Blood culture collection technique and pneumococcal surveillance in Malawi during the four year period 2003–2006: an observational study

BACKGROUND: Blood culture surveillance will be used for assessing the public health effectiveness of pneumococcal conjugate vaccines in Africa. Between 2003 and 2006 we assessed blood culture outcome and performance in adult patients in the central public hospital in Blantyre, Malawi, before and after the introduction of a dedicated nurse led blood culture team. METHODS: A prospective observational study. RESULTS: Following the introduction of a specialised blood culture team in 2005, the proportion of contaminated cultures decreased (19.6% in 2003 to 5.0% in 2006), blood volume cultured increased and pneumococcal recovery increased significantly from 2.8% of all blood cultures to 6.1%. With each extra 1 ml of blood cultured the odds of recovering a pneumococcus increased by 18%. CONCLUSION: Standardisation and assessment of blood culture performance (blood volume and contamination rate) should be incorporated into pneumococcal disease surveillance activities where routine blood culture practice is constrained by limited resources

Lutzomyia adiketis sp. n. (Diptera: Phlebotomidae), a vector of Paleoleishmania neotropicum sp. n. (Kinetoplastida: Trypanosomatidae) in Dominican amber

<p>Abstract</p> <p>Background</p> <p>Amber fossils can be used to trace the history of disease-vector associations because microorganisms are preserved "in situ" inside the alimentary tract and body cavity of blood-sucking insects.</p> <p>Results</p> <p><it>Lutzomyia adiketis </it>sp. n. (Phlebotomidae: Diptera) is described from Dominican amber as a vector of <it>Paleoleishmania neotropicum </it>sp. n. (Kinetoplastida: Trypanosomatidae). The fossil sand fly differs from all previously described extinct and extant members of the genus by the following combination of characters: Sc forked with the branches meeting the costa and radius veins; wing L/W value of 4.1; a δ value of 18; a ratio β/α value of 0.86, and the shape and size of the spatulate rods on the ninth sternite. The trypanosomatid is characterized by the structure of its promastigotes, amastigotes and paramastigotes and its transmission by an extinct species of sand fly.</p> <p>Conclusion</p> <p>Morphological characters show that the fossil sand fly is a new extinct species and that it is host to a digenetic species of trypanosomatid. This study provides the first fossil evidence that Neotropical sand flies were vectors of trypanosomatids in the mid-Tertiary (20–30 mya).</p

Transverse Colon Volvulus with Chilaiditis Syndrome

Volvulus of transverse colon is a rare cause of large bowel obstruction. To our knowledge only 75 cases have been reported in the world literature and additionally only three cases of transverse colon volvulus with Chilaiditis syndrome have been reported to date. Because of its rarity here we report a case of transverse colon volvulus which was indeed associated with Chilaiditis syndrome. This is probably the fourth case of Chilaiditis syndrome caused by transverse colon volvulus