Contribution of Dug-Out Wells to Salmonella Dissemination in Kwaebibirem District of Ghana

Typhoid fever is rare in the developed world, but in Kwaebibirem District of Ghana, Salmonella infections are very common. Typhoid and paratyphoid fevers in addition to gastroenteritis are frequently reported. The reservoir, prevailing Salmonella species and their antimicrobial susceptibility patterns are not known, but in Ghana treatment of these infections are mostly empirical. 464 samples (270 stool and 194 blood) were collected from patients and 188 water samples were collected from different water sources in Kwaebibirem District and cultured for Salmonella at St. Dominic Hospital, Akwatia. Salmonella prevalence of 11.6% (54/464) among patients and 2.7% (5/188) from dug-out wells were obtained. Total viable bacterial count in the water samples averaged 2.56 x103 -1.2 x 1013per milliliter. Five (5) out of 51 (9.8%) dug-out wells yielded Salmonellae upon culture. Typhoidal Salmonellae [11% (6/54)] and 68.6% (38/54) non-typhoidal Salmonellae were isolated from patients. The most affected age group ranged 6-15years with prevalence of 42.6% (23/54). The most frequent isolated was Salmonella Typhi 20% (11/54) followed by Salmonella Enterica, 29.6% (16/54). The Salmonella isolates were all susceptible to the cephalosporins (cefoxitin, cefotaxime, cefepime) the carbapenems (imipenem and meropenem) the quinolones (norfloxacin and ciprofloxacin) and the aminoglycoside (amikacin). Their resistant proportions to other drugs were ampicillin (69.5%), piperacillin (69.5%) and co-trimoxazole (76.3%). Salmonella infections were common in Kwaebibirem District, and home owned dug-out wells posed risk of Salmonella transmission to the people

Service Delivery, Customer Satisfaction and Customer Delight in the Real Estate Business. Evidence from Elite Kingdom Investment and Consulting Company Ghana

Businesses now focus more on how to create customers, retain and maintain customers through quality service delivery, customer satisfaction and customer delight. The purpose of the study was to identify whether customer delight and customer satisfaction depend on service provided by an organization. The research formulated hypothesis based on the three variables mentioned earlier. A simple random sampling was used to sample 248 customers of Elite Kingdom Investment and Consulting Company. Questionnaires were administered to the respondents to collect primary data. A reliability analysis was run to ascertain the inconsistency of the instruments used in the questionnaire. The statistical package used was SPSS version 20 to run the reliability analysis, test of normality, multivariate and univariate analyses, and Microsoft Excel was also used to generate pie and graph on personal data of respondents. The study revealed that service delivery is significant to customer satisfaction customer delight. Further findings in the study also revealed that there is a positive correlation between service delivery and satisfaction, and satisfaction and customer delight. It is therefore recommended that, the Elite Kingdom should move away from the basic understanding of customer satisfaction to delighting customers which might pave the way for repeat purchase among customers of the organization. Keywords: Service delivery, satisfaction, delight, repeat purchase, loyalty and profitabilit

Antimicrobial Resistance Patterns of Extended Spectrum Β-Lactamase Producing Klebsiellae and E. coli Isolates from a Tertiary Hospital in Ghana

Introduction: High proportions of E. coli and Klebsiellae isolates at Komfo Anokye Teaching Hospital (KATH) have developed resistance to the commonly prescribed antimicrobial drugs, but the cause of which is unknown. Detailed data upon which to advocate control interventions are scanty. This study determined the prevalence of ESBL Klebsiellae and E. coli at KATH, so as to establish the linkage (if any) between ESBL production and drug resistance to antimicrobials drugs at the Komfo Anokye Teaching Hospital. Method: 405 isolates consisting of 156 E. coli strains and 234 Klebsiella pneimoniae and 15 Klebsiella oxytoca were collected and tested for their antimicrobial susceptibility, ESBL production and the ESBL genotypes were determined by PCR. Results: High proportions of isolates were resistant to the β-lactam antibiotics with ampicillin recordeing 391 (91.7%) resistance followed by cefpodoxime 299 (73.8%), cefuroxime 286 (70.6%), ceftriaxone 224 (55.3%) and then cefotaxime 195 (48.1%). Proportion of isolates resistant non β-lactams tested ranged from 61% - 79%. ESBL producers had higher resistance proportions than non-ESBL producers. ESBL prevalence range from 49.4% in E coli, 61.5% in Klebsiella kpeumoniae to 86.7% in Klebsiella oxytoca. ESBL genotypes TEM, CTX-M were found in 151(64.5) isolates while 70(29.9) acquired the three ESBL genotypes. Conclusion: The widespread prevalence of ESBL producing E. coli and Klebsiellae call for immediate intervention strategies to prevent further spread. Training of laboratory personnel on phenotypic testing of ESBLs in addition to training clinical staff and prescribers on ESBL issues are advocated

Contribution of Dug-Out Wells to Salmonella Dissemination in Kwaebibirem District of Ghana

Typhoid fever is rare in the developed world, but in Kwaebibirem District of Ghana, Salmonella infections are very common. Typhoid and paratyphoid fevers in addition to gastroenteritis are frequently reported. The reservoir, prevailing Salmonella species and their antimicrobial susceptibility patterns are not known, but in Ghana treatment of these infections are mostly empirical. 464 samples (270 stool and 194 blood) were collected from patients and 188 water samples were collected from different water sources in Kwaebibirem District and cultured for Salmonella at St. Dominic Hospital, Akwatia. Salmonella prevalence of 11.6% (54/464) among patients and 2.7% (5/188) from dug-out wells were obtained. Total viable bacterial count in the water samples averaged 2.56 x103 -1.2 x 1013per milliliter. Five (5) out of 51 (9.8%) dug-out wells yielded Salmonellae upon culture. Typhoidal Salmonellae [11% (6/54)] and 68.6% (38/54) non-typhoidal Salmonellae were isolated from patients. The most affected age group ranged 6-15years with prevalence of 42.6% (23/54). The most frequent isolated was Salmonella Typhi 20% (11/54) followed by Salmonella Enterica, 29.6% (16/54). The Salmonella isolates were all susceptible to the cephalosporins (cefoxitin, cefotaxime, cefepime) the carbapenems (imipenem and meropenem) the quinolones (norfloxacin and ciprofloxacin) and the aminoglycoside (amikacin). Their resistant proportions to other drugs were ampicillin (69.5%), piperacillin (69.5%) and co-trimoxazole (76.3%). Salmonella infections were common in Kwaebibirem District, and home owned dug-out wells posed risk of Salmonella transmission to the people

Occurrence and distribution of extended-spectrum β-lactamase in clinical Escherichia coli isolates at Ho Teaching Hospital in Ghana.

Objective: This study determined the occurrence and distribution of Extended Spectrum β-Lactamase (ESBL) genotypes of E. coli isolates in Ho Teaching Hospital, Ghana.Design: A cross-sectional study.Setting: A single centre study was conducted at Ho Teaching Hospital of Ghana.Participants: Patients who visited Ho Teaching Hospital Laboratory with the request for culture and susceptibility testing.Main outcome measure: Escherichia coli were isolated, and Extended-Spectrum β-Lactamase genes were detected.Results: Of the 135 isolates, 56(41.5%,95% CI: 33.1% – 50.3%) were ESBL producers. More males, 14(58.3%), produced ESBL than females, 42(37.8%). The ESBL prevalence was highest among the elderly who were 80 years and above 3(100.0%), with the least prevalence among patients within 50-59 years and 0-9 years age bracket, representing 4(25.0%) and 3(27.3%), respectively. The total prevalence of ESBL was marginally higher among out-patients (41.8% 95% CI: 31.9% - 52.2%) compared to in-patients [40.5% 95% CI: 24.8% - 57.9]. BlaTEM-1 was the predominant ESBL genotype obtained from 83.9% (47/56) of the confirmed ESBL producing isolates, with the least being TOHO-1 4(7.1%). The co-existence of 2 different ESBL genes occurred in 19(33.9%) of the isolates. The single and quadruple carriage were 16(28.6%) and 3(5.4%), respectively. The highest co-existence of the ESBL genotypes was recorded for blaTEM-1 and blaCTXM-1 15(26.8%), followed by blaTEM-1, blaCTXM-1 and blaSHV-73 [12(21.4%)].Conclusion: The high prevalence of ESBL-producing E. coli isolates with multiple resistant gene carriage is a threat to healthcare in the study area

Application of the WHO Keys of Safer Food to Improve Food Handling Practices of Food Vendors in a Poor Resource Community in Ghana

Data was collected from food vendors in a poor resource community in Ghana, which showed that the vendors constituted an important source of oro-faecal transmission. Following this, the WHO five keys of safer food were utilized in an evidence based training programme for the vendors to improve their food handling practices. Impact assessment of the food safety training showed that 67.6% of the vendors had acquired some knowledge from the workshop and were putting it into practice. Lack of food safety equipment was a major hinderance to behavioral change among the vendors as far food handling practices are concerned

Effect of good hygiene practices intervention on food safety in senior secondary schools in Ghana

Eleven schools in three different hygiene categories were given hygiene training as an intervention to reported low hygiene standards. Staff hygiene knowledge scores, food temperature, food service time and microbiological quality of jollof rice (cooked rice in tomato sauce and fish) were measured before and after the intervention. Descriptive statistics and Wilcoxon’s Signed- Rank Test for repeated measures on SPSS were used to evaluate the effect of GHP intervention. Staff hygiene knowledge and practice scores, food temperature, aerobic colony count (ACC) and Staphylococcus aureus load in ready to eat (RTE) meal improved significantly (p≤0.05). Food hygiene training remains an essential legal and industrial requirement

A review on food safety and food hygiene studies in Ghana

Food safety and hygiene in Ghana was studied using desk top literature review. Food research was highly concentrated in the capital city of the country and most research focus were on commercial food operations specifically street foods and microbiological safety with limited information from institutional catering and other forms of food hazards. The media currently serves as the main source for reporting of food borne diseases. Food establishments and other sources contributing to food borne diseases included restaurants, food joints, food vendors, schools and individual homes. Limited use of prerequisites measures and food safety management systems was identified. Recommendations on regulating the General Hygiene Principles, implementation of HACCP to strengthen the food sector, regular food safety and hygiene workshops and training for food handlers that commensurate with their roles were made. Government support for SMEs and food handler's health screening were made. © 2014 Elsevier Ltd