Category: Volume 10.1

This is a prospective study of urinary tract infection in 65 children (38 males and 27 females, M: F ratio 1: 0.7). Urine samples were evaluated by culture, microscopy and leukocyte esterase dipstick test. Positive urine culture, with significant bacteriuria was found in 19(29.2%). Urine microscopy for leukocyturia identified positive urine culture in 6 of the 19 samples, giving a sensitivity of 43.1%. leukocyte esterase distick test correctly identified 14 of 19 urine samples with culture proven UTI (74% sensitivity). The positive and negative predictive values were 37.1% and 87.2% respectively.
The leukocyte esterase dipstick test was found to be better than leukocyturia in detecting UTI. in conclusion, leukocyte esterase is sensitive in detecting UTI, easy to perform, requires less time and does not need a highly trained personnel for the test.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 10-14

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Assessment Of Leukocyte Esterase Dipstick Test In Diagnosis Of Childhood urinary tract infection

The prevalence of trypanosome infection in trade cattle, goats and sheep was investigated in slaughtered animals at the Kaduna Abattoir. Wet, thin, thick films, animal inoculation, haematocrit centrifugation technique and buffy coat methods were used to detect rypanosomes in the jugular blood of the animals. The packed cell volume (PCV) was also determined. A total of 300 cattle, 300 goats and 300 sheep were examined within five months (September, 1998 – January, 1999) and the prevalence rates in cattle, goats and sheep were found to be 5.00%, 4.67% and 3.33% respectively.
Mean PCV of infected cattle was 20.33% against uninfected cattle 35.08%. In goats, the PCV was 20.29%, uninfected goats 31.56%; while that of sheep was 19.40% and uninfected 32.85%. Trypanosoma vivax infection accounted for 60%, T. brucei 26.67% and T. congolense 13.33% in cattle. In goats, T. vivax infection accounted for 71.43%, T. brucei 21.43% and T. congolense 7.14%. Also T. vivax infection accounted for 70%, T. brucei 30% and T. congolense 0% in sheep. Sex did not significantly (P>0.05) affect infection rates. Although the prevalence rate of trypanosomiasis in cattle, goats and sheep appeared low compared with the previous works, natural trypanosomiasis remains economically importance in cattle, goats and sheep in Nigeria.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 15-25

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The Prevalence Of Trypanosome Infection In Trade Cattle, Goats And Sheep Slaughtered At The Kaduna Abattoir

Serum antibodies to Onchocerca volvulus native sodium duodecylsulphate slat extracted antigens and epitopes recognized by three monoclonal antibodies designated Cam8, Cam22, and Cam28 were measured using indirect (sandwich) and competitive enzyme-linked immunosorbent assay (ELISA). Paired serum samples (n=32) were obtained before and two months post-ivermectin treatment. Those with increases of ten percent and above (≥10%) were 16 (50%) for IgG, 13 (40.7%) for both IgG1 and IgG4. Nine (28.2%) for IgM, eight (25%) for IgG3, IgA with four (12.5%) was the least, while IgG2 was not assayed due to cross-reaction. The higher increases in IgG, IgG1 and IgG4 antibodies in
females (n=16) than males (n=16) were significant by T-test of unpaired data (P<0.05). Those without onchocercal skin disease, OSD (n=18) had a significant increase of 20.5±29.6%, with pre- and posttreatment values of 0.59±0.15 versus 0.68±0.13 for IgG antibody (P<0.05). Both IgG1 and IgG4 antibodies for those with OSD (n=14) increased by 16.0±24.8%. Only IgG4 antibody increased with the presence of palpable nodule and higher skin microfilarial density. Trend exhibited by Cam 22 and Cam 8 were similar to that of IgG and IgG4, respectively. In conclusion, while IgG1 and IgG4 were both associated with skin diseases, IgG4 assay proved more suitable for onchocerciasis drug screening.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 26-37

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Quantitative Changes In Antibodies Against Onchocercal Native Antigens Two Months Postivermectin Treatment Of Onchocerciasis Patients

With depressing nature of economy in many countries such as Nigeria where per capita income is low, there is need for utmost consideration for cost containment measures.
Objective: The objective of this study is to conduct pharmacoeconomic evaluation of two antichlamydial indicated non-gonococcal urethritis therapeutic options and to make
recommendations for inclusion of economic evaluation of drug therapies in health policy formulations and decision making. Methods: Cost effectiveness analysis was carried out retrospectively for prescribed/dispensed antibacterials to out-patients with chlamydial implicated non-gonococcal urethritis among other infectious diseases, by examining out-patient case notes between 2005 and 2007 in Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Results : The result shows that doxycycline costs N1.33/unit of effectiveness while tetracycline costs N2.77/unit of effectiveness in the treatment of chlamydial implicated non-gonococcal urethritis. Doxycycline is therefore more cost effective than tetracycline capsules. Subjecting the costs and effectiveness to sensitivity analysis did not change this conclusion. There is statistically significant difference in the effectiveness (outcome) of doxycycline (78.8%) and tetracycline (58.7%) ( x2 =9.4; p<0.05) There is therefore association between effectiveness and therapeutic option chosen with doxycycline being a more cost-effective option. The result is significant because doxycycline is not currently included in the Essential Drug list of Nigeria. However, the result is in agreement with Zimbabwean Essential Drug list which recommended that tetracycline be replaced by doxycycline in all indications and should be used only when
doxycycline is not available2. Also doxycycline is a drug of choice for other disease like
gonorrhorea and syphilis in non-pregnant women2. It was concluded that Doxycycline 100mg bd x 1/52 is more cost effective than Tetracycline 500mg qid x 1/52
in the treatment of chlamydial implicated non-gonococcal urethritis. Adoption of economic evaluation of drug therapies in Nigeria Health policy formulation and decisions is likely to enhance overall Health System cost effectiveness.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 35-46

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Pharmacoeconomic Evaluation Of Doxycycline And Tetracycline In The Treatment Of Chlamydial Implicated Non-Gonococcal Urethritis In A Tertiary Healthcare Institution

Healthcare organizations, governments and individuals have been forced by prevailing circumstances of economic crisis to be increasingly oriented towards cost containment due to escalating nature of health expenditure.
Objective:
The objective of this study is to determine the comparative cost effectiveness of various antituberculous therapeutic options and to make recommendation for the adoption of costeffectiveness evaluations in National Health Policy formulation and decision-making.
Method
Retrospective cost effectiveness analysis was carried out for prescribed/dispended antibiotic to outpatients with tuberculosis among other infectious diseases in outpatients case notes between 2005 and 2007 in Ahmadu Bello University Teaching Hospital, Zaria Nigeria.
Results
The result shows that ethambutol tablet cost N8.40/unit of effectiveness while streptomycin
injection cost N81.50/unit of effectiveness in the treatment of tuberculosis. Ethambutol tablet therefore appears to be more cost effective than streptomycin injection. Subjecting the cost and effectiveness to sensitivity analysis did not change this conclusion. Statistical analysis shows that there is a statistically significant difference in the effectiveness (outcome) of ethambutol (95%) and streptomycin injection (76.73%) (X2 =13.75; p<0.5). Therefore there is association between effectiveness and therapeutic option chosen with ethambutol tablet being a more cost effective option. The result of this study is significant because ethambutol is usually traded off for less cost-effective streptomycin in many cases even when there is no contraindication to the use of ethambutol.
CONCLUSION
Ethambutol tablet is more cost effective than streptomycin injection at their usual therapeutic doses in combination with isoniazed, rifampicin and pyrazinamide in the treatment of tuberculos at the intensive phase.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 47-55

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Comparative Cost-Effectiveness Analysis Of Streptomycin And Ethambutol In The Treatment Of Tuberculosis In A University Teaching Hospital In Nigeria

A case-control study was done using a convenience sample of 100 pairs of mothers and children (less than five years old) divided into two groups; the first group made of children with diarrhoea and their mothers (case group) and the second group made up of mothers and children who did not have diarrhoea (control).
A structured interview schedule and review of routine data were used to collect data.
Only 12.5% of children less than six months in the case group were exclusively being breastfed compared with 75% of the control group. 56% of the cases used water from unprotected wells for domestic activity while 70% of the control group used pipe- borne water. Also 24% of the case group did not cover stored water while 76% of the control group covered stored water. This demonstrated poor food and water safety.
Only 10% of cases had access to flushing water closets for human excreta disposal while the remaining 90% either used pit latrines or disposal into surrounding bushes.
It was recommended that good amenities for the disposal of refuse in the communities be
provided by the government and the delivery of pipe-borne water be made more regular to the inhabitants Further, appropriate education in simple language is to be offered by health
personnel especially at Ante-Natal Clinic and on radio stations and mothers are to be
encouraged to put into practice what they learn about the treatment and prevention of
diarrhoea.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 56-63

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The Influence Of Environmental Sanitation Practices And Hygiene On The Incidence Of Diarrhoea – The Case Of Koforidua Municipality, Ghana