Understanding patient health-seeking behaviour to optimise the uptake of cataract surgery in rural Kenya, Zambia and Uganda: findings from a multisite qualitative study

Background Cataract is a major cause of visual impairment globally, affecting 15.2 million people who are blind, and another 78.8 million who have moderate or severe visual impairment. This study was designed to explore factors that influence the uptake of surgery offered to patients with operable cataract in a free-of-charge, community-based eye health programme. Methods Focus group discussions and in-depth interviews were conducted with patients and healthcare providers in rural Zambia, Kenya and Uganda during 2018–2019. We identified participants using purposive sampling. Thematic analysis was conducted using a combination of an inductive and deductive team-based approach. Results Participants consisted of 131 healthcare providers and 294 patients. Two-thirds of patients had been operated on for cataract. Two major themes emerged: (1) surgery enablers, including a desire to regain control of their lives, the positive testimonies of others, family support, as well as free surgery, medication and food; and (2) barriers to surgery, including cultural and social factors, as well as the inadequacies of the healthcare delivery system. Conclusions Cultural, social and health system realities impact decisions made by patients about cataract surgery uptake. This study highlights the importance of demand segmentation and improving the quality of services, based on patients’ expectations and needs, as strategies for increasing cataract surgery uptake

Incidence of community acquired ESBL-producing bacteria among asymptomatic University students in Anambra State, Nigeria

This study was conducted to investigate the incidence of community acquired extended-spectrum β-lactamase (ESBL)-producing bacteria among asymptomatic students of Nnamdi Azikiwe University, Awka, Anambra State, South-East Nigeria. A total of 102 non-duplicate strains of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were isolated from fecal samples (n=273) collected from the participating students. The isolates were subjected to antimicrobial susceptibility tests to determine their antimicrobial resistance profile. Their multiple antibiotic resistance (MAR) indices were also evaluated.  Screening of the isolates for possible ESBL production was carried out by disk diffusion test using cefotaxime and ceftazidime disks. ESBL-production by the resistant strains was confirmed using the double-disk synergy test. Most of the isolates were found to be multi-drug resistant, as all K. pneumoniae and P. aeruginosa strains (100%), and 98.4% of the E. coli strains, had MAR indices ≥0.2. A total of 22 ESBL-producing bacterial species were confirmed, and the frequency of E. coli, K. pneumoniae and P. aeruginosa isolates among the ESBL-producing bacteria were n=20 (90.9%), n=2 (9.1%), and n=0 (0.0%) respectively. The total number of ESBL-producing bacterial strains isolated accounted for 8.1 % of the entire sample population. Although this prevalence rate may not indicate an alarming situation, it is important that the proliferation of ESBL-producing bacteria in the community be contained, since a high incidence of ESBL-producing organisms will create significant therapeutic problems in the near future. There is therefore need to develop strategies to reduce their spread in the community especially through monitoring, surveillance and proper detection protocol. DOI: http://dx.doi.org/10.5281/zenodo.131471

Apport de l'imagerie dans le diagnostic des complications de la bilharziose urinaire

(J. de la Recherche Scientifique de l'Université de Lomé, 2000, 4(1): 255-258

Apport de l\'urographie intraveineuse (UIV) dans le diagnostic des lithiases urinaires

No Abstract. Journal de la Recherche Scientifique de l\'Universite du Benin Vol. 4 (2) 2000: pp. 259-26

Aspects echographiques des hypertrophies thyroidiennes au centre hospitalie universitaire de Lome-Tokoin

No Abstract. Journal de la Recherche Scientifique de l\'Universite du Benin Vol. 4 (2) 2000: pp. 277-27

Incidence of community acquired ESBL-producing bacteria among asymptomatic University students in Anambra State, Nigeria

This study was conducted to investigate the incidence of community acquired extended-spectrum β-lactamase (ESBL)-producing bacteria among asymptomatic students of Nnamdi Azikiwe University, Awka, Anambra State, South-East Nigeria. A total of 102 non-duplicate strains of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were isolated from fecal samples (n=273) collected from the participating students. The isolates were subjected to antimicrobial susceptibility tests to determine their antimicrobial resistance profile. Their multiple antibiotic resistance (MAR) indices were also evaluated.  Screening of the isolates for possible ESBL production was carried out by disk diffusion test using cefotaxime and ceftazidime disks. ESBL-production by the resistant strains was confirmed using the double-disk synergy test. Most of the isolates were found to be multi-drug resistant, as all K. pneumoniae and P. aeruginosa strains (100%), and 98.4% of the E. coli strains, had MAR indices ≥0.2. A total of 22 ESBL-producing bacterial species were confirmed, and the frequency of E. coli, K. pneumoniae and P. aeruginosa isolates among the ESBL-producing bacteria were n=20 (90.9%), n=2 (9.1%), and n=0 (0.0%) respectively. The total number of ESBL-producing bacterial strains isolated accounted for 8.1 % of the entire sample population. Although this prevalence rate may not indicate an alarming situation, it is important that the proliferation of ESBL-producing bacteria in the community be contained, since a high incidence of ESBL-producing organisms will create significant therapeutic problems in the near future. There is therefore need to develop strategies to reduce their spread in the community especially through monitoring, surveillance and proper detection protocol. DOI: http://dx.doi.org/10.5281/zenodo.131471