Pub Date : 2010-11-18DOI: 10.4314/NMP.V58I1-2.62148
R. Mordi, M. Ibadin
A range of infections is caused by Staphylococcal organisms prominent among them are nosocomial superficial infections manifesting as abscesses, furuncles, and wound infections. The study objective is to determine the degree to which Staphylococcus aureus is a cause of such lesions in a tertiary health care institution in Nigeria. The study which was prospective and cross-sectional involved participants who were patients seen at the various facilities in a tertiary healthcare institution. There were 832 patients made up of 336 (40.3%) males, 201 (24.2%) females and 295 (35.5%) children. Specimens, which were consecutively obtained, consisted of swabs from wounds, burns, abscesses, aspirates and secretions. Specimens were collected for culture and sensitivity before commencement of antibiotic therapy. The major isolated organism was Staphylococcus aureus . Others were Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris Proteus rettgerri, Alkaligenes faecalis, Acinetobacter calcoaceticus and Candida albican s. Six specimens did not yield growth. The in-vitro susceptibility of Staphylococcus aureus to ofloxacin, ceftazidime ,amoxicillin clavulanate and gentamycin was impressive While susceptibility to ceftriazone, cloxacillin, oxacillin and lincomycin was low. The organism was moderately susceptible to cefuroxime and 72.8% to vancomycin. The growing resistance of Staphylococcus aureus to many antimicrobial agents and especially to the penicillins and the cephalosporins is a cause for concern. Some measures were suggested for the control of Staphylococcus aureus infections. Keywords : staphylococcus aureus, superficial lesions, antibiotics
{"title":"The Pre - Eminence of Staphylococcus Aureus as The Causative Agent in Superficial Lesions, Aspirates And Secretions at a Tertiary Health Care Institution in Nigeria","authors":"R. Mordi, M. Ibadin","doi":"10.4314/NMP.V58I1-2.62148","DOIUrl":"https://doi.org/10.4314/NMP.V58I1-2.62148","url":null,"abstract":"A range of infections is caused by Staphylococcal organisms prominent among them are nosocomial superficial infections manifesting as abscesses, furuncles, and wound infections. The study objective is to determine the degree to which Staphylococcus aureus is a cause of such lesions in a tertiary health care institution in Nigeria. The study which was prospective and cross-sectional involved participants who were patients seen at the various facilities in a tertiary healthcare institution. There were 832 patients made up of 336 (40.3%) males, 201 (24.2%) females and 295 (35.5%) children. Specimens, which were consecutively obtained, consisted of swabs from wounds, burns, abscesses, aspirates and secretions. Specimens were collected for culture and sensitivity before commencement of antibiotic therapy. The major isolated organism was Staphylococcus aureus . Others were Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris Proteus rettgerri, Alkaligenes faecalis, Acinetobacter calcoaceticus and Candida albican s. Six specimens did not yield growth. The in-vitro susceptibility of Staphylococcus aureus to ofloxacin, ceftazidime ,amoxicillin clavulanate and gentamycin was impressive While susceptibility to ceftriazone, cloxacillin, oxacillin and lincomycin was low. The organism was moderately susceptible to cefuroxime and 72.8% to vancomycin. The growing resistance of Staphylococcus aureus to many antimicrobial agents and especially to the penicillins and the cephalosporins is a cause for concern. Some measures were suggested for the control of Staphylococcus aureus infections. Keywords : staphylococcus aureus, superficial lesions, antibiotics","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"16 10 1","pages":"3-7"},"PeriodicalIF":0.0,"publicationDate":"2010-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83495246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-11-18DOI: 10.4314/NMP.V58I1-2.62151
T. Ogunlesi, Olanrewaju Dm
Sepsis is a major cause of newborn death world wide but the burden is heaviest in the developing parts of the world where the incidence of newborn sepsis is highest. Newborn sepsis is managed with a wide range of antibiotics in different parts of the world depending on the spectrum of bacterial aetiologies. Although, there are standard guidelines for the treatment of neonatal sepsis in most parts of the developed world, the situation is a lot different in most parts of the developing world. In the latter, differences exist in the pattern of risk factors for newborn sepsis, pattern of organisms as well as resistance pattern of these organisms. However, key issues in the management of newborn sepsis include selection of the most appropriate subjects for antibiotic therapy, choice of drugs to use, best regimen of drug treatment in terms of number of drugs and route of administration of drugs as well as the effectiveness of adjuvant therapies apart from antibiotics. These issues must be resolved in terms of the best proven efficiency. Clinicians and researchers need to know if certain traditional methods of treating newborn sepsis are really supported by the available scientific evidences gathered from many parts of the world. These form the focus of this review article which attempts to highlight the key areas in the management of neonatal septicaemia against the background of the peculiarities in the third world. The accompanying local challenges are also discussed. Key words: Antibiotics, newborn, sepsis
{"title":"Evidence-based treatment of neonatal septicaemia","authors":"T. Ogunlesi, Olanrewaju Dm","doi":"10.4314/NMP.V58I1-2.62151","DOIUrl":"https://doi.org/10.4314/NMP.V58I1-2.62151","url":null,"abstract":"Sepsis is a major cause of newborn death world wide but the burden is heaviest in the developing parts of the world where the incidence of newborn sepsis is highest. Newborn sepsis is managed with a wide range of antibiotics in different parts of the world depending on the spectrum of bacterial aetiologies. Although, there are standard guidelines for the treatment of neonatal sepsis in most parts of the developed world, the situation is a lot different in most parts of the developing world. In the latter, differences exist in the pattern of risk factors for newborn sepsis, pattern of organisms as well as resistance pattern of these organisms. However, key issues in the management of newborn sepsis include selection of the most appropriate subjects for antibiotic therapy, choice of drugs to use, best regimen of drug treatment in terms of number of drugs and route of administration of drugs as well as the effectiveness of adjuvant therapies apart from antibiotics. These issues must be resolved in terms of the best proven efficiency. Clinicians and researchers need to know if certain traditional methods of treating newborn sepsis are really supported by the available scientific evidences gathered from many parts of the world. These form the focus of this review article which attempts to highlight the key areas in the management of neonatal septicaemia against the background of the peculiarities in the third world. The accompanying local challenges are also discussed. Key words: Antibiotics, newborn, sepsis","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"36 1","pages":"17-25"},"PeriodicalIF":0.0,"publicationDate":"2010-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88510474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-11-18DOI: 10.4314/NMP.V58I1-2.62150
A. Adewunmi, K. Adewunmi, A. Tayo, O. Aletan
We set out to determine the socio-demographic factors,pattern of presentation and management of ectopic pregnancy in a University Teaching Hospital in Lagos, Nigeria. A retrospective descriptive analysis of all cases of ectopic pregnancy over a 2-year period was carried out. The case notes were retrieved from the Records Department and the following information extracted; age, parity, clinical presentation, findings at laparatomy, estimated blood loss and the need for blood transfusion. Statistical analysis was done using Epi-info 3.5 statistical software (2008 version). The incidence during the period of study was 38.85/1000 live births.The mean age at presentation was 29.5 _ + 5.7 year(SD) and 124 patients constituting 30.1% were nulliparous .Presentation was usually late with rupture and haemoperitoneum as demonstrated by the large percentage (99.2%). Ampullary part of the fallopian tube was most commonly affected accounting for 360(87.6%) of the cases. Salpingectomy was done in majority of cases - 376(91.3%), while 181 (44%) did not require blood transfusion. There were 3 maternal deaths during the study period..Ectopic presents a major public health challenge among women of reproductive age group in Nigeria. Efforts should be directed to public awareness on sex education , contraception , prevention and treatment of common risk factors for ectopic pregnancy and in cases of early rupture, auto-tansfusion should be encouraged. Key words : Ectopic pregnancy, Factors, Operation
{"title":"Ectopic Pregnancy in Lagos State University Teaching Hospital. Ikeja, Lagos .Nigeria","authors":"A. Adewunmi, K. Adewunmi, A. Tayo, O. Aletan","doi":"10.4314/NMP.V58I1-2.62150","DOIUrl":"https://doi.org/10.4314/NMP.V58I1-2.62150","url":null,"abstract":"We set out to determine the socio-demographic factors,pattern of presentation and management of ectopic pregnancy in a University Teaching Hospital in Lagos, Nigeria. A retrospective descriptive analysis of all cases of ectopic pregnancy over a 2-year period was carried out. The case notes were retrieved from the Records Department and the following information extracted; age, parity, clinical presentation, findings at laparatomy, estimated blood loss and the need for blood transfusion. Statistical analysis was done using Epi-info 3.5 statistical software (2008 version). The incidence during the period of study was 38.85/1000 live births.The mean age at presentation was 29.5 _ + 5.7 year(SD) and 124 patients constituting 30.1% were nulliparous .Presentation was usually late with rupture and haemoperitoneum as demonstrated by the large percentage (99.2%). Ampullary part of the fallopian tube was most commonly affected accounting for 360(87.6%) of the cases. Salpingectomy was done in majority of cases - 376(91.3%), while 181 (44%) did not require blood transfusion. There were 3 maternal deaths during the study period..Ectopic presents a major public health challenge among women of reproductive age group in Nigeria. Efforts should be directed to public awareness on sex education , contraception , prevention and treatment of common risk factors for ectopic pregnancy and in cases of early rupture, auto-tansfusion should be encouraged. Key words : Ectopic pregnancy, Factors, Operation","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"11 1","pages":"13-16"},"PeriodicalIF":0.0,"publicationDate":"2010-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80147973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sa Sotimehin, T. Ogunlesi, A. Adekanmbi, M. Fetuga, Ea Odumuyiwa, O. Olowu
We report a three year old child who appeared to have a drug-induced muco-cutaneous hypersensitivity reaction during treatment for a febrile illness, but eventually manifested all the diagnostic criteria for Kawasaki Disease (KD) while on admission. Although an initial diagnosis of Steven-Johnson's Syndrome was made, the emerging clinical features, presence of thrombocytosis, low plasma proteins and high ESR, prompted a change of diagnosis to Kawasaki Disease. She received bed rest and steroid therapy due to the absence of Intravenous ImmunoglobulinGand our reluctance to use aspirin. Although she did not manifest any echocardiographic cardiac features while on admission, a verbal autopsy report of her sudden death two days after discharge against medical advice, suggested possible cardiac involvement. In view of the high mortality risk asscociated with non-institution or delay of definitive treatment, it is important to add KD to the list of differential diagnoses in febrile children with muco-cutaneous lesions. Key words; Atypical measles, Kawasaki Disease, Nigeria, Verbal Autopsy
{"title":"Kawasaki Disease in A Nigerian Child- a case report","authors":"Sa Sotimehin, T. Ogunlesi, A. Adekanmbi, M. Fetuga, Ea Odumuyiwa, O. Olowu","doi":"10.4314/NMP.V57I4.57943","DOIUrl":"https://doi.org/10.4314/NMP.V57I4.57943","url":null,"abstract":"We report a three year old child who appeared to have a drug-induced muco-cutaneous hypersensitivity reaction during treatment for a febrile illness, but eventually manifested all the diagnostic criteria for Kawasaki Disease (KD) while on admission. Although an initial diagnosis of Steven-Johnson's Syndrome was made, the emerging clinical features, presence of thrombocytosis, low plasma proteins and high ESR, prompted a change of diagnosis to Kawasaki Disease. She received bed rest and steroid therapy due to the absence of Intravenous ImmunoglobulinGand our reluctance to use aspirin. Although she did not manifest any echocardiographic cardiac features while on admission, a verbal autopsy report of her sudden death two days after discharge against medical advice, suggested possible cardiac involvement. In view of the high mortality risk asscociated with non-institution or delay of definitive treatment, it is important to add KD to the list of differential diagnoses in febrile children with muco-cutaneous lesions. Key words; Atypical measles, Kawasaki Disease, Nigeria, Verbal Autopsy","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"191 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85123947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To compare the quality of antihypertensive prescriptions at 2 different health care levels in a hypertensive Nigerian population.We carried out a retrospective comparative analysis of the quality and pattern of antihypertensive and low-dose aspirin prescription in a tertiary and two secondary health care institutions providing specialize and generalized care, respectively, in northwestern Nigeria.The study population included 114 and 146 patients managed in the tertiary and secondary health centres, respectively. Compared to the secondary health institutions, the tertiary health institution had significantly higher utilization of diuretics (P=0.002), calcium channel blocker (p Keywords: Anti-hypertensive prescription, health care levels.
{"title":"Utilization of Antihypertensive Drugs: A Comparison of Tertiary and Secondary Health Care Institutions in Northwestern Nigeria","authors":"C. Aminu, Isezuo Sa, E. Etuk, S. Bello","doi":"10.4314/NMP.V57I4.57938","DOIUrl":"https://doi.org/10.4314/NMP.V57I4.57938","url":null,"abstract":"To compare the quality of antihypertensive prescriptions at 2 different health care levels in a hypertensive Nigerian population.We carried out a retrospective comparative analysis of the quality and pattern of antihypertensive and low-dose aspirin prescription in a tertiary and two secondary health care institutions providing specialize and generalized care, respectively, in northwestern Nigeria.The study population included 114 and 146 patients managed in the tertiary and secondary health centres, respectively. Compared to the secondary health institutions, the tertiary health institution had significantly higher utilization of diuretics (P=0.002), calcium channel blocker (p Keywords: Anti-hypertensive prescription, health care levels.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88820338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The general population especially the mortuary workers are constantly exposed to formaldehyde (HCHO) and its compounds. The short half-life of formaldehyde makes it rapidly metabolized and its effect purportedly considered negligible. The hepatotoxic effect of formaldehyde was assessed in 25 male mortuary attendants, mean age 48.04±2.20 (range 23-61) years, classified according to duration of occupational exposure. The mean duration of exposure was 13.56+1.5 (range 2-24) years. Twenty five unexposed individuals, mean age 47.12±1.97 (range 25-61) years were selected as control. The weights and heights of the exposed and un-exposed subjects were measured and the body mass index (BMI) computed. The activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) as well as the total plasma protein and plasma albumin were also determined in both groups. Total globulin level was computed from the difference between total protein and albumin level. Result showed that the body mass index was significantly lower in exposed subjects than in control (p 0.05 respectively). Similarly, total bilirubin and its sub-fraction (conjugated and unconjugated) were not significantly different between mortuary workers and unexposed subjects (p>0.05) in all cases. These data suggest that among the most probable toxic effects of formaldehyde is impairment of the synthetic function of the liver in these mortuary workers. The significantly reduced total globulin level suggests that these workers may be at increased risk of suppressed humoral immunity. Key words: Detoxification, formaldehyde exposure, hepatotoxicity, liver synthetic function, mortuary workers and xenobiotic transformation.
{"title":"Assessment of The Effect of Formaldehyde Exposure on The Liver in Mortuaty Workers in South Western Nigeria.","authors":"W. Olooto","doi":"10.4314/NMP.V57I4.57942","DOIUrl":"https://doi.org/10.4314/NMP.V57I4.57942","url":null,"abstract":"The general population especially the mortuary workers are constantly exposed to formaldehyde (HCHO) and its compounds. The short half-life of formaldehyde makes it rapidly metabolized and its effect purportedly considered negligible. The hepatotoxic effect of formaldehyde was assessed in 25 male mortuary attendants, mean age 48.04±2.20 (range 23-61) years, classified according to duration of occupational exposure. The mean duration of exposure was 13.56+1.5 (range 2-24) years. Twenty five unexposed individuals, mean age 47.12±1.97 (range 25-61) years were selected as control. The weights and heights of the exposed and un-exposed subjects were measured and the body mass index (BMI) computed. The activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) as well as the total plasma protein and plasma albumin were also determined in both groups. Total globulin level was computed from the difference between total protein and albumin level. Result showed that the body mass index was significantly lower in exposed subjects than in control (p 0.05 respectively). Similarly, total bilirubin and its sub-fraction (conjugated and unconjugated) were not significantly different between mortuary workers and unexposed subjects (p>0.05) in all cases. These data suggest that among the most probable toxic effects of formaldehyde is impairment of the synthetic function of the liver in these mortuary workers. The significantly reduced total globulin level suggests that these workers may be at increased risk of suppressed humoral immunity. Key words: Detoxification, formaldehyde exposure, hepatotoxicity, liver synthetic function, mortuary workers and xenobiotic transformation.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78829417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Urinary tract infection (UTI), a significant but preventable cause of morbidity in children, is an important risk factor for development of renal insufficiency. Having simple and reliable means of screening children facilitate its prompt treatment.To evaluate the use of dipstick test for leukocyte esterase (LE) and nitrite as screening tool in the diagnosis of UTI in children.This cross-sectional study was done in the department of Paediatrics, University of Port Harcourt Teaching Hospital (UPTH) from February to October 2005. Children 2 to 15 years with symptoms suggestive of UTI were studied. Midstream urine specimen was collected from each patient forLEtest, nitrite test and culture.Out of 139 children, 72(51.8 percent) males and 67(48.2 percent) females studied, 33(23.7 percent) had positive urine culture. The prevalence of UTI was significantly higher in females than in males (p=0.001). The LE dipstick test correctly identified 17 of the 33 patients with culture proven UTI, with 51.5 percent sensitivity and 79.2 percent specificity. The nitrite dipstick test showed 42.4 percent sensitivity and 93.3 percent specificity. The combination ofLEand nitrite correctly identified 24, giving 73 percent sensitivity and 75.5 percent specificity. The LE seemed to have a higher sensitivity as a screening tool in the diagnosis of UTI than nitrite, but the difference was not statistically significant (p=0.46). However, the combination of LE and nitrite provided a higher sensitivity than either of them with a statistically significant difference (p=0.04). Key words: Dipstick urinalysis, Screening tool
{"title":"Dipstick Urinalysis as a Screening Tool in the Diagnosis of Urinary Tract Infection in Children.","authors":"G. Eke, I. Anochie, F. Eke","doi":"10.4314/NMP.V57I4.57939","DOIUrl":"https://doi.org/10.4314/NMP.V57I4.57939","url":null,"abstract":"Urinary tract infection (UTI), a significant but preventable cause of morbidity in children, is an important risk factor for development of renal insufficiency. Having simple and reliable means of screening children facilitate its prompt treatment.To evaluate the use of dipstick test for leukocyte esterase (LE) and nitrite as screening tool in the diagnosis of UTI in children.This cross-sectional study was done in the department of Paediatrics, University of Port Harcourt Teaching Hospital (UPTH) from February to October 2005. Children 2 to 15 years with symptoms suggestive of UTI were studied. Midstream urine specimen was collected from each patient forLEtest, nitrite test and culture.Out of 139 children, 72(51.8 percent) males and 67(48.2 percent) females studied, 33(23.7 percent) had positive urine culture. The prevalence of UTI was significantly higher in females than in males (p=0.001). The LE dipstick test correctly identified 17 of the 33 patients with culture proven UTI, with 51.5 percent sensitivity and 79.2 percent specificity. The nitrite dipstick test showed 42.4 percent sensitivity and 93.3 percent specificity. The combination ofLEand nitrite correctly identified 24, giving 73 percent sensitivity and 75.5 percent specificity. The LE seemed to have a higher sensitivity as a screening tool in the diagnosis of UTI than nitrite, but the difference was not statistically significant (p=0.46). However, the combination of LE and nitrite provided a higher sensitivity than either of them with a statistically significant difference (p=0.04). Key words: Dipstick urinalysis, Screening tool","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85961748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-08-11DOI: 10.4314/NMP.V57I5-6.57836
M. Mustapha, A. Rabasa, M. Ashir, A. Usman, S. Mohammed
Tuberculosis (TB) is a public health problem globally and Nigeria ranks fifth among countries with highTB burden world-wide. Tuberculosis in children accounted for 15-40% and 2-7% of cases in developing and developed countries respectively. The study was undertaken to document the pattern of presentation and management of TB in children in a tertiary health facility in Maiduguri. A retrospective review of case files of children (aged 0-15 years) who were managed for TB at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria, over a four year period was conducted in April and May, 2009. One hundred and sixteen children were managed for various forms of TB, out of total admission of 8582, giving a prevalence of 1.35%. The age of the study group ranged from 4 months to 14 years, median (IQ) age was 24 (12-58) months. Children in the low socio-economic class (SEC) were observed to be significantly more than those in the upper class. The common presenting symptoms were fever, chronic cough and weight loss, and 66 (57%) of the cases studied were HIV co-infected. While pulmonary TB, disseminated TB and TB adenitis accounted for 87(75%), 24(20.7) and 5(4.3%) cases respectively, no case of TB abdomen was recorded. Ninety five (81%) children completed 6-12 months of anti-TB treatment, which was tolerated well by the children. The prevalence of TB among children of low SEC is high, so also among HIV infected children. Prompt TB screening of all patients with suspected symptoms and signs of TB as well as evaluation of TB patients for HIVinfection is recommended. Key words: Childhood, Tuberculosis, Maiduguri, Management.
{"title":"Management of Childhood Tuberculosis: The Experience in a Tertiary Health Care Facility in Nigeria.","authors":"M. Mustapha, A. Rabasa, M. Ashir, A. Usman, S. Mohammed","doi":"10.4314/NMP.V57I5-6.57836","DOIUrl":"https://doi.org/10.4314/NMP.V57I5-6.57836","url":null,"abstract":"Tuberculosis (TB) is a public health problem globally and Nigeria ranks fifth among countries with highTB burden world-wide. Tuberculosis in children accounted for 15-40% and 2-7% of cases in developing and developed countries respectively. The study was undertaken to document the pattern of presentation and management of TB in children in a tertiary health facility in Maiduguri. A retrospective review of case files of children (aged 0-15 years) who were managed for TB at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria, over a four year period was conducted in April and May, 2009. One hundred and sixteen children were managed for various forms of TB, out of total admission of 8582, giving a prevalence of 1.35%. The age of the study group ranged from 4 months to 14 years, median (IQ) age was 24 (12-58) months. Children in the low socio-economic class (SEC) were observed to be significantly more than those in the upper class. The common presenting symptoms were fever, chronic cough and weight loss, and 66 (57%) of the cases studied were HIV co-infected. While pulmonary TB, disseminated TB and TB adenitis accounted for 87(75%), 24(20.7) and 5(4.3%) cases respectively, no case of TB abdomen was recorded. Ninety five (81%) children completed 6-12 months of anti-TB treatment, which was tolerated well by the children. The prevalence of TB among children of low SEC is high, so also among HIV infected children. Prompt TB screening of all patients with suspected symptoms and signs of TB as well as evaluation of TB patients for HIVinfection is recommended. Key words: Childhood, Tuberculosis, Maiduguri, Management.","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86534028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-08-11DOI: 10.4314/NMP.V57I5-6.57840
K. Osungbade, A. Olumide, O. Balogun, Eo Famakinwa, O. Jaiyeoba
Social health insurance was introduced in Nigeria in 1999 and had since been restricted to workers in the formal public sector. There are plans for scaling up to include rural populations in a foreseeable future. Information on willingness to participate and pay a premium in the programme by rural populations is dearth. This study sought to document willingness to participate and pay a premium in a social health insurance among indigenous members of a rural community in Nigeria. Adescriptive cross-sectional survey was conducted among heads of households in two randomly selected clusters in Igbo-Ora community. Interviews were conducted using a pre-tested semistructured questionnaire by trained interviewers. The questionnaire sought information on socio-demographic characteristics of the respondents, their awareness about social health insurance and willingness to participate and pay in the scheme. Monthly income was estimated by bidding game approach.Atotal of 410 heads of households were interviewed; their mean age was 45.2 ± 2.2 years. Of the 410 respondents, 66 (16.1%) were aware of an existing social health insurance; 344 (83.9%) were willing to participate, whereas 314 (76.6%) were willing to pay a premium. Respondents who were less than 40 years of age were 1.8 times more likely to be aware of the social health insurance (p = 0.04, OR = 1.83, 95% CI = 1.04 - 3.22) and 2.4 times more likely to participate in it (p = 0.01, OR = 2.42, 95% CI = 1.29 - 4.53) than those aged 40 years and above. Those who had at least secondary education were 2.1 times more likely to be aware than those who had either no formal or at most primary education (p = 0.01,OR= 2.1,95%CI = 1.17 - 3.79). However, those who had either no formal or at most primary education were 3.7 times more likely to be willing to participate than those with at least secondary education (p Keywords: Social health insurance, Awareness, Willingness to participate and pay a premium, Rural community, Igbo Ora
尼日利亚于1999年实行社会健康保险，此后仅限于正式公共部门的工人。有计划在可预见的未来扩大到包括农村人口。关于农村人口愿意参加该方案并支付额外费用的资料是缺乏的。本研究旨在记录尼日利亚农村社区土著成员参加社会健康保险并支付保费的意愿。在伊博-奥拉社区随机选择的两组户主中进行描述性横断面调查。访谈由训练有素的采访者使用预先测试的半结构化问卷进行。调查问卷旨在了解被访者的社会人口特征、他们对社会健康保险的认识以及参与和支付该计划的意愿。月收入通过竞价游戏的方式估算。共访问了410名户主;平均年龄45.2±2.2岁。在410名答复者中，66人(16.1%)知道现有的社会健康保险;344人(83.9%)表示愿意参加，314人(76.6%)表示愿意支付保费。40岁以下的被调查者对社会健康保险的知晓度是40岁及以上人群的1.8倍(p = 0.04, OR = 1.83, 95% CI = 1.04 ~ 3.22)，参加社会健康保险的可能性是40岁及以上人群的2.4倍(p = 0.01, OR = 2.42, 95% CI = 1.29 ~ 4.53)。至少接受过中等教育的人比没有接受过正规教育或最多接受过初等教育的人意识到这一点的可能性高2.1倍(p = 0.01, or = 2.1,95%CI = 1.17 - 3.79)。然而，那些没有受过正规教育或最多只受过小学教育的人比那些至少受过中学教育的人愿意参加的可能性高3.7倍(p关键词:社会健康保险，意识，参加和支付保险费的意愿，农村社区，伊博奥拉
{"title":"Social Health Insurance in Nigeria: Policy Implications in A Rural Community","authors":"K. Osungbade, A. Olumide, O. Balogun, Eo Famakinwa, O. Jaiyeoba","doi":"10.4314/NMP.V57I5-6.57840","DOIUrl":"https://doi.org/10.4314/NMP.V57I5-6.57840","url":null,"abstract":"Social health insurance was introduced in Nigeria in 1999 and had since been restricted to workers in the formal public sector. There are plans for scaling up to include rural populations in a foreseeable future. Information on willingness to participate and pay a premium in the programme by rural populations is dearth. This study sought to document willingness to participate and pay a premium in a social health insurance among indigenous members of a rural community in Nigeria. Adescriptive cross-sectional survey was conducted among heads of households in two randomly selected clusters in Igbo-Ora community. Interviews were conducted using a pre-tested semistructured questionnaire by trained interviewers. The questionnaire sought information on socio-demographic characteristics of the respondents, their awareness about social health insurance and willingness to participate and pay in the scheme. Monthly income was estimated by bidding game approach.Atotal of 410 heads of households were interviewed; their mean age was 45.2 ± 2.2 years. Of the 410 respondents, 66 (16.1%) were aware of an existing social health insurance; 344 (83.9%) were willing to participate, whereas 314 (76.6%) were willing to pay a premium. Respondents who were less than 40 years of age were 1.8 times more likely to be aware of the social health insurance (p = 0.04, OR = 1.83, 95% CI = 1.04 - 3.22) and 2.4 times more likely to participate in it (p = 0.01, OR = 2.42, 95% CI = 1.29 - 4.53) than those aged 40 years and above. Those who had at least secondary education were 2.1 times more likely to be aware than those who had either no formal or at most primary education (p = 0.01,OR= 2.1,95%CI = 1.17 - 3.79). However, those who had either no formal or at most primary education were 3.7 times more likely to be willing to participate than those with at least secondary education (p Keywords: Social health insurance, Awareness, Willingness to participate and pay a premium, Rural community, Igbo Ora","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77641511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-08-11DOI: 10.4314/NMP.V57I5-6.57838
R. Mordi, G. Ofovwe
Pseudomonas aeruginosa (Family Pseudomonadaceae) is an obligate aerobic, motile, gram negative bacillus.which is able to grow and survive in almost any environment and resistant to temperature extremes. It is involved in the etiology of several diseases including ocular, burn and wound infections. The study seeks to determine the involvement of Pseudumonas aeruginosa in the etiology of wound infections in University of Benin Teaching Hospital, Benin city. The study which was prospective and cross-sectional involved 2172 individuals who were patients seen at the various facilities in University of Benin Teaching Hospital. Males numbered 1570 (72.29%), females were 530 (24.40%) while children were 72 (3.31%). 2172 specimens consisting of swabs from wound, pus and secretions were submitted for bacteriological analysis during the period January 2009 to September 2009. There was no particular selection order except that they were consecutively obtained. Specimens were collected for culture and sensitivity before initiating antibiotic therapy. Cultures were put up immediately using standard microbiological methods. Any growth was identified by colonial morphology and characteristics and biochemical reactions. Antimicrobial sensitivity test was performed according to Kirby-Bauer disc diffusion method as per NCCLS recommendation. The control organism was a sensitive strain Pseudomonas aeruginosa (NCTC10662). 2067 (95.2%) out of 2172 specimens yielded growth of various organisms out of which 249 (11.5%) yielded growth of Pseudomonas aeruginosa. 105 (4.8%) yielded no growth. The organism was strongly susceptible to ceftazidime and ofloxacin was 53.4% sensitive to gentamycin. However it was poorly susceptible to cefuroxime, cloxacillin, lincomycin, cefotaxime, ceftriazone and amoxicillin clavulanate. The study clearly showed Pseudomonas aeruginosa as an important human pathogen and advanced suggestions as control measures. Keywords: Pseudomonas aeruginosa . Wound infections; antibiotic susceptibility
{"title":"Pseudomonas aeruginosa (Family Pseudomonadaceae) is an obligate aerobic, motile, gram negative bacillus.which is able to grow and survive in almost any environment and resistant to temperature extremes. It is involved in the etiology of several diseases i","authors":"R. Mordi, G. Ofovwe","doi":"10.4314/NMP.V57I5-6.57838","DOIUrl":"https://doi.org/10.4314/NMP.V57I5-6.57838","url":null,"abstract":"Pseudomonas aeruginosa (Family Pseudomonadaceae) is an obligate aerobic, motile, gram negative bacillus.which is able to grow and survive in almost any environment and resistant to temperature extremes. It is involved in the etiology of several diseases including ocular, burn and wound infections. The study seeks to determine the involvement of Pseudumonas aeruginosa in the etiology of wound infections in University of Benin Teaching Hospital, Benin city. The study which was prospective and cross-sectional involved 2172 individuals who were patients seen at the various facilities in University of Benin Teaching Hospital. Males numbered 1570 (72.29%), females were 530 (24.40%) while children were 72 (3.31%). 2172 specimens consisting of swabs from wound, pus and secretions were submitted for bacteriological analysis during the period January 2009 to September 2009. There was no particular selection order except that they were consecutively obtained. Specimens were collected for culture and sensitivity before initiating antibiotic therapy. Cultures were put up immediately using standard microbiological methods. Any growth was identified by colonial morphology and characteristics and biochemical reactions. Antimicrobial sensitivity test was performed according to Kirby-Bauer disc diffusion method as per NCCLS recommendation. The control organism was a sensitive strain Pseudomonas aeruginosa (NCTC10662). 2067 (95.2%) out of 2172 specimens yielded growth of various organisms out of which 249 (11.5%) yielded growth of Pseudomonas aeruginosa. 105 (4.8%) yielded no growth. The organism was strongly susceptible to ceftazidime and ofloxacin was 53.4% sensitive to gentamycin. However it was poorly susceptible to cefuroxime, cloxacillin, lincomycin, cefotaxime, ceftriazone and amoxicillin clavulanate. The study clearly showed Pseudomonas aeruginosa as an important human pathogen and advanced suggestions as control measures. Keywords: Pseudomonas aeruginosa . Wound infections; antibiotic susceptibility","PeriodicalId":85759,"journal":{"name":"The Nigerian medical practitioner","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87063839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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