Pneumococcal carriage in sub-Saharan Africa--a systematic review.

BACKGROUND: Pneumococcal epidemiology varies geographically and few data are available from the African continent. We assess pneumococcal carriage from studies conducted in sub-Saharan Africa (sSA) before and after the pneumococcal conjugate vaccine (PCV) era. METHODS: A search for pneumococcal carriage studies published before 2012 was conducted to describe carriage in sSA. The review also describes pneumococcal serotypes and assesses the impact of vaccination on carriage in this region. RESULTS: Fifty-seven studies were included in this review with the majority (40.3%) from South Africa. There was considerable variability in the prevalence of carriage between studies (I-squared statistic = 99%). Carriage was higher in children and decreased with increasing age, 63.2% (95% CI: 55.6-70.8) in children less than 5 years, 42.6% (95% CI: 29.9-55.4) in children 5-15 years and 28.0% (95% CI: 19.0-37.0) in adults older than 15 years. There was no difference in the prevalence of carriage between males and females in 9/11 studies. Serotypes 19F, 6B, 6A, 14 and 23F were the five most common isolates. A meta-analysis of four randomized trials of PCV vaccination in children aged 9-24 months showed that carriage of vaccine type (VT) serotypes decreased with PCV vaccination; however, overall carriage remained the same because of a concomitant increase in non-vaccine type (NVT) serotypes. CONCLUSION: Pneumococcal carriage is generally high in the African continent, particularly in young children. The five most common serotypes in sSA are among the top seven serotypes that cause invasive pneumococcal disease in children globally. These serotypes are covered by the two PCVs recommended for routine childhood immunization by the WHO. The distribution of serotypes found in the nasopharynx is altered by PCV vaccination

A Comparative Study of Back Pain among Taxi and Truck Drivers in Port Harcourt, Nigeria

Back pain is a common health problem with tremendous cost on the nation, family and individual economy. Back pain has also been associated with professional driving. This study was to determine and compare the prevalence of back pain among taxi and truck drivers. Following ethical approval, this descriptive cross sectional study carried out in Port Harcourt Nigeria, among 278 consenting taxi and truck drivers. Sample size was193 for taxi drivers and 193 for truck drivers respectively however 189 respondents actually participated in the study. A structured close ended interviewer administered questionnaire was administered probing socio-demographics, medical and occupational histories. Data was analyzed using SSPSS version 20. Descriptive and analytical statistics to analyze and present data. The prevalence of back pain in Port Harcourt for taxi drivers was 70.4% and 71.4% for truck drivers. The prevalence among truck drivers was due to age ,sitting position and shock absorbers. However variables like duration of driving, vibration, BMI, seat condition, alcohol and tobacco intake did not have any statistically significant association with back pain among the two groups of drivers. There was a high prevalence of back pain among the two study groups albeit higher among the truckers. It is recommended that all drivers be educated on occupational hazards (especially back pain) associated with their profession.Keywords: Back pain, taxi driver, truck driver, Port Harcour