A ten-year review of neonatal bloodstream infections in a tertiary private hospital in Kenya

Introduction: Neonatal mortality in developing countries is usually due to an infectious cause. The gold standard of investigation in developing countries is a positive blood culture. It is important to know the aetiology of neonatal bloodstream infections so that empiric treatment can be effective. Methodology: We conducted a retrospective clinical audit over ten years between January 2000 until December 2009, looking at the aetiology of both early and late onset neonatal sepsis. We analysed data from 152 (23%) patient isolates out of 662 suspected cases of neonatal sepsis. Results: Our study revealed that Gram-positive organisms were the predominant cause of both early and late onset sepsis; the common isolates were Staphylococcus epidermidis (34%) and Staphylococcus aureus (27%). There were no isolates of group B Streptococcus. Candida species was isolated only in patients with late onset sepsis (6.9%). Bacterial isolates were relatively sensitive to the commonly used first- and second-line empiric antibiotics. Conclusion: Gram-positive organisms remain the major cause of neonatal bloodstream infections in our setup. The findings of this study will guide clinicians in prescribing the right empiric therapy in cases of suspected neonatal sepsis before the definitive culture results are obtained

Prevalence of genital chlamydia infection in urban women of reproductive age, Nairobi, Kenya

Background: Chlamydia trachomatis is one of the major causes of sexually transmitted infections throughout the world. Most infections are asymptomatic and remain undetected. Burden of disease in the Kenyan population is not well characterised. This study was done to define the prevalence of genital Chlamydia infection in a representative female population. Findings: A cross-sectional study design was employed. All women attending out-patient clinics (antenatal, gynaecology, family planning) and accident and emergency departments at two study sites over a five month period were invited to consent to completion of a questionnaire and vaginal swab collection. A rapid point-of-care immunoassay based test was performed on the swabs. Women who tested positive for Chlamydia were offered treatment, together with their partner(s), and advised to come for a follow-up test. A total of 300 women were tested. The prevalence of genital Chlamydia trachomatis was found to be 6% (95% CI 3.31% – 8.69%). The prevalence was higher in women who represented a higher socioeconomic level, but this difference was not significant (p=0.061). Use of vaginal swabs was observed to be a more acceptable form of sample collection. Conclusion: The prevalence of genital Chlamydia is significant in our female population. There is a justifiable need to institute opportunistic screening programs to reduce the burden of this disease. Rapid and low cost point-of-care testing as a potential component of sexually transmitted infection (STI) screening can be utilised

Prevalence of genital chlamydia infection in urban women of reproductive age, Nairobi, Kenya

Background: Chlamydia trachomatis is one of the major causes of sexually transmitted infections throughout the world. Most infections are asymptomatic and remain undetected. Burden of disease in the Kenyan population is not well characterised. This study was done to define the prevalence of genital Chlamydia infection in a representative female population. Findings: A cross-sectional study design was employed. All women attending out-patient clinics (antenatal, gynaecology, family planning) and accident and emergency departments at two study sites over a five month period were invited to consent to completion of a questionnaire and vaginal swab collection. A rapid point-of-care immunoassay based test was performed on the swabs. Women who tested positive for Chlamydia were offered treatment, together with their partner(s), and advised to come for a follow-up test. A total of 300 women were tested. The prevalence of genital Chlamydia trachomatis was found to be 6% (95% CI 3.31% - 8.69%). The prevalence was higher in women who represented a higher socioeconomic level, but this difference was not significant (p=0.061). Use of vaginal swabs was observed to be a more acceptable form of sample collection. Conclusion: The prevalence of genital Chlamydia is significant in our female population. There is a justifiable need to institute opportunistic screening programs to reduce the burden of this disease. Rapid and low cost point-of-care testing as a potential component of sexually transmitted infection (STI) screening can be utilised.Publisher PDFPeer reviewe

Prevalence of genital chlamydia infection in urban women of reproductive age

Background: Chlamydia trachomatis is one of the major causes of sexually transmitted infections throughout the world. It is the primary cause for pelvic inflammatory disease, tubal infertility and ectopic pregnancy in females. Most infections are asymptomatic and remain undetected. The burden of disease in the Kenyan population is not well characterised and few previous studies, done in Kenya, show the prevalence of genital Chlamydia infection in sexually active females. There is a need to define prevalence in our local population as a public health need and to determine whether rapid point-of-care testing should be incorporated as a component of sexually transmitted infection testing. Objective: To assess the public health burden of genital Chlamydia infection in sexually active women of reproductive age in an urban population within Nairobi. Methods: A cross-sectional study design was employed. All women attending the gynaecology and antenatal clinics at the two study sites were invited to consent to completion of a questionnaire and vaginal swab collection. Women who tested positive for Chlamydia were offered treatment, together with their partner(s), and advised to come for a follow-up test. Results: A total of 300 women were tested. The prevalence of genital Chlamydia trachomatis was found to be 6% (95% CI 3.31% - 8.69%). The prevalence was higher in women who represented a higher socioeconomic level, but this difference was not significant (OR = 2.7). Use of vaginal swabs was established to be a more acceptable form of sample collection. Conclusion: The prevalence of genital Chlamydia is significant in our female population. There is a justifiable need to institute opportunistic screening programs to reduce the burden of this disease. Rapid point-of-care testing as a potential component of sexually transmitted infection testing can be utilised

Continuing professional development of dentists through distant learning: An Indira Gandhi National Open University-Dental Council of India experiment a report

To keep themselves updated with all the advancements in the field of dentistry, dentists should involve themselves in some kind of professional development. Distance learning is the most appropriate way to serve the growing demand due to technological advancements. Indira Gandhi National Open University in collaboration with Dental Council of India (DCI) developed and launched two continuing professional development programs in Endodontics (postgraduate certificate in endodontics) and postgraduate certificate in oral implantology and has trained over 400 and 280 BDS dentists respectively till date. The program package consists of self-instructional material, assignments, videos and practical training. The training is conducted in premiere dental colleges and institutions recognized by DCI. The certificate is awarded after a term end examination, both in theory and practical. The pass percentages of the theory courses ranged from around 63% to 98%, and 90% of the candidates cleared the practical exam

Macro CK in patients with elevated troponin I levels.

CK-MB activity levels can be falsely elevated by the presence of macro CK, especially if immune-inhibition assays are used in the measurement. In Patients with macro CK and cardiac pathology that could result in an elevated CK-MB activity, the diagnostic challenge lies in determining the true cause of the elevated CK-MB activity. We present two case reports of Patients with elevated CK-MB activity and troponin I levels, but who subsequently had CK-MB activity higher than total CK activity, raising the suspicion of the presence of macro CK