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Assessmen o he immunological p o ile o HIV-posi i e pa ien s co-in ec ed wi h
mala ia pa asi e a ending gene al hospi al No h-Bank, Maku di, Nige ia
Da id Augus ine Aondoackaa 1, *, I eanyichukwu Romanus I oha 2 and Pa cia Obekpa 1
1 Depa men o Mic obiology, Fede al Uni e si y o Ag icul u e Maku di, Nige ia.
2 Depa men o Applied Mic obiology, Ebonyi S a e Uni e si y, Abakaliki, Nige ia.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1557-1566
Publica ion his o y: Recei ed on 02June 2025; e ised on 12 July 2025; accep ed on 14 July 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.27.1.2614
Abs ac
Mala ia and HIV a e he wo mos impo an in ec ious diseases and ha e compa able global dissemina ions. Gi en he
eclec ic geog aphical o e lap on occu ence and he esul ing co-in ec ion; he in e ac ion be ween he wo diseases
clea ly has majo public heal h implica ions, mos ly in Sub-Saha an A ica. This s udy in es iga ed he immunological
al e a ions associa ed wi h HIV and Mala ia co-in ec ion in HIV posi i e indi iduals. The s udy was pe o med by
sampling 600 adul HIV pa ien s who ou inely isi he Gene al Hospi al No h-Bank Maku di, Benue S a e, Nige ia.
Blood samples we e ob ained o blood ilm mic oscopy iden i ica ion o mala ia pa asi es. Sc eening o immunological
p o iles was pe o med using he low cy ome e o he quan i ica ion o CD4+ cell coun . Resul s: O he 600 pa ien s
sampled, 221(36.8%) had no mal CD4+ coun (≥500cell/mm3), 320 (53.3%) had mode a e CD4+ coun (be ween 200
and 499cell/mm3) while 59 (9.8%) had poo CD4+ (less han 200cell/mm3). The mean CD4+ lymphocy e coun o HIV-
mala ia co-in ec ed pa ien s was lowe han HIV mono-in ec ed pa ien s. Mala ia and HIV co-in ec ion signi ican ly
educed he CD4+ coun o he subjec s. In gene al, o achie e be e managemen o all HIV pa ien s in his se ing,
diagnosing mala ia, p omp an i e o i al he apy, moni o ing CD4 and some haema ological indices on egula basis
is impo an . In ligh o he epidemiological connec ion and global epu a ion o he wo diseases, he e is an u gen
need o mo e esea ch on a wide ange in o de o elucida e he impac o co-in ec ion on hos immune dynamics in
HIV co-in ec ed indi iduals.
Keywo ds: Human Immunode iciency Vi us (HIV); Mala ia Pa asi e; Immunological P o ile; Oppo unis ic; Assessed;
Co-In ec ion; Clus e o Di e en ia ion (CD4+).
1. In oduc ion
Human Immunode iciency Vi us (HIV) and mala ia a e among he wo mos impo an global heal h p oblems o
de eloping coun ies, including Nige ia, which has been epo ed o cause mo e han 4 million dea hs a yea , wi h HIV
in ec ion inc easing he isk and se e i y o mala ia in ec ion and bu dens [1]. Fu he mo e, [1] epo ed ha HIV
acili a es he a e o mala ia ansmission which in u n causes s ong CD4 cell ac i a ion and up- egula ion o p o-
in lamma o y and cy okines p oduc ion which c ea e an ideal mic oen i onmen o he sp ead o HIV among CD4 cells
o apid HIV-1 eplica ion.
Mala ia and HIV co-in ec ions a e inc easingly epo ed wo ldwide and he in e ac ion may lead o poo ly unde s ood
e ec s on he disease ou come and clinical mani es a ions [2]. In an en i onmen whe e mala ia is common, he
incidence o clinical mala ia episodes is epo ed o be highe in pa ien s wi h CD4 cell coun s <200 cells/μl han in
hose wi h CD4 cell coun s >500 cells/μl [3]. HIV and mala ia bo h des oy impo an cells equi ed o p ope
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1557-1566
1558
immunological and hema ological unc ioning o he body [4]. Enhanced T-cell ac i a ion in HIV and mala ia co-in ec ed
pa ien s could wo sen he immune esponse o bo h diseases [5].
I was epo ed by [6] ha , "Oppo unis ic In ec ions in HIV-In ec ed Pa ien s Di e S ongly in F equencies and Spec a
be ween Pa ien s wi h Low CD4+ Cell Coun s Examined Pos mo em and Compensa ed Pa ien s Examined An emo em
I espec i e o he HAART E a"
Mala ia is he mos impo an pa asi ic in ec ion ha a ac s he g ea es global a en ion due o i s disp opo iona e
dis ibu ion [7]. The Wo ld Heal h O ganiza ion a i ms ha mala ia cons i u es a global heal h h ea wi h 228 million
cases and 405,000 dea hs in 2018 [8]. Mala ia is caused by i e species o Plasmodium namely; Plasmodium alcipa um,
Plasmodium i ax, Plasmodium o ale, Plasmodium mala iaeand Plasmodium knowlesi. O he i e Plasmodium species,
Plasmodium alcipa um accoun ed o mos mo bidi ies and consequen ly, highes mo ali y a es in A ica and o he
high- isk egions o he wo ld [9, 10]. The e o e, in ec ion wi h P. alcipa um equi es quick ecogni ion, p ope
ea men and e ec i e pa ien managemen [11].
In oduc ion o Human Immuno-De iciency Vi us (HIV) in o hos cells ac i a es a complex ne wo k o p o ec i e
esponses o igina ing om bo h he inna e and adap i e immune sys ems [12]. These esponses a e ei he insu icien
o oo la e o elimina e he i us. This enables li e-long i al la ency and ch onic in ec ion, which d i es ongoing immune
ac i a ion and p og essi e immunode iciency, cha ac e ized by high cell u no e , apop osis, and ac i a ion-induced
dea h o immune cells [13].
The e ha e been epo s o inc eased cases o mala ia and HIV in Nige ia by many esea che s. This s udy is he e o e
designed o es ablish ac s on he e ec s o Mala ia-HIV Co-in ec ion on he immune p o ile and ad ance possible
solu ions o he comba Co-in ec ion. The esul s om his esea ch will be o bene i o indi iduals so as o es ablish
he ela ionship be ween Mala ia/HIV and he immune sys em. The s udy would also gi e ligh o he le el o auma
ha he in ec ed subjec s unde go and he isk ac o s associa ed wi h such co-in ec ion. This s udy p o ides use ul
in o ma ion o policy make s and a clea e pic u e and unde s anding o he eal posi ion o hese in ec ions among he
populace so ha o mula ed policies can imp o e esea ch wo k on he ea ly de ec ion and ea men o hese diseases.
2. Ma e ials and me hods
2.1. S udy popula ion
The s udy popula ion was 600 medically diagnosed HIV/AIDS pa ien s who isi he s udy a ea o ou ine collec ion
o An i e o i al (ARV) D ugs and CD4 cell coun .
2.2. Si e
The s udy a ea was Gene al Hospi al, No h-Bank, Maku di, loca ed behind No h-Bank ma ke , Maku di, Benue s a e.
The hospi al is one o he HIV-designa ed cen es, app o ed by Benue S a e Minis y o Heal h, o he sc eening o
HIV/AIDS, checking o CD4 cell coun and adminis a ion o an i e o i al (ARV) d ugs.
2.3. E hical Conside a ion
E hical clea ance was ob ained om Benue s a e Minis y o Heal h e hical commi ee Maku di. In o med consen was
made a ailable o all he s udy pa icipan s. All p ocedu es we e in acco dance wi h he Na ional E hical S anda ds and
esul s we e ea ed wi h u mos con iden iali y.
2.4. P o ocol
In espec o he collec ion o demog aphic da a, an easy – o – ead and iendly ques ionnai e as well as pa icipan ’s
consen o ms we e p o ided.
2.5. Collec ion o Blood
The a ea whe e he blood was collec ed was cleaned wi h Me hyla ed spi i swab o loca e a p ominen ein. A unica e
was ied ound he pa ien ’s a m and is closed. A acu aine needle was hen inse ed in he p ominen ein ha is
loca ed and he unica e was loosened and he is opened. Fi e millili e s (5mls) o enous blood was collec ed and a
co on wool was placed on he ein o enable blood clo hing. The blood collec ed was sepa a ed in o es ubes, which
was u he used o Mala ia sc eening, CD4 cell coun , and ull blood coun espec i ely.
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2.6. De e mina ion o Mala ia Pa asi es
A d op o blood was placed on a clean g ease- ee slide. A co e slip was used as a sp eade o make hin and hick ilms.
The slide was labeled wi h he pa ien ’s iden i ica ion numbe o an alphabe and allowed o ai d y and hen s ained
wi h Giemsa solu ion. Eigh (8) d ops o he s ain we e added o he slide and allowed o s and o wo (2mins) minu es.
Twel e o i een (12-15) d ops o bu e ed dis illed wa e (pH 6.4) we e added and allowed o s and o 4-8minu es.
The slide was inally examined mic oscopically unde ×10 and ×40 objec i e lenses.
2.7. De e mina ion o Immunological p o ile
2.7.1. CD4 Cell coun
The blood sample d awn in he acu aine ube was placed on a mixe o 15minu es. Twen y mic o-li es (20µl) o he
CD4 absolu e coun eagen we e pipe ed in o a sepa a e sample ube and 20µl o he mixed blood was added o he
ube con aining he absolu e coun eagen and mixed, hen incuba ed o 15minu es o da k eac ion. Eigh hund ed
mic o li e s (800µl) o no-lyse bu e we e added o he blood in he ube and shaken well. The sample was analyzed
using he low cy ome e (PARTEC CYFLOW COUNTER II, made in Ge many). I con ains a special diode lase o ul a
iole , blue o ed exci a ion. The de ice has a display sc een ha displays clea ly he CD4 coun wi h ime and da e. I
has so wa e which iden i ies he T-lymphocy e popula ion and he capaci y o calcula e he absolu e coun s and display
isually on sc een.
Figu e 1 Map o Maku di showing he s udy si e (Gene al Hospi al No h-Bank, Maku di)
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1557-1566
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3. Resul
The immunological p o ile o HIV posi i e pa ien s co-in ec ed by mala ia pa asi e was in es iga ed a he Gene al
Hospi al No h-Bank Maku di. The esul s a e exp essed as ollows;
The socio-demog aphic cha ac e is ics o he sc eened pa ien s we e shown in Table 1. In espec o Residence, he
u al inhabi an s had he highes equency o 378 (63.0%). Based on age g oup, age 21-30 had he highes equency
o 227 (37.8%), while age 1-10 had he lowes equency o 28 (4.7%). In espec o gende , he emales had he highes
equency o 455 (75.8%). Based on educa ional quali ica ion, he highes equency was obse ed among he seconda y
wi h he alue 345 (57.5%) while he lowes equency was obse ed among he p ima y wi h he alue 52 (8.7%). In
espec o occupa ion, he a me s had he highes equency o 312 (52.0%) while he applican s had he lowes
equency o 22 (8.7%). In espec o Ma i al s a us, he ma ied had he highes equency o 357 (59.5%).
The mean dis ibu ion o sc eened pa ien s' CD4 coun wi h espec o age is shown in Table 2. Age g oup 1-10 had he
highes CD4 coun o 995.25 +536.97, while he leas CD4 coun was obse ed in age g oup 11-20 wi h he mean o al
alue o 516.03 +316.47. The highes a ended numbe was age g oup 21-30 (227) 37.8% while he leas a ended
numbe was age g oup 1-10 (28) 4.6%.
The sex dis ibu ion o pa icipan s' CD4 coun is shown in Table 3. The emales had he highes CD4 coun wi h mean
o al alue o 598.73 +347.78, while he males had CD4 coun wi h he mean o al alue o 524.06 +348.86.
The dis ibu ion o CD4 coun ange o subjec s sc eened wi h espec o age is eco ded in Table 4. I was obse ed ha
221 (36.8%) pa icipan s had good CD4 coun g ea e han o equals 500cell/mm3. 320 (53.3%) pa icipan s had
mode a e CD4 be ween 200 and 499cell/mm3 and 59 (9.8%) pa icipan s had poo CD4 coun less han 200cell/mm3.
The dis ibu ion o CD4 coun ange o subjec s sc eened wi h espec o gende is shown in Table 5. I was obse ed
among he emales ha 151 (33.2%) had CD4 coun ≥500cell/mm3, 267 (58.7%) had CD4 coun be ween 200-
499cell/mm3 and 37 (8.1%) had CD4 coun less han 200cell/mm3. Howe e , among he males, 61 (42.1%) had CD4
coun ≥500cell/mm3, 65 (44.8%) had CD4 be ween 200-499cell/mm3 and 19(13.1%) had CD4 coun less han
200cell/mm3.
The dis ibu ion o CD4 coun o subjec s sc eened wi h espec o esidence is eco ded in Table 6. I was obse ed
among he U ban esiden s ha 78 (35.1%), had CD4 coun ≥500cell/mm3, 127 (57.2%) had CD4 coun be ween 200-
499cell/mm3 and 17 (7.7%) had CD4 coun less han 200cell/mm3. Howe e , among he Ru al esiden s, 140 (37.0%)
had CD4 coun ≥500cell/mm3, 201 (53.2%) had CD4 be ween 200-499cell/mm3 and 37 (9.8%) had CD4 coun less han
200cell/mm3.
The dis ibu ion o pa icipan ’s mean CD 4+ Coun in espec o Ma i al S a us is shown in Table 7. I was obse ed ha
he single had he highes mean CD4 coun o 662.38+376.66, while he ma ied had he lowes mean CD4 coun o
525.07+317.95.
The Dis ibu ion o CD4 coun ange o HIV pa ien s non-coin ec ed wi h mala ia wi h espec o age is demons a ed in
Table 8. I was obse ed ha 221(36.8%) pa icipan s had good CD4 coun g ea e han o equals 500cell/mm3, 320
(53.3%) pa icipan s had mode a e CD4 be ween 200 and 499cell/mm3 and 59 (9.8%) pa icipan s had poo CD4 coun
less han 200cell/mm3.
The Dis ibu ion o CD4 coun ange o HIV pa ien s non-coin ec ed wi h mala ia wi h espec o gende is eco ded in
Table 9. I was obse ed among he emales ha 33(31.4%) had CD4 coun ≥500cell/mm3, 1(1.0%) had CD4 coun
be ween 200-499cell/mm3 and none had CD4 coun less han 200cell/mm3. Howe e , among he males, 69 (65.7%) had
CD4 coun ≥500cell/mm3, 2(1.9%) had CD4 be ween 200-499cell/mm3 and none had CD4 coun less han 200cell/mm3.
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Table 1 Socio-demog aphic Cha ac e is ics o Co-in ec ed Pa icipan s
Va iables
F equency (No.)
Pe cen age (%)
Residence
Ru al
378
63.0
U ban
222
37.0
Age G oup (Yea s)
1 – 10
28
4.7
11 – 20
37
6.2
21 – 30
227
37.8
31 – 40
192
32.0
41 – 50
78
13.0
Abo e 50
38
6.0
TOTAL
600
100
Gende
Male
145
24.0
Female
455
75.8
TOTAL
600
100
Ma i al S a us
Ma ied
357
59.5
Single
243
40.5
TOTAL
600
100
Educa ional Quali ica ion
P ima y
52
8.7
Seconda y
345
57.5
Te ia y
203
33.8
TOTAL
600
100
Occupa ion
Applican
22
3.7
Ci il se an
113
18.8
Fa me
312
52.0
S uden s
85
14.2
O he s
68
11.3
TOTAL
600
100
Table 2 Mean dis ibu ion o sc eened Co-in ec ed pa ien ’s CD 4+ Coun wi h espec o age
Age
N. Obs
Mean
S d. De .
1-10
28
995.25
536.97
11-20
37
516.03
316.47
21-30
227
572.79
319.96
31-40
192
561.86
358.62
41-50
78
560.67
286.97
51 and abo e
38
520.29
255.74
To al
600
Key: CD4 = Clus e o de e en ial 4, N. Obs = Numbe obse ed, S d. De . = S anda d De ia ion
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Table 3 Sex Dis ibu ion o Co-in ec ed pa icipan ’s CD4+ Coun
SEX
N. Obs
Mean
S d. De .
Female
455
598.73
347.78
Male
145
524.06
348.86
To al
600
Key: CD4 = Clus e o de e en ial 4, N. Obs = Numbe obse ed, S d. De . = S anda d De ia ion
Table 4 Dis ibu ion o CD4 coun ange o Co-in ec ed subjec s sc eened wi h espec o age
Age
g oup
CD4 coun ange
G ea e o Equals 500
cell/mm cube(%)
Be ween 200 and 499 cell/mm cube
(inclusi e)(%)
Less han 200 cells/mm
cube(%)
1-10
14(51.9)
11(39.3)
3(10.7)
11-20
22(59.5)
9(24.3)
6(16.2)
21-30
83(36.6)
118(52.0)
26(11.5)
31-40
65(33.9)
115(59.9)
12(6.3)
41-50
26(33.3)
45 (57.7)
7(9.0)
51
11(28.9)
22(57.9)
5(13.2)
To al
221(36.8)
320(53.3)
59(9.8)
Key:CD4 Coun 500 – Good heal h s a e; CD4 Coun 200-499 – Mode a e heal h s a e; CD4 Coun ange less han 200 – Poo heal h s a e
Table 5 Dis ibu ion o CD4 coun ange o co-in ec ed subjec s sc eened wi h espec o gende
Gende
CD4 coun ange
To al
G ea e O Equals 500
cell/mm cube
Be ween 200 and 499 cell/mm
cube (inclusi e)
Less han 200
cells/mm cube
Female
151(33.2)
267(58.7)
37(8.1)
455(100.0)
Male
61(42.1)
65(44.8)
19(13.1)
145(100.0)
To al
212(35.3)
332(55.3)
56(9.3)
600(100.0)
Table 6 Dis ibu ion o CD4 coun o co-in ec ed subjec s sc eened wi h espec o esidence
Residence
CD4 coun ange
To al(%)
G ea e o Equals 500
cell/mm cube(%)
Be ween 200 and 499 cell/mm
cube (inclusi e)(%)
Less han 200
cells/mm cube(%)
U ban
78(35.1)
127(57.2)
17(7.7)
222(100.0)
Ru al
140(37.0)
201(53.2)
37(9.8)
378(100.0)
To al
212(35.3)
332(55.3)
56(9.3)
600(100.0)
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Table 7 Mean Dis ibu ion o co-in ec ed pa icipan ’s CD 4+ Coun in espec o Ma i al S a us
MARITAL STATUS
Mean SD
N. Obs
Mean
MARRIED
357
525.07 317.95
SINGLE
243
662.38 376.66
To al
600
Key: N. Obs = Numbe obse ed, S d. De . = S anda d De ia ion
Table 8 Dis ibu ion o CD4 coun ange o HIV pa ien s non-coin ec ed wi h mala ia (con ol) wi h espec o age
Age
g oup
CD4 coun ange
G ea e o Equals 500 cell/mm
cube (%)
Be ween 200 and 499 cell/mm cube
(inclusi e) (%)
Less han 200 cells/mm
cube (%)
1-10
15(14.3)
0
0
11-20
10(9.5)
0
0
21-30
23(21.9)
0
0
31-40
41(39.0)
0
0
41-50
8(7.6)
1(1.0)
0
51
5(4.8)
2(1.9)
0
To al
102(97.1)
3(2.9)
0
Table 9 Dis ibu ion o CD4 coun ange o HIV pa ien s non-coin ec ed wi h mala ia (con ol) wi h espec o gende
Gende
CD4 coun ange
G ea e O Equals 500
cell/mm cube
Be ween 200 and 499 cell/mm cube
(inclusi e)
Less han 200 cells/mm
cube
Female
33(31.4)
1(1.0)
0
Male
69(65.7)
2(1.9)
0
To al
102(97.1)
3(2.9)
0
4. Discussion
The immunological p o ile o HIV-posi i e pa ien s co-in ec ed wi h mala ia pa asi e has been in es iga ed among 600
medically diagnosed HIV pa ien s a ending Gene al Hospi al No h-Bank, Maku di, Benue S a e.
Acco ding o [14], he s anda d CD4 cell coun ange is as ollows; ≥500cell/mm3 (good heal h s a e), be ween 200-
499cell/mm3 (mode a e heal h s a e) and less han 200cell/mm3 (poo heal h s a e). F om he esul s, emales had he
highes CD4 cell coun wi h good heal h s a e compa ed o he males. This may be because he HIV p esen in semen is
he mos p e alen ec o in ansmission o his disease as epo ed by [15].
Among he 600 pa icipan s sc eened, on he basis o age g oup, 221 pa icipan s in his ca ego y had heal hy CD4
coun s. This may be due o he use o HAART (Highly Ac i e An i e o i al The apy)), as epo ed by, [16], who
sugges ed ha he use o HAART could educe he immune supp ession posed by HIV. Howe e , i was obse ed ha
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1557-1566
1564
he u ban esiden s had highe CD4 coun han he u al esiden s. This may be due o he u al esiden s being mo e
suscep ible o mala ia and mus ha e had epea ed episodes o mala ia in ec ions due o he p esence o a ious
mosqui o b eeding si es compa ed o he u ban a eas. Thus, mala ia leads o an inc ease in he i al load o HIV as
epo ed by [17]
The esul om his s udy he e o e e ealed ha majo i y o he pa icipan s co-in ec ed had CD4 coun s lowe han
he no mal e e ence ange (≥500), implying ha hey had lowe ed immuni y, which u he leads o speedy
p og ession o he HIV disease o AIDS and o he in ec ions which os e poo esponse o HIV ea men s. This ag ees
wi h he epo o [18] and ha o [19], when CD4+ T cells decline o a c i ical le el, cell-media ed immuni y is los and
he body o he indi idual becomes suscep ible o o he oppo unis ic in ec ions. I is also in consonance [20], who
opined ha he e ec o Mala ia-HIV Co-in ec ion is g ea e in pa ien s wi h ad anced and supp essed immune unc ion
han hose wi h s ong immune sys em.
Howe e , 105 HIV posi i e indi iduals who we e no in ec ed wi h mala ia (con ol) we e sc eened. I was obse ed
ha 97% o he pa icipan s had CD4 cell coun ≥500cell/mm3 (good heal h s a e). This may be due o he use o HAART
which boos s he immune sys em he eby p o ec ing hem om o he oppo unis ic in ec ions ha would’ e lowe ed
hei immune sys ems. This ag ees wi h [14], who also sugges ed ha he use o HAART could educe he immune
supp ession posed by HIV.
5. Conclusion
This s udy e ealed ha , mala ia in ec ion in HIV posi i e indi iduals leads o u he educ ion in immunological
indices equi ed o pa ien s o manage he disease and s ay heal hy. The immunological pa ame e s we e a ec ed; he
esul showed a no iceable immune abno mali y. I was e iden om he esul ha Mala ia and HIV in e ac ion
exponen ially inc eases he ad e se e ec s o one in ec ion on he o he , also has a nega i e impac on he p ognosis,
and complica es he p e en ion and ea men o bo h in ec ions in pa ien s in ec ed. Thei in e ac ions p omo e he
incidence o bo h in ec ions. Thus, measu es should be aken o p e en o ea as ea ly as possible any co-in ec ion in
HIV pa ien s o ensu e an e ec i e immune es o a ion in all HIV in ec ed indi iduals unde going he apy. Also, pa ien s
should ensu e o ake An i e o i al D ugs which a e immune boos e s holis ically o p e en immune sys em
de e io a ion.
Recommenda ion
These indings highligh ed he need o ea ly con i ma o y diagnosis o mala ia in HIV in ec ed indi iduals, as well as
p o ision o mala ia he apy when he diagnosis is es ablished in o de o p e en he consequences o he mala ia
pa asi es on he immune sys em.
P o ision o ameni ies such as insec icidal ea ed mosqui o bed-ne s, insec icides and mosqui o epellan s should be
made o indi iduals li ing in mala ia endemic a eas as well as an i e o i al d ugs o help boos he immuni y o
in ec ed pe sons.
Awa eness should also be c ea ed on he isk o HIV/Mala ia co-in ec ion and he need o p ope moni o ing o CD4
cell coun in HIV in ec ed pe sons so as o enable ea ly de ec ion o changes in he immune p o iles.
Compliance wi h e hical s anda ds
Acknowledgmen s
I am g a e ul o he e hical commi ee o Benue S a e Heal h Managemen Boa d o hei p omp suppo . To P o . M s.
G. M. Gbe ikon and P o . I. O. Ogbonna all o he Depa men o Mic obiology, FUAM, o p oo eading he manusc ip
o his wo k, I say hank you. I also app ecia e my belo ed wi e M s. Vic o ia Asibi Aondoackaa o he inpu in collec ing
samples o his s udy and o my child en, Cha i y, Samuel, Pe e , Emmanuel and my g and child en Jasmine and Jason
o pu ing smiles on my ace.
Disclosu e o con lic o in e es
No con lic o in e es o be disclosed.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(01), 1557-1566
1565
S a emen o e hical app o al
E hical app o al was ob ained om he Benue S a e Heal h Managemen Boa d wi h an Issuance o an e hical clea ance
ce i ica e om he e hics commi ee. All pa icipan s we e in o med o he de ails o he s udy be o e samples we e
collec ed.
S a emen o in o med consen
In o med consen was ob ained om all indi iduals who pa icipa ed in his s udy.
Re e ences
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