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Perception of the efficacy of artemisinin-based combination therapy (ACT) and chloroquine prescription pattern and among nurses in South-West Nigeria

AM Efunshile, RO Oduyemi, DN Igwe, CN Igwenyi, V Adenugba

 

Abstract

Background-Malaria remains a threat to millions of children despite the recent advances recorded in the fight against the disease which remain the 3rd largest killer of children below the age of 5 years in endemic regions. Drug resistant plasmodium species continues to limit the fight against malaria, while the spread of fake and substandard antimalarial drugs has been recognized as a major problem across Africa because of its association with drug resistant parasite. We aim to find out the prescription pattern of chloroquine among nurses in South-West Nigeria and perception of artemisinin-based combination therapy (ACT).

Design and methods-About 180 pre-tested questionnaires were administered to randomly selected nurses out of which 155 were sufficiently completed and suitable for analysis. Results-Majority (56.1%) still have confidence in the efficacy of CQ which was still being prescribed by 45.2% of the respondents. CQ was mostly prescribed by those who had previous ACT treatment failure experience (54.3%) with their patients, P=0.03; as well as those who believe that ACT resistance malaria is now in circulation (44.3%). Fifty (32.3%) of our respondents claimed that they had come across fake and substandard ACT, from which 40.0% now prescribe CQ.

Discussion-The high rate of CQ prescription in this study showed that many of the health workers were still resistant to the change in antimalarial treatment policy, which is related to unsatisfactory experience with ACT. Additional measures are urgently required to verify this experience so as to win the confidence of healthcare workers away from chloroquine.

Keywords: Artemisinin-based combination therapy (ACT), chloroquine, substandard antimalarial

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Perception of the efficacy of artemisinin-based combination therapy (ACT) and chloroquine prescription pattern and among nurses in South-West Nigeria

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Prevalence of Entamoeba histolytica in stool specimens at Muhondo Health Center, Rwanda

Noel Gahamanyi, Jean de Dieu Mugabo, Claude Bayingana

 

Abstract

Entamoeba histolytica is a protozoan parasite causing amebiasis. It occurs usually in the large intestine and causes internal inflammation as its name means (histo = tissue, lytic = destroying). Between 40 and 50 million people are infected worldwide, mostly in tropical countries, in areas of poor sanitation. The infection occurs by ingestion of mature cyst in fecally contaminated food, water or hands. The disease shows different symptoms including vomiting, abdominal pain, nausea, watery and bloody diarrhea. While the infection becomes extra intestinal, it may cause abscess in other organs such as liver, kidney, brain and lungs.

The present study was carried out to determine the prevalence of E. histolytica in stool specimens at Muhondo Health Center. A total of 103 fecal specimens were collected over a period of three months. Out of 103 specimens, only 26 (25.2%) were positive for E. histolytica. Out of the 26 specimens positive for E. histolytica, 17 (16.5%) and 9 (8.7%) were from males and females respectively. Furthermore, of the 26 Specimens positive for E. histolytica, 15 (14.6%) and 11 (10.7%) were from people ≤ 15 and >15 years of age respectively. Entamoeba histolytica was more prevalent 26 (25.2%) than other parasites including Giardia with 15 (14.6%), Ascaris sp with 5 (4.9%), Trichomonas intestinalis with 16 (15.5%) and Entamoeba coli with 1 (1%). In order to reduce Entamoeba histolytica contamination and infections, the following recommendations were pointed out: (i) improving personal hygiene (washing hand before eating and after using latrines) ; (ii) avoiding fecal contamination of food, water, and utensils ; and (iii) boiling drinking water before consumption.

Keywords: Parasites, Prevalence, Entamoeba histolytica, amebiasis, Stool specimens, Muhondo Health Center

Prevalence of Entamoeba histolytica in stool specimens at Muhondo Health Center, Rwanda

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Sero-prevalence study of parasitic infections among HIV positive and Negative patients in Lagos, Nigeria

AO Sanyaolu, WA Oyibo, NC Iriemenam, OS Badaru

 

Abstract

Background: Diseases caused by opportunistic pathogens are the major clinical signs of HIV infected and AIDS patients with parasitic infection being part of the common causes of morbidity and mortality.

Objectives: This was a cross-sectional study to determine the sero prevalence of serum antibodies to three parasitic infections namely Entamoeba histolytica, Schistosoma sp. and Toxoplasma gondii, which are opportunistic infections among HIV/AIDS patients.

Methods: One thousand and eighty patients that attended three healthcare institutions in Lagos were recruited for the study through convenience sampling method. Venous blood was collected from the recruited patients and screened for HIV infection as well as the presence of serum antibodies to three parasitic infections. All positive sera samples were confirmed for HIV infection.

Result: The results revealed that 65/1080 (6%) of the recruited patients were HIV sero-positive. In addition, 5/65 (7.7%) of the HIV positive patients had E. histolytica co-infection, 1/65 (1.5%) had Schistosoma sp. co-infection while 2/65 (3.1%) had T. gondii co infection. The results also indicated that the proportion of patients with E. histolytica was significantly higher among HIV sero-positive patients than the sero-negative patients (P = 0.031).

Conclusion: The study showed the opportunistic potential of the three parasitic infections among HIV/AIDS patients in the study area.

Keywords: HIV, AIDS, Seropositive, Seronegative, Toxoplasma gondii, Entamoeba histolytica, Schistosoma haematobium

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Sero-prevalence study of parasitic infections among HIV positive and Negative patients in Lagos, Nigeria

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Intestinal helminths in some cases of acute appendicitis operated in Bamenda, Cameroon

C Pisoh-Tangnyin, FHL Kamga, FA Kechia, NS Laah, ML Guifo, S Takongmo

 

Abstract

Background: Acute appendicitis is the most frequent infectious surgical abdominal emergency and previous studies have noted the presence of parasites in the appendicular lumen.

Objective: This study was done to determine the involvement of intestinal worms in the etiology of acute appendicitis.

Materials and Methods: This was a prospective and descriptive study concerning cases of confirmed and operated acute appendicitis between 15th April, 2013 and 14th April, 2015 at the People’s Clinic, Ngomgham, Bamenda, Cameroon. The appendicular content was macroscopically examined for parasites and formol-ether concentration technique was carried out for ova detection.

Results: A total of 112 patients were operated for acute abdominal pain within the study period. There were 74 (60.8%) cases confirmed with acute appendicitis of which 45 (60.1%) were males and 29 (39.2%) were. The most affected age group was the 21 to 40 years (50%). The removed appendices appeared congestive in 30 (40.5%) cases, suppurated in 27 (40.5%) cases and gangrenous in 17 (23.0%) cases.There was no relationship between the appearance of the removed appendix and the gender of participants (P>0.05).Three different helminth ova were identified in the 74 samples. In decreasing prevalence, the parasite trend was 8 (10.8%) Ascaris lumbricoides, 5 (6.8%) Enterobius vermicularis, 3 (6.0%), Ankylostoma duodenale, Adult Ascaris lumbricoides and Enterobius vermicularis were seen in 1 and 3 cases respectively.

Conclusion: A small percentage of parasitic worm eggs were found in the appendicular content, though a good portion of patients took medications against parasites before surgery. Intestinal worms could not be incriminated in the causation of the appendicitis; nevertheless, one adult ascaris was found as an evident cause of appendicular lumen obstruction.

Keywords:

C Pisoh-Tangnyin, FHL Kamga, FA Kechia, NS Laah, ML Guifo, S Takongmo

 

Abstract

Background: Acute appendicitis is the most frequent infectious surgical abdominal emergency and previous studies have noted the presence of parasites in the appendicular lumen.

Objective: This study was done to determine the involvement of intestinal worms in the etiology of acute appendicitis.

Materials and Methods: This was a prospective and descriptive study concerning cases of confirmed and operated acute appendicitis between 15th April, 2013 and 14th April, 2015 at the People’s Clinic, Ngomgham, Bamenda, Cameroon. The appendicular content was macroscopically examined for parasites and formol-ether concentration technique was carried out for ova detection.

Results: A total of 112 patients were operated for acute abdominal pain within the study period. There were 74 (60.8%) cases confirmed with acute appendicitis of which 45 (60.1%) were males and 29 (39.2%) were. The most affected age group was the 21 to 40 years (50%). The removed appendices appeared congestive in 30 (40.5%) cases, suppurated in 27 (40.5%) cases and gangrenous in 17 (23.0%) cases.There was no relationship between the appearance of the removed appendix and the gender of participants (P>0.05).Three different helminth ova were identified in the 74 samples. In decreasing prevalence, the parasite trend was 8 (10.8%) Ascaris lumbricoides, 5 (6.8%) Enterobius vermicularis, 3 (6.0%), Ankylostoma duodenale, Adult Ascaris lumbricoides and Enterobius vermicularis were seen in 1 and 3 cases respectively.

Conclusion: A small percentage of parasitic worm eggs were found in the appendicular content, though a good portion of patients took medications against parasites before surgery. Intestinal worms could not be incriminated in the causation of the appendicitis; nevertheless, one adult ascaris was found as an evident cause of appendicular lumen obstruction.

Keywords: Intestinal Helminthes, Acute appendicitis, Bamenda

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Intestinal helminths in some cases of acute appendicitis operated in Bamenda, Cameroon

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Antifungal and toxicological activities of compounds from traveller’s tree (Ravenala madagascariensis sonnerat)

AK Onifade, DO Fadipe, MO Bello

 

Abstract

This study was done to investigate the antifungal and toxicological activities of extracts from the leaves of traveller’s tree (Ravenala madagascariensis). Different concentrations (i.e. 25 – 200 mg/ml) of the extracts prepared using ethanol; n-Hexane, hot water and cold water were tested against some selected human pathogenic fungi using agar well diffusion method. The in vivo effects of the extracts on vital organs such as liver, kidney and some haematological parameters (Pack cell volume, Erythrocyte sedimentation rate, Red blood cell count, White blood cell count, Hemoglobin, Lymphocytes, Neutrophils, Monocytes, Eosinophils and Basophils) were determined using experimental rats. The haematological analyses revealed that there were no significant differences (p≤0.05) between the values of haematological parameters obtained from the treated animals and the control groups before treatment and at the end of the treatment. The extracts appeared haematologically not toxic to the experimental rats, but deleterious effects were observed on the vital organs such as liver and kidney of the experimental rats. This may be due to the presence of higher percentage of Cyanogenic glycoside (47%), thus suggesting that the extracts could be potentially deleterious to human health when consumed orally.

Keywords: Antifungal activity, Toxicological effect, in vivo, Haematological parameters

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Antifungal and toxicological activities of compounds from traveller’s tree (Ravenala madagascariensis sonnerat)

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Factors infleuncing neonatal septicaemia in Maiduguri, north-eastern Nigeria

S Pius, M Bello, Y Mava, BA Ibrahim, AG Faruk, JP Ambe

 

Abstract

BACKGROUND: Neonatal septicaemia is a leading cause of morbidity and mortality worldwide, especially in the tropics. The risk factors vary, and the clinical features of neonatal septicaemia may be vague and nonspecific, therefore a high index of suspicion is vital to early diagnosis and treatment. The aetiological agents and their antibiotic sensitivity pattern have continued to change (in the same centre over time), hence the need to have undertaken this study.

AIMS AND OBJECTIVES: The primary objective of the study was to determine the risk factors influencing the aetiology of neonatal septicaemia at the University of Maiduguri Teaching Hospital.

PATIENTS AND METHODS: The study was prospective and all the newborn that had clinical diagnosis of septicaemia were consecutively enrolled and admitted to the Special Care Baby Unit of the Department of Paediatrics of University of Maiduguri Teaching Hospital (UMTH). The patients were appropriately investigated including blood cultures, cerebrospinal fluid cultures and urine culture among others.

RESULTS: One hundred and ten neonates were studied, of these 46(42.0%) had positive blood culture, while 64 (58.0%) were blood culture negative. Eighteen (39.1%) of the septicaemic neonates were inborn, while 28 (60.9%) were out born. The incidence of neonatal septicaemia among babies delivered at UMTH was 5.9/1000 live births and the male to female ratio among septicaemic neonates was 1.9:1. The common risk factors for NNS were prolonged rupture of membrane (PROM), prematurity and low socioeconomic status of parents among others. Fever was the commonest clinical feature at presentation (87%), others include: poor feeding (64 %), excessive crying (33%), tachypnoea, hepatomegaly were some of the common examination findings. Staphylococcus aureus 16(69.6%) and Streptococcus pyogenes 5(21.8%) were the predominant Gram positive organisms isolated while Escherichia coli 9(39.1%) and Klebsiella Pneumoniae 7(30.4%) were the predominant Gram negative organisms isolated.

CONCLUSION: Mortality was high in infection associated with Gram negative organisms and in the presence of conditions/complications like urinary tract infections, tetanus and meningitis

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Factors infleuncing neonatal septicaemia in Maiduguri, north-eastern Nigeria

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Microbiological and kinetic detection of gram negative bacilli producing extended-spectrum- β-lactamases (esbl) in emergencies and reanimation units of university hospital center, Yalgadoouedraogo, Burkina Faso

KJ Zongo, A Metuor Dabire, B Kaborel, I Sanou, L Sangare, J Simpore, B Zeba

 

Abstract

Background: Epidemiology of extended-Spectrum- β-lactamases has become worldwide, and our aim was to establish the prevalence of isolates producer in university hospital center Yalgado OUEDRAOGO particularly in reanimation and emergencies units.

Material and methods: Prospective study was drive during July 2009 to march 2012 in order to collect strains resisting to third generation of cephalosporin during diagnosis analysis of biological specimens. Susceptibility of bacteria to antimicrobial agents was evaluated by disc diffusion method. Production of extended-spectrum β-lactamases has been investigated by double disc diffusion and kinetic methods.

Results: 259 isolates which resisted at least to one of third generation of cephalosporins were collected. Among them 188 (72, 58 %) were positive to synergy test by a double disc diffusion method. The MICs of ceftriaxone determined by E-test were under than 50kg/ml, 100kg/ml et 256kg/ml for respect 81,57°/° ; 55,26°/° et 39,74°/° of isolates. Hydrolyze of β-lactam ring by bacterial extract followed at spectrophotometer showed speeds running at 0 to 0,090UAb.mn-1 for both isolates. Extract of 171 bacterial strains positives to synergy test had hydrolyzed at least one of oxy-iminocephalosporins and were identified as producing extended- spectrum β-lactamases. Spices reported by this study were 99 Escherichia coli (57,89%) ; 28 Klebsisella pneumonia (16,37%) ; 15 Enterobactersp (8,77%) ; 19 Pseudomonas aeruginosa (11,11%) ; 4 Citrobactersp (2,33%) 2 Acinetobactersp (1,16%), 3 Proteus mirabilis (1,75%) and 1 Salmonella typhi (0,05%).

Conclusion: This study showed that bacterial resistances by extended- spectrum β-lactamases are a reality in University Hospital center YalgadoOuedraogo. It calls about antibiotics prescription and hospital hygiene in order to reduce emergence and propagation of new resisting bacterial.

Keywords: microbial and kinetic analysis, Gram negative bacilli, extended-Spectrum- β-lactamase, emergencies, reanimation

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Microbiological and kinetic detection of gram negative bacilli producing extended-spectrum- β-lactamases (esbl) in emergencies and reanimation units of university hospital center, Yalgadoouedraogo, Burkina Faso

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Determination of the antimicrobial susceptibility pattern of extended spectrum beta lactamase (esbl) producing and the non-esbl producing strains of Escherichia coli

Y Mohammed, GB Gadzama, SB Zailani, AA Abubakar, MM Dalhat, BS Ibrahim, AA Olufemi, U Bajoga, P Nguku

 

Abstract

Background: The extended spectrum beta lactamases producing bacteria are bacteria of great concern among Gram negative bacilli. Escherichia coli stand out as major carrier of this enzyme. The appropriate control of this resistance pattern depends on using the antimicrobial regimen of best choice. Therefore the value of the susceptibility profile of organism harboring this enzyme cannot be overemphasized.

Objectives: To determine the antimicrobial susceptibility of extended spectrum beta lactamases (ESBL) producing and the non-ESBL producing strains of Escherichia coli from clinical isolates of Escherichia coli in University of Maiduguri Teaching Hospital.

Methodology: Confirmed variants of Escherichia coli were screened and confirmed for ESBL possession. Subsequently, modified Kirby Bauer method was utilized to test for antibiotic susceptibility using the commercially available Oxoid single disc for some major antibiotics.

Results: A total of 172 strains of Escherichia coli were identified during the study period. Out of this number; 131 were identified as ESBL positive while a total of 41 were ESBL negative. The highest sensitivity for both the ESBL positive and ESBL negative strains of Escherichia coliwas observed with Imipenem followed closely by Gentamicin.

Conclusion: The study reveals narrow choice of antibiotics for the ESBL positive isolates of Escherichia coli although Imipenem antibiotic still retains its sensitivity.

Keywords: Cephalosporins, Resistance, Maiduguri, Nigeria

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Determination of the antimicrobial susceptibility pattern of extended spectrum beta lactamase (esbl) producing and the non-esbl producing strains of Esche

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Prevalence and antibiotic susceptibility pattern of methicillin resistant Staphylococcus aureus in burns and pressure ulcer patients

TK Udeani, CJ Onyebuchi, MC Ikpenwa, UR Ezenwaka

 

Abstract

Methicillin resistant Staphylococcus aureus (MRSA) is a multidrug resistant bacterium that threatens the continued effectiveness of antibiotics worldwide. The objective of this study was to investigate the prevalence of MRSA and its antibiotic susceptibility pattern in patients with burns and bedsore. This was a cross- sectional study that was carried out at National Orthopaedic Hospital, Enugu, Nigeria. A structured questionnaire was used to obtain information on demographic and source of wounds. Pus from the wound was collected with swab sticks or 2ml syringe and analyzed bacteriologically, using mannitol salt agar sheep red cell blood agar. Isolates of Staphyloccus aureus were subjected to oxacillin and cefoxitin disc-diffusion assay and confirmed by chromogenic Brilliance MRSA 2 Agar; for identification of MRSA and MSSA. The MRSA and MSSA strains were tested for antimicrobial susceptibility patterns and multiple antibiotic index calculated. Of 104 wound swabs analyzed, 52 (50%) were Staphylococcus aureus isolates, while 21 (20.2%) were MRSA and 31 (29.8%) were MSSA. No significant differences were observed in the prevalence of MRSA among gender, duration of wounds, wound dressing interval and source of wound. There was an association between age, prolonged hospital admission MRSA infection. Methicillin-resistant Staphylococcus aureus isolates showed high resistance to ampicillin 90.5% followed by erytromycin 81% and ciprofloxacillin 71.4%.All the MRSA isolates were susceptible to vancomycin. All isolates of MRSA were resistant to β-lactams, aminoglycosides and quinolones group of antibiotic used. Minimum Inhibitory Concentration of vancomycin showed that the break point was between 0.5-2kg/ml and that of ampicillin was ranges from 4 kg/ml-128 kg/ml. MAR Index was >0.2 which indicates the resistance emanates from hospital. The high prevalence of MRSA and antibiotics resistance may increase the disease burden amongst these patients. It is necessary to establish an antimicrobial susceptibility surveillance system and to improve current infection control programs in the hospitals and community settings, to prevent the spread of MRSA.

Keywords: MRSA, Brillience ChromAgar, ampicillin, vancomycin, multiple antibioticindex

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Prevalence and antibiotic susceptibility pattern of methicillin resistant Staphylococcus aureus in burns and pressure ulcer patients

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Identification and detection of antibiotic susceptibility of the most common anerobes causing infection in surgical hospital, Faculty of Medicine Zagazig University, Egypt

NE El Badawy, RM El shabrawy, RA Ghonaim, Z Allam

 

Abstract

Objectives: Anaerobic infections are considered to be the most difficult organisms to be identified in the microbiology laboratory. It requires strict conditions, proper sampling , long time and laboratory skills. In addition most of them are mixed infections having both aerobic and anaerobic organisms. Choice of the proper antibiotic for treating these anaerobes is live saving for the patient.

Methods: Identification of anaerobic organisms using MALDI-TOF (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry) as a recent tool for identification together with API 20A (as a reference method). Antibiotic susceptibility test was done for the anaerobic isolates using Agar Dilution Method. With the the most commonly used antibiotic in our hospital which are Amoxacillin/Clavulonic acid, clindamycin, metronidazole and Imipenem.

Results: Anaerobic infections constitutes 21.7% of total 249 specimen from different surgical departments. Bacteroids spp. (41%) were the most prevalent anaerobic organisms followed by peptostreptococcus (26.9%). MALDI TOF MS system and API achieved 100% agreement for identification of Porphoryomonas spp. and Fusobacterium, while near results were obtained for other isolates. Bacteroid spp. shows the highest rate of resistance to clindamycin (69%). Excellent results were obtained for Imipenem and metronidazole. Most of resistance to Amoxacillin/Clavulonic acid is related to Bacteroid spp. and Fusobacterium spp.

Conclusion: MALDI TOF MS System is a useful tool for identification of. Anerobes are showing higher rates of resistance to commonly used antibiotics thus detection of resistant strains is vital for proper selection of antibiotics.

Keywords: Anaerobes, MALDI TOF System, API 20, Agar Dilution Method, Zagazig

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Identification and detection of antibiotic susceptibility of the most common anerobes causing infection in surgical hospital, Faculty of Medicine Zagazig