Microbiological Assessment of Commercial Yogurt Sold in Ota Metropolis, Ogun State, Nigeria

Ten authorized Yogurt products purchased within Ota metropolis, Ogun State of Nigeria were subjected to pH, Total Bacterial Count (TBC) and Total Fungal Count (TFC) analysis. pH values were in the range of 4.05 to 5.50, the TBC and TFC values ranged between 1.0 x 103 - 5.0 x 105 cfu/ml and 1.0 x 103- 5.0 x 105 cfu/ml respectively. Eleven bacterial isolates were detected in the yogurt samples. Lactobacillus spp. and Bacillus spp. constituted 16% of the total microbial load, Corynebacterium spp., Klebsiela spp., Staphylococcus spp., and Pseudomonas spp. constituted 8% while Proteus spp., Micrococcus spp., Shigella spp., Listeria spp., and Streptococcus spp. constituted 4%. Fungal isolates obtained were Mucor spp. (22%), Geotrichum spp. (17%), Montospora spp. (11%), while Aspergillus spp., Rhizopus spp., and Fusanrium spp. constituted 6%.The antimicrobial susceptibility test showed that the isolates exhibited susceptible to Ciprofloxacin and Ofloxacin and resisted Nitrofurantoin, Augumentin, Cefixime, Ceufuroxime, Gentamicin and Ceftazidime. The isolates were plasmid encoded, with size range of 20,000- 40,000 Kilo base pairs. Result show no significant difference within the bacteria isolates (P> 0.05), while the fungi isolates showed significant difference (P<0.05). Significant difference also occurred between the bacteria and the fungi isolate (P< 0.05)

Understanding the gaps in DR-TB care cascade in Nigeria: A sequential mixed-method study

Background: Despite the availability of free drug-resistant tuberculosis (DR-TB) care in Nigeria since 2011, the country continues to tackle low case notification and treatment rates. In 2018, 11% of an estimated 21,000 cases were diagnosed and 9% placed on treatment. These low rates are nevertheless a marked improvement from 2015 when only 3.4% were diagnosed and 2.3% placed on treatment of an estimated 29,000 cases. This study describes the Nigerian DR-TB care cascade from 2013 to 2017 and considers factors influencing gaps in care. Methods: Our study utilized a mixed-method design. For the quantitative component, we utilized the national diagnosis and treatment databases, as well as the World Health Organization's estimates for prevalence to construct a 5-year care cascade: numbers of patients at each level of DR-TB care, including incident cases, individuals who accessed testing, were diagnosed, initiated treated and completed treatment in Nigeria between 2013 and 2017. Using retrospective data for patients diagnosed in 2015, we performed the Fisher's exact test to determine the association between patient (age and gender) and provider/patient (region- north or south) variables, permitting a closer look at the gaps in care revealed across the 5 years. Barriers to care were explored using framework thematic analysis of 57 qualitative interviews and focus group discussions with patients, including 5 cases not initiated on treatment from the 2015 cohort, treatment supporters, community members, healthcare workers and program managers in 2017. Results: A 5-year analysis of cascade of care data shows significant, but inadequate, increases in overall numbers of cases accessing care. On average, between 2013 and 2017, 80% of estimated cases did not access testing; 75% of those who tested were not diagnosed; 36% of those diagnosed were not initiated on treatment and 23% of these did not finish treatment. In 2015, children and patients in Northern Nigeria had odds of 0.3 [95% CI 0.1–0.7] and 0.4 [0.3–0.5] of completing treatment once diagnosed; while males were shown to have a 1.34 [95% CI 1.0–1.7] times greater chance of completing treatment after diagnosis

Rates and timeliness of treatment initiation among drug-resistant tuberculosis patients in Nigeria- A retrospective cohort study.

BackgroundThere were an estimated 580,000 new cases of multidrug/rifampicin resistant TB (DR-TB) in 2015, and only 20% were initiated on treatment. This study explored health system and patient factors associated with initiation and timeliness of treatment among DR-TB patients in Nigeria, ranked 4th globally for estimated TB cases in 2015.MethodsA retrospective cohort study using 2015 diagnosis and treatment data from the Nigerian TB program electronic records examined "treatment ever received" (yes/no) and "treatment within 30 days" (yes/no). We compared health system and patient characteristics using binomial logistic regression, while controlling for confounders.ResultsOf 996 patients diagnosed nationwide in 2015 (aged 0-87 years, median 34), 47.8% were never treated. Of those treated (n = 520), 51.2% were treated within the 30 days prescribed in the National treatment guideline. Healthcare facility locations were significantly associated with ever receiving treatment and timely treatment. Predictors of timely treatment at the national level also included level of care and patient treatment history. The South-West zone, where DR-TB programs started, showed overall better access to DR-TB healthcare.ConclusionsHealthcare facility geographic locations were significantly associated with treatment initiation and timeliness. Significant regional differences in access to DR-TB care in Nigeria persist, reflecting uneven contexts for national DR-TB treatment rollout

Challenges in engaging the private sector for tuberculosis prevention and care in Nigeria: a mixed methods study

Objectives This study aimed to assess the practices of private practitioners regarding tuberculosis (TB), and to ascertain factors related to the low contribution of private healthcare providers to TB prevention and care in Nigeria.Design This is a mixed methods study comprising a quantitative retrospective review and qualitative study.Setting Private health facilities (HF) in Oyo State and the Federal Capital Territory (FCT), Nigeria.Participants We used routinely collected data on patients with tuberculosis (TB) notified between 1 January 2017 and 31 December 2018. In-depth interviews were also conducted with the clinical staff of the facilities.Primary and secondary outcome measures The study outcomes are practices of TB case notification and treatment outcome, as well as the barriers and enablers of TB notification.Results A total of 13 (11.0%) out of 118 private HF were designated as ‘engaged’ TB care facilities in Oyo State and none (0%) of the 198 private HF in the FCT held this designation. From the 214 patients with presumptive TB, 75 (35%) were diagnosed with TB, 42 (56%) had a bacteriological test done, 12 (16%) had an X-ray of the chest alone and 21 (28%) had other non-specific investigations. Most patients diagnosed were referred to a public HF, while 19 (25%) patients were managed at the private HF. Among them, 2 (10.5%) patients were treated with unconventional regimens, 4 (21%) were cured, 2 (11%) died, 3 (16%) lost to follow-up and 10 (53%) were not evaluated. The general practitioners did not have up-to-date knowledge of TB with a majority not trained on TB. Most referred patients with presumptive and confirmed TB to the public sector without feedback and were unclear regarding diagnostic algorithm and relevant tests to confirm TB.Conclusion Most private facilities were not engaged to provide TB services although with knowledge and practice gaps. The study has been used to develop plans for strategic engagement of the private sector in Nigeria