaluate the ventilatory functions of participants with direct exposure to smoke from roasted food and compared the findings with their counterparts (controls). Methods We conducted a cross-sectional comparative study involving food vendors (cases) of smoked food and workers (controls) operating in the same vicinity but not directly exposed to the smoke. A spirometer was used to measure the forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR). Thereafter, the percentage predicted FEV1, FVC, and FEV1/FVC indices were used to determine ventilatory impairment in both cases and controls. Results A total of 600 participants were enrolled, of which half (50.0%) were cases while the remaining 50.0% were in the control group. Respiratory symptoms such as coughing and wheezing, and the duration of presentation were higher in cases compared with the controls, with a statistically significant difference; p = 0.003, p = 0.001 and p = 0.011, respectively. In addition, impaired ventilatory functions were significantly higher in the cases compared with the controls (p <0.001). Similarly, a significant proportion of the food vendors with ≥ 5 years of exposure had obstructive and mixed patterns of lung defects and a lesser proportion with normal lung functions compared with those with < 5 years of exposure (p = 0.009). Likewise, the mean FEV1 (p <0.001), FVC (p <0.001), and PEFR (p = 0.005) were significantly higher in controls compared with cases. Conclusion The direct exposure of food vendors to smoke may impair lung function. Driving awareness of this occupational hazard is very crucial as it is a common source of livelihood in the Nigerian setting.