Understanding adverse drug-related emergency department visits: development of a conceptual model through a systematic review

Background: The burden of adverse drug event (ADE)-related emergency department (ED)visits is increasing despite several preventive measures. The objective of this paper was todevelop and validate a conceptual model for a better understanding of ADE-related ED visitsand to guide the design and implementation of effective interventions.Methods: The development of the model involved a systematic review of the literatureusing PubMed and Embase databases. Studies reporting the risk factors associatedwith ADE-related ED visits were included. The methodological qualities of the includedstudies were assessed using the Mixed Methods Appraisal Tool (MMAT). The model wasmapped and validated using face and content validity by an expert panel. Deficiencies andtargeted interventions were identified, and steps for the design and implementation wererecommended.Results: The literature search generated 1361 articles, of which 38 were included in thereview; 41 risk factors associated with ADE-related ED visits were identified. All factors weremapped, and the model was validated through face and content validity. The model consistedof six concepts related to sociodemographic factors, clinical factors, ADE-related to ED visits,ADE while in the ED, outcomes, and consequences. Interventions could be targeted at thefactors identified in each concept to prevent ADE-related ED burden.Conclusion: A conceptual model to guide the successful design and implementation ofstrategies to prevent ADE-related ED visits and the occurrence of ADE at ED was developed.Clinicians should take these factors into consideration to prevent untoward events, especiallywhen treating high-risk patients

ANTIMICROBIAL SUSEPTIBILITY OF NEISSERRIA GONORRHOEAE ISOLATED FROM PATIENTS ATTENDING VARIOUS CLINICS IN PAMBEGUWA, KADUNA STATE.

Antimicrobial resistant strains of gonococcal isolates have spread in many developing countries. In most African countries, the susceptibility of Neisseria gonorrhoeae is rarely tested. The antimicrobial susceptibility of one hundred and eight (108) Neisseria gonorrhoeae was therefore determined. Of the 108 isolates tested, 80 (74.07%) were resistant to penicillin, 74 (68.5%) were resistant to ampicillin. The resistance profiles for the remaining antibiotics tested were as follows: Erythromycin (58.3%), Tetracycline (62%) and gentamicin (25.9%). All the isolates were susceptible to ceftriaxone, cefuroxime and ofloxacin. Of the 80 penicillin resistant strains, 65 (81.3%) were penicillinase producing Neisseria gonorrhoeae (PPNG). The Minimum Inhibitory Concentration (MIC) of Penicillin against 9 gonococcal isolates, Ampicillin against 5 Neisseria gonorrhoeae isolates and Tetracycline against 2 gonococcal isolates was 32.0µg/ml. A total of 108 isolates were susceptible to 0.125µg/ml of ceftriaxone, cefuroxime and ofloxacin respectively. The high prevalence of PPNG and multiple drug resistance strains of Neisseria gonorrhoeae is associated with self-medication and sexual interaction between commercial sex workers (CSWs) resident in Pambeguwa and the long-distance truck drivers. Antimicrobial susceptibility test should be carried out on every gonococcal isolate obtained to ensure effective therapy. The present study was undertaken to assess the antimicrobial susceptibility of gonococcal isolates recovered from patients in Pambeguwa,Kaduna state, Nigeria

Association of Chlamydia serology with HIV in Nigerian women

This research was carried out to detect the presence of Chlamydia in pregnant women and gynaecologic patients in the North-central geopolitical zone of Nigeria. Blood samples were collected and analysed by ELISA techniques. The blood samples were also screened for HIV infection. A sero-prevalence of 59.0% was recorded for the study area. The sero-prevalence was higher among the gynaecologic patients (62.0%) than the pregnant women (57.5%). The difference was statistically significant (P = 0.0001). Of the four centers chosen for the study, the Federal Capital Territory (Abuja) had the highest prevalence (84.7%), while Niger State had the least (28.7%). The difference was also statistically significant (P<0.0001). The prevalence rate of HIV among the participants in the study center was found to be 17.2%. Abuja had the highest prevalence rate of 24.6%, followed by Benue, 16.7%, then Kogi, 12.0% and finally, Niger, 4.7%. Chlamydia was found to be associated with HIV (p<0.0001). The sero-prevalence of chlamydia in the North-Central zone of Nigeria was found to be high. Chlamydia was found to be correlated with HIV in the study area and may have contributed to the zone emerging with the highest HIV prevalence in the country. For an infection that is largely asymptomatic but has devastating effects on populations, only a preventive approach would have beneficial effects in controlling the disease and its effects on women’s health in the country.Keywords: Chlamydia trachomatis, HIV, pregnant women, gynaecologic patients, co-infectio

Re-calculating the cost of coccidiosis in chickens

Coccidiosis, caused by Eimeria species parasites, has long been recognised as an economically significant disease of chickens. As the global chicken population continues to grow, and its contribution to food security intensifies, it is increasingly important to assess the impact of diseases that compromise chicken productivity and welfare. In 1999, Williams published one of the most comprehensive estimates for the cost of coccidiosis in chickens, featuring a compartmentalised model for the costs of prophylaxis, treatment and losses, indicating a total cost in excess of £38 million in the United Kingdom (UK) in 1995. In the 25 years since this analysis the global chicken population has doubled and systems of chicken meat and egg production have advanced through improved nutrition, husbandry and selective breeding of chickens, and wider use of anticoccidial vaccines. Using data from industry representatives including veterinarians, farmers, production and health experts, we have updated the Williams model and estimate that coccidiosis in chickens cost the UK £99.2 million in 2016 (range £73.0–£125.5 million). Applying the model to data from Brazil, Egypt, Guatemala, India, New Zealand, Nigeria and the United States resulted in estimates that, when extrapolated by geographical region, indicate a global cost of ~ £10.4 billion at 2016 prices (£7.7–£13.0 billion), equivalent to £0.16/chicken produced. Understanding the economic costs of livestock diseases can be advantageous, providing baselines to evaluate the impact of different husbandry systems and interventions. The updated cost of coccidiosis in chickens will inform debates on the value of chemoprophylaxis and development of novel anticoccidial vaccines