Use of population-based surveillance to define the high incidence of shigellosis in an urban slum in Nairobi, Kenya.

BACKGROUND: Worldwide, Shigella causes an estimated 160 million infections and >1 million deaths annually. However, limited incidence data are available from African urban slums. We investigated the epidemiology of shigellosis and drug susceptibility patterns within a densely populated urban settlement in Nairobi, Kenya through population-based surveillance. METHODS: Surveillance participants were interviewed in their homes every 2 weeks by community interviewers. Participants also had free access to a designated study clinic in the surveillance area where stool specimens were collected from patients with diarrhea (≥3 loose stools within 24 hours) or dysentery (≥1 stool with visible blood during previous 24 hours). We adjusted crude incidence rates for participants meeting stool collection criteria at household visits who reported visiting another clinic. RESULTS: Shigella species were isolated from 262 (24%) of 1,096 stool specimens [corrected]. The overall adjusted incidence rate was 408/100,000 person years of observation (PYO) with highest rates among adults 34-49 years old (1,575/100,000 PYO). Isolates were: Shigella flexneri (64%), S. dysenteriae (11%), S. sonnei (9%), and S. boydii (5%). Over 90% of all Shigella isolates were resistant to trimethoprim-sulfamethoxazole and sulfisoxazole. Additional resistance included nalidixic acid (3%), ciprofloxacin (1%) and ceftriaxone (1%). CONCLUSION: More than 1 of every 200 persons experience shigellosis each year in this Kenyan urban slum, yielding rates similar to those in some Asian countries. Provision of safe drinking water, improved sanitation, and hygiene in urban slums are needed to reduce disease burden, in addition to development of effective Shigella vaccines

Efficacy of Candlewood Zanthoxylum xanthoxyloides (Lam.) for the control of Sitophilus zeamais (Mots.) (Coleoptera: Curculionidae) and Callosobruchus maculatus F. (Coleoptera: Bruchidae)

The bioactivity of dried leaves, bark and root of Zanthoxylum xanthoxyloides (Lam.) was assessed in the laboratory for their ability to protect stored grains from damage by Sitophilus zeamais and Callosobruchus maculatus on maize and cowpea, respectively. One hundred grams of sterilized grains were measured in glass jars and the ground plant materials added as direct admixtures to test for toxicity, progeny production and weight loss. The plant materials tested initially at a concentration of 5% (wt/wt) showed the root and bark inducing 100% mortality and causing significant (

Occupational Stress among Radiographers in Lagos, Nigeria

Background: Occupational stress induced injuries occur in various professions that require repetitive motion or physical exertion, such as Radiography. The injuries may involve body parts such as the neck, the upper back, mid back, low back (waist), knee, elbow, wrist and hand and eyes.Objective: To assess work related injuries medical radiographers are prone to, during practice of the profession in relation to their working conditions.Methods: This study was conducted among registered practicing radiographers in Lagos State, South-West, Nigeria. Lagos is one of Nigeria's most populated states and economic nerve centre of Nigeria. Due to its population, there are many hospitals with radiodiagnostic facilities and radiodiagnostic centres which are either government or privately owned. Eighty registered radiographers in 21 hospitals and diagnostic centres participated in the study. They include three federal government owned institutions, three State government owned institutions and fifteen privately owned diagnostic centres. The respondents' status were made up of 38 males and 42 females where 37 of them were between 20-30 years, 11 were between 41-50 years and those above 51 years were 12.Results: The results revealed that a majority (91.2%) of respondents stand during the course of their work. Waist, neck, heel, wrist and shoulder pains were common among the respondents. Some respondents frequently manifest frustration (78.7 %), insomnia (52.5 %), difficulty in concentration (56.2%), poor appetite (50.0%), irritation (67.5 %) and tension (63.8%) while lesser percentages experience such.Conclusion: This study showed that occupational stress sites susceptible to work induced stress injury. Musculoskeletal strain was the most common type. Waist/ low back, plantar/heel and wrist pains were also common among radiographers in Lagos, Nigeria.Keywords: Radiographer, stress, injury, pain, occupatio

Minimal invasive right ventricular and atrial pacemaker lead repositioning as a first alternative is superior in avoiding pocket complications with passive fixation leads.

PURPOSE: Lead dislocations of pacemaker systems are reported in all and even in high-volume centers. Repeated procedures necessitated by lead dislocations are associated with an increased risk of complications. We investigated a minimal invasive method for right atrial and ventricular lead repositioning. METHODS: The minimal invasive method was applied only when passive fixation leads were implanted. During the minimal invasive procedure, a steerable catheter was advanced through the femoral vein to move the distal end of the lead to the appropriate position. Retrospective data collection was conducted in all patients with minimal invasive and with conventional method, at a single center between September 2006 and December 2012. RESULTS: Forty-five minimal invasive lead repositionings were performed, of which eight were acutely unsuccessful and nine electrodes re-dislocated after the procedure. One hundred two leads were repositioned with opening of the pocket during the same time, including the ones with unsuccessful minimal invasive repositionings. One procedure was acutely unsuccessful in this group and four re-dislocations happened. A significant difference of success rates was noted (66.6% vs. 95.1%, p = 0.001). One complication was observed during the minimal invasive lead repositionings (left ventricular lead microdislodgement). Open-pocket procedures showed different types of complications (pneumothorax, subclavian artery puncture, pericardial effusion, hematoma, fever, device-associated infection which necessitated explantation, atrial lead dislodgement while repositioning the ventricular one, deterioration of renal function). CONCLUSIONS: The minimal invasive method as a first alternative is safe and feasible. In those cases when it cannot be carried out successfully, the conventional method is applicable