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Acute Respiratory Infections in the Middle-Belt Region of Nigeria

SK Ernest, A-WBR Johnson, OA Mokuolu, OT Adedoyin, JK Afolabi, CO Nwabueze, MA Ernest, CI Aderinola, AJ Alarape

 

Abstract

Background: ARI continues to be a leeding cause of death among children globally beyond the year 2000. Close 12 million children under the age of 5years die each year in the developing countries, mainly from preventable causes and approximately 2.28 million (19%) were due to acute respiratory infections (ARI). It therefore became necessary to assess the present status of the disease in Nigeria to mastermind workable plans for reducing the mortality and morbidity burden.
Methods: A designed pro-forma was used to collect and collate information from mothers or direct care givers of children at both hospital and community levels relating to family background, home setting, anthropometry, clinical presentation of ARI, previous medications, investigations, complications and outcomes of illness.
Results: A total of 163 children were recruited for the study. One hundred and six had moderate and severe form of ARI while 57 had mild form. The in-patients accounted for 15.2% of all the admission within the study period.All children were under 12 years of age with male preponderance. Fast breathing, Tarchypnoea, Cough and Fever were the leading ways of presentations. The immunization coverage of study population by various antigens in the EPI were poor. Majority of the hospital children had pre-consultation antibiotics while none of the children from the rural community had pre-recruitment antibiotics. Streptococcus pneumoniae and Staphylococcus aureus were the leading organisms isolated with good sensitivity to Quinolones, Gentamycin and Cephalosporins. Heart failure was the leading complications. Mortality was 12.3% among the hospitalized patient and none among the community children.
Conclusion: It was concluded that ARI is still a major cause of morbidity and mortality among children with opportunity for burden reduction.

Keywords: Acute Respiratory Infection, present outlook, burden

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Acute Respiratory Infections in the Middle-Belt Region of Nigeria

 

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Nosocomial Wound Infection amongst Post Operative Patients and their Antibiograms at Tertiary Care Hospital in India

S Mehta, N Sahni, VA Singh, R Bunger, T Garg, P Shinu

 

Abstract

Nosocomial infection constitutes a major public health problem worldwide. Increasing antibiotic resistance of pathogens associated with nosocomial infections also becomes a major therapeutic challenge for physicians. Thus, the aim of this study was to identify post operative bacterial infections in the patients developing surgical site infections at a tertiary University hospital in North India during July 2013 to Dec 2013.
Methods: One hundred and ninety six swabs/pus specimens from various types of surgical sites suspected to be infected on
clinical grounds were processed, by standard methods and antibiotic susceptibility testing of all the isolates was done by using
Kirby Baur disc diffusion technique.
Results: Of the one hundred and fifty-eight organisms isolated, the most common was Staphylococcus aureus (27.8 %), followed
by Escherchia coli (24.05 %), Klebsiella pneumoniae (13.29 %), Pseudomonas aeruginosa (6.32%), Klebsiella oxytoca (5%),
Enterococcus (5.6%) and other miscellaneous gram negative rods (9.4%) and Streptococcus pyogenes (1.30%). About 50% of the
Staphylococcus aureus isolates were found to be methicillin resistant. In case of Escherichia coli, more than one-third of the isolates were found to be ESBL producers. The resistance to third generation cephalosporins and the quinolone ciprofloxacin was also quite high. Other isolates also showed a very high level of antibiotic resistance.
Conclusion: In addition to the economic burden for antibiotic treatment, such infections for multi-resistant organisms are a serious threat to our surgical patients. To prevent these happenings, there is ar urgent need to adopt basic principles of asepsis and sterilization and to make judicious use of prophylactic and therapeutic antibiotics and determine current antimicrobial resistance to commonly prescribed drugs.

Keywords: Wound infection; microorganisms; anti-microbial sensitivity

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Nosocomial Wound Infection amongst Post Operative Patients and their Antibiograms at Tertiary Care Hospital in India

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Prevalence of Antibiotic-Resistant Strains of Escherichia coli in Drinking Water Samples from Mowe Metropolis, Ogun State, Nigeria

SA Adenodi, NE Oyejide, SO Fayemi, F Ayoade

 

Abstract

A measured Escherichia coli level in drinking water is perhaps the most popular means of determining human health risks globally. Water samples from wells, boreholes and sachet water, the 3 predominant sources of drinking water in the study area were evaluated for the presence of bacteria, particularly E coli. Bacteria isolation was done using standard microbiological procedures while identification of isolates was done using cultural, morphological and biochemical characteristics. Enumeration of standard plate count was done by spread plate method on serially diluted water samples. The prevalence of E coli in the water samples and the activities of cefoxitin, fusidic acid, meticillin, penicillin and vancomycin against the E coli isolates and the susceptibility testing data were obtained using Kirby Bauer method. A total of six bacteria species Escherichia coli, Pseudomonas aeruginosa, Bacillus cereus, Klebsiella pneumonia, Staphylococcus aureus, Enterobacter aerogenes were isolated from water samples obtained from borehole, well and sachet water samples in the study area. The mean bacteria counts ranged between 3.74 x 104 to 1.65 x 102 CFU/ml for well and borehole water and 0.81 to 5.1 x 102 CFU/ml for sachet water samples. Out of the 6 E coli strains representing 27.2% of the isolated bacteria species; two, representing 33.3% of the strains
showed moderate to high resistance against meticillin. These findings are expected to motivate public health stakeholders in the study location to attempt reducing the growing resistance of pathogenic bacteria in the environment, and their ecotoxic effects.

Key words: antibiotic resistance, meticillin, water quality, E. coli

 

Un niveau d’Escherichia coli mesurées dans l’eau potable est peut-être le moyen le plus populaire de la détermination des risques pour la santé humaine à l’échelle mondiale. Des échantillons d’eau de puits, de forages et de l’eau de sachet, les trois principales sources d’eau potable dans la zone d’étude ont été évalués pour la présence de bactéries, en particulier E. coli. L’isolement de bactéries a été effectué en utilisant des procédures microbiologiques standard tandis que l’identification des isolats a été effectuée à l’aide des caractéristiques culturelles, morphologiques et biochimiques. Énumération de nombre de plaque standard a été effectuée par la méthode de la plaque de propagation sur des échantillons d’eau dilués en série. La prévalence de E. coli dans les échantillons d’eau et les activités de la céfoxitine, l’acide fusidique, la méticilline, la pénicilline et
de la vancomycine contre les isolats de E. coli et les données de tests de sensibilité ont été obtenus en utilisant la méthode de Kirby Bauer. Un total de six espèces de bactéries :Escherichia coli, Pseudomonas aeruginosa, Bacillus cereus, Klebsiella pneumoniae, Staphylococcus aureus,  Enterobacter aerogenes ont été isolés à partir d’échantillons d’eau provenant de puits, de forage et des échantillons d’eau de sachet dans la zone d’étude. Les bactéries, les valeurs moyennes se situaient entre 3,74 x 104 à 1,65 x 102 UFC / ml pour le bien et l’eau de forage et de 0,81 à 5,1 x 102 UFC / ml pour les échantillons d’eau de sachet. Sur les 6 souches d’E.coli représentant 27,2% des espèces de bactéries isolées ; deux (33,3 %) des souches ont montré une résistance modéré à haute à la pénicilline. Ces résultats devraient inciter les intervenants en santé publique dans le lieu de l’étude de tenter de réduire la résistance croissante des bactéries  pathogènes dans l’environnement et leurs effets écotoxiques.

Mots clés: Résistance aux antibiotiques, pénicilline, qualité l’eau, E. coli.

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Prevalence of Antibiotic-Resistant Strains of Escherichia coli in Drinking Water Samples from Mowe Metropolis, Ogun State, Nigeria

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Microbial Contamination of Locally Produced Cheese and Determination of their Antimicrobial Potential in Nigeria

DO Ogbolu, AAO Terry, AS Oluremi, AA Olanrewaju

 

Abstract

The high consumptionrate of soft cheese and manner of cheese production in Nigeria prompted the need to determine the microbial quality and  antimicrobial properties of locally produced cheese in Nigeria. A total of 20 cheese samples were obtained from different points in 4 cities in southern Nigeria, 5 cheeses per city. They were investigated for some physico-chemical properties, isolation and microbial counts and determination of antimicrobial potential. There was no significant variation in the  composition of physic-chemical properties of cheese samples from various cities except for the acidity of cheese sample obtained from Ilorin. All the 20 samples (100%) yielded low level of lactic acid bacteria (LAB) with counts ~ 103. Escherichia coli or Klebsiella species were constantly isolated in all the cheese samples. Similarly, yeast and Aspergillus species were isolated either alone or in a mixed culture. The result showed increase in total bacteria count from the point of production to the hawkers.  Antimicrobial potential was not found in cheese against the  microorganisms used in the study. The study identified local cheese (‘wara’) as a high risk food in Nigeria due to the high rate of contamination since they are ready-to-eat food item and no antimicrobial property detected in the soft cheese.

Key Words: Cheese; Bacteria; Fungi; Nigeria, Susceptibility

 

Le taux de fromage à pâte molle et les modalités de production de  fromage au Nigeria à forte consommation a incité la nécessité de déterminer la qualité microbienne et propriétés antimicrobiennes de  fromage produit localement au Nigeria. Un total de 20 échantillons de fromage ont été obtenues à partir de différents points dans 4 villes au sud du Nigeria, 5 fromages par ville. Ils ont été étudiés pour certaines  propriétés physico-chimiques, l’isolement et les numérations microbiennes et détermination du potentiel antimicrobien. Il n’y avait aucune variation significative dans la composition des propriétés physico- chimiques des échantillons de fromage à partir de différentes villes à l’exception de l’acidité de l’échantillon obtenu à partir de fromage de la ville d’Ilorin. Tous les 20 échantillons (100%) ont donné un faible niveau de bactéries lactiques (LAB) avec environs 103 espèces. Escherichia coli ou Klebsiella
ont été constamment isolés dans tous les échantillons de fromage. De même, des espèces de levures et d’Aspergillus ont été isolés soit seuls, soit dans une culture mixte. Le résultat a montré l’augmentation des bactéries totales compté du point de production aux colporteurs. Potentiel antimicrobien n’a pas été trouvé dans le fromage contre les micro-organismes utilisés dans l’étude. L’étude a identifié fromage local (‘ wara ‘) comme un aliment à haut risque au Nigeria en raison du taux élevé de contamination, car ils sont prêts à consommer l’aliment et aucune  propriété antimicrobienne détecté dans le fromage à pâte molle.

Mots clés: Fromage; bactéries; champignons; Nigeria, sensibilité

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Microbial Contamination of Locally Produced Cheese and Determination of their Antimicrobial Potential in Nigeria

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Candiduria among HIV- Infected Patients Attending a Tertiary Hospital in Benin City

NO Esebelahie, IB Enweani, FO Newton-Esebelahie, R Omoregie

 

Abstract

Background: Candiduria is a common finding. However, in  immunocompromised patients like HIV-infected individuals, it has high risk of morbidity and mortality as it could be a pointer to systemic candidiasis. Unfortunately, there are no clear criteria for differentiating between colonization and infection or between upper or lower urinary tract infections.

Objective: This study focused on determining the spectrum of Candida species implicated in candiduria among HIV-infected individuals and their
susceptibility to fluconazole and voriconazole in a tertiary hospital.

Methods: A total of 300 subjects comprising of 200 HIV patients and 100 non-HIV individuals were used for this study. Clean catch midstream were collected from each individual and processed using standard  microbiological techniques. Emergent Candida isolates were identified with CHROMagar Candida and sugar fermentation tests.

Results: The overall prevalence of candiduria among HIV patients was 13.5%. HAART-naive patients had a significantly higher prevalence  (OR=4.165, 95%CI=1.602, 10.828; P=0.0038) than their counterpart on highly active antiretroviral therapy (HAART). Female gender was a  significant risk factor for acquiring candiduria. Age had no significant effect on the prevalence of candiduria in this study. A CD4+ count <200 cells/µl was a significant risk factor for acquiring candiduria only among  HAART-naive patients (OR=11.711; 95%CI=3.943, 34.780; P= 0.0001). The three species of Candida recovered from this study were C. albicans, C. krusei and C.parapsilosis. C. albicans (64.52%, 83.36%) and C. krusei (66.67%, 100.00%) were resistant to fluconazole and voriconazole  respectively.

Conclusion: There is a significant relationship between  antiretroviral therapy, CD4+ counts, and the prevalence of candiduria among the study population.

Keywords:HAART, HAART-naive, candiduria, CD4+ counts, Candida,  prevalence.

 

Contexte: La candidurie est un problème commun de sante publique. Cependant, chez les patients immunodéprimés comme les individus infectés par le VIH, elle présente un risque élevé de morbidité puisqu’elle peut évoluer vers la candidose systémique. Malheureusement, il n’existe pas de critères clairs permettant de distinguer la colonisation et l’infection de même que les infections des voies urinaires supérieures et inférieures.

Objectif: Cette étude a porté sur la détermination du spectre d’espèces de Candida impliqués dans la candidurie chez les personnes infectées par le VIH et leur sensibilité au fluconazole et voriconazole dans un hôpital tertiaire.

Methodes : Un total de 300 sujets comprenant 200 patients atteints du VIH et 100 personnes non -VIH ont été utilisés dans cette étude. Les echantillons d’urine ont été collectées auprès de chaque personne par la methode de ‘‘Clean catch midstream’’et traitées en utilisant des techniques microbiologiques standard. Les isolats émergents de Candida ont été identifiés avec CHROMagar Candida et les tests de fermentation de sucre.

Résultats : La prévalence globale du VIH chez les patients atteints de candidurie était de 13,5%. Les patients en naïfs de la multithérapie HAARTavaient une prévalence significativement plus élevée (OR = 4,165, IC à 95% =1,602, 10,828, p = 0,0038 ) par rapport a leurs homologues sous traitement antiretroviral hautement actif (HAART ) . Le sexe feminin etait un facteur de risque important d’acquisition de candidurie. L’age n’avait pas d’effet significat nif sur la prevalence de candidurie dans cette etude. Un compte de CD4 + < 200 cellules / µl ete un facteur de risque important pour l’acquisition de candidurie que chez les patients en multitherapie naifs (OR = 11,711 ; IC a 95% = 3, 943, 34, 780, p = 0,0001). Les trois especes de Candida recuperes de cette etude etaient C. albicans, C. krusei et C.parapsilosis. C. albicans(64,52%, 83,36 %) et C. krusei (66,67%, 100,00 %) etaient resistants respectivement au  fluconazole et voriconazole.

Conclusion: Il existe une relation significative entre le traitement  antiretroviral, CD4 +, et la prevalence de candidurie parmi la population de l’etude..

Mots-cles: multitherapie HAART , naifs , candidurie , CD4 + , Candida , prevalence

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Candiduria among HIV- Infected Patients Attending a Tertiary Hospital in Benin City

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Serological Screening for Ante-Natal Toxoplasmosis in Maiduguri Municipal Council, Borno State, Nigeria

SO Oyinloye, M Igila-Atsibee, B Ajayi, MA Lawan

 

Abstract

Toxoplasma gondii infection causes devastating defects including,  blindness, neurological impairment and mental retardation in congenitally infected children. Congenital infection occurs when a woman becomes infected during pregnancy; and the severity of the illness is related to the trimester period. This research was designed to evaluate the  seroprevalence of toxoplasmosis amongst pregnant women (n=90) using enzyme linked immunosorbent assay (ELISA) kit (Cortez Diagnostics Inc. USA). A structured questionnaire was used to collect socio-demographic data. A significant (x2 Cal 233.0/ x2 tab 124.1, p=0.01) overall prevalence of 22.2% (20/90) was obtained. Pregnant women within 25-29years had the highest prevalence of 33.3% (3/9); this was significant (x2 Cal 35.85/ x2 tab 9.21, p=0.01). An association between high levels of toxoplasma IgG and miscarriage was established in four of twenty five women who had suffered miscarriage (t cal 5.3/t tab 2.81, p=0.01). The results presented indicate that toxoplasmosis is a significant public health burden in the area of study, which requires drastic remedial measures.

Key words: Toxoplasmosis, pregnant women, miscarriage, Nigeria

 

L’infection de Toxoplasma gondii provoque des malformations dévastatrices, y compris, la cécité, des troubles neurologiques et un retard mental chez les enfants infectés congénitalement. L’infection congénitale se produit quand une femme est infectée au cours de la grossesse, et la gravité de la maladie est liée à la période de trimestre. Cette recherche a été conçue pour évaluer la séroprévalence de la toxoplasmose chez les femmes enceintes (n = 90) à l’aide de dosage immunoenzymatique (ELISA) (Cortez Diagnostics Inc. USA). Un questionnaire structuré a été utilisé pour
recueillir des données socio- démographiques. Une prévalence importante globale de 22,2 % (20/ 90) a été obtenu (p =0,01). Les femmes  enceintes dans les tranche d’âge25- 29 ans ont eu la plus forte prévalence de 33,3 % (3/9)qui était significative (p = 0,01). Une association entre des niveaux élevés de Toxoplasme IgG et fausse couche a été établie dans quatre des vingt-cinq femmes qui avaient subi une fausse couche (p = 0,01). Les résultats présentés indiquent que la toxoplasmose est un problème de santé publique dans cette localité, ce qui nécessite des mesures correctives drastiques.

Mots clés: Toxoplasmose, femmes enceintes, fausses couches, Nigeria

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Serological Screening for Ante-Natal Toxoplasmosis in Maiduguri Municipal Council, Borno State, Nigeria

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Toxoplasma Gondii Infection in HIV/AIDS: Prevalence and Risk Factors

O Okwuzu, NN Odunukwe, OC Ezechi, TA Gbajabiamila, AZ Musa, PM Ezeobi, BA Oke, T Somefun, RN Okoye, CC Onyeitu, MA Adetunji, AO Otubanjo

 

Abstract

BACKGROUND: Toxoplasmosis is an infection caused by the protozoan Toxoplasma gondii. It is common in severely immunecompromised
persons.
OBJECTIVE: To determine the seroprevalence of T. gondii infection and the risk factors associated with the infection and to investigate the association between T. gondii infection and CD4 cell count.
METHODS: Sera collected from 242 HIV positive HAART- naive patients were tested for T. gondii specific immunoglobulin G antibodies. Information was obtained using a structured questionnaire. Baseline CD4 cell counts were obtained from patients case files. Data was managed using SPSS version 20 software and Microsoft Excel worksheet.
RESULTS: One hundred and sixty eight (69.4%) subjects were females while 74(30.6%) were males. One hundred (41.3%) of study participants were Toxoplasma IgG antibody positive. Thirty two(32) HIV positive pregnant women were among this group studied with 12( 37.5%) being Toxo IgG antibody positive. Toxoplasma seropositivity was higher in females (42.8%) than in males (39.2%), P= 0.60. CD4 cell count level of < 200 was negatively associated with Toxoplasma seropositivity than CD4 count . 200 by logistic regression (OR= 0.6; 95% CI 0.3- 1.0). Living in proximity with cat was positively associated with T. gondii infection (P= 0.01).
CONCLUSION: T. gondii infection is common in pregnant women indicating greater probability of congenital transmission of T. gondii. This could form a basis for recommending intensifying health education and prophylactic treatment for all HIV positive pregnant women. Measures should be taken to prevent stray cats from entering homes.

Keywords: Toxoplasma gondii , IgG, Seroprevalence, HIV positive, CD4 cells.

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Toxoplasma Gondii Infection in HIV AIDS Prevalence and Risk Factors

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Prevalence of Acid-Alcohol-Fast Bacilli among Patients with Suspected Cases of Pulmonary Tuberculosis in Jos, Nigeria

EI Bigwan, MC Ohaeri, HI Okonkwo, IS Udosen, GC Markus, Z Sheyin

 

Abstract

Mycobacterium tuberculosis is a major public health problem in globally due to its high tendency of person-person transmission, morbidity, and  mortality. This study aimed at determining the prevalence of AAFB within the study area. Sputum samples were collected from three hundred and three (303) patients with suspected cases of pulmonary tuberculosis attending Plateau State Specialist Hospital and Faith Alive Foundation. The samples were examined using Ziehl Neelsen method. Structured  questionnaires were administered to obtain some demographic data from patients that consented. Results were tested statistically for significance at p < 0.05 using Chi-square test. Out of the samples examined,29(9.57.0%) were positive for AAFB .The study showed that the prevalence of smear-positive increased with age between 15 and 45 and then decreased from age groups 46 and above. The study also revealed that males had a higher prevalence with 19(12.34%)than females who had 10(6.71%  ).Marital status showed that divorced individuals had the highest  prevalence of 2(12.50%) followed by married ,singles and the widowed with 18(11.76%),8(6.34%),and 1(5.90%) respectively. Statistically the study reveals that age groups, sex, hospital (location) does not have any effects on the prevalence (p > 0.05) while marital status showed a significant  effect on the prevalence (p < 0.05).There is need for a more collaborative efforts and political will by the government and non-governmental agencies in order to fast track prevention and control measures aimed at eliminating the infection in the nearest future.

Key words: AFB, Tuberculosis, Jos, Nigeria.

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Case-Detection Rate of Direct Sputum Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Abia State, Nigeria

EO Ekundayo, SD Abbey, O Okorie

 

Abstract

The accuracy of sputum smear microscopy, the tuberculosis case-finding method in the Abia State TB Control Programme has never been assessed due to lack of culture facilities. To assess the accuracy of sputum smear microscopy in routine control programme conditions in Abia State, sputum samples from patients undergoing investigation for tuberculosis were analyzed using Ziehl-Neelsen staining technique for sputum smear  microscopy and culture on Löwenstein-Jensen medium as reference standard. Out of 150 participants tested, 51 were smear –positive for acid fast bacilli (positivity rate, 34.0 %, 51/150) while 79 were culture positive for Mycobacterium tuberculosis complex and 12 for non-tuberculous mycobacteria (NTM). Thirty-seven of the 79 culture positive for M. tuberculosis were smear positive giving a ratio of smear to culture positivity of 46.84%. Forty-two (42.4%) of the 99 smear negative cases were culture positive for M. tuberculosis. The sensitivity of smear microscopy was 50.0%
(95%CI=39.0-61.0) and specificity was 92.3% (95% CI=86.4-98.2). The prevalence of HIV/TB coinfection among the study participants was 48% (12/25). Although the case- detection rate of smear microscopy was moderate in this study, the large proportion of TB patients missed by smear microscopy is a cause for concern and requires concerted effort to improve the sensitivity of smear microscopy. Introduction of more sensitive diagnostic methods like culture also need to be considered.

 

La précision des frottis, la méthode la recherche de cas de tuberculose  dans le programme de lutte contre la tuberculose dans l’Etat d’Abia n’a jamais été évalué en raison du manque d’installations de culture. Pour évaluer la précision des frottis dans les conditions du programme de  contrôle de routine dans cet Etat , les expectorations de patients subissant une enquête de la tuberculose ont été analysées à l’aide de technique de coloration de Ziehl-Neelsen pour la microscopie des frottis de crachats et
de la culture sur milieu de Löwenstein- Jensen en tant que norme de  référence . Sur les 150 participants testés, 51 étaient à frottis positif pour les bacilles acido rapide (taux de positivité, 34,0%, 51/150), tandis que 79 étaient positifs à la culture pour complexe Mycobacterium tuberculosis et 12 pour les mycobactéries non tuberculeuses (NTM). Trente-sept de la culture 79 positive pour M.tuberculosis étaient à frottis positif donnant un ratio de frottis de positivité de la culture de 46,84 %. Quarante-deux  (42,4%) des 99 cas à frottis négatifs étaient positifs à la culture pour M. tuberculosis. La sensibilité de la microscopie des frottis était de 50,0 % (IC à 95% = 39,0 à 61,0) et la spécificité était de 92,3 % (IC à 95% = 86,4 à 98,2). La prévalence du VIH / TB coïnfection parmi les participants à l’étude était de 48% (12 /25). Bien que le taux de microscopique des  frottis de dépistage des cas ait été modéré dans cette étude, la forte proportion de patients atteints de tuberculose manqués par examen microscopique des frottis est un sujet préoccupant et exige un effort concerté pour améliorer la sensibilité de la microscopie des frottis. La présentation des méthodes de diagnostic plus sensibles comme la culture doivent aussi être pris en considération.

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Case-Detection Rate of Direct Sputum Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Abia State, Nigeria