ARTICLES

Wound biopsy is a reliable way of diagnosing wound infection in patients with chronic ulcer of the limbs and in burn patients. The biopsy specimen is subjected to both histological and microbiological analysis. While wound swabs often cultured mixed contaminants, biopsy specimens usually reveal single organism growth. This is a prospective study of fifty patients with chronic leg ulcers attending surgical outpatient department over a period of 10 months. The ulcers were subjected to histopathology study. The clinical status of the ulcers were correlated with the histopathology result. There was both statistical and clinical significance between the ABDEFS’ and HISTOPATHOLOGY scores. A clinician can therefore reasonably predict the degree of bacterial invasion of the ulcer based on the assessment of its clinical appearance and thus commence appropriate treatment before further complication sets in.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(1): 11-12)

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A Correlation Study Of Ulcer Status With Bacterial Colonization And Invasion

A prospective study was conducted at Ogun State University Teaching Hospital (OSUTH) between August 1999 and July 2000 in the Orthopaedics, Obstetrics and Gynaecological units to identify the bacterial pathogens associated with infected wounds as well as their antibiotic sensitivity profile.
A total of 1670 patients were seen in these units, out of which 130 (7.78%) developed wound infections. There was a statistical difference (P < 0.05) between the septic wounds associated with the non-operative cases (11.9%) and those of post-operative cases (6.41%). Amongst the 186 bacterial agents isolated from all the samples examined, Klebsiella species (25.3%) accounted for the most common isolates while the least was Enterococcus faecalis (5.4%). Klebsiella species was observed to be most prevalent in the Obstetrics and Gynaecological wounds while Pseudomonas aeruginosa was the commonest in the Orthopaedic wounds.
The sensitivity profile of the isolates to the commonly used antibiotics including those used as pre-operative prophylactic agents ranged between 1.67-46.8%, the range for the aminoglycosides was between 61.8-75%, while the fluoroquinolones had a range of 82.8%-89.2%.
The high level of bacterial resistance to the common antibiotics in this study, re-emphasized the need to properly monitor the use of antibiotics including those used as pre-operative prophylactic agents in this country.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(1): 13-16)

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Bacterial pathogens associated with infected wounds in Ogun State University Teaching Hospital, Sagamu, Nigeria

Thirty-one patients with newly diagnosed pulmonary tuberculosis were longitudinally studied between January 1997 and June 1998; each for 6 months to determine the pattern of drug induced hyperuricaemia. Biochemical indices determined were serum urate and 24 hours urinary output of urate, before and during treatment with antituberculosis therapy.

At the end of the 1st and 2nd months of therapy 16 (51.6%) and 15 (48.4%) of the patients respectively were hyperuricaemic. These were statistically significant when compared with the pretreatment data with P value of 0.001 and 0.002 respectively. At the end of the 6th months there was no significant difference in the incidence of hyperuricaemia observed as compared with the pretreatment level.

The pretreatment mean 24 hours urinary urate output was 4.83 mmol/24 hours, the corresponding values at the end of the 1st and second months of treatment was 3.38 mmol/24 hour and 3.74mmol/24 hours. These value are significantly lower than the pretreatment value with P value of P < 0.05 respectively. This however returns to the pretreatment range by the end of he 6th month of treatment with a value of 4.05 mmol/24 hours and P – value of 0.178.

We concluded therefore that while hyperuricaemia is a known cause of nephropathy, the pattern of drug induced hyperuricaemia that occurs in patients with pulmonary tuberculosis is self- limiting and should therefore not hinder us from optimizing the benefits of the drugs.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(1): 17-20)

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Pattern Of Drug Induced Hyperuricaemia In Nigerians With Pulmonary Tuberculosis

This is a review of 32 consecutive cases of patients with genital ulcers or who were repeatedly reactive to serological tests for syphilis (STS) at the Venereology Clinic of the University Teaching Hospital, Ilorin, Nigeria, between January 1993 and April 1995. The criteria for diagnosis of the various conditions included the history, clinical presentation and the results of laboratory investigations. The commonest cause of genital ulcers was chancroid, accounting for 6(18.7%) of the 32 cases. Other common causes were lymphogranuloma venereum (LGV), gential herpes and primary syphilis, each acounting for 12.5 percent of the cases. An unusual presentation of oro-genital aphthosis, with hyperkeratosis and paraesthesia of a localized area on the palm, in addition to the usual genital and oral lesions was reported. Also reported were cases of perigenital cutaneous onchocerciasis and a case of leprosy presenting as chronic biological false positive (BFP) to STS. Patients with chancroid responded favourably to treatment with ceftriaxone (Rocephin) and so was the hyperkeratosis of oro-gential aphthosis to topical treatment with flumethasone pivalate/salicylic acid ointment (Locasalen). The importance of histological technique for making the diagnosis of some tropical conditions affecting the genitals was highlighted, and the exercise of caution in interpreting the results of STS was advocated.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(1): 21-23)

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Genital ulcer disease in Ilorin Nigeria

This study was carried out between November and December 1999 in a peri urban area of Ibadan in Lagelu Local Government Area to determine the prevalence rate of intestinal helminth infection among malnourished school children. Stool samples and finger prick blood samples were respectively collected from pupils in form 3 to form 6 for analysis. The relationship between infection and their nutritional status was determined using such parameters as weight, height, age, sex, arm to head circumference. The haematocrit value and worm density in subjects were determined to rate level of infectivity in the individual.
The study shows that there are three common intestinal worms in the area Ascaris lumbricoides has the highest prevalence rate of 40.7% followed by Tribchuris trichiura (4.8%) and hookworm (4.4%).
Age and sex gender made no significant difference in the distribution of infection (P >0.05). however, there was a significant effect on weight and height by worm burden (P <0.05). Worm density impact negatively on the blood level in body thereby precipitating anaemia in the children. Epidemiological factors affecting the infection among the subject is discussed.
The strategies for control of the infection are discussed. It is recommended that the public be adequately health educated on the epidemiology of the infection through the mass media and community health talks. The academic curriculum in schools should include epidemiology and control of parasitic infestation. Periodic mass treatment of children is advocated.

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Intestinal helminthiasis among malnourished school age children in peri-urban area of Ibadan, Nigeria

 

(Af. J. of Clinical and Experimental Microbiology: 2002 3(1): 24-28)

To determine the prevalence of onchocerciasis and diagnostic method for a rapid assessment of the disease in Iwo Local Government Area (LGA) of Osun State, Nigeria.
Method: the study area was randomly selected using lottery method. The study subjects are from all works of life of both sexes and not below the age of 10. Structured questionnaire was administered to obtain vital epidemiological information from study subjects. Skin snip as standard method of diagnosing onchocerciasis was done using method as described and was compared with other potential diagnostic indicators. The methods of sample analysis are described. Data were analysed by using correlation coefficient, Duncan multiple range test, and analysis of variance where appropriate.
Results: of the 240 subjects examined, 35.4% were skin snip positive. Whereas infection increases with age of subjects (P<0.05), the difference in the infection among male and female subjects is not significant (P > 0.05). Of all the methods of diseases assessment, only nodule palpation method correlate well with the standard diagnostic method skin snip.
Conclusion: the merit of nodule palpation and criteria for the determination are discussed. Nodule palpation assessment method (NPAM) was recommended as an alternative rapid assessment method of large scale surveillance of onchocerciasis in Nigeria. NPAM could be used for monitoring and evaluation of the current programme of mectizan distribution in the country.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(1): 29-32)

The public health importance of Lassa fever can not be over emphasized if one considers the high infectivity and mortality rates associated with the disease. This study dealt extensively on the epidemiology, clinical features and current management of Lassa fever through literature review. The aim of this study is to sensitise the public on what it needs to know on Lassa fever as well as updating the knowledge of health workers on current management of the disease and important precautive measures to take when handling a patient with Lassa fever. Strict barrier nursing, isolation, use of protective devices are important preventive measures when managing a patient with Lassa fever infection. As Lassa fever may have a long incubation period (Up to 20 days), it is possible that travellers from endemic areas may be incubating the disease. However, one case of Lassa fever entering a non-endemic area should not cause fear of an epidemic as long as correct infection control procedures are followed.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(1): 33-37)

The prevalence of antibodies to Newcastle disease virus (NDV) in Nigerian indigenous chickens raised in Ibadan was surveyed using the indirect enzyme-linked immunosorbent assay (ELISA). Sera from 161 chickens from 3 are as of Ibadan viz University campus, Agbowo and Oremeji were analysed. The prevalence rate obtained ranged between 52.5% and 83.4% with an overall prevalence of 73.3%. The extent and implication of NDV activity in the Nigerian indigenous chicken as well as the advantages, sensitivity and usefulness of ELISA in serological investigation were discussed.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(1): 38-40)

Classical water purification methods include boiling, filtration, irradiation and the use of chemicals while traditional water purification methods in use are boiling, filtration, sedimentation, long storage and solar radiation. Waterborne diseases are m ore common in the rural communities where potable water supply coverage is usually low. Therefore, this study was designed to assess and modify existing water purification methods in use in the rural communities so as to encourage their regular use.
Water samples collected from various sources serving six rural communities in Agege, Epe and Ikorodu Local Government areas of Lagos State were purified using each of the traditional methods. Viable counts were carried out on each of the water samples before and after the purification process. Water samples contamination with known pathogens were also included in the test.
The boiling method was the most efficient giving 100% decontamination after three minutes of continuous boiling. The solar method gave varying degrees of decontamination of the water samples (42-100%) depending on the turbidity of the water and the type of container used for the test. The long storage method and the cloth filtration methods decontaminated the water by (0.6-4.2%) and 41% respectively.
The solar water purification method should be encouraged. Turbid water samples should be cloth filtered prior to exposure to the sun for maximum efficiency.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(1): 41-44)

The effect of acute caprine trypanosomiasis on haemoglobin (Hb) concentration, urea and serum electrolytes was studied in Red Sokoto goats infected with Trypanosoma vivax. The course of infection lasted only two weeks when the infected goats died of fulminating parasitaemia and high fever. Haemoglobin concentation of the infected goats was only slightly decreased. However, the serum urea level was significantly increased (P <0.05) while Cl, K+ and HCO3 levels were slightly increased above pre-infection values by week two post infection (PI). Serum Na+ increased only in the first week PI but returned to pre-infection values by the second week.

(Af. J. of Clinical and Experimental Microbiology: 2002 3(1): 45-47)