24 research outputs found

    Physicochemical Assessment of Ground Water Quality from Borehole and Hand Dug Wells around Obajana Community, Lokoja, Kogi State, Nigeria

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    The groundwater qualities of Obajana in Kogi State were determined. The study consisted of the determination of some heavy metals and physicochemical properties of drinking water samples. The samples were analyzed for the following parameters iron, copper, manganese, zinc, lead,using AAS Varian AA240FS. Nitrates, sulphate, phosphate, colour, dissolved solids, electrical conductivity, pH, dissolved oxygen (DO), biological oxygen demand (BOD), chemical oxygen demand (COD), temperature, turbidity, total hardness and total alkalinity using standard method. The data showed the variation of the investigated parameters in samples as follows: temperature 26-30oC,  pH 5.53-7.89, electrical conductivity (EC) 6.210-339.670 ÎĽS/cm, total hardness 50.00- 424.20 mg/l, alkalinity 1.10-145.67mg/l, turbidity 0.00-34 FTU, colour 5-15TCU, phosphate 0.02-0.760 mg/l, nitrate 10.24-48.20mg/l, sulphate  24.70-222.13mg/l, dissolved oxygen 0.2-1.8 mg/l,  BOD 0.2-1.0mg/l, COD 1.1-3.2mg/l, Cu 0.00.1-0.10mg/l , Fe 0.01-0.060mg/l, Zn 0.029-5.046mg/l, Mn  0.0-0.44mg/l and Pb 0.0348-1.046mg/l. The concentrations of some of the investigated parameters in the drinking water samples from the research region were above the permissible limits of the World Health Organization standard for drinking water quality guidelines. lead was found to exceed 0.01mg/l which is the WHO maximum limit, also zinc and manganese were found to exceed the WHO maximum limit of 3.0mg/l and 0.1mg/l

    Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS)

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    Background Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin–gentamicin as first-line therapy for the management of neonatal sepsis. In the BARNARDS observational cohort study of neonatal sepsis and antimicrobial resistance in LMICs, common sepsis pathogens were characterised via whole genome sequencing (WGS) and antimicrobial resistance profiles. In this substudy of BARNARDS, we aimed to assess the use and efficacy of empirical antibiotic therapies commonly used in LMICs for neonatal sepsis. Methods In BARNARDS, consenting mother–neonates aged 0–60 days dyads were enrolled on delivery or neonatal presentation with suspected sepsis at 12 BARNARDS clinical sites in Bangladesh, Ethiopia, India, Pakistan, Nigeria, Rwanda, and South Africa. Stillborn babies were excluded from the study. Blood samples were collected from neonates presenting with clinical signs of sepsis, and WGS and minimum inhibitory concentrations for antibiotic treatment were determined for bacterial isolates from culture-confirmed sepsis. Neonatal outcome data were collected following enrolment until 60 days of life. Antibiotic usage and neonatal outcome data were assessed. Survival analyses were adjusted to take into account potential clinical confounding variables related to the birth and pathogen. Additionally, resistance profiles, pharmacokinetic–pharmacodynamic probability of target attainment, and frequency of resistance (ie, resistance defined by in-vitro growth of isolates when challenged by antibiotics) were assessed. Questionnaires on health structures and antibiotic costs evaluated accessibility and affordability. Findings Between Nov 12, 2015, and Feb 1, 2018, 36 285 neonates were enrolled into the main BARNARDS study, of whom 9874 had clinically diagnosed sepsis and 5749 had available antibiotic data. The four most commonly prescribed antibiotic combinations given to 4451 neonates (77·42%) of 5749 were ampicillin–gentamicin, ceftazidime–amikacin, piperacillin–tazobactam–amikacin, and amoxicillin clavulanate–amikacin. This dataset assessed 476 prescriptions for 442 neonates treated with one of these antibiotic combinations with WGS data (all BARNARDS countries were represented in this subset except India). Multiple pathogens were isolated, totalling 457 isolates. Reported mortality was lower for neonates treated with ceftazidime–amikacin than for neonates treated with ampicillin–gentamicin (hazard ratio [adjusted for clinical variables considered potential confounders to outcomes] 0·32, 95% CI 0·14–0·72; p=0·0060). Of 390 Gram-negative isolates, 379 (97·2%) were resistant to ampicillin and 274 (70·3%) were resistant to gentamicin. Susceptibility of Gram-negative isolates to at least one antibiotic in a treatment combination was noted in 111 (28·5%) to ampicillin–gentamicin; 286 (73·3%) to amoxicillin clavulanate–amikacin; 301 (77·2%) to ceftazidime–amikacin; and 312 (80·0%) to piperacillin–tazobactam–amikacin. A probability of target attainment of 80% or more was noted in 26 neonates (33·7% [SD 0·59]) of 78 with ampicillin–gentamicin; 15 (68·0% [3·84]) of 27 with amoxicillin clavulanate–amikacin; 93 (92·7% [0·24]) of 109 with ceftazidime–amikacin; and 70 (85·3% [0·47]) of 76 with piperacillin–tazobactam–amikacin. However, antibiotic and country effects could not be distinguished. Frequency of resistance was recorded most frequently with fosfomycin (in 78 isolates [68·4%] of 114), followed by colistin (55 isolates [57·3%] of 96), and gentamicin (62 isolates [53·0%] of 117). Sites in six of the seven countries (excluding South Africa) stated that the cost of antibiotics would influence treatment of neonatal sepsis

    Participant experiences in a combination HIV cure-related trial with extended analytical treatment interruption in San Francisco, United States

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    Background There is limited systematic information available about the perspectives of participants enrolled in intensive combination HIV cure-related trials inclusive of an extended analytical treatment interruption (ATI). Objective To assess and understand experiences of people with HIV involved in a combination HIV cure-related trial with an extended ATI. Methods The trial included five interventions and was followed by an ATI lasting up to 52 wk. From 2022 – 2023, we conducted in-depth interviews with study participants following their extended ATIs. Interviews were audio-recorded, transcribed, and analyzed via conventional thematic analysis. Results We interviewed seven participants. The majority were male, White, and non-Hispanic, with a median age of 37 years. Trust in the research team, scientific altruism and hope of becoming a post-intervention controller were key motivators for joining the trial. Interviewees reported being satisfied with their decision to participate in the trial and the extended ATI. Most recounted feelings of worry related to viral rebound during the ATI. Participants reported both defeat and relief with ART restart. Four faced challenges with protecting partners from HIV during their ATI, such as trying to find out if their partner(s) were using pre-exposure prophylaxis. Conclusions Our findings demonstrate potential improvements for future ATI trial participant experiences, such as more robust resources for psychosocial support and partner protections. Dedicating greater effort to understanding participant ATI experiences can inform the design of future participant-centered HIV cure trial protocols
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