Trends in profiles of bacteria causing neonatal sepsis in Central Nigeria Hospital

Developing countries suffer from a huge burden of neonatal sepsis. Neonatal  mortality and long term sequelae or morbidity portends huge costs for the poor Nigerian economy. We identified trends in bacterial agents implicated in neonatal sepsis and their antibiotic susceptibility profiles at the National Hospital Abuja over two periods of three years each a decade apart. A retrospective study of bacterial agents of sepsis from 2013-2015 was carried out and this was compared to an already published study from the same hospital ten years earlier(2002-2004) to determine changing trends using standard statistical methods. We identified a significant shift to predominance of gram positive organisms especially Staphylococcus aureus (59% vs 40%) as against the predominance of gram negative organisms especially Klebsiella pneumoniae (11% vs 44%) in the previous decade. Almost all antibiotics tested (92%) had reduced susceptibility in the later review compared to the former. Surveillance of bacterial agents of neonatal sepsis is vital for the detection of trends in causative organisms and their susceptibilities. This is important to direct empiric therapy and also to encourage implementation and monitoring of antibiotic stewardship programs

Evolution of SARS-CoV-2 variants: a mini-review

SARS-CoV-2 has evolved over time with several mutations, especially on the spike protein, which has led to emergence of various variants. With the evolution of SARS-CoV-2 come new challenges in surveillance, effectiveness of preventive and treatment strategies, and outcome of the disease.  Despite the lockdowns, mask mandates and other preventive measures put in place, in addition to over 10 million vaccine doses that have been  administered globally as of February 2022, COVID-19 cases have risen to over 435 million and resulted in over 5.9 million deaths, largely as a result  of the evolution of SARS-CoV-2 variants. To review the evolution of these variants, we searched different online database sources using keywords  such as “source of SARS-CoV-2”, “SARS-CoV-2 origin”, “evolution of SARS-CoV-2”, “SARS-CoV-2 variants”, “variants of concern”, “variants of interest”,  and “variants of high consequence”. This was to enable us give a good report about the various variants of SARS-CoV-2 that have emerged so far,  and the public health challenges posed by them

Performance of Improved Agricultural Technology Information among Small Scale Alcohol Consuming Farmers in Madagali, Adamawa State, Nigeria

This study aimed at analysing the performance of improved agricultural technologies information among small scale alcohol consuming farmers of Madagali Local Government Area, Adamawa State. The study assessed the socio-economic characteristics of small scale alcohol consuming farmers of the study area, finding the effect of alcohol consumption and addiction on agricultural production and to analyse the adoption and effect of the performance of agricultural technology information among small scale alcohol consuming farmers. The frame of the study was based on the five (5) districts of Madagali Local Government Area where two (2) were purposively selected for the study. A random selection of one village per each of the two districts was done to pick up two villages for the study. Fifteen alcoholic farmers were purposively selected from each of the two villages to make up thirty (30) farmers for the study. Structured questionnaire and interview schedule was employed to gather primary data. Among the results obtained from this study, it was found that, most of the alcoholic consuming farmers were male between the age of 31-45 years and they are all farmers. They practice mixed farming system and obtain their agricultural technology information through ADPs. Their average alcohol consumption is above five bottles per day and spends more than five hundred naira everyday. The result of the findings also shows that, most of the improved agricultural technology information communicated were very effective and perceived  modern storage, planting techniques, diseases and pests management, use of fertilizer etc as being effective, but adoption varies. The effects of alcohol on these farmers made them to have low adoption to modern agricultural technology information consequently led to low agricultural production in the study area. Hence, an orientation exercise should be organised intensively to make them be aware of the dangers associated with alcohol consumption on agricultural productivity and their health situations. Key words: Agricultural Technology Information, Alcohol Consumption, Performance and Small Scal

A review of the epidemiology, diagnosis, treatment, vaccines and economic impact of human monkeypox (Mpox) outbreaks

The current monkeypox outbreak is a public health emergency of international concern and is coming in the wake of the SARS-CoV-2 pandemic. Human monkeypox is a viral zoonotic infection caused by monkeypox virus, an enveloped double-stranded DNA virus of the genus Orthopoxvirus and family Poxviridae that also contain smallpox, cowpox, Orf, and vaccinia viruses. Online databases including PubMed, Google Scholar and Web of Science were searched to obtain relevant publications on the epidemiology, treatment, vaccines and the economic impacts of the current monkeypox (Mpox) outbreak

Urine culture contamination: a one-year retrospective study at the national hospital, abuja

Background: Urine culture contamination is a significant cause of delay in treatment of patients being investigated for urinary tractinfection. Though contamination is not completely avoidable, several measures have been proven to decrease contamination rates.There are few studies detailing urine contamination rates in laboratories in Nigeria.Aim: To determine the frequency and factors associated with urine culture contamination in samples submitted to the MedicalMicrobiology Laboratory in National Hospital Abuja (NHA).Method: Retrospective study of urine culture contamination in which data from Medical Microbiology Laboratory from January 1 toDecember 31 2012 at National Hospital Abuja were reviewed. Patients’ age, gender, location and urine culture result were assessed.Contamination rates for different genders, age groups and departments were assessed and results presented in simple averages andpercentages.Results: Overall contamination rate was 13.1%. Females had a contamination rate of 16.9%, which was significantly higher than thecontamination rate of 6.8% in males. The Gynaecology and Antenatal clinics had the highest contamination rates amongst departmentswith 22.5% and 21.3% respectively. Lowest contamination rates were in Emergency Paediatric Unit (EPU) and intensive Care Unit (ICU)with rates of 5.9%and 9.5% respectively. The female gender was found to be the most significant predictor of higher contamination rate.Conclusion: Contamination rate of urine cultures in this study is unacceptably high. Appropriate interventions need to be instituted toreduce the current urine culture contamination rate in National Hospital Abuja.Key Words: Urine, Contamination, National Hospital, Abuja

A profile of wound infections in National Hospital Abuja

Background: Wound Infections cause prolonged hospital stay, increased costs and also can result in increased patient morbidity and mortality.The current spread of multi -drug resistant bacteria has further heightened the need for regular bacteriological review of infected wounds and regular antibiotics surveillance studies so as to avoid the unguided empirical treatment of wound infections which is quite common in this environmentAim: To determine the distribution of the isolates from wound specimens submitted to the medical microbiology laboratory of National Hospital Abuja for processing.Method: A review and analysis of 380 woundspecimens results from various wards in the hospital over a period of 10 months (1st Marto Dec 31st 2010) was conducted.Result: A total of 314 isolates were recovered from the 380 wound specimens giving a yield of 83%. 240(76%) yielded single isolates of various pathogens, while 74(24%) were poly-microbial. Gram negative bacilli constituted 66% of all the pathogens with Pseudomonas aeruginosa (19%) and Proteus species (18%) as the most frequent, while gram positive isolates made up 33% with S aureus (27%) as most predominant and most frequently isolated bacteria from all the wound specimens. Two candida species comprised about 1% of the isolates. Frequency of infection was highest in surgical wards (27%), gynaecology ward (14%) and accident and emergency unit (12%). The fluoroquinolones, aminoglycosides, and Beta-lactam antibiotics were the most effective drugs for most of the isolates. Staphylococcus aureus was most sensitive to amikacin (83%) and erythromycin (79%); Pseudomonas aeruginosa to imipenem (96%) and amikacin (83%) and Proteus species to amikacin (100%) and imipenem (78%).Conclusion: S aureus, Pseudomonas aeruginosa and Proteus species were the predominant bacteria from wounds, with surgery and gynaecology wards having the highest prevalence. Resistance to commonly used antibiotics is high. There is need to institute antibiotic stewardship and effective and efficient infection control measures in the hospitalKeywords: Wound infections, National Hospital , Abuj

Using longitudinal antibiotic point prevalence survey (PPS) to drive antimicrobial stewardship programmes in a Nigerian tertiary hospital

Background: Antimicrobial stewardship (AMS) provides a means of tackling antimicrobial resistance (AMR). Unfortunately, in Nigeria, like in some other low-and-middle-income countries (LMICs), AMS practice has been lacklustre due to poor institutional support amongst other factors. Efforts were made to address this situation by engaging with the management of National Hospital Abuja, Nigeria, using antibiotic prescription information obtained through repeated point prevalence survey.Methodology: Two rounds of antibiotic PPS were conducted in 2015 and 2017 using the Global Point Prevalence Survey (G-PPS) format. Data were collected from all inpatients receiving antibiotics on the selected day of study, including patient characteristics, antimicrobial prescription details, laboratory results and information on a set of quality indicators. The data were uploaded to an online G-PPS application hosted at the University of Antwerp in Belgium for validation, analysis and reporting.Results: The PPS data showed that hospital-wide antibiotic use prevalence increased from 58% in 2015 to 61% in 2017. Surgical prophylaxis beyond 24 hours also increased from 88-90% in 2015 to 100% in 2017, and only minority of therapies were supported by laboratory input for diagnosis and monitoring; 22% in 2015 and 5% in 2017.Conclusion: These results were used for evidence-based engagement with the management to formally support AMS activities in the hospital. Positive outcomes were the formal reconstitution and inauguration of AMS committee in 2018 as well as the issuance of a formal policy statement by the hospital in 2020. The ease and free availability of Global PPS methodology makes it ideal in driving antimicrobial stewardship programme (ASP) in LMICs like Nigeria. Keywords: Antibiotic stewardship checklist, institutional support, point   French Title: Utilisation d'une enquête longitudinale sur la prévalence ponctuelle des antibiotiques (PPS) pour conduire des programmes de gestion des antimicrobiens dans un hôpital tertiaire nigérian Contexte: La gestion des antimicrobiens (AMS) offre un moyen de lutter contre la résistance aux antimicrobiens (RAM). Malheureusement, au Nigéria, comme dans certains autres pays à revenu faible ou intermédiaire (PRFI), la pratique de la MGS a été médiocre en raison d'un soutien institutionnel insuffisant, entre autres facteurs. Des  Longitudinal PPS for AMS programmes efforts ont été faits pour remédier à cette situation en collaborant avec la direction de l'hôpital national d'Abuja, au Nigéria, en utilisant les informations sur les prescriptions d'antibiotiques obtenues grâce à une enquête ponctuelle répétée de prévalence.Méthodologie: Deux séries d'antibiotiques PPS ont été menées en 2015 et 2017 en utilisant le format Global Point Prevalence Survey (G-PPS). Des données ont été recueillies auprès de tous les patients hospitalisés recevant des antibiotiques le jour sélectionné de l'étude, y compris les caractéristiques des patients, les détails de la prescription d'antimicrobiens, les résultats de laboratoire et les informations sur un ensemble d'indicateurs de qualité. Les données ont été téléchargées sur une application en ligne G-PPS hébergée à l'Université d'Anvers en Belgique à des fins de validation, d'analyse et rapports.Résultats: Les données PPS ont montré que la prévalence de l'utilisation d'antibiotiques à l'échelle de l'hôpital est passée de 58% en 2015 à 61% en 2017. La prophylaxie chirurgicale au-delà de 24 heures est également passée de 88 à 90% en 2015 à 100% en 2017, et seule une minorité de thérapies a été soutenue par entrée de laboratoire pour le diagnostic et la surveillance; 22% en 2015 et 5% en 2017.Conclusion: Ces résultats ont été utilisés pour un engagement fondé sur des données probantes avec la direction afin de soutenir officiellement les activités AMS à l'hôpital. Les résultats positifs ont été la reconstitution formelle et l'inauguration du comité AMS en 2018 ainsi que la publication d'une déclaration de politique formelle par l'hôpital en 2020. La facilité et la disponibilité gratuite de la méthodologie Global PPS la rend idéale pour conduire le programme de gestion des antimicrobiens (ASP) en PRFI comme le Nigéria. Mots clés: liste de contrôle pour la gestion des antibiotiques, soutien institutionnel, enquête ponctuelle de prévalence, déclaration de politique prevalence survey, policy statement &nbsp

The Health Impact of Fuel Wood Utilization on Users in Yelwa Village, Nasarawa State, Nigeria

The health effects associated with the use of domesti

Urban livability indicators for secondary cities in ASEAN region

Urban livability indicators have tremendous influence on policies and growth trajectories of cities or metropolises to the benefit of their communities. Livability is a threshold for measuring the social dimension of people wrought by exogenous factors like infrastructure, environment, social cohesion, transportation, health and education, among others. This research is aimed to generate prototype urban livability indicators for secondary cities in Southeast Asia, benchmarked on the livability indicators of Iskandar Malaysia, Davao City in the Philippines and Makassar in Indonesia. A three-round iterative Delphi survey (scoping, convergence, and consensus) was conducted to pre-qualified 60 experts with equal representations from the three metropolises. The significant phase was the scoping where experts have to supplement the given framework for their aspired urban livability sub-indicators under specific domain indicators. In the convergence phase, reconsideration of sub-indicators and preliminary ranking of domain indicators using the 5-point Likert Scale’s degree of agreement and Kendall’s W coefficient of concordance were performed. In the consensus phase, both domain indicators and sub-indicators were ranked separately and assigned corresponding weightings. With the total of 108 framework-based and supplementary sub-indicators categorized under the 11 domain indicators, the study conclusively yielded 75 common, comparative, interconnected, and consistent urban livability indicators ranked according to the aspiration of stakeholders in three ASEAN secondary cities. This research, through the employ of robust methodology, has generated comprehensive composite urban livability indicators for secondary metropolitan settlements in Southeast Asia; thus, the resulting final indicators can be potentially engaged to determine a comparative urban livability index of cities in the ASEAN region

Corrigendum: Antimicrobial Stewardship Implementation in Nigerian Hospitals: Gaps and Challenges

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