Bacterial contaminations of informally marketed raw milk in Ghana

Background: Milk has an outstanding nutritional quality but is also an excellent medium for bacterial growth and an important source of bacterial infection when consumed without pasteurization. Objective: To estimate the bacterial health risk of milk consumption in Accra and Kumasi, the twomajor cities in Ghana. Method: A total of 96 raw milk samples collected in 2002 from the two sites were cultured and theisolated organisms identified by standard bacteriological methods. Results: Overall, the organisms identified and their prevalence rates were Yersinia spp. (19.8%), Klebsiella spp (16.7%), Proteus spp. (7.3%), Enterobacter spp. (6.3%), Escherichia coli (2.1%), andStaphylococcus spp (14.6%), Bacillus spp. (11.5%) and Mycobacterium spp. (1%). Most of the organisms identified were enterobacteria indicating probable faecal contamination of the milkas a result of poor hygiene. Most of the bacteria identified in the milk sampled are potential foodborne pathogens, and though some of them occurred in few samples, the practice of pooling milk from different sources by traders, and the absence of pasteurization generally observed among them could increase the risk posed by such organisms.Conclusion: The study has shown that informally marketed raw milk in the two cities could be an important source of infection with a wide range of organisms, particularly enterobacteria. There is the need for instituting effective control measures including improved hygienic handling of milk and its pasteurization to protect public h

A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study

Background: Global assessment of antimicrobial agents prescribed to infants in the neonatal intensive care unit (NICU) may inform antimicrobial stewardship efforts. Methods: We conducted a one-day global point prevalence study of all antimicrobials provided to NICU infants. Demographic, clinical, and microbiologic data were obtained including NICU level, census, birth weight, gestational/chronologic age, diagnoses, antimicrobial therapy (reason for use; length of therapy), antimicrobial stewardship program (ASP), and 30-day in-hospital mortality. Findings: On July 1, 2019, 26 of infants (580/2,265; range, 0�100; median gestational age, 33 weeks; median birth weight, 1800 g) in 84 NICUs (51, high-income; 33, low-to-middle income) from 29 countries (14, high-income; 15, low-to-middle income) in five continents received �1 antimicrobial agent (92, antibacterial; 19, antifungal; 4, antiviral). The most common reasons for antibiotic therapy were �rule-out� sepsis (32) and �culture-negative� sepsis (16) with ampicillin (40), gentamicin (35), amikacin (19), vancomycin (15), and meropenem (9) used most frequently. For definitive treatment of presumed/confirmed infection, vancomycin (26), amikacin (20), and meropenem (16) were the most prescribed agents. Length of therapy for culture-positive and �culture-negative� infections was 12 days (median; IQR, 8�14) and 7 days (median; IQR, 5�10), respectively. Mortality was 6 (42, infection-related). An NICU ASP was associated with lower rate of antibiotic utilization (p = 0·02). Interpretation: Global NICU antibiotic use was frequent and prolonged regardless of culture results. NICU-specific ASPs were associated with lower antibiotic utilization rates, suggesting the need for their implementation worldwide. Funding: Merck & Co.; The Ohio State University College of Medicine Barnes Medical Student Research Scholarship © 2021 The Author

Coping strategies of women seeking infertility treatment in southern Ghana

Infertility is a health problem faced by an estimated 15% of women of childbearing age in Ghana. This study explores the coping strategies adopted by 615 women seeking infertility treatment in southern Ghana. Both closed and open-ended questions were used through a survey conducted using face-to-face interviews in three languages at three health sites – a hospital, a health centre and a private clinic. The findings suggest that the majority of the women preferred to keep issues of their fertility problems to themselves. The reason could be due to the associated stigma of infertility. Further, the majority of the women coped through drawing on their Christian faith. Others also coped through the support they received from their husbands, their occupation by way of achieving economic independence, and some avoided situations that reminded them of their infertility problem. The findings should have implications for health personnel as some strategies infertile women use may do more harm than good (Afr J Reprod Health 2009; 13[4]:81-93)

Risk of exposure to marketed milk with antimicrobial drug residues in Ghana

The study was carried out to determine the extent to which antimicrobial drugs may be translocated into milk and the associated risk of exposure by consumers. A total of 394 milk samples were collected in the study sites in dry and wet seasons, and from different categories of milk market agents, including producers (farmers), processors, wholesalers (assemblers) and retailers. The milk samples were screened for antimicrobial drug residues using the Charm Aim-96 antimicrobial inhibition assay screening kit. Overall, 35.5% (140/394) of the milk samples collected were contaminated with one or more of the antimicrobial drugs screened. This translates into an average risk of exposure every third time a consumer drinks locally produced milk. There was no significant difference in contamination levels between season and area of sampling. Among market agents, contamination levels ranged from 16.6% (9/54) for wholesalers or milk assemblers to 54.2% (13/24) for milk processors. There were no significant differences in prevalence proportions of drug residues in milk from different types of traders between and within locations

Risk factors in the hygienic quality of milk in Ghana

The study was carried out to identify risk factors associated with bacterial contamination of locally produced raw milk and its adulteration with water. A total of 419 respondents of different categories of milk agents in the study sites were sampled for data and milk collection in the dry and wet seasons. The data collected focused on milk marketing factors and handling practices likely to affect milk quality, while the milk samples were analysed to determine the extent of bacterial contamination and adulteration with water. The proportion of milk samples adulterated was 18%. While 23.5% of the milk samples had unacceptably high total plate count ( > 6.3 log10 cfu/ml), all the samples had unacceptably high coliform plate count ( > 0.7 log10 cfu/ml). Risk factors associated with high bacterial counts were related to milk marketing channels (p < 0.05), milk market agents (p < 0.01), and milk containers (p=0.06) as well as their mode of cleaning (p=0.06). The only risk factor identified for adulteration of milk was related to season (p=0.04)