An evaluation study of the sputum smear concentration technique for the laboratory diagnosis of pulmonary tuberculosis

The microbial diagnosis of Pulmonary Tuberculosis plays a key role in routine treatment and Tuberculosis control Programmes in developing countries. Many patients have presented with signs and symptoms of pulmonary tuberculosis, of which consecutive direct sputum smear microscopy have given negative results for Acid-Fast Bacilli (AFB). Microscopy of smears made directly from sputum has a low sensitivity and there is an urgent need for improved methods. This study was carried out at the Yaoundé University Teaching Hospital and is aimed at evaluating the sputum smear concentration technique in the laboratory diagnosis of pulmonary TB. Sputum samples were collected in screw-cap tight containers and evaluated by both the direct and concentrated methods. Microscopy of direct smears of sputum after liquefaction with 5% sodium hypochlorite (NaOCl) solution; and concentration of the organisms by centrifugation were compared and evaluated. Results showed an increase in sensitivity from 18.27% to 25% with a specificity of 90.95%. The tuberculosis prevalence was 25%. 13.33% belongs to the age range 20-40 years and 11.67% to the age range >40 years. The positive predictive value was 73%. We concluded that the use of sodium hypochlorite (NaOCl) in the concentration of acid-fast bacilli (AFB) in sputum significantly improves the laboratory diagnosis of pulmonary tuberculosis.Keywords: Sputum smear concentration, Laboratory diagnosis, Pulmonary tuberculosi

The effects of antiretroviral treatment on liver function enzymes among HIV-infected out patients attending the Central Hospital of Yaounde, Cameroon

The emergence of liver diseases as one of the major causes of death in people infected with HIV has paralleled the introduction of more effective antiretroviral therapies. This study was carried out with the aim of determining the effects of antiretroviral treatment on liver enzymes (SGOT and SGPT) in patients placed on antiretroviral therapy. A prospective cross-sectional 3 years study was carried out among patients confirmed to be HIV positive and who were to be placed on antiretroviral drugs at the HIV/AIDS out patient clinic of the Yaoundé Central Hospital, . Cameroon. Levels of transaminases of patients were measured in four phases using the International Federation of Clinical Chemistry (IFCC) protocol. Of the 150 patients who participated in the study, 54.0 %( 81/150) presented with transaminitis at the final phase of the study with respect to aspartate aminotransferase (AST), 77.78% (63/81) of whose AST levels only increased after initiation of highly active antiretroviral therapy (HAART). 22.67% (34/150) presented with transaminitis with respect to alanine aminotransferase (ALT). At the final phase, 70.58% of whose ALT levels only increased after HAART initiation. Increase in blood transaminase levels was statistically independent on age group and the drug combinations. Increase in AST levels was associated with an increase in ALT levels upon treatment (r = 0.58). There was a significant positive linear relationship between duration of treatment and concentration of transaminases over the years (r= 0.9). We therefore concluded that highly active antiretroviral therapy (HAART) is associated with low level hepatotoxicity at therapy initiation, regardless of drug class or combination.Keywords: Antiretroviral treatment, Liver function enzymes, Hepatotoxicity, Highly active antiretroviral therap

Prevalence of septicaemia and antibiotic sensitivity pattern of bacterial isolates at the University Teaching Hospital, Yaoundé, Cameroon

Bloodstream infections are important causes of mortality and morbidity. Rapid empiric antibiotic therapy is often needed. Knowledge of epidemiological data of common pathogens and their antibiotic sensitivity pattern is needed for rapid therapy. This study was aimed at determining the common causes of septicaemia and their antibiotic sensitivity pattern from the University Teaching Hospital, Yaoundé. Blood samples were collected and cultured aerobically. Isolates were identified using bacteriological and biochemical methods and antibiotic sensitivity was done using the Kirby- Bauer disc diffusion method. Results showed that of the 396 patients examined 112 (28.3%) had septicaemia. Children below the age of 15 years constituted the greatest percentage of infected subjects (63.4%) followed by patients aged between 16-30 years (10.7%) (P < 0.05). The highest incidence of septicaemia were from medicine (8.95‰), followed by paediatrics (7.04‰), surgery (6.46 ‰), out-patients (5.79‰), neonatology (5.12‰), obstetrics and gynaecology (5.05‰) and emergency (2.05‰) wards. The overall incidence of septicaemia was 5.79 per 1000 admissions. Gram-positive bacteria were encountered more often than gram negative bacteria (56.2% versus 43.8%,

Epidemiological, clinical features and susceptibility pattern of shigellosis in the buea health district, Cameroon

<p>Abstract</p> <p>Background</p> <p>Shigellosis is an acute invasive enteric infection caused by bacteria belonging to the genus <it>Shigella</it>; it is clinically manifested by bloody diarrhoea. Shigellosis is endemic in many developing countries including Cameroon and also occurs in epidemics causing considerable morbidity and mortality. This study evaluated the epidemiological and clinical features of <it>Shigella </it>and the resistance pattern of isolates to commonly used antibiotics in the Buea Health District in Cameroon, from April to August, 2010.</p> <p>Results</p> <p>Of the 223 stool samples cultured, 10 (4.5%) yielded <it>Shigella </it>species. Isolation rate was observed to be more in children below 15 years (7.89%), and also higher in rural areas (6.35%). All 10 isolates showed resistance to at least two antibiotics and 9 (90%) were multi-drug resistant. The highest resistance rates were encountered with cotrimoxazole (90%) and amoxicillin (80%). Least resistance was observed with azithromycin (10%).</p> <p>Conclusion</p> <p>Shigellosis is more prevalent in children below 15 years in the Buea District. There is a high level of resistance to most of the antibiotics used for the treatment of shigellosis including extended-spectrum beta-lactamases (ESBLs) as well as evidence of resistance to quinolones. Azithromycin was found to be the drug of choice for shigellosis in this setting.</p

Paediatric Metabolic Conditions of the Liver

Paediatric metabolic disorders with the most clinical manifestations of deranged hepatic metabolism are discussed. The conditions which will be stressed are those for which effective treatment is available and early diagnosis is essential. Accurate diagnosis of other disorders for which no treatment is, as yet, available is also important as a guide to prognosis and for accurate genetic counselling. With the advancement in amniocentesis techniques there is a growing role for gene therapy. For selected metabolic disorders, paediatric liver transplantations have been successful

Delay in diagnosis of congenital anal stenosis

Although a minor anorectal malformation the delay in diagnosis and treatment of anal stenosis may result in significant early or late complications. Early inspection of the perineum in the neonate to pick up and correct anorectal malformation improves long term outcome but this requires proper anal examination or it could be missed. We present and discuss a case of delayed diagnosis of congenital anal stenosis (a low anorectal anomaly) with an imminent colonic perforation. Severe anal stenosis will always require examination under anesthesia with graded Hegar's dilatation followed by postoperative maintenance. The Hegar dilator is thus both diagnostic and therapeutic in congenital anal stenosis