Journal Article > ResearchFull Text
Int J Environ Res Public Health. 1 September 2022; Volume 19 (Issue 17); 10927.; DOI:10.3390/ijerph191710927
Osei MM, Dayie NTKD, Azaglo GSK, Tettey EY, Nartey ET, et al.
Int J Environ Res Public Health. 1 September 2022; Volume 19 (Issue 17); 10927.; DOI:10.3390/ijerph191710927
Nasopharyngeal carriage of aerobic Gram-negative bacilli (GNB) may precede the development of invasive respiratory infections. We assessed the prevalence of nasopharyngeal carriage of aerobic GNB and their antimicrobial resistance patterns among healthy under-five children attending seven selected day-care centres in the Accra metropolis of the Greater Accra region of Ghana from September to December 2016. This cross-sectional study analysed a total of 410 frozen nasopharyngeal samples for GNB and antimicrobial drug resistance. The GNB prevalence was 13.9% (95% CI: 10.8–17.6%). The most common GNB were Escherichia coli (26.3%), Klebsiella pneumoniae (24.6%), and Enterobacter cloacae (17.5%). Resistance was most frequent for cefuroxime (73.7%), ampicillin (64.9%), and amoxicillin/clavulanic acid (59.6%). The organisms were least resistant to gentamicin (7.0%), amikacin (8.8%), and meropenem (8.8%). Multidrug resistance (MDR, being resistant to ≥3 classes of antibiotics) was observed in 66.7% (95% CI: 53.3–77.8%). Extended-spectrum beta-lactamase (ESBL)-producing bacteria constituted 17.5% (95% CI: 9.5–29.9%), AmpC-producing bacteria constituted 42.1% (95% CI: 29.8–55.5%), and carbapenemase-producing bacteria constituted 10.5% (95% CI: 4.7–21.8%) of isolates. The high levels of MDR are of great concern. These findings are useful in informing the choice of antibiotics in empiric treatment of GNB infections and call for improved infection control in day-care centres to prevent further transmission.
Journal Article > CommentaryFull Text
Public Health Action. 21 September 2014; Volume 4 (Issue 3); DOI:10.5588/pha.14.0028
Zachariah R, Kumar AMV, Reid A, Van der Bergh R, Isaakidis P, et al.
Public Health Action. 21 September 2014; Volume 4 (Issue 3); DOI:10.5588/pha.14.0028
Journal Article > LetterFull Text
Trop Med Int Health. 30 May 2013; Volume 18 (Issue 8); DOI:10.1111/tmi.12133
Zachariah R, Reid AJ, Van der Bergh R, Dahmane A, Kosgei RJ, et al.
Trop Med Int Health. 30 May 2013; Volume 18 (Issue 8); DOI:10.1111/tmi.12133
Journal Article > ResearchFull Text
PLOS One. 7 February 2017; Volume 12 (Issue 2); e0170882.; DOI:10.1371/journal.pone.0170882
de Plecker E, Zachariah R, Kumar AMV, Trelles M, Caluwaerts C, et al.
PLOS One. 7 February 2017; Volume 12 (Issue 2); e0170882.; DOI:10.1371/journal.pone.0170882
OBJECTIVES
In a rural district hospital in Burundi offering Emergency Obstetric care-(EmOC), we assessed the a) characteristics of women at risk of, or with an obstetric complication and their types b) the number and type of obstetric surgical procedures and anaesthesia performed c) human resource cadres who performed surgery and anaesthesia and d) hospital exit outcomes.
METHODS
A retrospective analysis of EmOC data (2011 and 2012).
RESULTS
A total of 6084 women were referred for EmOC of whom 2534(42%) underwent a major surgical procedure while 1345(22%) required a minor procedure (36% women did not require any surgical procedure). All cases with uterine rupture(73) and extra-uterine pregnancy(10) and the majority with pre-uterine rupture and foetal distress required major surgery. The two most prevalent conditions requiring a minor surgical procedure were abortions (61%) and normal delivery (34%).
A total of 2544 major procedures were performed on 2534 admitted individuals. Of these, 1650(65%) required spinal and 578(23%) required general anaesthesia; 2341(92%) procedures were performed by ‘general practitioners with surgical skills’ and in 2451(96%) cases, anaesthesia was provided by nurses. Of 2534 hospital admissions related to major procedures, 2467(97%) were discharged, 21(0.8%) were referred to tertiary care and 2(0.1%) died.
CONCLUSION
Overall, the obstetric surgical volume in rural Burundi is high with nearly six out of ten referrals requiring surgical intervention. Nonetheless, good quality care could be achieved by trained, non-specialist staff. The post-2015 development agenda needs to take this into consideration if it is to make progress towards reducing maternal mortality in Africa.
In a rural district hospital in Burundi offering Emergency Obstetric care-(EmOC), we assessed the a) characteristics of women at risk of, or with an obstetric complication and their types b) the number and type of obstetric surgical procedures and anaesthesia performed c) human resource cadres who performed surgery and anaesthesia and d) hospital exit outcomes.
METHODS
A retrospective analysis of EmOC data (2011 and 2012).
RESULTS
A total of 6084 women were referred for EmOC of whom 2534(42%) underwent a major surgical procedure while 1345(22%) required a minor procedure (36% women did not require any surgical procedure). All cases with uterine rupture(73) and extra-uterine pregnancy(10) and the majority with pre-uterine rupture and foetal distress required major surgery. The two most prevalent conditions requiring a minor surgical procedure were abortions (61%) and normal delivery (34%).
A total of 2544 major procedures were performed on 2534 admitted individuals. Of these, 1650(65%) required spinal and 578(23%) required general anaesthesia; 2341(92%) procedures were performed by ‘general practitioners with surgical skills’ and in 2451(96%) cases, anaesthesia was provided by nurses. Of 2534 hospital admissions related to major procedures, 2467(97%) were discharged, 21(0.8%) were referred to tertiary care and 2(0.1%) died.
CONCLUSION
Overall, the obstetric surgical volume in rural Burundi is high with nearly six out of ten referrals requiring surgical intervention. Nonetheless, good quality care could be achieved by trained, non-specialist staff. The post-2015 development agenda needs to take this into consideration if it is to make progress towards reducing maternal mortality in Africa.
Journal Article > CommentaryFull Text
Public Health Action. 21 September 2013; Volume 3 (Issue 3); DOI:10.5588/pha.13.0066
Harries AD, Kumar AMV, Satyanarayana S, Bissell K, Hinderaker SG, et al.
Public Health Action. 21 September 2013; Volume 3 (Issue 3); DOI:10.5588/pha.13.0066
Journal Article > ResearchFull Text
Public Health Action. 21 June 2015; Volume 5 (Issue 2); 93-98.; DOI:10.5588/pha.15.0004
Joshi B, Chinnakali P, Shrestha A, Das M, Kumar AMV, et al.
Public Health Action. 21 June 2015; Volume 5 (Issue 2); 93-98.; DOI:10.5588/pha.15.0004
SETTING
Seven intervention districts with intensified childhood tuberculosis (TB) case-finding strategies implemented by a non-governmental organisation and seven control districts under the National Tuberculosis Programme, Nepal.
OBJECTIVES
To assess the differences in childhood TB case registrations and case registration rates per 100 000 population between two time periods (Year 1 = March 2012-March 2013 and Year 2 = March 2013-March 2014) in intervention and control districts.
DESIGN
Retrospective record review using routinely collected data.
RESULTS
Childhood TB cases increased from 271 to 360 between Years 1 and 2 in the intervention districts (case registration rate from 18.2 to 24.2/100 000) and from 97 to 113 in the control districts (13.4 to 15.6/100 000): the increases were significantly higher in the intervention districts compared with the control districts. The increases were also significantly higher in children aged 0-4 years and in those with smear-negative pulmonary TB and extra-pulmonary TB. Of the various case-finding strategies, household contact screening, private-public mix services and mobile health chest camps produced the highest yield of TB.
CONCLUSION
A package of intensified case-finding strategies in children was associated with an increase in childhood TB case registrations in Nepal. Additional diagnostic approaches to increase case registrations also need to be considered.
Seven intervention districts with intensified childhood tuberculosis (TB) case-finding strategies implemented by a non-governmental organisation and seven control districts under the National Tuberculosis Programme, Nepal.
OBJECTIVES
To assess the differences in childhood TB case registrations and case registration rates per 100 000 population between two time periods (Year 1 = March 2012-March 2013 and Year 2 = March 2013-March 2014) in intervention and control districts.
DESIGN
Retrospective record review using routinely collected data.
RESULTS
Childhood TB cases increased from 271 to 360 between Years 1 and 2 in the intervention districts (case registration rate from 18.2 to 24.2/100 000) and from 97 to 113 in the control districts (13.4 to 15.6/100 000): the increases were significantly higher in the intervention districts compared with the control districts. The increases were also significantly higher in children aged 0-4 years and in those with smear-negative pulmonary TB and extra-pulmonary TB. Of the various case-finding strategies, household contact screening, private-public mix services and mobile health chest camps produced the highest yield of TB.
CONCLUSION
A package of intensified case-finding strategies in children was associated with an increase in childhood TB case registrations in Nepal. Additional diagnostic approaches to increase case registrations also need to be considered.
Journal Article > ResearchFull Text
Public Health Action. 21 June 2015; Volume 5 (Issue 2); 150-152.; DOI:10.5588/pha.15.0006
Rajapakshe W, Isaakidis P, Sagili KD, Kumar AMV, Samaraweera S, et al.
Public Health Action. 21 June 2015; Volume 5 (Issue 2); 150-152.; DOI:10.5588/pha.15.0006
Given the well-known linkage between diabetes mellitus (DM) and tuberculosis (TB), the World Health Organization recommends bidirectional screening. Here we report the first screening effort of its kind from a chest clinic in the Ampara district of Sri Lanka. Of 112 TB patients registered between January 2013 and October 2014, eight had pre-existing DM. Of those remaining, 83 (80%) underwent fasting plasma glucose testing, of whom two (2%) and 17 (20%) were found to have diabetes and impaired fasting glucose, respectively. All of these were enrolled in care. Screening TB patients for DM was found to be feasible at the district level. Further studies at the provincial/country level are required before making any decision to scale up bidirectional screening.
Journal Article > ResearchFull Text
Trans R Soc Trop Med Hyg. 1 June 2018; Volume 112 (Issue 6); DOI:10.1093/trstmh/try054
Timire C, Takarinda KC, Harries AD, Mutunzi H, Manyame-Murwira B, et al.
Trans R Soc Trop Med Hyg. 1 June 2018; Volume 112 (Issue 6); DOI:10.1093/trstmh/try054
In Zimbabwe, while the Xpert MTB/RIF assay is being used for diagnosing tuberculosis and rifampicin-resistance, re-treatment tuberculosis (TB) patients are still expected to have culture and drug sensitivity testing (CDST) performed at national reference laboratories for confirmation. The study aim was to document the Xpert MTB/RIF assay scale-up and assess how the CDST system functioned for re-treatment TB patients.
Journal Article > Short ReportFull Text
Public Health Action. 21 June 2016; Volume 6 (Issue 2); DOI:10.5588/pha.16.0023
Das M, Isaakidis P, Van der Bergh R, Kumar AMV, Sharath BN, et al.
Public Health Action. 21 June 2016; Volume 6 (Issue 2); DOI:10.5588/pha.16.0023
Journal Article > CommentaryFull Text
Public Health Action. 21 June 2013; Volume 3 (Issue 2); DOI:10.5588/pha.13.0002
Mlilo N, Sandy C, Harries AD, Kumar AMV, Masuka N, et al.
Public Health Action. 21 June 2013; Volume 3 (Issue 2); DOI:10.5588/pha.13.0002