Assessment of healthcare waste management practices among healthcare workers at two hospitals in Abuja, Nigeria

Healthcare waste (HCW) is generated from hospitals or healthcare related facilities and is considered a major source of environmental contamination because it is made up of potentially harmful substances. In developing countries, especially Nigeria, management of HCW is becoming an issue of concern. The main objective of this study was to assess the current HCW management practices at two hospitals in Abuja, Nigeria. This cross-sectional study was conducted from June to July 2018 among randomly selected healthcare workers (HWs) practising at two hospitals in Abuja, Nigeria, using an electronic interviewer-administered questionnaire installed on a smartphone via an open data tool kit. We evaluated the waste segregation practices and assessed the knowledge of HWs regarding HCW in one public secondary and one private tertiary health facility. The status of waste management practice in the health facilities was carried out using the following criteria: waste management (responsibility, segregation, storage and packaging); waste transport; waste recycling and reuse; waste treatment and final disposal. Data gathered were analysed by performing descriptive statistics. Of the 105 health workers interviewed, 69 (65.7%) were females and mostly (44.8%) were within the age group 31-40 years. The proportion of respondents who had received specific training in the management of HCW was 17.1% (18/105). The level of HCW management practices in both facilities was found to be level 2: operating in a manner with some aspects that are considered sustainable. HCW management (HCWM) in Abuja is worth sustainable, especially in resource-limited settings. Hospital Management Board needs to ensure that measures needed to improve the HCWM at hospitals are provided

A Retrospective Study of Rabies Cases Reported at Vom Christian Hospital, Plateau State, Nigeria, 2006 – 2010

Rabies is a zoonosis of public health importance in Nigeria. Exposure to bites of rabid dogs is the cause of over 99% of human cases of rabies worldwide. Post-Exposure Prophylaxis (PEP) is a vital aspect of clinical rabies prevention in humans The aim of this study was to determine the magnitude of rabies disclosure among dogbite victims (DBVs) and their compliance with a PEP regimen. We reviewed patient records of DBVs who were treated at the Vom Christian Hospital, Plateau State, from 2006 – 2010, obtained information on patient demographics and rabies status of implicated dogs from patients' hospital records. A trend of reported rabid dog bites in children was determined. We assessed compliance of DBVs with the recommended dosage regimen for PEP which is local wound treatment followed by vaccine therapy on days 0, 3, 7, 14 and 30. Over the five-year period, 713 DBVs were reported; 377(52.9%) were children <15 years, 404(56.7%) were males and 299 (41.9%) were bitten by laboratory-confirmed rabid dogs.Rabid dog-bites among children increased exponentially from 2007(6/1,000,000) to 2009(41/1,000,000) with a steep decline in 2010 (24/1,000,000). Of all DBVs, 677 (95%) first sought veterinary care. Of all implicated dogs, 305(42.8%) were tested and 299 (98.0%) were positive for rabies. Nearly all (99.6%) DBVs were treated using human diploidcell rabies vaccine, while only 49.1% completed the recommended doses. Of the 299 DBVs bitten by rabies-positive dogs, 59.2% completed the regimen and were likely to be PEP compliant than those bitten by untested dogs (p<0.01). No mortalities among DBVs were reported to the hospital. Rabies in dogs is a serious public health problem in Plateau State, in which children constitute the highest proportion of rabid DBVs reported. We recommend joint sensitization of physicians and veterinarians about the need for detailed DBV and animal information for rabies management.Keywords: Rabies, Dog bite victims, Post Exposure Prophylaxis, NigeriaNigerian Veterinary Journal, VOL:32 (4) 366-37

Global diversity and antimicrobial resistance of typhoid fever pathogens: Insights from a meta-analysis of 13,000 Salmonella Typhi genomes

Background: The Global Typhoid Genomics Consortium was established to bring together the typhoid research community to aggregate and analyse Salmonella enterica serovar Typhi (Typhi) genomic data to inform public health action. This analysis, which marks 22 years since the publication of the first Typhi genome, represents the largest Typhi genome sequence collection to date (n=13,000). Methods: This is a meta-analysis of global genotype and antimicrobial resistance (AMR) determinants extracted from previously sequenced genome data and analysed using consistent methods implemented in open analysis platforms GenoTyphi and Pathogenwatch. Results: Compared with previous global snapshots, the data highlight that genotype 4.3.1 (H58) has not spread beyond Asia and Eastern/Southern Africa; in other regions, distinct genotypes dominate and have independently evolved AMR. Data gaps remain in many parts of the world, and we show the potential of travel-associated sequences to provide informal ‘sentinel’ surveillance for such locations. The data indicate that ciprofloxacin non-susceptibility (>1 resistance determinant) is widespread across geographies and genotypes, with high-level ciprofloxacin resistance (=3 determinants) reaching 20% prevalence in South Asia. Extensively drug-resistant (XDR) typhoid has becomedominant in Pakistan (70% in 2020) but has not yet become established elsewhere. Ceftriaxone resistance has emerged in eight non-XDR genotypes, including a ciprofloxacin-resistant lineage (4.3.1.2.1) in India. Azithromycin resistance mutations were detected at low prevalence in South Asia, including in two common ciprofloxacin-resistant genotypes. Conclusions: The consortium’s aim is to encourage continued data sharing and collaboration to monitor the emergence and global spread of AMR Typhi, and to inform decision-making around the introduction of typhoid conjugate vaccines (TCVs) and other prevention and control strategies