Prevalence of group B Streptococcus colonization among pregnant women attending antenatal clinic of Hawassa Health Center, Hawassa, Ethiopia

Background: Group B streptococcus (GBS) or Streptococcus agalactiae are members of the normal flora of the female genital tract. GBS has become the major cause of bacterial infections in the peri-natal period, includingbacteraemia, amnionitis, endometritis, and urinary tract infection in pregnant women as well as sepsis and meningitis in neonates and young infants. Infection of the new born may be acquired by the intra-amniotic route or directly during passage through the birth canal.Objectives: This study was undertaken to determine the prevalence of group B Streptococcus (GBS) colonization and to analyze related risk factors among pregnant women attending the antenatal clinic of Hawassa Health centre, Adare Hospital Hawassa, Ethiopia.Methods: A total of 139 pregnant women were screened for GBS  colonization between May and June 2010. Standard microbiological methods were used to isolate and identify GBS from vaginal and ano-rectal swabs obtained from study subjects. An antimicrobial susceptibility test was performed for all GBS isolates according to the criteria of the Clinical and laboratory Standards Institute (CLSI) by disk diffusion method.Results: A total of 29 out of 139 (20.9%) pregnant women were colonized by GBS. No statistically significant association was observed for GBS colonization with any of socio-demographic characteristics of the study subjects including age, occupation, type of contraceptive used, parity, number of antenatal clinic visits. All GBS strains were susceptible to penicillin, ampicillin, vancomycin and gentamicin. Resistance was observed against erythromycin (6.9%), tetracycline (48.2%), ceftriaxone (10.3%), chloramphenicol (51.7%), ciprofloxacin (13.8%) and norfloxacin(10.3%).Conclusion: This study showed that prevalence of GBS colonization was 20.9% among the study subjects. The finding of this study was comparable with findings reported from developed and developing countries. However,further epidemiological investigations should be done in different parts of the country in order to know the actual GBS colonization rate in pregnant women and to consider the use of intra-partum antibiotics prophylaxis for prevention of early onset GBS-neonatal diseases.[Ethiop. J. Health Dev. 2012;26(1):36-42

High utility of active tuberculosis case finding in an Ethiopian prison

SETTING: Hawassa Prison, Southern Region of Ethiopia. OBJECTIVE: To determine the burden of pulmonary tuberculosis (TB) using active case finding among prisoners. DESIGN: In this cross-sectional study, prisoners were screened for TB using a symptom screen. Those with cough of 2 weeks had spot and morning sputum samples collected for acid-fast bacilli (AFB) smear microscopy and molecular diagnostic testing (Xpert® MTB/RIF). RESULTS: Among 2068 prisoners, 372 (18%) had a positive cough screen. The median age of these 372 persons was 23 years, 97% were male and 63% were from urban areas. Among those with a positive symptom screen, 8 (2%) were AFB sputum smear-positive and 31 (8%) were Xpert-positive. The point prevalence of pulmonary TB at the prison was 1748 per 100 000 persons. In multivariate analysis, persons with cough >4 weeks were more likely to have TB (OR 3.34, 95%CI 1.54–7.23). CONCLUSION: A high prevalence of TB was detected among inmates at a large Ethiopian prison. Active case finding using a cough symptom screen in combination with Xpert had high utility, and has the potential to interrupt transmission of Mycobacterium tuberculosis in correctional facilities in low- and middle-income, high-burden countries

The management of tetanus in adults in an intensive care unit in Southern Vietnam

Background: Tetanus remains common in many low- and middle-income countries (LMICs) yet the evidence base guiding management of this disease is extremely limited, particularly with respect to contemporary management options. Sharing knowledge about practice may facilitate improvement in outcomes elsewhere. Methods: We describe clinical interventions and outcomes of 180 adult patients ≥16 years-old with tetanus enrolled in prospective observational studies at a specialist infectious diseases hospital in Southern Vietnam. Patients were treated according to a holistic management protocol encompassing wound-care, antitoxin, antibiotics, symptom control, airway management, nutrition and de-escalation criteria. Results: Mortality rate in our cohort was 2.8%, with 90 (50%) patients requiring mechanical ventilation for a median 16 [IQR 12-24] days. Median [IQR] duration of ICU stay was 15 [8-23] days. Autonomic nervous system dysfunction occurred in 45 (25%) patients. Hospital acquired infections occurred in 77 (43%) of patients. Conclusion: We report favourable outcomes for patients with tetanus in a single centre LMIC ICU, treated according to a holistic protocol. Nevertheless, many patients required prolonged intensive care support and hospital acquired infections were common

Modelling the dynamics of bus use in a changing travel environment using panel data

Travel mode choice, Dynamics, Panel data, Unobserved heterogeneity, State dependence, Initial conditions,