Abstract: This cross sectional study is aimed at evaluating the risk factors and antibiogram profiles of Escherichia coli O157:H7 in children stool and bovine meat obtained from selected households across Cross River State, Southern Nigeria. A total of 360 samples of fresh household bovine meat and 366 children diarrheal and nondiarrheal stool samples each were collected and examined for E. coli O157: H7 using standard culture and serological methods. Confirmed E. coli O157: H7 isolates were evaluated for antimicrobial susceptibility using the Agar disc diffusion method. The total positive samples for E. coli O157: H7 in household meat was 76/360 (21.11%,) while the diarrheaic and nondiarrheaic stool samples had 70/366 (19.13%) and 5/366 (1.37%) positive samples respectively. A significant difference was observed in the prevalence values among the bovine meat samples from various households and between the diarrheaic and nondiarrheaic samples at p<0.05. Risk factors such as Age range with highest prevalence value at 1-2yrs (26.83%); Occupation of parent/guardian with highest value from farming (25.67%) and Main domestic water source with highest value from surface water (28.21%) were observed to significantly affect the prevalence of the pathogen in children diarrheaic stool (p<0.05). All 70 diarrheaic isolates were resistant to one or multiple antibiotics with highest values obtained from tetracycline (88.6%) and cotrimoxazole (77.1%). This study revealed that bovine meat and some human and environmental factors play a vital role in the establishment of E. coli O157:H7 infection in children in the study communities with diarrheal stool being the main vehicle for secondary infections in humans. Cattle therefore serve as a major source of transmission of multi drug resistant E. coli O157:H7 to humans hence the need for continuous surveillance of this pathogen and implementation of legislation against indiscriminate use of antibiotics in diary farms.Abstract: This cross sectional study is aimed at evaluating the risk factors and antibiogram profiles of Escherichia coli O157:H7 in children stool and bovine meat obtained from selected households across Cross River State, Southern Nigeria. A total of 360 samples of fresh household bovine meat and 366 children diarrheal and nondiarrheal stool samples each w...Show More
Abstract: Long queue and long waiting time for taking appointment, consulting a doctor and to get drugs is a critical problem to patients with Non-communicable diseases who are following in government health sector. Many primary healthcare services in Sri Lanka is delivered through vertical systems, where services for routine issuing appointment, consultation and issuing drugs are co-located but use separate physical space, staff and medical records. Aim of the research leads to integration of the systems deteriorates the waiting time and reduces the worse health outcomes in the long run. A care model was developed integration of consultation and issuing drugs, with permanent issuing of routine appointment in rural healthcare settings, Elpitiya. Data on waiting time of patients during two seven-day periods before and six months after the integration were collected using a time and motion study. Statistical tests were conducted to investigate whether the two observation periods differed in operational details such as staffing, patient arrival rates, mix of patients etc. Previous level of attendance was analysed by their clinic records (before intervention). Multiple linear and logistic regression repeated measures analyses were used to assess the program's effects. Comparison of raw data showed that waiting times decreased by 7.2 hours to 3hours, after integration (p<0.01). Clinic patients attendance was remarkably improved with regular clinic service after implementing appoint system from 35%-60% to 85%-90%. The rate of clinic attendance was increased dramatically over the period from 6 months. Waiting time for attending clinic was declined and waiting in lines were avoided. Moreover, the intervention did improve clinic utilization and satisfaction. Integrating health services have the potential of reducing waiting times due to more efficient use of resources. Encouraging patients by new model is challenging and does appear to provide significant realistic benefits at rural, resource poor health settings beyond those provided by basic clinic services.Abstract: Long queue and long waiting time for taking appointment, consulting a doctor and to get drugs is a critical problem to patients with Non-communicable diseases who are following in government health sector. Many primary healthcare services in Sri Lanka is delivered through vertical systems, where services for routine issuing appointment, consultatio...Show More
Roger Ivan Calderon Espinoza,Maria Belen Arriaga Gutierrez,Kattya Lopez Tamara,Nadia Nilda Barreda Ponce,Carole Diane Mitnick,Geraint Rhys Davies,David John Coleman
Abstract: The BACTEC MGIT 960 system is widely used for recovery of Mycobacterium tuberculosis, but high contamination rates compromise its diagnostic performance. Efforts to control contamination must balance elimination of contaminating organisms while preserving growth of tuberculous bacilli. Fosfomycin has activity against many bacteria responsible for culture contamination yet is inactive against Mycobacterium tuberculosis. Therefore, it holds potential as a selection agent for the culture of M. tuberculosis clinical samples with the MGIT system. In this study, we assess the ability of fosfomycin supplement to MGIT cultures of clinical sputum specimens. Sputum specimens collected at 62 diagnosis and treatment monitoring visits during a randomized controlled trial of high-dose rifampin (ClinicalTrials.gov NCT01408914) were split: one-half was treated as conventional and the other half was treated with 1mg of fosfomycin. The frequencies of contamination and of recovery of M. tuberculosis were compared using McNemar and Wilcoxon signed-rank test, respectively, with a=0.05. In the fosfomycin-treated samples, 2/62 (3.2%) yielded contaminated cultures while 12/62 (19.4%) of untreated cultures were contaminated (p<0.001, McNemar Test). Detection of M. tuberculosis was not significantly altered by the addition of fosfomycin (Time to positivity, p=0.576, Student’s T Test; log colony forming units), nor the Colony Forming Unit Counts (Wilcoxon signed-rank test p=0.671). These results suggest that the use of fosfomycin to control contamination does not affect the natural growth of MTB. Its use could result in a significant improvement in recovery of M. tuberculosis in MGIT.Abstract: The BACTEC MGIT 960 system is widely used for recovery of Mycobacterium tuberculosis, but high contamination rates compromise its diagnostic performance. Efforts to control contamination must balance elimination of contaminating organisms while preserving growth of tuberculous bacilli. Fosfomycin has activity against many bacteria responsible for c...Show More