Phytochemical Screening and Antibacterial Activities of Aframomum melegueta (K. Schum) Seed Extracts on Salmonella typhi and Klebsiella pneumoniae

The phytochemical screening and antibacterial effects of Aframomum melegueta (K. Schum)on Salmonella typhi and Klebsiella pneumoniae was carried out. The phytochemical screening revealed the presence of alkaloids, flavonoids, tannins, saponins, steroids, anthraquinones, terpenoids, glycosides and phenols in the seed extract. The susceptibility test showedzones of inhibition (ZOI) of S. typhi (11.0mm) and K. pneumonia (13.0mm) with methanolic seed extract (MSE), while the hot aqueous seed extract (HASE) recorded 3.0mmas ZOI for both test organisms. The Minimum inhibitory concentration (MIC) of 200mg/ml and 100mg/ml were recorded against S. typhi and K. pneumoniae respectively with MSE, while HASE indicated 400mg/ml and 200mg/ml MICs against S. typhi and K. pneumoniae respectively. The Minimum Bactericidal Concentration (MBC) obtained from MSE were 200 mg/ml and 25mg/ml for S. typhiand K. pneumoniae, while HASE had > 400mg/ml for test microbes. The effectiveness of different concentrations of the test plant extracts on the test organisms was significant (P<0.05). Further trials involving other clinical isolates and botanicals at different concentrations be conducted, to optimize theprocess

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Comparative seroprevalence of measles virus immunoglobulin M antibodies in children aged 0&ndash;8 months and a control population aged 9&ndash;23 months presenting with measles-like symptoms in selected hospitals in Kaduna State

AE Olaitan, EE Ella, JB Ameh Department of Microbiology, Ahmadu Bello University, Zaria, Nigeria Background: Measles remains the leading cause of vaccine-preventable childhood mortality in developing countries, with its greatest incidence in children younger than 2 years of age. The aim of this study was to determine the seroprevalence of measles virus in children (aged 0&ndash;8 months) and older children (aged 9&ndash;23 months) presenting with measles-like symptoms. Methods: A total of 273 blood samples comprising 200 from children aged 0&ndash;8 months and 73 from children aged 9&ndash;23 months were collected and analyzed for measles virus IgM antibodies by enzyme-linked immunosorbent assay. Results: An overall prevalence of 21.2% was obtained, with a prevalence of 6.5% in children aged 0&ndash;8 months and 61.6% in children aged 9&ndash;23 months. The prevalence of measles virus increased with age in children aged 0&ndash;8 months and decreased with age in older children (aged 9&ndash;23 months), showing a significant association between measles virus and age of the child (P=0.000). A higher prevalence was found in females (27.5%) than in males (16.3%) and this difference was significant (odds ratio 1.942, P=0.025). There was no significant association with the level of parental education, parental occupation, or number of children in the family (P&gt;0.05). With respect to children&#39;s vaccination status and breastfeeding, there was a significant association (P&lt;0.05). The marital status of the family, place of residence, and household size showed no significant association with the prevalence of measles virus. However, a significant association was observed in relation to maternal measles history (odds ratio 2.535, P=0.005) and maternal vaccination status (odds ratio 1.791, P=0.049), as well as between measles virus infection and all presenting symptoms, except for vomiting, malaria, typhoid, and pneumonia, which showed no significant association (P&gt;0.05). Conclusion: The findings of this study confirm the presence of measles virus infection in children aged 0&ndash;8 months. Keywords: measles virus, malaria, vaccination, breastfeedin