Profile of septic work up among patients admitted into the intensive care unit in University of Abuja teaching hospital Gwagwalada, Abuja

Background: Several infectious agents are responsible for sepsis in all age groups presenting with fever which can have devastating consequences if not adequately treated. Sepsis may arise from bacteria, fungi and viral origin but are localized in particular organ or system with systemic affectation. Febrile illness is a leading reason for admission to the intensive care unit of hospitals in the tropics and these patients comes mostly from inpatients rather than from outpatients. Diagnostic apparatus needed for sepsis work up are usually not available in most cases and the data regarding septic work up are very scanty. Therefore, this research set out to determine the pattern of isolates from septic work-up among patients admitted to the intensive care unit in Abuja.Methodology: This was a descriptive cross-sectional study. Sixty-four consecutive patients admitted to the intensive care unit with symptoms such as fever were involved in the study in a view to determine the septic state of the patients. Samples were collected. Blood culturing was performed using the BACTEC 9050® system and biochemical analytical profile index were used for identification and confirmation of bacterial isolates.Results: The mean age of the patients admitted to ICU was 40.9±3.2 with the highest proportion within the age range of 31-40 years accounting for 31.7% of the patients enrolled and the lowest proportion being 10-20 years group accounting for 5.0%.Out of the 64 patients investigated in the ICU 60 patients had clinical and positive cultures with an overall positive and negative infection rate of 93.8% and 6.3% respectively. From the positive cultures yields 86.7% were bacteremia and 13.3% were fungaemia. Multiple infections were observed among the male patients, Multi-drug resistance bacteria were observed among Klebsiella pneumonia, E. coli and P. aeroginosa isolates.Conclusion: Bacterial and fungal isolates were found in this study but increased rate of polymicrobial isolation and nosocomial infections calls for concern.Key words: Profile of infectious agents, sepsis, fever, septic work up, Abuj

Chitosan-Based Coatings for Shelf Life Elongation of Cassava Root Tubers

Cassava is a major staple crop for millions of people in Africa and most developing countries. It is also a good raw material for bioethanol production. However, it suffers a major limitation to serve its full potential due to its high susceptibility to postharvest physiological deterioration (PPD). The aim of this study is to explore the use of formulated chitosan-antioxidant coatings for exogenous application on cassava cultivars for shelf-life elongation. The formulated films were derived from chitosan and two antioxidants namely ascorbic acid and quercetin. The films were found to have pronounced effects on PPD responses in the different cassava cultivars used in this study. Chitosan-quercetin film recorded up to 81% decline in the production of hydrogen peroxide (H2O2), a predominant reactive oxygen species that contributes to cassava PPD. Chitosan-ascorbic acid and chitosan films recorded 67% and 52% decline respectively, in the level of H2O2 produced in the cassava cultivars. The chitosan-antioxidant film formulations applied in this study proved effective in attenuating the PPD in the cassava samples, with evidence on the drastic reduction of H2O2 produced in the coated samples compared with the uncoated cultivars. The cyanide content and moisture content of the cassava cultivars on harvest may have contributed to the rate of PPD as presented in this study

Salmonellosis in Lagos, Nigeria: Incidence of Plasmodium falciparum-associated Co-infection, Patterns of Antimicrobial Resistance, and Emergence of Reduced Susceptibility to Fluoroquinolones

The present study was undertaken to examine the status of antimicrobial resistance in Salmonella-associated diseases, by verifying possible emergence of reduced susceptibility to fluoroquinolones in Salmonella isolates and determining the incidence of Plasmodium falciparum-associated co-infection with Salmonella serotypes. Antimicrobial resistance in clinical isolates of Salmonellae was examined for a 12-month period. Four hundred and forty-one patients comprising two groups were recruited. Group A comprised 235 patients diagnosed by clinicians of having pyrexia, and group B included stool samples of 206 patients presenting with gastroenteritis. Samples were cultured and isolates identified, and drug susceptibility testing was performed using the standard methods. Of the 235 samples screened in group A, 42 Salmonella isolates and 107 Plasmodium spp. were identified. Of the 42 Salmonella isolates, 19 (45.2%) were Salmonella Typhi, 9 (21.4%) S. Enteritidis, and 7 (16.7%) each of S. Paratyphi and S. Arizonae. Plasmodium spp.-associated co-infection with Salmonellae was observed in 16 patients mostly in complicated typhoidal cases and S. Enteritidis-associated bacteraemia. Fiftty-three of the 206 stool samples from group B patients were confirmed positive for bacterial pathogens, made up of 35 Salmonella and 18 Shigella isolates. Of the Salmonella isolates, 18 (51.4%) were S. Enteritidis, 11 (31.4%) S. Arizonae, 4 (11.4%) S. Paratyphi, and 2 (5.7%) S. Typhi. There was no statistically significant difference (p<0.01) in antimicrobial resistance patterns exhibited among typhoidal Salmonellae isolated in 2000 and 2005. A similar trend in resistance was recorded for non-typhoidal Salmonellae (p<0.05). For the first time in Lagos, Nigeria, Salmonella isolates (10–18%) with reduced susceptibility to both ciprofloxacin and ofloxacin at MIC50 and MIC90 values of 0.015 and 0.03 μg/mL respectively were found. Despite this development, ciprofloxacin and ofloxacin remain the drug of choice for severe cases of salmonellosis, although caution should be exercised by clinicians in their pres-criptions such that fluoroquinolone antibiotic therapy is used only in laboratory-proven cases of typhoid fever and Salmonella-associated bacteraemia to preserve its efficacy

The Supreme Being (God) and Man: Who Is to Blame for Bad Destiny?

In Yoruba traditional thought, human destiny has a mysterious power that controls human events. It is believed that every person has their life history before coming to the world. This implies that anything one does is not something done out of free will is done in fulfillment of a preordained or preordained sequence of events. However, Yoruba has such a controversial understanding of the meaning, nature, relevance and reality of the concept of destiny (ayanmo), which has long elicited philosophical interest. While various metaphysical interpretations have been given for this issue, it could be said that most of these interpretations may be seen in four forms: fatalism, predestination, soft-determinism and hard-determinism. However, less emphasis has been placed on man’s free will in determining destiny. Who is to be blamed for bad destiny between the Supreme Being (Olodumare) and man was not completely resolved. Therefore, this paper re-examines who is responsible for the bad destiny suffered by man, between God and Man. Having used critical analysis, this paper argues that in the light of human moral responsibility, character, afterlife, justice andjudgment, there is a shared responsibility between Supreme Being (God) and the man on the bad destiny suffered by man

Human Campylobacteriosis in Developing Countries1

Campylobacteriosis is a collective description for infectious diseases caused by members of the bacterial genus Campylobacter. The only form of campylobacteriosis of major public health importance is Campylobacter enteritis due to C. jejuni and C. coli. Research and control efforts on the disease have been conducted more often in developed countries than developing countries. However, because of the increasing incidence, expanding spectrum of infections, potential of HIV-related deaths due to Campylobacter, and the availability of the complete genome sequence of C. jejuni NCTC 11168, interest in campylobacteriosis research and control in developing countries is growing. We present the distinguishing epidemiologic and clinical features of Campylobacter enteritis in developing countries relative to developed countries. National surveillance programs and international collaborations are needed to address the substantial gaps in the knowledge about the epidemiology of campylobacteriosis in developing countries

Cholera Epidemiology in Nigeria: an overview

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium, Vibrio cholera. Choleragenic V. cholera O1 and O139 are the only causative agents of the disease. The two most distinguishing epidemiologic features of the disease are its tendency to appear in explosive outbreaks and its predisposition to causing pandemics that may progressively affect many countries and spread into continents. Despite efforts to control cholera, the disease continues to occur as a major public health problem in many developing countries. Numerous studies over more than a century have made advances in the understanding of the disease and ways of treating patients, but the mechanism of emergence of new epidemic strains, and the ecosystem supporting regular epidemics, remain challenging to epidemiologists. In Nigeria, since the first appearance of epidemic cholera in 1972, intermittent outbreaks have been occurring. The later part of 2010 was marked with severe outbreak which started from the northern part of Nigeria, spreading to the other parts and involving approximately 3,000 cases and 781 deaths. Sporadic cases have also been reported. Although epidemiologic surveillance constitutes an important component of the public health response, publicly available surveillance data from Nigeria have been relatively limited to date. Based on existing relevant scientific literature on features of cholera, this paper presents a synopsis of cholera epidemiology emphasising the situation in Nigeria. Pan African Medical Journal 2012; 12:5

Salmonellosis in Lagos, Nigeria: Incidence of Plasmodium falciparum -associated Co-infection, Patterns of Antimicrobial Resistance, and Emergence of Reduced Susceptibility to Fluoroquinolones

The present study was undertaken to examine the status of antimicrobial resistance in Salmonella-associated diseases, by verifying possible emergence of reduced susceptibility to fluoroquinolones in Salmonella isolates and determining the incidence of Plasmodium falciparum -associated co-infection with Salmonella serotypes. Antimicrobial resistance in clinical isolates of Salmonellae was examined for a 12-month period. Four hundred and forty-one patients comprising two groups were recruited. Group A comprised 235 patients diagnosed by clinicians of having pyrexia, and group B included stool samples of 206 patients presenting with gastroenteritis. Samples were cultured and isolates identified, and drug susceptibility testing was performed using the standard methods. Of the 235 samples screened in group A, 42 Salmonella isolates and 107 Plasmodium spp. were identified. Of the 42 Salmonella isolates, 19 (45.2%) were Salmonella Typhi, 9 (21.4%) S. Enteritidis, and 7 (16.7%) each of S. Paratyphi and S. Arizonae. Plasmodium spp.-associated co-infection with Salmonellae was observed in 16 patients mostly in complicated typhoidal cases and S. Enteritidis-associated bacteraemia. Fiftty-three of the 206 stool samples from group B patients were confirmed positive for bacterial pathogens, made up of 35 Salmonella and 18 Shigella isolates. Of the Salmonella isolates, 18 (51.4%) were S. Enteritidis, 11 (31.4%) S. Arizonae, 4 (11.4%) S. Paratyphi, and 2 (5.7%) S. Typhi. There was no statistically significant difference (p&lt;0.01) in antimicrobial resistance patterns exhibited among typhoidal Salmonellae isolated in 2000 and 2005. A similar trend in resistance was recorded for non-typhoidal Salmonellae (p&lt;0.05). For the first time in Lagos, Nigeria, Salmonella isolates (10-18%) with reduced susceptibility to both ciprofloxacin and ofloxacin at MIC50 and MIC90 values of 0.015 and 0.03 \ub5g/mL respectively were found. Despite this development, ciprofloxacin and ofloxacin remain the drug of choice for severe cases of salmonellosis, although caution should be exercised by clinicians in their prescriptions such that fluoroquinolone antibiotic therapy is used only in laboratory-proven cases of typhoid fever and Salmonella-associated bacteraemia to preserve its efficacy

Anaemia in HIV positive mothers on antiretroviral therapy for prevention of mother-to-child transmission HIV in a tertiary health institution in North Central Nigeria

Background: Anaemia in pregnancy and HIV infection are two common public health issues in sub-Saharan African with Nigeria bearing the greatest burden. The duo occurring together poses a higher risk of morbidity and mortality for both the foetus and the mother. We therefore conducted this study to determine the burden of anaemia and other haematological abnormalities among HIV positive pregnant mothers on antiretroviral therapy who attended antenatal clinical services in our health institution.Methods: A 10-year retrospective review from January 2010 to December 2019 of medical records of HIV positive mothers on highly anti-retroviral therapy in attendance for antenatal clinical services in our health institution was carried out for the above objectives. Information extracted were, age, HIV status, gestational age at delivery, type of antiretroviral drugs used, duration of use, haemoglobin level, platelet, and complete blood count at booking of the positive mothers.Results: Of a total of 330 HIV positive mothers seen during the review period, 82.7% were from rural communities, 88.8% were from middle socio-economic class, 80.0% were Christians, and 80.3% started their highly active antiretroviral therapy before their index pregnancy. Most, 51.5% and 42.7% were on zidovudine, lamivudine and nevirapine, and tenofovir with lamivudine and lopinavir boasted ritonavir combinations, while 94.2% were on 1st line antiretroviral medication. Their mean age, gestational age at delivery, and parity were 31.11±4.7 years, 38.57±3.1 weeks, and 2.0±1.6 respectively. The prevalence of anaemia, thrombocytopenia and leucopoenia were 36.1%, 4.8%, and 6.7% respectively while their mean CD4 cell count and viral loads at the point of booking were 543.63±283.7 cells/μl, and 2953.02±1619.9 copies/ml. The two maternal variables that showed significant relationship with haemoglobin concentration of <10 gm/dl was mother’s level of education x2=6.29, p=0.043, and her socio=economic class, x2=10.162, p=0.006.Conclusions: There is high burden of anaemia among HIV positive mothers on antiretroviral therapy in our environment. The prevalence of thrombocytopenia and leucopoenia was much lower. The burden of maternal anaemia was associated with maternal level of education and her socio-economic class

Persistence of fluoroquinolone-resistant Salmonella enterica serovar Kentucky from poultry and poultry sources in Nigeria

Introduction: This study investigated the antimicrobial resistance and clonality of Salmonella enterica serotype Kentucky in poultry and poultry sources in Nigeria, and compared the isolates with the clone of S. Kentucky STI98-X1 CIPR using (PFGE) and (MIC). Methodology: Fecal samples from chickens and poultry sources (litter, water, rodent and lizard fecal samples) were collected from  fourteen (14) poultry farms in 2007, 2010 and 2011 and were analyzed for S. Kentucky. Results and conclusions: Six percent of the samples were positive for S. Kentucky – all resistant to nalidixic acid and ciprofloxacin. The isolates are grouped within the PFGE cluster X1 of S. Kentucky STI98 CIPR, indicating the association to the emerging and widely spread CIPR S. Kentucky clone with poultry and poultry sources.</jats:p