Dalhatu Araf Specialist Hospital Research Articles

Pattern of Road Traffic Injuries Presenting at a Tertiary Hospital in North-Central Nigeria

Abstract Background: Road traffic injuries (RTIs) constitute a major economic and health challenge globally, particularly in developing countries. Nasarawa state, north-central Nigeria, is heavily motorised due to the use of motorcycles as a popular means of transportation. The study aims to determine the pattern and prevalence of RTIs within the state. Materials and Methods: A 6-year retrospective study was conducted at the Dalhatu Araf Specialist Hospital (DASH) in Lafia, Nasarawa state. Data were obtained from the medical records of patients admitted with RTIs at the hospital and were analysed using the Statistical Package for the Social Sciences version 26. Results: A total of 929 patients with 1307 injuries were reported. There were 518 (55.8%) males and 411 (44.2%) females, with a male-to-female ratio of 1.3:1. The age of the patients ranged from 1–85 years, with a mean age of 30 ± 20 years. Young adults aged 18–44 years constituted the most injured age group. Motorcycle-related crashes accounted for injuries in 530 (57.1%) patients. These injuries were predominantly traumatic brain injuries (TBIs) and extremity injuries. The body region most affected was the head and face (560, 42.8%), with traumatic brain injuries (448, 32.7%) being the most common type. After treatment, most patients (571, 61.5%) were discharged home, while the mortality rate was 2.4%. Conclusion: In our study, motorcycle-related crashes were prevalent. Young adult males were mostly the victims of RTIs. Traumatic brain injuries and extremity injuries were the predominant types of injuries, often associated with motorcycle and pedestrian crashes. Multisystem injuries and TBIs were major factors contributing to mortality.

Microscopy and Antigenic Detection of Trichomonas vaginalis Infections among Female Patients Attending the Gynecology Unit of Dalhatu Araf Specialist Hospital, Lafia.

Microscopy and Antigenic Detection of Trichomonas vaginalis Infections among Female Patients Attending the Gynecology Unit of Dalhatu Araf Specialist Hospital, Lafia.

Longitudinal study of change in CD4+ cell counts on HIV-Positive patients at Dalhatu Araf Specialist Hospital, Lafia

The aim of this study was the Longitudinal Study of Change in CD4+ Cell Counts on HIV-Positive Patients at Dalhatu Araf Specialist Hospital, Lafia. The study deployed linear mixed effects models to check if the mean response CD4+ cell count varies with time. The study also attempted to test if the mean response varies in the two groups. An attempt to estimate the relationship between the response and observations according to gender. The study revealed that the trajectory of the mean response over time has a very high variability where we see that there is a general rise in the CD4+ cell counts at the initiation of ART. It was further seen that the CD4+ cell counts in male patients is observed to be higher with higher median value after the sixth observation. A linear mixed effect model was used and tested where it was noted that there is evidence of between-individual heterogeneity which further shows that the decision to choose a mixed effects model instead of an only fixed effects model was in order. The model summary showed that the mean CD4+ cell counts at the baseline (OBS1) was averagely good, but at the initiation of ART, there was a significant increase in the mean response where it was further revealed that the pattern of the mean response over time is not flat. In modelling the group effects, we see the difference between the mean CD4 cell count of male versus female is -113.62 CD4 cell count (i. e. 95% CI= -290.64 to 63.39) lower than female, adjusting with time. Finally, the Wald test does not show any significant evidence of interaction between the observations and gender (p=0.2925) which suggests that the mean response based on gender may be parallel.

Tuberculosis prevalence and rifampicin resistance among presumptive patients in Nasarawa State: A three-year retrospective study

Objective: To investigate the prevalence and rifampicin resistance of tuberculosis among presumptive patients in Nasarawa state, Nigeria. Methods: Patient data collected from January 2019 to December 2021 were retrospectively computed from the register at the tuberculosis laboratory of Dalhatu Araf Specialist Hospital, Lafia. A total of 91884 patient records were analyzed to determine tuberculosis prevalence, rifampicin resistance, and patients’ characteristics using Chi-squared test. Results: An overall prevalence of 8.0% was recorded among presumptive patients over the three-year period with a decreasing trend in prevalence from 10.0% (2019) to 6.5% (2021), though the number of samples progressively increased each year and more than doubled in 2021. Most of the patients tested for tuberculosis were females (52.6%) and were mostly older than 15 years (84.1%). Conversely, a higher resistance to rifampicin was observed among tuberculosis positive male patients (55.6%) than in females (44.4%). Similarly, tuberculosis positive patients older than 15 years (84.6%) showed greater resistance to rifampicin than those younger than 15 years (15.4%). Statistically, no relationship was established among age, sex, year of sampling and tuberculosis prevalence or rifampicin resistance rate. Conclusions: Despite the downward trends in tuberculosis prevalence and rifampicin resistance rate observed in this study, measures at maintaining the gains achieved in the fight against tuberculosis must remain paramount as the race towards reducing tuberculosis incidence and mortality by 2025 continues.

Phylogenetic Characterization of Resistant Salmonella Strains in Typhoid Fever Patients in Nigeria.

Salmonella species are Enterobacteriaceae associated with typhoid fever. In this study, the distribution of broad-spectrum β-lactamase regulatory genes and genetic relatedness of isolates was determined. Stool samples (400) were collected from patients with fever in Dalhatu Araf Specialist Hospital (DASH), Lafia, Nigeria, between March 2020 and April 2021. Salmonella species were isolated and extended-spectrum β-lactamase distribution was determined among resistant isolates using polymerase chain reaction (PCR). Genetic relatedness of Salmonella species resistant to the 10 first-line antibiotics administered was determined among S typhi isolated. Of the 60 isolates that were confirmed to belong to the genus Salmonella, 12 (20.0%) isolates with bla SHV genes were the most prevalent, blaOXA-1 and blaCTX-M-9 were present in 5 isolates each, while blaCTX-M-4 and blaTEM genes with a prevalence of 1.7% each were the least obtained in the isolates. Two isolates had a multidrug-resistant index (MDRI) of 1, and 2 others were positive with the S typhi staG gene. Sequencing to determine their diversity showed that isolates ST36 and ST138, respectively, had MDRI = 1 and are clustered in a group with a similarity coefficient of 0.00634. The 2 isolates had the highest genetic similarity, which indicates that the genetic diversity between the isolates is low, while Salmonella strain ST313L2 had a high level of genetic distance from the other isolates. The most resistant isolates are closely related which calls for concern.

Prevalence and Antifungal Susceptibility of Fungal Isolates Associated with Otomycotic Patients in Lafia

This study assessed the fungal pathogens associated with otomycosis and their antifungal profile. A cross-sectional study was done to collect, examine and culture 177 exudate swabs from patients presenting with otomycosis at the Dalhatu Araf Specialist Hospital for three months. Fungal isolates were identified using their morphological and microscopic structure and characteristics. Mycological assessments showed that 20.90% were positive for fungal agents. Males (70.27%) had more positive cases than females (29.73%). Age group 31-40 had the most predominant number of cases (49.95%) than any other age group. A. niger (51.35%) was the most predominant, followed by Candida spp. (32.43%), while A. flavus (16.22%) was the least prevalent. The month of May had the most positive cases (16; 43.24%), and March had the least (24.32%). Antifungal assay showed varied susceptibility of the isolates to the antifungals. A. flavus showed no resistance to Itraconazole. However, multiple drug resistance was observed amongst the samples, with A. niger showing high resistance to ketoconazole and fluconazole. This study showed that A. niger, A. flavus and Candida spp. are etiological agents associated with otomycosis in Lafia. Caution also needs to be taken in managing this infection as multiple drug resistance was also observed.

Trend and Epidemiology of Tetanus in Nasarawa State, Nigeria: A Five Years Review

Background: Tetanus is a vaccine preventable, non-communicable disease known as lockjaw and characterized by muscle spasm. It is a forgotten disease in the developed world but remained an infection of public health importance in the developing countries. This study aimed to determine the trend in its epidemiology and outcome in Nasarawa state. Subjects and Method: A retrospective study using secondary data from the medical records of three selected health facilities, one each across the three senatorial zones of the state. All those who had tetanus were included while those with incomplete records, 5 were excluded. Data analysis was done using a statistical package for social sciences version 23. The dependent variable was the outcome of tetanus while the independent variables were incubation period, onset period, type of tetanus, risk factors, vaccination history, and manifestations of tetanus. Results: The subject consists of 53.8% males and single with age (Mean=15; SD=6.90). Four and 17 days were the shortest and longest incubation periods while one and six days were the shortest and longest onset periods respectively. A total of 24 (93.3%) patients had generalized tetanus. Nail puncture, road traffic accidents, and umbilical infection were the commonest sources of post-neonatal and neonatal tetanus in this study. Spasm is the commonest manifestation, present in 19 (73.1%) of the study population. This is closely followed by trismus in 57.7% of the cases. About half have a positive vaccination history. This study found case fatality of 7.7%. Conclusion: Generalized tetanus was the commonest type seen in this study, while nail puncture, road traffic accident and umbilical infection were the most common sources of infection. Although, more than half of the study subjects received immunization to prevent tetanus, the case fatality in this study was in one in twelve sufferers. Keywords: Epidemiology, review, tetanus, trend. Correspondence:Bello Surajudeen Oyeleke. Department of Paediatrics Dalhatu Araf Specialist Hospital. Shendam Road, PMB 07, Lafia, Nasarawa State. Email: surajudeenbello4@gmail.com. Mobile: +2347064641540.

SOURCES OF HEALTH CARE FINANCING AMONG SURGICAL PATIENTS SEEN AT THE DALHATU ARAF SPECIALIST HOSPITAL LAFIA NASARAWA STATE NIGERIA

Sources of healthcare financing especially among surgical patients in Nasarawa state is presently unknown. Sub-Saharan African countries have introduced a number of methods to funding healthcare system. The Nigerian government commenced implementation of a social health insurance scheme (National Health Insurance Scheme; NHIS) so as to improve on healthcare funding for its citizens. This study determined the sources of financing surgical cases, type of surgeries and compared the cost of treatment among patients attending the Dalhatu Araf Specialist Hospital and other Health Centers in Nasarawa State. It was a hospital based cross-sectional descriptive study among 420 adults aged 18 years to 75 years in a study that lasted for two years. The data collected was analyzed using Statistical package for the Social Science (SPSS) version 20.0. Significant p was < 0.05. The average age of patient was 28.6 ± 11.9 years. There were more females (75.5%) with most (73.8) of our participants living in rural areas. Majority (60.0%) had Caesarean Section and one-sixth had exploratory laparotomy respectively. Most spending for healthcare needs was Out-Of-Pocket (OOP) with only a handful (6.7%) enjoying insurance coverage. The average cost of surgery was 41,337.73 Naira and 28,426.47 Naira among the low and high socio-economic class respectively. Most of the participants in this study were on Out-Of[1]Pocket healthcare financing with only one out of fifteen having health insurance coverage of the NHIS. Most of the surgical patients are from the rural areas, are females, do not attend tertiary level of education and are of low socio-economic status. Caesarean section and exploratory laparatomy were the predominant indications for surgeries. Those from the lower socio-economic status pay more for surgeries even though they earn less. We recommended that the state consider State health insurance agency and this should cater for people in both the formal ana the non-formal sectors. In addition, rural dwellers and surgeries such as caesarean section and emergency laparatomies should not be left out.

Isolation and Antibiotic Resistance of Staphylococcus aureus Isolated from Nosocomial Sources

Methicillin resistance Staphylococcus aureus have been reported worldwide to emerge mostly in developing and developed countries. This study aimed at isolated and antibiotic resistance from nosocomial sources in Dalhatu Araf specialist Hospital, Lafia, Nigeria. A total of (200) samples were collected from February 2021 to May 2021 from different Nosocomial sources such as door handles, seat handles, surgical equipment and stretchers and Staphylococcus aureus was isolated and identified using standard microbiological method. The Antibiotic susceptibility test for the isolates were carried out and interpreted in accordance with Clinical and Laboratory Standard Institute (CLSI) protocol. The occurrence of Staphylococcus aureus from the samples was 50 (25%). The highest occurrence of Staphylococcus aureus is from seat handle swab with (32%) and the lowest occurrence is (18%) from surgical equipments. The Antibiotic resistance of Staphylococcus aureus showed that the isolates were more resistant to oxacillin.

Assessment of ear infection in children attending Dalhatu Araf specialist Hospital, Lafia

Bacterial infection of the ear, especially amongst children from low-income countries, is a major cause of hospitalization, presenting in different forms and severity. The prevalence and antibiotic profile of bacteria associated with ear infection amongst children between the ages 0–10years presenting with symptoms was determined using standard microbiological procedures and Kirby-Bauer disk diffusion methods. The results showed an 89.6% prevalence rate of bacterial ear infections, with males and children aged 0–1 years accounting for 53.7% and 28.9% of cases respectively. Pseudomonas spp. was the most prevalent (32.6%) bacteria isolated, while Klebsiella spp. was the least prevalent (8.9%). Male children had higher distribution and presence of bacterial growths than their female counterparts. Antimicrobial assay revealed high susceptibility rates as well as multidrug resistance of the bacterial isolates to the antibiotics tested. Cefuroxime and Augmentin were most effective against all isolates. This study showed a high prevalence of bacterial-associated ear infections dominated by Pseudomonas spp. and more prevalent in males and children between 0 and 3 years old. This calls for improved postnatal care education and child hygiene by nursing mothers, midwives and nannies to forestall and prevent any public health challenge that might arise from the uncontrolled spread and increase in pathogenicity of infections caused by the isolates.

Isolation and Antibiotic Sensitivity of Klebsiella pneumoniae among Urinary Tract Infected Patients in Dalhatu Araf Specialist Hospital Lafia, Nasarawa State Nigeria

Background and Objectives: Klebsiella pneumoniae complications with limited therapeutic options is considered as one major health issues concerning healthcare professionals worldwide. It is one of the leading nosocomial bacterial pathogen that causes most urinary tract infection, and recently the antibiotic resistance of Klebsiella pneumonia has totally increased dramatically. Cross-sectional study was performed from September 2021 to the end of December 2021. This aimed at the isolation and antibiotic sensitivity of the Klebsiella pneumoniae among patients with signs and symptoms of UTI.
 Materials and Methods: Cross- sectional study was performed from September 2021 to the end of December 2021. About120 urine specimens collected were analysed to detect the presence of Klebsiella pneumoniae. The Disc diffusion method was used to determine the antibiotic sensitivity pattern of the isolates.
 Results: Of the 120 specimens collected, only 72 (60%) produced growth. The sensitivity test revealed that all the isolates were sensitive to levofloxacin, 30 isolates (14.2%) were sensitive to ciprofloxacin, 28 isolates (13.2%) were sensitive to gentamycin, 20 isolates (9.4%) were sensitive to travid, while Augmentin has the sensitivity of 17 (8.1%). It revealed that levofloxacin has the lowest resistance of 0 (0%) while travid has the highest resistance of 15(21.7%).
 Conclusion: The antibiotic sensitivity pattern of the isolate revealed that all the isolates were completely sensitive to levofloxacin and more resistant to Augmentin and travid.

Knowledge and perception of caregivers of febrile children with malaria at the Dalhatu Araf Specialist Hospital Lafia Nasarawa state, Nigeria

Objectives: Malaria is an infectious disease caused by Plasmodium and transmitted by the bite of an infected female Anopheles mosquito. This study determined the knowledge and perception of caregivers about malaria at a tertiary health facility in Lafia Nigeria. Material and Methods: A prospective cross-sectional study carried out among caregivers of children aged 6 months to <15 years in Lafia Nigeria. Interviewer administered questionnaire was completed. Bivariate analysis was done. P < 0.05 is significant. Results: Most (66.9%) lived in rural locations. Almost half either had no formal education or primary school certificate only. About one quarter was unemployed. Almost all (92.6%) reported knowledge of fever as a symptom of malaria and 96.1% reported knowledge of mosquito bites as the cause of malaria. Conclusion: There is good awareness about malaria, it cause and some preventive strategies. However, more efforts are required in reaching out to those in the rural areas.

Antifungal Effect of Henna (Lawsonia inermis) Extract on Pathogenic Fungi

The study aimed at undertaking preliminary phytochemical studies and antifungal activities of Lawsonia inermis leaf extracts against clinical Candida isolates from female patients attending Dalhatu Araf Specialist Hospital (DASH) Lafia, Nasarawa State. HVS (High Vaginal Swab) samples were collected from 185 subjects and transported to the laboratory for analysis. Microbial culture and isolations were done on Sabouraud dextrose agar (SDA), Blood agar, Potato dextrose agar (PDA) and Sabouraud dextrose broth. Identification of clinical isolates was done following standard guideline for Candida identification including microscopic, cultural and biochemical characteristics (sugar utilization and fermentation). Antifungal susceptibility tests of the plant extracts at different concentrations were carried out against Candida isolates. Distilled water and ketoconazole drug served as negative and positive control respectively. Zones of inhibitions, the minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of the extracts were determined. Data were analysed on the Minitab 16.0 software for descriptive (mean with standard error) and inferential statistics and Chi Square at 95% confidence limit. In conclusion, L.inermis leaf has been shown to have antifungal properties since it contained quality phytochemicals in sufficient quantity that may be explored in the synthesis of drugs against some species of Candida. This finding is crucial in the management and control of candidiasis in the study.

Prevalance of Mycobacterium tuberculosis Complex in HIV Sero-positive Patients Attending Dalhatu Araf Specialist Hospital, Lafia Nasarawa State Nigeria

Tuberculosis is a public health problem especially in developing countries, including Nigeria. The aim of the study was to determine the prevalence of Mycobacterium tuberculosis complex in HIV patients attending Dalhatu Araf Specialist Hospital Lafia, Nasarawa State, Nigeria. A total of 399 sputum samples were collected from HIV patient and examined using culture technique, Gene-Xpert, and SD-Bioline techniques. SD-Bioline test was used to differentiate between MTBC and non-Tuberculosis mycobacteria (NTM). Risk factors for MTBC were investigated. One hundred and forty-eight (148) MTBC isolates were detected using the culture techniques, 88 MTBC by the Gene-Xpert technique and 37 by the Ziehl-Neelson staining method, and 88 by the rapid test (SD- Bioline test kit) differentiating MTBC from NTM. This result indicates that most of the samples contained NTM (77.9%; 311/399) signifying latent tuberculosis, and 22.1% (88/399) were MTBC. Rate of rifampicin resistance was 13.5% (n = 54) in the study population. RIF resistance was higher in samples from male patients (16.5%; 22/134) than in those from female patients (12.1%; 32/265).

Prevalence of Hepatitis B and C Infections among Pregnant Women at Dalhatu Araf Specialist Hospital Lafia, Nasarawa State Nigeria

Hepatitis infections are global public health concern more especially hepatitis B virus (HBV) and hepatitis C virus (HCV) infections which can easily be transmitted from mothers to newborn babies through contact with body secretions. This research was conducted to investigate the prevalence of Viral Hepatitis B and C infections among pregnant women in Dalhatu Araf Specialist Hospital Lafia, Nasarawa State. Cross sectional study design was carried out from January 2017 to December 2017 among 374 pregnant women. Blood sample was collected from each pregnant woman and screened using enzyme-linked immunosorbent assay (ELISA) kit produced by Nantong Diagnos Biotechnology Co., Ltd., China. Overall prevalence infections of viral hepatitis B and C among the participant was 35(9.4%) and 18(4.8%) respectively. Hepatitis B prevalence was higher than Hepatitis C (P>0.05). Some of the pregnant women were found to be multi-gravida patients ranged from 20-29 years of age with prevalence of 9.6% HBV and 5.1% HCV (P> 0.05). The findings of this research suggest need to initiate public awareness to reduce disease load and transmission; immunization to all pregnant women and their newborn babies.

Outcomes of tuberculosis treatment in a tertiary health facility in north-central Nigeria

Background: Tuberculosis (TB) remains a major public health concern despite being a curable and preventable disease. The treatment of TB using a cocktail of drugs over a period of six months under the directly observed treatment short-course strategy has led to a reduction in cases but is plagued by some challenges that leads to unsuccessful or poor outcomes, which can ultimately result in spread of infections, development of drug resistance and increase in morbidity and mortality. The objectives of this study are to determine outcomes of TB treatment in Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria and the factors that may be associated with the outcomes.
 Methodology: This was a retrospective study using the medical records of patients who were registered for TB treatment over a five-year period between 2016 to 2020. Data from TB registers including demographic and relevant clinical information, and treatment outcomes, were extracted into a structured data extraction format, and analysed with SPSS version 21.0 software package. Univariate and bivariate analyses were conducted, and Chi square test was used to determine association between TB outcomes and independent variables at 95% confidence interval and p<0.05 was considered as the significant value.
 Results: Records of 1,313 patients were studied, 744 (56.7%) were males while 569 (43.3%) were females. The age range of the patients was ≤ 1 year - 96 years, with a mean age of 30±16.7 years. Most were pulmonary TB cases (88.8%, n=1,166), newly diagnosed (95.5%, n=1254), and human immunodeficiency virus (HIV) negative at the time of TB diagnosis (63.7%, n=837). Eight hundred and seven (61.5%) patients had successful treatment, and 34% (n=446) had unsuccessful outcomes made of ‘loss to follow-up’ 25.8% (n=339), deaths 7.8% (n=102) and treatment failure 0.4% (n=5), while 2.3% (n=30) were transferred out and 2.3% (n=30) removed from TB register. Treatment success rate was significantly higher in patients with pulmonary TB (p=0.0024), residents in Lafia LGA (p=0.0005), those treated in 2016 (p=0.0006) and bacteriologically confirmed cases (p<0.0001), while death rate was significantly lower among patients who were HIV-negative at the time of TB diagnosis (p<0.0001).
 Conclusion: TB treatment success rate in this study fell short of the WHO average rate. High rates of ‘loss to follow-up’ and deaths in this study is a wake-up call to all stakeholders in the facility and the State to put in place measures to reduce poor outcomes of TB treatment.

The impact of gender discrimination and HIV stigma on women living in North Central Nigeria

Gender discrimination and HIV stigma among women living with HIV/AIDS are significant psychosocial and public health issues that influence health and well-being. Most adolescent girls exposed to early and forced marriages, sexual violence, and unwanted practices increase the risk of contracting sexually transmitted diseases like HIV and AIDS. The objective of this study is to explore the influence of psychosocial determinants of gender discrimination and HIV stigma on the health and well-being of women living with HIV/AIDS in North Central Nigeria. The study employs qualitative research using research protocol to interview participants and collect data with the approval of the National Health Research Ethics of the Ministry of Health. Forty participants, male and female aged 18 and above selected through purposive sampling technique from Dalhatu Araf Specialist Hospital (DASH) in Nasarawa State, North Central Nigeria. Data collected were analyzed through thematic analysis using ATLAS.ti8 software to code, transcribe, and present a graphical and words cloud frequency analysis. The findings indicate that forced marriage predominantly among the uneducated and low socioeconomic status is a socio-cultural practice that contributes to gender discrimination and HIV stigma. It leads to psychological problems like anxiety and depression in marriage. The study, therefore, concludes that community-based behavioral intervention strategies should advocate gender equality and anti-discrimination law. Also, public awareness on sex education, forced marriage, skills acquisition, and social support system be encouraged.

Prevalence and antibiotic resistance profile of Staphylococcus aureus and Eschericia coli among patients attending urology clinic of Dalhatu Araf specialist hospital (DASH) Lafia, Nasarawa State, Nigeria

No abstract.

Validity of Ziehl-Neelsen and LED Fluorescence Microscopy Technique in the Diagnosis of Mycobacterium Tuberculosis Infection among HIV Patients in Lafia, Nigeria, 2017

Tuberculosis (TB) is a public health problem caused by the Mycobacterium tuberculosis complex. An estimated 70% of TB patients living with HIV are from sub-Saharan Africa largely depends on direct smear microscopy light microscopy for TB diagnosis, which has low Sensitivity, especially among HIV patients. Hence, we conducted this study to evaluate the Performance of Auramine O LED Fluorescence microscopy and the Ziehl-Neelsen technique in Tuberculosis among HIV-positive patients. The study was conducted using a cross-sectional design among 107 consecutively selected HIV/AIDS patients with presumptive Tuberculosis attending ART clinic in Dalhatu Araf Specialist Hospital (DASH), Lafia, Nasarawa State. Three samples were collected from each patient in two visits. Each sample was examined using ZN, LED FM, and Gene-Xpert. Data on socio-demographic characteristics was collected from the subject participant. Univariate and bivariate analyses were done using MS Excel and Epi Info. The Sensitivity and Specificity were compared using McNemar’s chi-square. Seventy-three (68%) patients were female, 33 (30.8%) were in the age group 28-32 years, and 61 (56%) were employed. Ziehl-Neelsen and LED fluorescent microscopy respectively yielded 11 (10.3%) and 15 (14.0%) positive results, while Gene-Xpert gave 18 (16.3%). The Sensitivity for direct ZN and LED FM were 61.1% and 83.3 %, respectively (P-value 0.01) with 100% specificity for both methods. LED microscopy has a much higher sensitivity than ZN microscopy and would be a better alternative in the diagnosis of Tuberculosis in high HIV settings where the use and expertise with culture and Gene-Xpert are limited. Keywords: HIV, LED Fluorescence, Sensitivity, Specificity, Ziehl-Neelsen.

Prevalence of surgical site infection and antibiotic susceptibility pattern among post-operative patients at a tertiary hospital in Lafia Nasarawa state, Nigeria

Background: Surgical site infection is a common challenge to both the surgical patients and the surgical specialists and may lead to morbidity and mortality. The aetiologic agents vary from one place to the other, ditto the antibiotic sensitivity pattern. This study determined the prevalence of surgical site infection, the aetiologic agents and the antibiotic susceptibility pattern in a tertiary health facility in Lafia. Methods: The study was carried out over 5 (2015 – 2019) year period on post operative patients at the Dalhatu Araf Specialist Hospital (DASH) in the surgical and obstetrics and gynaecological wards. Swab taken from infected wounds were cultured using 2 plates of blood agar, MacConkey agar and Mannitol salt agar. The antibiotic susceptibility testing was done using Kirby Bauer technique. The data was analysed using SPSS version 23. Results obtained were presented in tables. Significant p value is < 0.05. Results: The mean age of the respondents is 28.6 ± 11.2 years. Of the 408 surgical patients seen within the 5 year period, 15 (3.7%) had surgical sites infection given a prevalence of 3.7%. A total of 6.6% of the patients who had undergone surgeries were immune-compromised. Escherichia coli and Klebsiella species were the two cultured organisms accounting for 75% and 25% respectively. Antibiotic susceptibility revealed that all (100%) were sensitive to the quinolone (ciprofloxacin). Conclusion: Surgical site infection is most common in the third decade of life with a mean age of 28.6 ± 11.2 years. There is a low prevalence of surgical site infection from this study. Eschericia coli and Klebsiella species were the two common organism isolated with both having a good sensitivity to ciprofloxacin