University of Nairobi Journal Systems
Not a member yet
1034 research outputs found
Sort by
CHARACTERISATION OF VIBRIO PARAHAEMOLYTICUS ISOLATED FROM FISH IN KENYA
No full textBackground: Acute gastroenteritis associated with fish has been reported since 1951 but isgaining importance with increase in fish consumption in Kenya. Thecausativeagent is Vibrioparaltaemolyticus. The importance of this organism is increasing due to the rise in theincidence of outbreaks of food poisoning related to it.Objective: To iisolate and characterise local strains of Vibrioparahaemolyticus from sea andfresh-water fish.Design: A prospective study.Setting: Threc: lakes, a river, a dam and the Kenyan coastline.Subjects: Wat.er and fish samples collected from the study sites.'Wain outcointl measllres: Isolation of Vibrio parahaemolyticus on glucose-salt- teepol broth(GTSB), and ,triphenyltetraxolium chloride soya tryptone (TSAT) and several biochemicalmedia, testing the pathogenicity for the isolates by Kanagawa phenomenon and testing theplasmids profiles, coagglutination sensitivity to antimicrobial substance using standardmethods.Results: Twenty nine isolates (4%) were obtained from a total of 666 samples screened,twenty seven of which were isolated from 62 coastal samples. They were Kanagawa negativealthough their plasniid profiles and sensitivity to antimicrobials varied.Conclusion: There is need to recognise V. parahaemolyticus as a potential problem due to the.increase in consumption of fish as an alternative source of protein
PATHOGENIC INTESTINAL PARASITES AND BACTERIAL AGENTS IN SOLID WASTES
No full textABSTRACTObjective: To determine the profile of potentially pathogenic enteric parasites andbacterial agents in municipal refuse dumps in Ibadan, Nigeria.Design: A cross-sectional survey.Setting: Five major market places refuse dumps in Ibadan municipality, Nigeria.Methods: The major market places in Ibadan city were randomly selected by lotterymethod. The refuse sludge were sampled and examined parasitologically andbacteriologically using the methods as described. Data analysis was done by using chisquaretest where applicable.Results: Cases of multiple intestinal parasites and bacterial agents were commonlyencountered in the sludge refuse samples. The commonly found parasitic agents wereof both human and veterinary importance. These include Ascaris Lumbricoides (9.3 egp),Entamoeba histolytica (8.07 cyst per gram), Hookworm/strongyle (6.27 egp) and Ascarissuum (1.07 egp). Others were Ascaris vitolorum (1.09epg), Strongyloides papillosu (0.52larvae per gram.), Schistosoma suis (0.31 epg) Dicrocoelium dendriticum(0.9egp). Themost commonly found bacterial agents were Klebsiella species, Escherichia Coli, Proteusspecies, streptococci, and other gram-positive organisms. Climatic conditions affected thedistribution of both parasites and bacterial agents in the sludge (P<0.001). Moreintestinal parasites 2423 (53.4%) and bacterial agents 2150 (27.2%) were encounteredat mean air temperature 26.1±0.6, mean relative humidity of 72±3.5%. The degree ofcontamination by market locations varies significantly (P<0.001).Conclusion: A high degree of contamination of solid waste dumpsites with bacterial andparasitic agents was observed in the present study. As a result of the public healthimportance of the organisms isolated it is opined that well planned waste managementand health education programs will go a long way to reduce the potential epidemicrisks posed by such sites in Ibadan, Nigeria
Prevalence of Helicobacter pylori in children less than three years of age in health facilities in Nairobi province
No full textObjectives: To determine the prevalence of Helicobacter pylori in children less than three years of age and to determine socio-demographic correlates of Helicobacter pylori infection in these children.Design: Cross sectional study.Setting: The “well baby clinics,” in Nairobi Province.Subjects: Children less than three years of age.Results: A total of 195 children were analysed in the study. There were 103 (52.8%) males and 92(47.2%) females giving a male to female ratio of 1.1:1. The mean age was 17.7 months and the median age was 16 months (range 2 weeks to 36 months). H. pylori antigen was found in stool of 89(45.6%) of the children. Low socio-economic status, crowding in the homes and poor sanitation were associated with H. pylori infection.Conclusion: There is a high prevalence rate of H. pylori infection in children less than three years as found in this study which is in agreement with studies done in other developing countries.Family income is associated with H. pylori infection and families with low income are at higher predisposition to H. pylori infection when compared to families with high income
DETERMINANTS OF TUBERCULOSIS DIAGNOSIS AND THE ROLE OF COUNSELLING
No full textObjective: To study patient determinants that may affect completion of the diagnostic process intuberculosis control, highlighting the role of counselling.Design: Cross-sectional study.Subjects: TB patients.Setting: Rhodes Chest Clinic, Nairobi, City Council.Results: Ninety five percent of the suspects delivered three sputum samples but only 27% consentedto a HIV test; several determinants for none consenting were mentioned. On average US8.62 for following the entire diagnostic process. Cost factorsincluded transport, loss of income and food.Conclusion: Individual pre-test counselling seems important for obtaining three sputum specimens.It takes time and for settings with a large number of suspects, alternative methods may be required.To obtain consensus for a HIV test in a TB clinic is complicated. Costs spent on transport andloss in income are important determinants and may contribute to poor patient adherence to thediagnostic process
LIFE THREATENING SPINAL SHOCK AND COMPLETE NEUROLOGICAL RECOVERY FOLLOWING MINOR SPINAL CORD TRAUMA IN A PATIENT WITH PRE-EXISTING CERVICAL CANAL STENOSIS: CASE REPORT
No full textMild to moderate trauma to the spinal cord that is complicated by existing cervical canalstenosis or spondylosis can be a life threatening event. It is against this backgroundthat we present a 41 year old male with cervical spinal stenosis who developed markedquadriparesis and respiratory embarrassment following collision with a colleague. He wasadmitted to the intensive care unit, electively sedated, paralysed and ventilated for a periodof 48 hours. During the initial 24 hours of admission, he received methylprednisolone asper the National Acute Spinal Cord Injury Studies (NASCIS) protocol. Forty five hourslater he had regained full neurological and respiratory function, allowing extubationand subsequent discharge from the intensive care unit. While patients with cervicalspinal cord trauma in a setting of cervical canal stenosis or spondylosis can deterioratedramatically, early recognition of this condition and prompt management usingmethylprednisolone, cervical stabilisation and ventilatory support during the initialwindow of opportunity will enable them make a full recovery
STROKE-RELATED MORTALITY AT KORLE BU TEACHING HOSPITAL, ACCRA, GHANA
No full textObjectives: To determine whether mortality from and the pattern of stroke have changedsince the last study in Accra in 1981, the sites of the different types of stroke and the role ofhypertension and cerebrovascular disease and to describe the age and sex distribution.Design: Cross-sectional stud) of fatal stroke cases over a five-year period.Setting: Korle Bu Teaching Hospital, Accra, Ghana.Subjects: All fatal strokes in persons aged 20 years and above, confirmed at autopsy.Results: Mortality from stroke constituted eleven per cent of autopsies carried out at theKorle Bu Teaching Hospital, Accra, in the five-year period 1994 to 1998. A similar study in1981 showed the same proportion indicating that the proportion of deaths due to stroke hasnot changed. The overall male to female ratio was 1.2:l but the relative risk (RR) of deathfrom stroke was higher for females at 1.23 (95% CI=l.lO-1.38). Although haemorrhagicstroke was still more common than cerebral infarction the proportion (61 %) was much lessthan that of the previous study (89%). Males were more likely (RR 2.07 95% C1= 1.75-2.45)to die from haemorrhagic stroke than females (RR 1.32,95% C1=1.10-1.57). Sixty nine percent of stroke patients died in less than 24 hours after onset of stroke. The peak age of fatalhaemorrhagic stroke was 50-59 years and that of infarction was 60-69 years. Male mortalityexceeded female mortality in all age groups up to 60-69 yeilrs after which female mortalitybecame preponderant ( ~ 2 with Yates correction = 4.28,0.05>p<0.02). Hypertension was thedominant factor in haemorrhage and an important factor in infarction while cerebralathttrosclerosis was the major factor in infarction. Haemorrhage into intraparenchymalsites, mainly the cerebral hemispheres, was more common than into the subarachnoid space.Conclusion: The proportion of deaths from stroke in autopsy cases has not changed since thelast study in 1981 and stroke still remains an important cause of death in Accra. Cerebralhaemorrhage is still a more common cause of fatal stroke than infarction, although thepattern appears to be changing gradually. Females have a slightly greater risk of dying fromstroke than males. A community-based study is needed to provide more insight into someaspects of the problem and to provide the basis for appropriate interventions and policy,especially with regard to a control of risk factors
COMPARISON OF DYNABEADS AND CAPCELLIA METHODS WITH FACSCOUNT FOR THE ESTIMATION OF CD4 T-LYMPHOCYTE LEVELS IN HIV/AIDS PATIENTS IN LAGOS, NIGERIA
No full textObjective: To compare the efficacy of the Capcellia assay and the Dynabeads technique against the FACScount technique in the estimation of CD4 T-lymphocytes within a Nigerian setting.Design: Prospective study.Setting: Urban area in Nigeria.Subjects: Ninety seven subjects (51 HIV seronegative and 46 HIV seropositive adults) seen in the blood banks and two out patient clinics in Lagos within the study period.Main Outcome Measures: Dynadeads technique with a higher correlation coefficient is a feasible alternative to the FACScount method.Results: There was an overall correlation coefficient of r = 0.75 for CD4 cell counts as determined by the Dynabeads technique in comparison with the FACScount method. Also, an overall correlation coefficient of r = 0.17 for CD4 cell counts as determined by the Capcellia technique against the FACScount method.Conclusion: Dynabeads technique is simple to carry out and cheaper in terms of demand for human expertise and infrastructural requirements than the FACScounts. Therefore, it was recommended for use in the laboratory for monitoring of ARV therapy in Nigeria and any other resource poor country
EFFECT OF MICRONUTRIENT FORTIFIED BEVERAGE ON NUTRITIONAL ANAEMIA DURING PREGNANCY
No full textABSTRACTObjective: To evaluate the efficacy of a multiple micronutrient fortified beveragecontaining eleven nutrients at physiological levels in prevention of anaemia andimproving iron and vitamin A status during pregnancy.Design: A randomised double blind placebo controlled study.Setting: Mpwapwa and Kongwa Districts in Dodoma Region of Tanzania.Subjects: Five hundred and seventy nine pregnant women were screened for entry intothe study and 439 women who met the study criteria were enrolled.Interventions: Study participants received either a fortified (F) or non-fortified (NF)orange flavoured drinks identical in appearance, provided in two self administeredservings per day for an eight week period.Main outcome measures: Comparison of haemoglobin (Hb), serum ferritin (SF) andserum retinol (SR) at baseline and follow up.Results: After eight weeks of supplementation, the F group (n=129) had a significantlyhigher Hb increase of 0.86g/dL compared to 0.45g/dL in the NF group (n=130) p<0.0001.Gestational age at entry into the study, moderated the effect on Hb of the fortifieddrink. Women at earlier gestational age upon entry, had a higher rise in Hb than womenof late gestational age (0.8g/dL versus 0.04 g/dL rise respectively, p=0.038, n=188). Therisk of being anaemic at the end of the study for those in the F group was reducedby 51% (RR=0.49, CI=0.28 to 0.85). Iron stores (by serum ferritin levels) increasedby 3μg/L in the F group (p=0.012) and a decrease of 2μg/L in the NF group (p=0.115).The follow up ferritin concentration depended on initial ferritin level. Regardless oftreatment group, serum retinol concentrations were significantly higher in mothers whohad delivered. Mothers who had adequate levels at entry benefited more from thesupplement than those with low levels (0.26 μmol/L versus no significant difference).Conclusions: The multiple micronutrient-fortified beverage given for eight weeks topregnant women improved their haemoglobin, serum ferritin and retinol status. Therisk for anaemia was also significantly reduced. The important predictors of Hb increaseat follow up were the fortified beverage, baseline Hb, serum retinol, baseline ferritinand gestational age at entry into study. Anthropological research showed that thebeverage was highly acceptable and well liked
