Nasal carriage of methicillin resistant Staphylococcus aureus among medical students of a private institution in Ilishan-Remo, Ogun State, Nigeria

Background: Nasal carriage of methicillin resistant Staphylococcus aureus (MRSA) is a major factor for its transmission especially from the health workers and medical students to their patients. There are a number of published data on the prevalence of MRSA among health workers but data on nasal colonization of medical students by MRSA are sparse in Nigeria. The objectives of this study are to determine the prevalence of nasal carriage of MRSA among medical students of the Ben Carson School of Medicine, Babcock University, Ilishan-Remo, Ogun State, Nigeria, and identify risk factors associated with this nasal carriage. Methodology: A case control study involving 100 clinical (study group) and 100 pre- clinical (control group) medical students was undertaken between March 2018 and October 2019. Structured questionnaire was administered to obtain socio-demographic information and potential risk factors. Nasal swab was collected from each student and cultured for isolation of S. aureus by standard microbiology techniques. Phenotypic MRSA was detected by the cefoxitin 30μg disk diffusion method according to the guideline of Clinical and Laboratory Standards Institute. The mecA gene was detected by conventional polymerase chain reaction (PCR) assay. Results: The prevalence of S. aureus nasal carriage among the study group was 14% (14/100) while the prevalence among the control group was 6% (6/100) (p=0.097). The prevalence of phenotypic MRSA among the study group was 4% (4/100) and 1% (1/100) among the control group (p=0.3687) while mecA gene was detected in 3 of the 4 (75%) phenotypic MRSA positive study participants and in the only (100%) phenotypic MRSA positive (1%) control group. Antibiotics usage without prescription, antibiotic treatment of common cold, and use of antibiotics in the previous one year, were significantly associated with MRSA carriage among the study group. Conclusion: Although the prevalence of nasal carriage of S. aureus and MRSA among clinical and pre-clinical medical students was not statistically significant, the risk factors identified with carriage of MRSA among the study group indicates the need for antimicrobial stewardship program to reduce carriage and transmission of MRSA by medical students. Keywords: methicillin resistant, Staphylococcus aureus, mecA gene, nasal carriage, medical student

Assessment of the knowledge and management of diarrhoea among women in Abakaliki metropolis, Nigeria

ABSTRACT Background: Diarrhoea remains the 2nd cause of death among children globally despite the fact that the resources to control and prevent it are inexpensive and widely available. Aim: This study was carried out to evaluate the perception of mothers regarding diarrhoea so as to identify areas in need of further education and enlightenment campaign in this community. Methods: A total of 365 mothers were surveyed at 4 Primary Health Centers in Abakaliki, South-Eastern Nigeria between January and March 2015. Pre-tested questionnaires were administered to participants who had the information translated and explained to them in local dialects. Results: Piped water was not available in this metropolis. Most participants, 88.0%, (321/365) usually wash their hands with soap and water after using the toilet. Majority of the respondents, 93.7% (342/365) agreed that inadequate sanitation and hygiene was associated with childhood diarrhoea, but there were those who believed that teething, 48.0% (175/365) can also cause diarrhoea. Overall diarrhoea incidence in the study population was 38.4% (140/365). Prevalence was lowest in children below the age of 1 year (p=0.001). Hand washing and keeping children in daycare centers had negative and positive association with diarrhoea risk respectively. Management of diarrhoea with Oral Rehydration Salt/Salt Sugar Solution was most practiced by mothers above the age of 30 years (91.7%) as well as those with the highest level of education (92%) while management which included stopping breastfeeding and normal feeding were mostly practiced by mothers below 20 years (21.9% and 34.4% respectively) and those with primary level of education (15.1 % and 18.9% respectively). Conclusion: Health education and enlightenment campaign regarding hand washing, need to continue breastfeeding /normal feeding should be scaled up in this community, especially among young mothers, those with little or no formal education as well as in day care centers

Toxoplasmosis - Awareness and knowledge among medical doctors in Nigeria

Toxoplasma gondii is a zoonotic parasite causing high disease burden worldwide. A One Health approach is needed to understand, prevent, and control toxoplasmosis, while knowledge gaps in the One Health aspects have been identified among medical professionals in earlier studies. As a One Health collaboration between veterinary and medical fields, we surveyed the knowledge on toxoplasmosis among medical doctors in Nigeria. The knowledge questions, which the participants answered without consulting literature and colleagues, covered epidemiological One Health aspects as well as clinical interspecialty aspects of T. gondii infections. Altogether 522 medical doctors from four tertiary hospitals completed the questionnaire. The mean number of correct answers in the knowledge questions was 7.5, and 8.4% of the participants selected at least 12 of the 17 correct answers. The proportion of medical doctors scoring such a high score was significantly higher among those who reported having seen a case of clinical toxoplasmosis than in those who did not. While 62% of the medical doctors participating in our study knew that cats can shed T. gondii in their feces, 36% incorrectly suggested that humans could do that too. That T. gondii infection can be meatborne was known by 69%, but that it can be also waterborne only by 28% of the medical doctors participating in our study. Most of the medical doctors, 78%, knew that clinical toxoplasmosis may involve the central nervous system, while only 37% answered that it can involve the eyes. Our results suggested knowledge gaps, which need to be addressed in Continuous Medical Education. The identified gaps included both intersectoral One Health aspects and interspecialty aspects: For prevention and management of toxoplasmosis, knowing the main transmission routes and that the parasite can affect several organs is relevant.Peer reviewe