Ekwueme Federal University Teaching Hospital Research Articles

Occurrence and management of lower respiratory tract infections in children at a Nigerian tertiary hospital

Objectives Infectious diseases such as pneumonia, diarrhea, and malaria are the major causes of child mortality, with pneumonia, a lower respiratory tract infection (LRTI), being the foremost of the three. Antimicrobial agents are required to treat LRTIs, such as pneumonia caused by bacteria, while those commonly caused by viruses, such as bronchiolitis, do not benefit from antimicrobial therapy unless laboratory tests indicate otherwise. When not shown, empirical management of patients using antimicrobials remains a risk factor for antimicrobial resistance in the management of LRTIs. This study aimed to determine the occurrence of LRTIs in children who presented with acute respiratory tract infections (RTIs) and evaluate their management in comparison with the guidelines. Material and Methods The study was a descriptive retrospective review of prescribing records for respiratory tract infections (RTIs) presented at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AE-FUTHA), Ebonyi State, Nigeria. Data were collected through systematic sampling of the case folders of children aged five years and below who presented with RTIs from January to December 2021, using a data collection proforma. Collected data were cleaned and coded, and Statistical Package for Social Sciences (SPSS) Version 28 was used for analysis. Results There were 422 case folders containing diagnoses of RTIs. Of these, 36 (8.5%) were diagnosed with LRTIs and 28 (6.6%) had no comorbidity. Of the 28 cases without comorbidities, pneumonia (20;71.4%) and bronchiolitis (8;28.6%) were the only two LRTIs. Antibiotics were the most prescribed medications, followed by vitamins (8;28.6%) and antihistamines (7;25.0%). There were seven types and three combinations of antibiotic medications, the most being cefuroxime (10;35.7%) followed by amoxicillin/clavulanic acid (7; 25.0%). One case of pneumonia did not receive an antibiotic. Laboratory investigations were not conducted for the majority (25;89.3%) of the cases presented. Conclusion This study showed that the LRTIs presented were mostly managed using the recommended antibiotics for pneumonia. Antibiotics for bronchiolitis without confirmation by laboratory tests may not have been justified as most of them are of viral origin. Deviations from guidelines may be reduced if national protocols are developed in managing LRTIs.

Lymphoma and Other Lymph Node Pathologies Among Adult Patients with Lymphadenopathy in Abakaliki, Nigeria.

Lymphadenopathy is usually due to benign or malignant conditions. It can also be local or systemic in distribution and can involve peripheral or deep-seated lymph nodes. This study aimed to determine the prevalence of lymphoma and the distribution pattern of lymph node pathologies among adult patients who presented with lymphadenopathy and its relationship with age and sex. A retrospective study was conducted, and a record of all cases of lymphadenopathy with histological diagnosis over 5-year period (January 2017 to December 2021) was extracted from Departments of Anatomical Pathology of Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The data generated were analyzed using Statistical Package for Social Sciences (SPSS) software, version 26. One hundred and ninety results were extracted with an age range of 18 to 94 years and a mean age of 41 ± 16 years. They were made up of 75 (39.5%) males and 115 (60.5%) females, with a male-to-female ratio of 1:1.5. The prevalence of lymphoma was 50.0% (95/190). Thirty-five (18.4%) were Hodgkin's lymphoma (HL), while 60 (31.6%) were non-Hodgkin's lymphoma (NHL). Other pathologies manifested by cases of lymphadenopathy include metastatic tumor deposits (38 (20%)), reactive lymphoid hyperplasia (29 (15.3%)), and tuberculous lymphadenitis (18 (9.5%)). Others include sinus histiocytosis (4 (2.1%)), dermatopathic lymphadenitis (5 (2.6%)), and Castleman's disease (1 (0.5%)). About half of all patients who presented with lymphadenopathy were lymphoma with a high prevalence of 50%, and the majority were NHL. Other major causes of lymphadenopathy were metastatic tumor deposits, reactive lymphoid hyperplasia, and tuberculous lymphadenitis. Any case of lymphadenopathy should be properly investigated early for effective management.

Service Compact (SERVICOM) and Service Delivery in the Nigerian Public Sector: A Study of Alex Ekwueme Federal University Teaching Hospital, Abakaliki

This study was carried out to examine the effect of SERVICOM on service delivery in public institutions in Nigeria with particular reference to Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Specifically, the research among others sought to ascertain the extent to which SERVICOM has enhanced timely response to patients’ complaints in AE-FUTHA; to examine the extent to which SERVICOM has improved quality healthcare delivery in AE-FUTHA. The study was anchored on New Public Management Theory by Hood (1991). A descriptive survey design was adopted with a sample size of 380. Data for the study were obtained from the structured questionnaire, which were presented in frequency distribution tables for purpose of analysis. The findings of the study revealed among others - that there was significant positive relationship between SERVICOM and timely response to patients’ complaints in AE-FUTHA; that there was significant positive relationship between SERVICOM and improved quality healthcare delivery in AE-FUTHA. The implication of the findings is that SERVICOM is very strategic to entrenching efficient service delivery in the health facility. Therefore, the following recommendations among others were proffered: that SERVICOM unit in the health sector should be strengthened to always ensure reduction to delays in addressing the health and other related complaints of patients in the hospital; that there should be regular capacity building of the staff of the SERVICOM unit in the health institution to enable them sustain quality healthcare delivery in the hospital

Comparing the Use of Smartphone and Vernier Calipers for Corneal Diameter Measurement in Nigerian Term Neonates.

Corneal diameter (CD) measurement in newborns is essential for the detection of blinding ocular pathologies. It requires specially trained personnel, contact techniques, and the use of anesthesia. Smartphone use may obviate these challenges. This study compares CD measurement among newborns using a Smartphone and manual calipers. This is a cross-sectional comparative study done at Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria. Consecutively selected stable term neonates whose mothers consented to the study and met the inclusion criteria had their CDs measured with both calipers and smartphones and the values compared. Mean, range, and standard deviation were calculated using Statistical Package for the Social Sciences (SPSS) IBM (version 22), while paired t-test calculated the difference in mean CD measurements between both methods. Pearson's correlation and Bland-Altman's analysis determined the correlation and agreement between both methods, respectively. Inter and intraobserver repeatability were assessed. A P value less than 0.05 was taken as statistically significant. The mean CD measurement using calliper method was 10.01 ± 0.29mm and 10.03 ± 0.24 mm right eye (RE) and left eyes (LE), respectively) for investigator 1 and 10.16 ± 0.25 mm and 10.19 ± 0.21 mm (RE, LE) for investigator 2. Using smartphone measurement, mean CD measurements of 9.98 ± 0.21 mm and 10.00 ± 0.29 mm (RE, LE) were observed for investigator 1 and 10.07 ± 0.19 mm and 10.06 ± 0.21 mm (RE, LE) for investigator 2. The difference in mean CD for both instruments and by both investigators was not statistically significant (P value > 0.05). Corneal diameter measurement in neonates using smartphone technology does not deviate significantly from caliper measurement; it is safe, easy to use, and advocated.

Pharmacological management of upper respiratory tract infections in children: An assessment of a tertiary institution practice in Nigeria

Objectives: Upper respiratory tract infections (URTIs) are the most common acute RTIs that occur in children. Therapy addressing symptoms is recommended for URTI management. The use of antibiotics without culture and sensitivity tests is a risk factor for antimicrobial resistance. Materials and Methods: This study was set to assess the pharmacological management of URTIs in children from a tertiary institution practice. This study was conducted in Alex Ekwueme Federal University Teaching Hospital, Abakaliki Ebonyi State, Nigeria. It was a retrospective review of 275 prescriptions of medicines for URTIs in children, from January to December 2021. A systematic sampling technique was used to collect data. Data were analyzed using the Statistical Package for the Social Sciences version 28.0. Results: Of the 275 sampled URTI cases, 157 (57.1%) occurred in male children. No laboratory test was conducted for 265 (96.4%) cases. The majority (207; 75.3%) were diagnosed as non-specific URTI. Other diagnoses include tonsillitis (46; 16.7%), otitis media (8; 2.9%), and rhinitis (6; 2.2%) among others. Antibiotics were the most prescribed medications, (212; 77.1%) followed by antihistamines, (110; 40.0%), vitamins (75; 27.3%), and antimalarials (55; 20.0%). The most prescribed antibiotic was amoxicillin-clavulanic acid (79; 28.7%). There was no statistically significant association between the age category of children and the number of medicines prescribed, whether antibiotics were prescribed, and the number of antibiotics prescribed (P > 0.05). Conclusion: Antibiotics were the mainstay for the management of URTIs in the study center. This mode of therapy could lead to antimicrobial resistance since culture and sensitivity tests were not done before the initiation of antibiotic therapy.

PREVALENCE OF MULTIDRUG RESISTANT ESCHERICHIA COLI AND KLEBSIELLA PNEUMONIAE SPECIES ISOLATED FROM URINE SAMPLES OF PATIENTS AT ALEX EKWUEME FEDERAL UNIVERSITY TEACHING HOSPITAL ABAKALIKI, EBONYI STATE, NIGERIA

Aim and Objective: In hospitals and community, morbidity and mortality are attributed to urinary tract infections (UTIs). This study investigated the prevalence of multi-drug resistant isolates of Escherichia coli and Klebsiella species from urine samples of patients visiting Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA), Ebonyi State. Method: With the use of standard microbiological and biochemical techniques for analysis, a total of 300 mid-stream samples of urine were collected in sterile bottles. Phynotype screening for extended spectrum beta lactamase (ESBL) production was achieved by double disc synergy test (DDST). Disc diffusion method was used to check for ESBL producing bacteria susceptible to antibiotics. With specific primers, the presence of temoniera (TEM) and sulfhydryl variable (SHV) beta lactamases genes was determined using polymerase chain reaction (PCR). Results: 88 isolates of E coli and Klebsiella species were isolated from the urine samples; 29 were E coli and 59 were K. pneumonia species. 47 ESBL positive isolates were identified with E. coli, 19 (40%) and Klebsiella, 28 (60%). Escherichia coli isolated from GOPD patients, gynecology, and men's surgery ward were 100% resistant to ofloxacin, ceftazidime, amoxicillin, nitrofurantoin, chloramphenicol, and aztreonam, while Klebsiella species isolated from gynecology department, maternity ward, and psychiatric ward were 100% resistant to ofloxacin, Nitrofurantoin and chloramphenicol. Multiple antibiotics resistance index (MARI) of E. coli and Klebsiella species isolated recorded an average of 0.64 for E. coli and 0.41 for Klebsiella species.The molecular analysis revealed that 44.4% of SHV beta lactamase and 65.6% TEM-type β-lactamase genes were present in ESBL producing E. coli while 54.5% of SHV beta lactamase gene and 45.5% TEM-type β-lactamase genes were present in ESBL producing Klebsiella species. Conlusion: In conclusion, TEM and SHV-type β-lactamase genes are the primary cause of β-lactam antibiotic resistance in E. Coli and Klebsiella species resulting in increased infections caused by organisms harboring the ESBL gene. Nitrofurantoin, ceftazidime, cefalexin, and cefotaxime may be the antibiotic of choice in the treatment of UTIs. Peer Review History: Received: 1 January 2023; Revised: 14 February; Accepted: 7 March 2023, Available online: 15 March 2023 Academic Editor: Dr. Amany Mohamed Alboghdadly, Princess Nourah bint abdulrahman university, Riyadh, amalbgadley@pnu.edu.sa Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Prof. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, shmahe@yemen.net.ye Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg Similar Articles: ANALYSIS OF THE ANTIBIOGRAM PROFILES OF BIOFILM FORMING STAPHYLOCOCCUS AUREUS AND ESCHERICHIA COLI

Determinants of enrolment in health insurance scheme among HIV patients attending a clinic in a tertiary hospital in South-eastern Nigeria.

The study aimed to assess the determinants of enrolment in health insurance schemes among people living with HIV. The study was a cross-sectional study. A pre-tested interviewer-administered questionnaire was used to collect information from 371 HIV clients attending the clinic. Chi-square statistic was used for bi-variate analysis, and analytical decisions were considered significant at a p-value less than 0.05. Logistic regression was done to determine predictors of enrolment in health insurance. The study was carried out in the HIV clinic of Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria. HIV clients attending a clinic. Mean age of respondents was 45.4±10.3, and 51.8% were males. Almost all the respondents were Christians. Only 47.7% were married, and most lived in the urban area. Over 70% had at least secondary education, and only 34.5% were civil servants. About 60% of the respondents were enrolled in a health insurance scheme. Being single (AOR: 0.374, CI:0.204-0.688), being self-employed (AOR: 4.088, CI: 2.315-7.217), having a smaller family size (AOR: 0.124, CI: 0.067-0.228), and having the higher income (AOR: 4.142, CI: 2.07-8.286) were predictors of enrolment in a health insurance scheme. The study has shown that enrolment in a health insurance scheme is high among PLHIV, and being single, self-employed, having a smaller family size, and having a higher monthly income are predictors of enrolment in the health insurance scheme. Increasing the number of dependants that can be enrolled so that larger families can be motivated to enrol in health insurance is recommended. None declared.

Urinary Catheter Documentation in a Nigerian Teaching Hospital: Are We Recording Enough?

Urinary catheters are an important armamentarium of urologic practice. Several indications for their use exist. A good knowledge of the details surrounding every urinary catheter inserted is necessary for the proper management of the patients. Inadequate documentation can lead to complications such as urinary tract infection or even forgotten catheters. This study aimed at auditing the practice of documentation of urinary catheter parameters in our hospital as a means to improving the standard of care and aligning with international best practices with respect to the use of urinary catheters in our hospital. This study was a 3-month audit on the quality of documentation on the parameters of each urinary catheter use in Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria. The parameters included the indication for catheterisation, route of catheterisation, staff who catheterised, size of catheter, type of catheter, volume of water used for inflating catheter balloon, volume of urine drained, if aseptic technique was followed during catheterisation, informed consent and complications encountered. Data were summarised as frequencies and means. Statistical significance was pegged at P < 0.05. Seventy-four patients were men, whereas two were women. The mean age of the patients was 67.29 ± 15.17 years. Overall, sex (76 [100%]), age (76 [100%]) and route of catheterisation (68 [89.5%]) were the three most commonly documented information. The documentation on complications and volume of fluid instilled to inflate the catheter balloon were the least-documented parameters (6 [7.9%] and 11 [14.5%], respectively). The following parameters were better documented in the SPC arm: The staff who passed the catheter p = 0.000), the type of catheter passed (p = 0.004), asepsis (p = 0.001) and acquisition of informed consent (p = 0.043). Documentation following urinary catheter use was noted to be poor in this study. Documentation of catheter parameters was noted to be higher in patients who had SPC than those who had urethral catheterisation.

Detection of Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae Implicated in Urinary Tract Infection

Background and Objectives: Carbapenemase-producing bacteria are super bugs that make Urinary Tract Infections (UTIs) difficult to treat with drug of last resort such as carbapenem and other antibiotic thus limiting the treatment options. Carbapenemase production is increasing in clinical isolates of E. coli and K. pneumoniae, their potential to spread widely among patients necessitates molecular detection of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae implicated in Urinary Tract Infection.&#x0D; Methodology: A total of twelve (12) non-repeated clinical isolate of Escherichia coli (E1, E2, E3, E4, E5, E6, E7) and Klebsiella pneumoniae (K8, K9, K10, K11, K12) were selected based on their in vitro phenotypic resistant to carbapenem antibiotics from patients diagnosed with urinary tract infection at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AE-FEUTHA) Ebonyi Sate Nigeria. Escherichia coli and Klebsiella pneumoniae were further confirmed using standard routine microbiological technique for isolation and identification of bacteria. Escherichia coli and Klebsiella pneumoniae strains were further screen for carbapenemase-producing gene by PCR specific primer.&#x0D; Result: PCR analysis with specific primer for carbapenemase gene revealed the presence and predominant of blaKPC in Escherichia coli and Klebsiella pneumoniae 12(100 %) followed by blaNDM 11(91.7 %), blaIMP 7(58.3 %) and blaVIM 2(16.7) as the least carbapenemase-producing gene in Escherichia coli and Klebsiella pneumoniae. blaKPC was predominant in Escherichia coli 7(58.3 %) followed by blaNDM 6(50.0 %) and blaIMP 5(41.7 %) while both blaOXA and blaVIM (16.7 %) were the least detected carbapenemase gene. Klebsiella pneumoniae harbor high proportion of blaNDM and blaKPC both recording 5(41.7 %) followed by blaOXA and blaIMP both recording 2(16.7 %) but blaVIM gene was not identified in Klebsiella pneumoniae.&#x0D; Conclusion: The current findings highlight the occurrence of carbapenemase-producing gene in Escherichia coli and Klebsiella pneumoniae implicated in UTI. Since these genes are carried on the bacteria plasmid there is a tendency of cross-species dissemination over time. The detection of carbapenemase-producing gene call for prompt epidemiological surveillance and preventive strategies to limit the spread of these carbapenemase resistant genetic determinant and the need for antibiotic susceptibility testing of available antibiotic agent.

Association between Placenta Malaria Parasites and Preeclampsia/Eclampsia among Parturient Mothers in Alex Ekwueme Federal University Teaching Hospital Abakaliki

In tropical countries, malaria and preeclampsia/eclampsia are common diseases of pregnancy; and placenta have been implicated in the pathophysiology of both disease processes. The two diseases have pathophysiologic similarities in the placenta such as placenta ischaemia, endothelial dysfunction and production of pro-inflammatory cytokine. Yet, there is paucity of studies on the association of these two disease processes. Determining the association between the two disease processes may help to unravel the pathogenesis of preeclampsia and also help in its prevention and patient management. Objective: Determined the association between placenta malaria parasitemia and preeclampsia/eclampsia among parturients at Alex Ekwueme Federal University Teaching Hospital Abakaliki. Materials and Methods: This was a case control study that was conducted in the Labour wards of department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) and Mile 4 Missionary Hospital Abakaliki, a comprehensive health care centre in Abakaliki, Ebonyi state. It was conducted over a period of 6 months between 1st October 2021 and 31st March, 2022. The cases in this study were parturients that developed preeclampsia/eclampsia in the course of pregnancy, while the controls were parturient without preeclampsia/eclampsia. Interviewer-administered questionnaires were used to collect data on socio-demographic characteristics, obstetrics and medical histories. Histological examinations were conducted to isolate plasmodium falciparum parasites from placenta samples obtained from the maternal surface of the placenta. The data was processed using Epi Info software. Categorical variables were analyzed using Mc Nemar X2 test, with a p-value of 0.05 considered statistically significant. Logistic regression models were used to estimate the odds ratios (OR) and 95% CI of the association between placenta malaria parasites and preeclampsia/eclampsia was conducted. Relative risk with 95% CI was used to determine both fetal and maternal outcomes. Results: The prevalence of preeclampsia during the study period was 2.9%. Placenta malaria was positive in twenty one (21) of the 67 cases of preeclampsia/eclampsia analyzed, giving a prevalence of 31.3% and in eleven (11) out of 68 controls (normotensive) patients analyzed, giving a prevalence of 16.2%. The presence of placenta malaria significantly increased the odds of developing preeclampsia/eclampsia among parturients (OR = 2.4, 95% CI = 1.0 - 5.4, P value = 0.04). Presence of placenta malaria in mothers with preeclampsia/eclampsia was associated with adverse pregnancy outcomes such as cerebrovascular accident (RR = 19.2, 95% CI = 1.1 - 341.7, P value = 0.04), DIC (RR = 10.9, 95% CI = 1.4 - 88.0, P value = 0.02), abruptio placenta (RR = 2.4, 95% CI = 1.2 - 4.8, P value = 0.01), pulmonary edema (RR = 2.7, 95% CI = 1.1 - 25.9, P value = 0.03), IUGR (RR = 2.1, 95% CI = 1.1 - 4.5, P value = 0.03) and IUFD (RR = 3.8, 95% CI = 1.3 - 11.7, P value = 0.02). Presence of placenta malaria also increased the risk of NICU admission (RR = 2.6, 95% CI = 1.1 - 6.0, P value = 0.03), Low 1st minute APGAR score (RR = 2.7, 95% CI = 1.2 - 6.1, P value = 0.02) and Low 5th minute APGAR score (RR = 3.0, 95% CI = 1.0 - 8.6, P value = 0.04) among neonates delivered by mothers with preeclampsia/eclampsia. However, presence of placenta malaria did not significantly increase maternal and perinatal mortalities. Conclusion: There is a higher prevalence of placenta malaria among mothers with preeclampsia/eclampsia when compared with normotensive controls and this was associated with increased risk of certain maternal and perinatal morbidities. Placental malaria was not associated with increased risk of either maternal or perinatal mortality.

Synopsis of Clients Seen at the Adolescent and Social Paediatrics Unit of a Tertiary Health Facility in South-East Nigeria: A Three-year Review

Background: The adolescent period is a unique and crucial period of growth and development, in which the child transits from childhood to adulthood. It is characterised by several changes, both physiological and psychological, in preparation for adulthood. Thus, their health needs and health challenges differ from that of other children. Hence, the need to pay special attention to them and provide health and social support tailored toward their needs. Aim: This study aimed to determine the pattern of cases that presented to the Adolescent and Social Pediatrics Unit (ASP) of the Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA) over a three-year period. Materials and Methods: This was a retrospective study done to determine the pattern of cases seen at the Adolescent and Social Paediatrics Unit of the Alex Ekwueme Federal University Teaching Hospital, Abakaliki, between 2017 and 2019. Case files of all patients seen within the study period were retrieved, and all were included in the study. Relevant information such as age, gender, social class, diagnosis for both adolescent and nonadolescent age groups, treatment modalities, clinical subspecialties involved in management, and the outcome were retrieved. Data were entered and analysed using SPSS version 25, and results were presented as ratios, means, and proportions, whereas comparisons were made with the Chi-square test or Fisher’s exact were applicable. P &lt; 0.005 was considered statistically significant. Results: A total of 220 clients were seen over the given period. The adolescents were 148 (67.3%), whereas nonadolescents were 72 (32.7%). Among the adolescents, common diagnoses include sexual assault (24.3%), acne (8.1%), Pelvic Inflammatory Disease (PID)/sexually transmitted infection (STI) (8.1%), HIV (8.1%), somatisation disorder (6.8%), suicide attempts (5.4%), oppositional deviant disorders (4.1%), and conduct disorder (2.7%). In nonadolescents, common diagnoses include sepsis (30.6%), Severe Acute Malnutrition (SAM) (30.6%), and malaria (11.1%). There was a significant difference between the adolescents and nonadolescents with respect to diagnosis (P &lt; 0.001), treatment modalities (P &lt; 0.001), type of care received (P &lt; 0.001), and outcome (P = 0.002). Conclusion: The study has portrayed that the common medical conditions seen among adolescents include sexual assault, acne, HIV, PID/STI, and somatisation. This will be useful in developing health-care services and program geared toward adolescent health.

Case Series of Recrudescence in Lassa fever - The Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA) Experience.

Case Series of Recrudescence in Lassa fever - The Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA) Experience.

Antibiotic Susceptibility Profile of Clinical Isolate of Carbapenem-Resistant Pseudomonas aeruginosa

Background and Objectives: Carbapenem-resistant Pseudomonas aeruginosa, are among the top tier of the list of antibiotic-resistant priority pathogens that pose the greatest threat to human health. In recent years, the rate of carbapenem resistance in Pseudomonas aeruginosa has increased worldwide and has become of great concern since it significantly restricts the therapeutic options for patients. Therefore this study was undertaken to determine the antibiotic susceptibility profile of the clinical isolate of Carbapenem-resistant Pseudomonas aeruginosa.&#x0D; Methodology: A total of five hundred (500) clinical samples were collected from patient’s attending Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State (AFEUTHA). The collected samples were analyzed for the presence of Pseudomonas aeruginosa using standard microbiological techniques for isolation and characterization of bacteria. Further strain confirmation was performed using VITEK 2 System. Phenotypic detection of Carbapenem-resistant Pseudomonas aeruginosa was performed using Modified Hodge testing. Antibiotic susceptibility was performed by employing Kirby-Bauer disk diffusion method and the results were interpreted using the Clinical Laboratory Standard Institute (CLSI) zone diameter breakpoints.&#x0D; Results: The occurrence rate of Pseudomonas aeruginosa in clinical samples accounted for 119(23.8%) consisting of a high proportion from urine sample 81(27.4%) followed by wound swabs 13(25.5%), high vaginal swabs 17(20.7) while the least occurrence rate was observed against catheter tips 5(12.8%) and sputum 3(9.4%). Modified Hodge testing revealed 31(6.2%) carbapenem-resistant Pseudomonas aeruginosa comprising of high proportion of 24(8.1%) from urine samples followed by wound swab 5(9.8%) while Carbapenem-resistant Pseudomonas aeruginosa was absent in High Vaginal Swab recording 0(0.0%). Carbapenem-resistant Pseudomonas aeruginosa isolates were highly resistant to amoxicillin-clavulanic 100%, colistin 100%, tetracycline 100%, nitrofurantoin 70.8%, aztreonam 87.5% but were susceptible to nalixidic acid 50.0 %, ofloxacin 75.0%, and ciprofloxacin 100%.&#x0D; Conclusion: As in-vitro susceptibility of carbapenem-resistant Pseudomonas aeruginosa isolates to ofloxacin and ciprofloxacin is known, their judicious utilization will accelerate a significant improvement in the patient's condition. As such, there is a substantial need for the evaluation of a wide spectrum and new therapies in different classes to counteract this imminent crisis of resistance among Carbapenem-resistant Pseudomonas aeruginosa.

2023/2024, Alex Ekwueme Federal University Teaching Hospital Abakaliki Admission Form is out c

2023/2024, Alex Ekwueme Federal University Teaching Hospital Abakaliki Admission Form is out c

COVID-19 vaccination acceptance among community members and health workers in Ebonyi state, Nigeria: study protocol for a concurrent-independent mixed method analyses of intention to receive, timeliness of the intention to receive, uptake and hesitancy to COVID-19 vaccination and the determinants

IntroductionThe COVID-19 pandemic has gravely affected the lives and economies of the global population including Nigeria. The attainment of herd immunity through mass COVID-19 vaccination is the foremost control strategy,...

Knowledge, Attitude and Practices (KAP) of Preconceptional Folic Acid supplementation among pregnant women (18-45years) attending antenatal clinic in Alex Ekwueme Federal University Teaching hospital Abakaliki, Ebonyi State, Nigeria

Background: Folate deficiency is associated with poor pregnancy outcomes and is one of the most common vitamin deficiencies in women, especially those of reproductive age. Folic acid intake prior to, and during, the first months of pregnancy significantly reduces the risk of fetal neural tube defects. Maternal folate status has been associated with other adverse pregnancy outcomes such as preeclampsia, malformations (orofacial clefts, Neural tube defects, anencephaly and encephalocele resulting from incomplete neural tube closure during early embryogenesis), spontaneous abortion, fetal death, fetal growth restriction and preterm delivery. Methods: The study embraced a cross-sectional study that assess Knowledge, Attitude and Practice of preconceptional folic acid supplementation among pregnant women (18-45years) attending antenatal clinic in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State. 152 women attending antenatal clinics in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State were interviewed using structured questionnaire. Data collected were analyzed using SPSS version 21 for frequency and percentage at P &lt; 0.05 significance level. Results: 98.7% of the participants had heard about folic acid, but an analysis of data shows that 26.6% of them knew that folic acid is a vitamin. In addition, very few (29.6%) knew that folic acid could prevent neural tube defects. The main source of information about folic acid supplementation among the surveyed women were through the health workers. Incidence of at least one episode of adverse pregnancy outcome was noted in about 35.5% of the population under study though a majority indicated the form for their loss were miscarriage and stillbirth. Finding showed that 37.5% of the respondent claimed to have used folic acid before pregnancy while 40.1% of the women in this study were aware of the right time to start using folic acid. 46% of the women took folic acid during Antenatal care and their reason were attributed to late presentation for antenatal care, delayed prescription of the folic acid for women during pregnancy, unplanned pregnancy while others claimed they are getting enough folate from food. Approximately 40.8% of the respondents had started supplementation on antenatal booking and from analysis of data on the preferred/normal booking time of the respondents it shows that a high percentage of them attended antenatal from the third month of pregnancy this shows that the majority of the respondents started supplementation too late which is inconsistent with the ideal time to start folic acid supplementation in prevention of neural tube defect. In this study it has been revealed that 48% of the respondents could identify green leafy vegetable as the only source of folate in local foods and 0.7% could identify other food sources like legumes and fruits as sources of folate. Conclusion: There is a low overall level of awareness of folic acid among pregnant women including lack of understanding of its natural sources, usefulness in preventing Neural Tube Defects and preconceptional intake recommendation. Health education regarding the preconceptional use of folic acid among women of reproductive age is recommended.

Effects of 8-Week Circuit Exercise Training on the Cardiorespiratory Fitness and Health Status of People Living with HIV at Abakaliki, Ebonyi State, Nigeria

Introduction: Exercise is regarded as an important adjuvant therapy for reducing the negative effects of Antiretroviral Therapy and improving the health status of people living with HIV (PLWH), but there is limited evidence on the effects of circuit exercise training on PLWH. Objective: This study determined the effects of circuit exercise on the cardiorespiratory fitness and health status of PLWH. Methods: This pretest-posttest randomized control study recruited 120 PLWH from the HIV clinic at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Participants were consecutively invited at the clinic to join the study. Fish bowl method was used to randomize the participants to either intervention group or control group. Moderate intensity (50 – 75% MHR) circuit exercise training was administered to the participants 3 times a week, between 30-60 minutes per session, for 8 weeks. Cardiorespiratory fitness and health status were measured at baseline and at 8-week. Descriptive statistics of mean, standard deviation, percentages, and bar chart was used to summarize data. Paired sample t-test and independent sample t-test were used to determine the mean difference within and between the groups respectively. Alpha level was set at P&lt;0.05. Results: There was statistically significant difference in mean score of cardiorespiratory fitness and health status within the intervention group, and between the groups after 8-week circuit exercise training. Bar chart showed improvement in all the domains of health status. Conclusion: An 8-week circuit exercise training improved cardiorespiratory fitness, and health status of PLWH.

Prevalence and determinants of use of traditional methods of infertility treatment among women attending infertility clinic in Southeast Nigeria.

Infertility, an obstacle to healthy living, makes its victims patronize traditional methods of infertility treatment (TMIT) in spite of associated complications. They turn to hospitals when this method fails. This is actually a serious issue because the presence of contaminated herbal products and the relationship between the use of TMIT and noncompliance with biomedical treatment regimens constitutes a major concern in medical practice. And the use of traditional methods of infertility treatment has been correlated with severe and fatal consequences. Therefore, the study assessed prevalence/determinants of TMIT use among patients visiting the gynaecology clinic at Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA). Descriptive cross-sectional design was adopted for the research. Only 263 women took part in the study. The research instrument was questionnaire. Data were analyzed using descriptive statistics. Findings revealed that 95.4% of these women have used traditional methods for infertility treatment and factors influencing infertile women's use of TMIT are demographic characteristics, infertility duration, husbands' relatives' pressure and cheap cost of traditional medical treatment. Again, inability of infertile women to disclose TMIT use to healthcare providers makes effective treatment difficult. Therefore, these impediments expose infertile women to use TMIT. The result is a guide to healthcare providers who are expected to know the extent of their parents' use of TMIT.

Wound Bed Preparation Using Unripe Pawpaw in a Resource-poor Environment: A Prospective Study.

BACKGROUNDChronic wounds affect mainly the productive age group in developing countries and stretch the limited healthcare facility. We aimed to establish the efficacy or otherwise of pawpaw dressing in management of common forms of wounds in resource-poor settings using the Nigerian pawpaw in humans.METHODSThis study was a prospective research carried out at Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria between September 2019 and August 2020 using patients with lower extremity wounds. Thirty patients who had lower extremity wounds that required debridement were enrolled in the study after giving consent. They had wound dressing with unripe pawpaw as an enzymatic debriding agent to evaluate the rapidity of eschar separation and bacterial clearance. The data obtained with a proforma were analyzed using IBM SPSS.RESULTSThere were 16 males and 14 females with an average wound size of 127.13+ 103cm2. Eschar separation occurred earliest after 3 d of dressing and the latest after 14 d with a mean period of 5.5+ 2.255 days. A case had negative bacterial culture on the first test. Others had a variable period of clearance with a maximum of 18 d and a mean of 6.73+3.750 days. Both eschar separation and bacterial clearance correlated positively with the wound size.CONCLUSIONWound bed preparation with unripe pawpaw dressing showed promising outcomes with rapid eschar and slough separation, and bacterial clearance resulting in a faster wound healing. This is recommended for wounds needing debridement in which the patients are not fit for anesthesia or could not afford the cost of surgery.

Malaria rapid diagnostic test positivity rate among febrile patients seen at the Paediatric emergency unit of a tertiary care facility

Background: Malaria, a life-threatening parasitic disease transmitted to humans by the female Anopheles mosquito is one of the infectious causes of fever in children. In Nigeria, malaria remains one of the most important health problems, accounting for 25% of infants and 30% of under-five mortalities. The objective of this study was to determine the prevalence of malaria among febrile children presenting at the children's emergency room (CHER) of a tertiary health facility in Abakaliki using a malaria rapid diagnostic test (mRDT).&#x0D; Methodology: This was a retrospective study that involved children presenting with fever in CHER over a 3-year period. A total of 1,273 febrile children below 18 years of age were tested with a malaria rapid diagnostic test (mRDT) kit during this period. Medical records of the patients were assessed to retrieve information such as age, gender, and clinical diagnoses. Data were analyzed using SPSS version 25.&#x0D; Results: A total of 707 (55.5%) were males and 883 (69.4%) were below 5 years of age. The overall prevalence of malaria by the mRDT test was 26% (n=331). Uncomplicated malaria, 283 (22.2%) was the commonest clinical diagnosis made while the least was malnutrition 3 (0.2%). Children aged 10-&lt;18 years were predominantly affected as mRDT positivity rate was significantly higher in children age group 10-&lt;18 years (40.4% 76/189) than other age groups (X2=44.76, p&lt;0.001). Similarly, the rate was significantly higher (OR 9.625, 95% CI 7.233-12.808, p&lt;0.0001) in children with the clinical diagnosis of malaria (55.2%, 235/426) than those with the clinical diagnosis of other illnesses (11.3%, 96/847), and significantly higher (OR 0.19, 95% CI 0.1186-0.3043, p&lt;0.0001) among those clinically diagnosed with complicated (79.7%, 114/143) than those with uncomplicated malaria (42.8%, 121/283).&#x0D; Conclusion: There is a high prevalence of malaria among febrile children presenting at the CHER of Alex Ekwueme Federal University Teaching Hospital Abakaliki. Children age group 10-&lt;18 years were predominantly affected. The use of mRDT should be encouraged both as a screening and diagnostic tool with a protocol such that febrile children who have positive results are confirmed as having malaria while those with negative results are further evaluated with microscopy.