Prevalence and pattern of infectious dermatoses referrals to clinical microbiologists in a tertiary hospital in Southern Nigeria

Background: Infectious dermatoses are rife in low resource tropical countries. The consultative roles of clinical microbiologists in these countries are not portrayed in the literature. Specifically, their role in the management of infectious dermatoses has not been emphasized. The objective of this study is to determine the prevalence and pattern of infectious dermatoses referrals to an out-patient infectious disease clinic run by clinical microbiologists.Method: A retrospective analysis of all outpatient referrals to the clinical microbiologists in a tertiary hospital in southern Nigeria from October 2016 to September 2018 was conducted. The infectious dermatoses referrals were further analysed for patient demographics and frequency of clinical diagnosis.Results: A total of 545 consults were received, 82 (15.0%) of which were outpatient referrals. Infectious dermatoses accounted for 67 (81.7%) of the outpatient referrals. The male to female ratio was 0.9:1 and mean age was 39.7 ± 17.9 years. Paediatric referrals accounted for 10.4%. The commonest referral diagnoses were tinea corporis/capitis in 28 (41.8%), onchodermatitis in 15 (22.4%) and onychomycosis in 10 (14.9%). Leprosy was suspected in 5 cases (7.5%), lymphatic filariasis in 5 cases (7.5%), and pityriasis in 2 cases (3.0%). Referral diagnosis in 27 cases (38.8%) was a skin-related neglected tropical disease. Microbiological testing confirmed clinical suspicion in 31.3% of cases.Conclusion: Infectious dermatoses referrals constitute a substantial proportion of referrals to clinical microbiologists in the study location. Clinical microbiologists must be adept in the diagnosis of mycotic and parasitic dermatoses. The trending global health interest in integrated management of skin NTDs should be exploited to advocate for more sensitive diagnostic testing for infectious dermatoses.Keywords: Clinical, Microbiology, Infectious dermatoses, Consultation, Nigeri

Instagram: A niche for microlearning of undergraduate medical microbiology

No Abstrac

Healthcare Workers’ Preparedness to tackle COVID-19: A Study on Knowledge and Compliance with Standard Precautions in a Tertiary Hospital in Southern Nigeria

Background: Hospitals may serve as amplifiers of infectious disease rates during outbreak situations. The strict implementation of and compliance with standard precautions (SPs) is the primary strategy for preventing healthcare-associated infections. This study was conducted to assess the knowledge and level of compliance with SPs in a tertiary hospital as a measure of preparedness to tackle the COVID-19 pandemic.Methods: This descriptive cross-sectional study was conducted among healthcare workers selected using stratified sampling technique in the University of Benin Teaching Hospital, Benin City, Nigeria during the COVID-19 pandemic. Data was collected using an adapted, self-administered questionnaire and analyzed using IBM SPSS version 25.0. Knowledge and compliance with SPs were assessed using six domains each. Statistical measures for analysis were the odds ratios (OR) and 95% confidence intervals (CI). The level of significance was set at p < 0.05.Results: A total of 524 respondents with mean age 38.1 ± 9.7 years participated in this study. Majority, 432 (84.2%) were female and 467 (89.1%) were clinical staff. Overall, knowledge and compliance of SPs were good in 457 (87.2%) and 293 (60.0%) respondents, respectively. Clinical health workers were 2.5 (95% CI: 1.3 – 5.1) times more likely to have good knowledge while respondents with poor knowledge were 0.5 (95% CI: 0.3 – 0.9) timesless likely to have good compliance with SPs.Conclusion: Knowledge of SPs in the studied population was high and compliance was good. Continued education and behavioural change communication are needed to improve compliance especially in the face of a pandemic

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

No Abstract

Antimicrobial Stewardship Implementation in Nigerian Hospitals: Gaps and Challenges

Background: Antimicrobial resistance (AMR) is a major clinical challenge globally. It is mainly a consequence of inappropriate prescribing and use of antibiotics. Antimicrobial stewardship (AMS) ensures that antibiotics are prescribed and used appropriately. This study assessed AMS practice in selected Nigerian hospitals.Methodology: This was a cross sectional survey of 20 Federal, State and Private tertiary hospitals randomly selected from the six geopolitical zones of Nigeria. Using an adapted WHO tool on AMS, data were collected from each hospital as regard the existence of AMS committee, Accountability and Responsibility, AMS actions, Education and Training, Monitoring and Evaluation, Infection Prevention and Control (IPC) practice, facilities to support AMS, and challenges to AMS implementation. Gaps and challenges to the implementation of the AMS among the hospitals were identified.Results: Only 6 (30%) of the 20 hospitals had AMS committees while 2 (10%) had any evidence of leadership commitment to AMS. All the hospitals had laboratory facilities to support culture and sensitivity testing. There were no regular AMS-related education or training, monitoring, evaluation or reporting activities in the hospitals, except in 7 (25%) that had participated in the global point prevalence survey (Global-PPS) of antimicrobial use and resistance being hosted by the University of Antwerp, Belgium. Challenges impeding AMS activities included lack of human and financial resources, prescribers’ opposition, lack of awareness and absence of AMS committees. Most of the gaps and challenges bordered on seeming lack of knowledge and inadequate communication among prescribers and other stakeholders.Conclusion: There is need for intense education and training activities for prescribers and other stakeholders, including but not limited to hospital administrators. Keywords: Survey, Antimicrobial Stewardship, Antimicrobial Resistance; Nigeria   French title: Mise en œuvre de la gestion des antimicrobiens dans les hôpitaux Nigérians: lacunes et défis Contexte: La résistance aux antimicrobiens (RAM) est un défi clinique majeur à l'échelle mondiale. C'estprincipalement une conséquence d'une prescription et d'une utilisation inappropriées d'antibiotiques. La gestion des antimicrobiens (AMS) garantit que les antibiotiques sont prescrits et utilisés de manière appropriée. Cette étude a évalué la pratique de l'AMS dans certains hôpitaux Nigérians. Méthodologie: Il s'agissait d'une enquête transversale de 20 hôpitaux tertiaires fédéraux, d'État et privéssélectionnés au hasard dans les six zones géopolitiques du Nigéria. À l'aide d'un outil OMS adapté sur l'AMS, des données ont été collectées auprès de chaque hôpital en ce qui concerne l'existence d'un comité AMS, la responsabilité et la responsabilité, les actions AMS, l'éducation et la formation, le suivi et l'évaluation, la  pratique de prévention et de contrôle des infections (IPC), les installations pour soutenir l'AMS. et les défis de la mise en œuvre de l'AMS. Les lacunes et les défis liés à la mise en œuvre de l'AMS parmi les hôpitaux ont été identifiés. Résultats: Seuls 6 (30%) des 20 hôpitaux avaient des comités AMS tandis que 2 (10%) avaient des preuves d'engagement du leadership envers l'AMS. Tous les hôpitaux disposaient d'installations de laboratoire pour soutenir la culture et les tests de sensibilité. Il n'y avait pas d'activités régulières d'éducation ou de formation, de suivi, d'évaluation ou de rapportage liées à la MGS dans les hôpitaux, sauf dans 7 (25%) qui avaient participé à l'enquête mondiale sur la prévalence ponctuelle (Global-PPS) de l'utilisation et de la résistance aux  antimicrobiens organisée par l'Université d'Anvers, Belgique. Les défis entravant les activités de l'AMS  comprenaient le manque de ressources humaines et financières, l'opposition des prescripteurs, le manque de sensibilisation et l'absence de comités AMS. La plupart des lacunes et des défis se limitaient à un manque apparent de connaissances et à une communication inadéquate entre les prescripteurs et les autres intervenants.Conclusion: Des activités d'éducation et de formation intensives sont nécessaires pour les prescripteurs et autres intervenants, y compris, mais sans s'y limiter, les administrateurs d'hôpitaux. Mots clés: enquête, gestion des antimicrobiens, résistance aux antimicrobiens; Nigeria   &nbsp