The sensitivity status of community-acquired Staphylococcus aureus isolated from various infectious sites in Kano-City, Nigeria to selected antibacterial agents

Community acquired Staphylococcus aureus was isolated from various infectious sites in two private laboratories in Kano-city, Nigeria. A total of 247 (11%) Staphylococcu aureus isolates were recovered from all infectious sites except cerebro-spinal fluid. The least Staphylococcus aureus isolates were found in urine specimens (5.4%). Twenty three (23) out of 62 (37.1%) and 10 out of 26 (38.5%) of the wound and pus specimens respectively incriminated Staphylococcus aureus as the major pathogens. High resistance rates were recorded with ciprofloxacin (55%), chloramphenicol (76.4%), amoxicillin (81.8%), nitrofurantoin (84.2%), erythromycin (93.1%), cotrimoxazole (94.3%), tetracycline (94.7%) and nalidixic acid (96.8%) but ofloxacin, co-amoxiclav, gentamicin and ceftriaxone showed moderate activity. The widespread resistance of community acquired Staphylococcus aureus was worst with the older antibacterial agents possibly due to their indiscriminate use after existence in the market for long. Thus, many older generation antibacterial agents are not appropriate for chemotherapy of community acquired Staphylococcus aureus infections.Keywords: Sensitivity status, Community-acquired infection, Staphylococcus aureus, KanocityìEast and Central African Journal of Pharmaceutical Sciences Vol.13 (2010) 58-6

Optimising oral systems for the delivery of therapeutic proteins and peptides

Therapeutic proteins/peptides are mostly administered as parenteral (injectable) preparations as a result of their poor oral bioavailability which is due to degradation by proteolytic enzymes, poor membrane permeability and large molecular size. However, the oral route would be preferred to theparenteral administration because it is more convenient for   self-administration, non-invasive and more patient friendly. Consequently, efforts have intensified over the past two decades to maximize theextent of absorption of protein and peptide drugs in order to achieve optimum bioavailability via the oral route. A suitable oral delivery system should retain the drug and maintain its integrity until it gets to the region of maximum absorption where the protein/peptide is released. It would be advantageous for such a delivery system to be capable of attaching itself to the absorptive cells in that region during the course of drug release by means of specific interactions with the tissue components. Furthermore,movement of drug should be independent of prevailing factors in the gut during passage. This review examines the various efforts and strategies that have been used to pursue the goals of effective oral peptide delivery, progress made so far, as well as current trends and future prospects. Relevant issues and phenomena such as membrane permeability control, intestinal absorption, paracellular pathway and targeting have also been discussed

Nutritional status of maize fermented meal by fortification with bambara-nut

Studies were conducted to develop an appropriate household/small scale enterprise level technique for the production of bambara-nut-fortified fermented maize dough or meal by comparing different treatments, processing methods and fortification levels.The effect of fortification of maize based traditional foods with legume protein, bambara-nut at 0%. 10% and 20% replacement levels, on the rate of fermentation and organoleptic product quality were investigated. Sensory characteristics, amino acid pattern, proximate composition (moisture, protein, fat, ash, carbohydrate) pH, titratable acidity and rheological properties (pasting temperature, peak viscosity, viscosity at 95oC and 95oC hold and viscosity at 50oC) were used as the indices of quality. The results obtained showed that Bambara-nut addition caused only minimal changes in the proximate composition with the exception of protein content, which increased remarkably from 10.1% to 16.4% and 10.1% to 16.2% with 20% bambara-nut addition respectively for boiled and raw bambara-nut fortified fermented maize dough. The product pH decreased with concomitant increase in moisture, fat, ash and titratable acidity with increasing bambara-nut addition. A significant improvement was also achieved in the lysine and tryptophan pattern of the fortified dough compared to the unfortified lot. However, boiling bambara-nut for 20 min before incorporation into the maize for milling and fermentation imparted a desirable flavour. This results showed that the most appropriate technique for the production of bambara- fortified high protein fermented maize dough has been suggested to involve incorporation of boiled whole bambara-nut in soaked maize before milling and fermentation for improved sensory characteristics, enhanced nutritive value and optimal functional properties. Little or no changes in the pasting viscosity characteristics occurred in raw bambara-nut fortified fermented maize dough. Organoleptic evaluation revealed that the foods were well accepted. Based on the findings of the study, the application of Bambara-nut fortification to traditional foods suggests a viable option of promoting the nutritional quality of African maize – based traditional foods with acceptable rheological and cooking qualities.Keywords: Fermented maize meal, bambara-nut fortification, protein quality,rheolog

Effect of Solvent Type and Drying Method on Protein Retention in Chitosan-Alginate Microcapsules

Purpose: The effect of solvent used in dissolving chitosan (membrane material) and the microcapsule drying method used, on protein retention in chitosan-alginate microcapsules were studied since these factors affect the physicochemical characteristics of the coating membrane. Method: The microcapsules were prepared by extruding a solution containing alginate and BSA into chitosan/calcium chloride solution prepared with different acid solvents – acetic acid, formic acid, tartaric acid and hydrochloric acid. A portion of the microcapsules was air-dried at ambient temperature while the remaining portion was freeze-dried. The elution of protein from the microcapsules in simulated gastric fluid was monitored spectrophotometrically at λmax 280 nm. Results: Tartaric acid effected the highest mean protein retention (54%) after 9 h followed by acetic acid (35%), hydrochloric acid (31%) and formic acid, (30%). There appears to be a link between the pKa of the acids and the degree of chitosan–solvent interaction on the one hand, and protein retention on the other hand. Increase in elution pH from 1.2 to 5.0 did not significantly (P>0.05) affect protein retention. Furthermore, there was no significant difference (p>0.05) between the protein retention capacities of air-dried and freeze-dried microcapsules as both types showed protein retention of 50% after 5 h. Conclusion: Tartaric acid was the most suitable solvent for enhancing protein retention in chitosan-alginate microcapsules in simulated gastric fluid . Keywords: Tartaric acid, chitosan, solvent type, microcapsules, air-drying, freeze-drying.> Tropical Journal of Pharmaceutical Research Vol. 5 (2) 2006: pp. 583-58

16S rRNA gene sequence and phylogenetic tree of lactobacillus species from the vagina of healthy Nigerian women

Lactobacilli are ubiquitous in nature and in humans they play a very significant role in the general health maintenance of the host. Identification of lactobacilli has previously been based on culturedependent methods and recently molecular techniques involving gene sequencing are now the ‘gold standard’. Scarce information exists in Africa on the real identity of Lactobacillus species, albeit phylogenetic distances among the species present in the human vagina. In this study, 185 vaginal swabs were collected from healthy premenopausal women (18 to 48 years). Bacterial DNA was extracted, amplified using PCR, with group specific Lactobacillus primers, and processed by denaturing gradient gel electrophoresis (DGGE). Phylogenetic tree was constructed with the sequencesof the V2-V3 region of 16S rRNA gene. Results show two distinct divisions among the Lactobacillus species. The study presents a new understanding of the nature of the Lactobacillus vaginal microbiota of women in Nigeria, which may lead to the design of probiotic-lactobacilli for biotherapy

Improving HIV Outcomes in Resource-Limited Countries: The Importance of Quality Indicators

Background: Resource-limited countries increasingly depend on quality indicators to improve outcomes within HIV treatment programs, but indicators of program performance suitable for use at the local program level remain underdeveloped. Methods: Using the existing literature as a guide, we applied standard quality improvement (QI) concepts to the continuum of HIV care from HIV diagnosis, to enrollment and retention in care, and highlighted critical service delivery process steps to identify opportunities for performance indicator development. We then identified existing indicators to measure program performance, citing examples used by pivotal donor agencies, and assessed their feasibility for use in surveying local program performance. Clinical delivery steps without existing performance measures were identified as opportunities for measure development. Using National Quality Forum (NQF) criteria as a guide, we developed measurement concepts suitable for use at the local program level that address existing gaps in program performance assessment. Results: This analysis of the HIV continuum of care identified seven critical process steps providing numerous opportunities for performance measurement. Analysis of care delivery process steps and the application of NQF criteria identified 24 new measure concepts that are potentially useful for improving operational performance in HIV care at the local level. Conclusion: An evidence-based set of program-level quality indicators is critical for the improvement of HIV care in resource-limited settings. These performance indicators should be utilized as treatment programs continue to grow

Efficiency of Divisionalization and Departmentalization on Corporate Returns with Regards to Transfer Pricing

The study was carried out to examine the effect of transfer pricing between divisions and departments on corporate returns. Data were gathered through questionnaire on the selected sample companies in Nigeria. The study found out that transferred prices relate to performance measurements in that they affect, and establish a ceiling on the amount of profit or markup that a division is able to generate on its products. It was equally established that divisionalisation encourages managers to be profit responsible. That is, it encourages responsibility for generation of revenues, cost control and  satisfactory returns on investment of capital in the operations of an organization. It was therefore recommended that high budgeted controllable profit target should be set if divisional mangers must make enough profit that will cover both their own operational cost and the corporate expenses. More so divisionalized companies should ensure that their divisional managers concentrate on increase of controllable profit thus focus on the revenues and costs under their control, and be less worried about costs they cannot control. Keywords: Efficiency, Divisionalization, Departmentalization, Corporate returns, Transfer  pricing, Performance measurement

CLIMATE CHANGE VARIABILITY AND ASSOCIATED HEALTH EFFECTS AMONG FARMING HOUSEHOLDS IN ONDO STATE, NIGERIA

Objectives: The study examined climate change variability and associated health effects among farming households in Ondo State, Nigeria. It specifically described the socioeconomic characteristics of the farming households, identified the health issues experienced as a result of climate change, and analyzed the determinants of health effect of climate change and other socioeconomic variables among farming households in the study area. Methods: One hundred and twenty respondents selected through multistage sampling technique were used for the study. Data were collected with the aid of questionnaire and analyzed using descriptive and logit regression model. Results: Majority (92.9%) of the respondents were male, married (82.1%) with a mean household size of six people and a mean age of 49 years. Headache (95.5%), dizziness (95%), malaria (92%), body weakness (91.1%), cough (81.3%), typhoid fever (67.9%), skin rashes (58%), and rheumatic pain (48.2%) were the major health problems experienced by the farming households as a result of climate change in the study area. The significant variables determining the health effects of climate change among farming households in the study area were temperature (p<0.01), relative humidity (p<0.01), rainfall (p<0.01), sunshine (p<0.01), pressure (p<0.10), sex (p<0.10), marital status (p<0.01), household size (p<0.10), farming experience (p<0.01), and income (p<0.05). Conclusion: The health and well-being of the farming households were compromised by the vagaries in climatic condition in the study area. Hence, agricultural extension workers should be empowered to accommodate health education and preparedness measures that take into account, differences in the level of exposure, perceptivity, and acclimation capacity of different households may help to alleviate health effects of climate change on farming households in the study area

Patterns and predictors of incident return to HIV care among traced, disengaged patients in Zambia

Background: Dynamic movement of patients in and out of HIV care is prevalent, but there is limited information on patterns of patient re-engagement or predictors of return to guide HIV programs to better support patient engagement. Methods: From a probability-based sample of lost to follow-up, adult patients traced by peer educators from 31 Zambian health facilities, we prospectively followed disengaged HIV patients for return clinic visits. We estimated cumulative incidence of return and time to return using Kaplan Meier methods. We used univariate and multivariable Cox proportional hazards regression to conduct a risk factor analysis identifying predictors of incident return across a social ecological framework. Results: Of the 556 disengaged patients, 73.0% (95% CI: 61.0-83.8) returned to HIV care. Median follow-up time from disengagement was 32.3 months (IQR: 23.6-38.9). The rate of return decreased with time post-disengagement. Independent predictors of incident return included a prior gap in care (aHR: 1.95, 95%CI: 1.23-3.09) and confronting a stigmatizer once in the past year (aHR: 2.14, 95%CI: 1.25-3.65). Compared to a rural facility, patients were less likely to return if they sought care from an urban facility (aHR: 0.68, 95%CI: 0.48-0.96) or hospital (aHR: 0.52, 95%CI: 0.33-0.82). Conclusions: Interventions are needed to hasten re-engagement in HIV care. Early and differential interventions by time since disengagement may improve intervention effectiveness. Patients in urban and tertiary care settings may need additional support. Improving patient resilience, outreach after a care gap, and community stigma reduction may facilitate return. Future re-engagement research should include causal evaluation of identified factors

Empty rituals? A qualitative study of users’ experience of monitoring & evaluation systems in HIV interventions in western India

In global health initiatives, particularly in the context of private philanthropy and its ‘business minded’ approach, detailed programme data plays an increasing role in informing assessments, improvements, evaluations, and ultimately continuation or discontinuation of funds for individual programmes. The HIV/AIDS literature predominantly treats monitoring as unproblematic. However, the social science of audit and indicators emphasises the constitutive power of indicators, noting that their effects at a grassroots level are often at odds with the goals specified in policy. This paper investigates users' experiences of Monitoring and Evaluation (M&E) systems in the context of HIV interventions in western India. Six focus groups (totalling 51 participants) were held with employees of 6 different NGOs working for government or philanthropy-funded HIV interventions for sex workers in western India. Ten donor employees were interviewed. Thematic analysis was conducted. NGO employees described a major gap between what they considered their “real work” and the indicators used to monitor it. They could explain the official purposes of M&E systems in terms of programme improvement and financial accountability. More cynically, they valued M&E experience on their CVs and the rhetorical role of data in demonstrating their achievements. They believed that inappropriate and unethical means were being used to meet targets, including incentives and coercion, and criticised indicators for being misleading and inflexible. Donor employees valued the role of M&E in programme improvement, financial accountability, and professionalising NGO-donor relationships. However, they were suspicious that NGOs might be falsifying data, criticised the insensitivity of indicators, and complained that data were under-used. For its users, M& E appears an ‘empty ritual’, enacted because donors require it, but not put to local use. In this context, monitoring is constituted as an instrument of performance management rather than as a means of rational programme improvement