Asymptomatic genital infection among pregnant women in Sagamu, Nigeria.

Background: Untreated genital tract infections in pregnancy may be associated with adverse effects on foetal and maternal health leading to poor pregnancy outcome.Aim: The aim of this study is to determine the prevalence and microbial isolates associated with asymptomatic genital infectionsin pregnancy.Methodology: This was a cross-sectional study on 252 pregnant women attending their first antenatal clinic. Data on socio-demographic characteristics of study participants was recorded. Microbial culture was carried out on High Vaginal and Endocervical swab samples. Statistical analysis was done using IBM-SPSS Windows version 20.Results: The prevalence of asymptomatic genital infection was 44.8%. Multiparity had statistically significant association with increased prevalence of the condition. Candida albicans and Staphylococcus aureus were the most predominant microbial isolates. Erythromycin and Levofloxacin were the most sensitive antibiotics against the bacterial isolates.Conclusion: This prevalence of asymptomatic genital infectionsis high in pregnant women in Sagamu. It is recommended that routine screening and treatment of these infections should be included in the antenatal clinic services offered to pregnant women so as to prevent the adverse foetal and maternal effects associated with asymptomatic genital infections in pregnancy.Keywords: Genital infection, Pregnancy, Asymptomatic, Sagamu

Asymptomatic Urinary Tract Infection among Pregnant Women in Sagamu, Nigeria

A cross-sectional study involving 201 pregnant women with no symptoms and/or clinical signs of urinary tract infection who attended antenatal booking clinic of Olabisi Onabanjo University Teaching Hospital, Sagamu Nigeria. The two hundred and one pregnant women were examined for asymptomatic bacteriuria, 34 (16.9%) had positive urine culture for significant bacteriuria and 12 (5.9%) had candiduria. There were statistically significant associations between bacteriuria and age (p=0.018), educational level (p=0.019) and occupation (p=0.008). The most prevalent bacterial isolate was Staphylococcus aureus (47.1%) and least cultured isolate was Escherichia coli (5.9%). Cotrimoxazole and ofloxacin were the most sensitive antimicrobial agents while Nitrofurantoin was the least sensitive. The prevalence of asymptomatic bacteriuria among women attending antenatal care in Sagamu is still high (16.9%) and this underscores the need for routine antenatal screen for all pregnant women at least on the first antenatal visit.Keywords: Urinary tract infection, Asymptomatic bacteriuria, Pregnant women, Age, Educational level, Occupation, Sagamu

An ICT-Based Agricultural Extension Service Delivery for Nigeria

This paper proposed an ICT-based extension service delivery for Nigeria. The proposed design, though to be use as supplement to the existing system would engender an extension delivery system that is void of many of the limitations inherent in the earlier approaches. Basically, it revolves round the use ICT facilities like VSAT, Routers/Switches, PCs, Radio/Antennae, etc. to provide agricultural information through the internet. Farmers in the remotest rural villages in Nigeria can communicate with extension workers without having to meet face to face with them; an integral aspect of many of the traditional approaches. The communication provided by the Internet can be real time voiced communication, video conferencing, chats, etc. or pre-recorded data in the form of texts (mail), audio or audio-visuals which can be used to provide training/instruction/guidance to farmers about farm activities. This would go a long way to enhance the government’s agricultural transformation agenda (ATA) as it has the potential to ensure the inclusion of more rural farmers. The design, once deployed, is almost self sustainable.Key words: ICT, Internet, Agricultural Information, Traditional Extension Approach

The burden of bacterial antimicrobial resistance in the WHO European region in 2019: a cross-country systematic analysis

Background: Antimicrobial resistance (AMR) represents one of the most crucial threats to public health and modern health care. Previous studies have identified challenges with estimating the magnitude of the problem and its downstream effect on human health and mortality. To our knowledge, this study presents the most comprehensive set of regional and country-level estimates of AMR burden in the WHO European region to date.  Methods: We estimated deaths and disability-adjusted life-years attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen–drug combinations for the WHO European region and its countries in 2019. Our methodological approach consisted of five broad components: the number of deaths in which infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antimicrobial drug of interest, and the excess risk of mortality (or duration of an infection) associated with this resistance. These components were then used to estimate the disease burden by using two counterfactual scenarios: deaths attributable to AMR (considering an alternative scenario where infections with resistant pathogens are replaced with susceptible ones) and deaths associated with AMR (considering an alternative scenario where drug-resistant infections would not occur at all). Data were solicited from a wide array of international stakeholders; these included research hospitals, surveillance networks, and infection databases maintained by private laboratories and medical technology companies. We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity.  Findings: We estimated 541 000 deaths (95% UI 370 000–763 000) associated with bacterial AMR and 133 000 deaths (90 100–188 000) attributable to bacterial AMR in the whole WHO European region in 2019. The largest fatal burden of AMR in the region came from bloodstream infections, with 195 000 deaths (104 000–333 000) associated with resistance, followed by intra-abdominal infections (127 000 deaths [81 900–185 000]) and respiratory infections (120 000 deaths [94 500–154 000]). Seven leading pathogens were responsible for about 457 000 deaths associated with resistance in 53 countries of this region; these pathogens were, in descending order of mortality, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium, Streptococcus pneumoniae, and Acinetobacter baumannii. Methicillin-resistant S aureus was shown to be the leading pathogen–drug combination in 27 countries for deaths attributable to AMR, while aminopenicillin-resistant E coli predominated in 47 countries for deaths associated with AMR.  Interpretation: The high levels of resistance for several important bacterial pathogens and pathogen–drug combinations, together with the high mortality rates associated with these pathogens, show that AMR is a serious threat to public health in the WHO European region. Our regional and cross-country analyses open the door for strategies that can be tailored to leading pathogen–drug combinations and the available resources in a specific location. These results underscore that the most effective way to tackle AMR in this region will require targeted efforts and investments in conjunction with continuous outcome-based research endeavours. </p

Age-sex differences in the global burden of lower respiratory infections and risk factors, 1990-2019: results from the Global Burden of Disease Study 2019

Background The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across a groups by sex, for 204 countries and territories.Methods In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used dinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466-469, 470.0, 480-482.8, 483.0-483.9, 484.1-484.2, 484.6-484.7, and 487-489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4 B97.6, 109-115.8, J16 J16.9, J20-121.9, J91.0, P23.0 P23.4, and U04 U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23109 site-years of vital r *stration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian metaregression tool, to analyse age sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and daims and inpatient data. Additio y, we estimated age sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors.Findings Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240-275) LRI incident episodes in males and 232 million (217-248) in females. In the same year, LRIs accounted for 1.30 million (95% UI 1.18-1.42) male deaths and 1.20 million (1.07-1.33) female deaths. Age-standardised incidence and mortality rates were 1.17 times (95% UI 1.16-1.18) and 1.31 times (95% UI 1.23-1.41) greater in males than in fe es in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126.0% [95% UI 121.4-131.1]) and deaths (100.0% [83.4-115.9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest dedine was observed for LRI deaths in males younger than 5 years (-70.7% [-77.2 to 61.8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53.0% [95% UI 37.7-61.8] in males and 56.4% [40.7-65.1] in females), and more than a quarter of LRI deaths among those aged 5-14 years were attributable to household air pollution (PAF 26.0% [95% UI 16.6-35.5] for males and PAF 25.8% [16.3-35.4] for females). PAFs of male LRI deaths attributed to smoking were 20.4% (95% UI 15.4-25.2) in those aged 15-49 years, 305% (24.1-36. 9) in those aged 50-69 years, and 21.9% (16. 8-27. 3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21.1% (95% UI 14.5-27.9) in those aged 15-49 years and 18 " 2% (12.5-24.5) in those aged 50-69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11-7% (95% UI 8.2-15.8) of LRI deaths.Interpretation The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children you - than 5 years was dearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, induding promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities.Copyright 2022 The Author(s). Published by Elsevier Ltd