Secondary Health Centers Research Articles

Prevalence and predictors of job stress among healthcare workers in secondary health centers in a Nigerian City

Prevalence and predictors of job stress among healthcare workers in secondary health centers in a Nigerian City

The Stunting Determinants in Toddlers from Landak Regency, West Kalimantan: A Cross-Sectional Study

Background: Stunting is a nutrition problem that can slow down the growth. With prevalence at 32.5%, Landak Regency in West Kalimantan has been designated as a stunting hotspot. The lack of a maximum penalty for the stunting case in Landak Regency is not based on factors causing the stunting itself, because there is no identifiable factor causing the stunting in certain area due to narrow roads and sharp curves. Objectives: The objective of this study was to identify causes and distribution of the stunting case in Landak Regency. Methods: A total of 330 households in Meranti, Sebangki, and Senakin were included in this cross-sectional study because they were at a risk of the stunting. Toddlers, mothers, health care, and environmental factors were among the found variables. The researchers employed a basic random sampling strategy for the sampling and used the secondary health center data to find out whether or not toddlers were stunted. Researchers in this study collected data on the independent variables by observing and interviewing participants. Using the chi-square test, the data was analyzed. Results: The results showed that determinants of the stunting in Landak Regency were the history of early breastfeeding initiation (p-value=0.032), exclusive breastfeeding (p-value=0.042), frequency of exclusive breastfeeding (p-value=0.040), the continued breastfeeding (p-value=0.024), complementary feeding (p-value=0.042), immunization history (p-value=0.007), infectious disease history (p-value=0.000), maternal height (p-value=0.046), delivery assistance (p-value=0.000), access to health services (p-value=0.004), the role of health workers (p-value=0.002), and family latrine ownership (p-value=0.000). Conclusions: Several factors were found to be associated with incidence of the stunting among toddlers in Landak Regency.

Clinicoepidemiological profile of measles in adults: A study from semi-urban area in South India

BackgroundMeasles is a highly contagious, airborne disease caused by rubeola virus of paramyxoviridae family. It presents with fever, rash, and other associated symptoms like headache, cough, coryza, and conjunctivitis. It is common in children, and when occurs in adults, it is usually morbid. The clinical data on adults’ measles in Indian scenario are sparse. We report here an outbreak of measles affecting 52 adults. The primary objective of the study was to describe the clinical and laboratory findings obtained in an outbreak of adult measles cases from semi-urban area in India. MethodsThe study was an observational study conducted in a secondary care health center over a period of 2 months. ResultsFifty-two males with median age of 22.02 ± 3.5yr were diagnosed and treated for measles. All presented with fever and rash. The characteristic Koplik's spots appeared in 21 cases. On the day of their admission, 48% had lymphopenia and only one had thrombocytopenia. Liver enzyme dearrangements were seen in 18 patients. Sixteen patients had complications which included eight pneumonitis, three corneal ulcerations, three otitis media, and one case of acute encephalitis and polyserositis each. No deaths were reported in our study. We followed 34 cases and observed that their rashes healed with scars and laboratory parameters got normalized after six weeks. ConclusionClinician should be vigilant of measles as a differential in adults presenting as fever with rash. In doubt, the serological sampling should be carried out. Mass immunization is necessary to prevent the outbreaks.

Evaluation of the Presentation of Newly Diagnosed Type 1 Diabetes Mellitus in Children During and After the COVID-19 Pandemic

Background: The COVID-19 pandemic has been a global health problem with high morbidity and mortality. In this study, it was aimed to compare the clinical and laboratory findings of patients diagnosed with type 1 diabetes(T1D) during the pandemic and after the pandemic. Method: This is a 30-month, single-center, cross-sectional study. Between October 2020 and December 2021 was defined as the pandemic period, and between January 2022 and March 2023 as the post-pandemic period. The clinical and laboratory parameters of the newly diagnosed T1D patients who applied in these two time periods were compared. Results: While 87 patients were diagnosed during the pandemic period, 86 patients were diagnosed during the post-pandemic period. The rate of male patients diagnosed during the pandemic period was significantly higher (56%, 36%, respectively, p=0.007). Anti-islet Cell antibody (ICA) positivity was statistically significantly higher in those diagnosed during the pandemic period. (52.6%, 18.6%, respectively, p<0.001). There was no difference between the groups in terms of hemoglobin A1C, thyroid autoantibodies and tissue transglutaminase antibodies (p>0.05).C peptide levels were significantly lower in those diagnosed during the pandemic period (0.39±0.4, 0.63±0.6, respectively, p=0.021). Admissions with severe acidosis were more common during the pandemic than those admitted after the pandemic (29.9%, 16.3%, respectively, p=0.151). Conclusions: The numbers of children with T1D newly diagnosed in a secondary health center were similar during and after the pandemic. In the pandemic period, admissions with autoantibody positivity, low C-peptide and severe acidosis were more common.

A Pediatric Cardiology Outreach Clinic in a Local Hospital: An Experience Review from South A'Sharqiyah, Oman.

Specialized pediatric cardiology clinics conducted in local hospitals are an important part of delivering specialized care to patients close to their homes. This study aimed to review our experience with a specialized pediatric cardiology outreach clinic at Jaalan Bani Bu Ali Hospital, South A'Sharqiyah, Oman. Patient records for each individual, seen in the outreach clinic between March 2018 and June 2022, were reviewed to determine demographic information, reason for referral, underlying diagnosis, and clinic visit outcomes. Over the study period, 29 clinics were conducted, with 360 patients seen. Of these, 200 (55.6%) were male with a median age of 13 months. The majority of patients (n = 271; 75.3%) were referred due to a cardiac murmur. Most patients had a normal cardiac evaluation (n = 177; 49.2%). The most common congenital heart diseases detected were mild pulmonary valve stenosis (14.8%) and moderate to large secundum atrial septal defects (13.7%). Significant cardiac lesions detected included severe pulmonary hypertension (2.2%), tetralogy of Fallot (1.6%), and cor triatriatum sinistrum (0.5%). Overall, 70 (19.4%) patients were referred to tertiary care hospitals, and 179 (49.7%) were reassured and discharged. Conducting specialized pediatric cardiology outreach clinics in overpopulated areas is effective and well-received by families. It reassures many families and reduces the need for unnecessary travel to specialized centers. These clinics also play a crucial role in detecting patients with significant cardiac defects requiring urgent care. Implementing specialized clinics in primary and secondary health centers could be beneficial for other subspecialties in reducing long waiting lists.

Are institutional deliveries equitable in the southern states of India? A benefit incidence analysis

BackgroundDespite a commendable rise in the number of women seeking delivery care at public health institutions in South India, it is unclear if the benefit accrues to wealthier or poorer socio-economic groups. The study’s aim was to investigate at how the public subsidy is distributed among Indian women who give birth in public hospitals in the southern regions.MethodsData from the Indian Demographic Health Survey’s fifth wave (NFHS-5, 2019–21) was used in this study. A total of 22, 403 were institutional deliveries across all the southern states of India were included. Out-of-pocket expenditure (OOPE) on childbirth in health institutions was the outcome variable. We used summary statistics, Benefits Incidence Analysis (BIA), concentration index (CI), and concentration curve (CC) were used.ResultsMost women in the lowest, poorest, and medium quintiles of wealth opted to give birth in public facilities. In contrast, about 69% of mothers belonging to highest quintile gave birth in private health institutions. The magnitude of CI and CC of institutional delivery indicates that public sector usage was concentrated among poorer quintiles [CIX: − 0.178; SE: 0.005; p < 0.001] and private sector usage was concentrated among wealthier quintiles [CIX: 0.239; SE: 0.006; p < 0.001]. Benefit incidence analyses suggest that middle quintile of women received the maximum public subsidy in primary health centres (33.23%), followed by richer quintile (25.62%), and poorer wealth quintiles (24.84%). These pattern in the secondary health centres was similar.ConclusionPoorer groups utilize the public sector for institutional delivery in greater proportions than the private sector. Middle quintiles seem to benefit the most from public subsidy in terms of the median cost of service and non-payment. Greater efforts must be made to understand how and why these groups are being left behind and what policy measures can enhance their inclusion and financial risk protection.

Drug Supply Chain Management in Public Secondary Health Facilities in Lagos State Nigeria

This study was conducted to analyze the drug supply chain at nineteen selected public secondary health centers (SHC) commonly referred to as General Hospitals, in Lagos State. Data was collected from both primary and secondary sources. The primary data were collected through a well-structured questionnaire while the secondary data were sourced from journals, Lagos State Ministry of Health, Lagos Bureau of Statistics (LBS), National Agency for Food and Drug Administration and Control (NAFDAC), etc. A descriptive statistical method was employed for data analysis using the statistical package for Social Science (SPSS) version 2.0 and ArcGIS 10.8 version. Maps, frequency counts, percentages, and analysis of variance (ANOVA) were also used to test the hypothesis The study contributed to the existing body of knowledge by establishing the Euclidean distance of SHC from Central Medical Store (CMS) Oshodi, the residences within and outside the buffer zone of 2km radius around the SHC in Lagos state and the distribution and accessibility of patients to essential drugs in the study area. Findings confirmed that 79.6% of Pharmacists have received training on supply chain practices. The respondents also said that SHC in Lagos gets about 75% of their drug supplies from Central Medical Store. The result also revealed there is a significant relationship between the number of dispensing outlet and the amount paid for drug by patients. Also, 57.5% of the patients preferred to have their drugs delivered at home and 49.5% were willing to pay extra cost for home delivery. The study suggests strong regulation and strict enforcement of National Drug Distribution Guidelines of 2012 (NDDG) by the regulator. The study concludes that effective supply chain will deliver safe, efficient, and quality drugs to meet the health need of the patients.

Use of cyclin-dependent kinase 4 and 6 inhibitors in treating metastatic breast cancer - a year-long experience of Subotica General Hospital in patient follow-up

Introduction. According to GLOBOCAN data from 2020, breast cancer ranks first in the number of newly diagnosed malignancies. The treatment of advanced, hormone-positive breast cancer has evolved with the use of cyclin-dependent kinase 4 and 6 inhibitors in first- and second-line treatment for metastatic, hormone-positive, HER2-negative breast cancers, in combination with endocrine therapy. As of May 31, 2022, these drugs have become available in the Republic of Serbia. This paper aims to present a one-year experience of a secondary health center in monitoring patients using the treatments. Material and Methods. The data analysis included patients treated with cyclin-dependent kinase 4 and 6 inhibitors from June 1, 2022, to June 1, 2023, at General Hospital Subotica. The analysis covered demographic data, disease presentation, previous therapies, drug usage, side effects, duration, and therapy outcomes. Patients were categorized into two groups based on age (&lt;60 and &gt;60 years) and by the nature of their disease (relapsed or initially metastatic). Results. A total of 43 patients were treated with cyclin-dependent kinase 4 and 6 inhibitors: 23 (53.5%) in the first line and 20 (46.5%) in the second line. The median therapy duration was eight cycles for patients younger than 60 years. A good therapeutic response was observed in 53.5% of patients. Patients younger than 60 years with late relapse exhibited statistically significantly better treatment outcomes compared to those older than 60 years (p=0.04). The most common site of metastases was the bones (51%, 22 patients), with half of these patients showing a good therapeutic response. Conclusion. Although the observed period is short, ongoing monitoring and further research are planned to share experiences on the use of these drugs.

Quality provision in Pakistani health care system: insights into a major obstacle and the way forward.

Madam, Safety, cost-effectiveness, efficiency and equity are all components of quality healthcare. Key factors determining quality are’ and their families’ satisfactions and better disease outcomes.1 Doctors, paramedics, pharmacists, laboratory technicians, administrative staff, pharmaceutical companies, government agencies and policymakers are the caregivers who have an essential direct or indirect role in providing, sustaining and improving health care.1 A population's health is crucial to a state's stability and growth. Quality in healthcare has been a subject of discussion across the globe for decades, with developed nations contributing the majority of its measures and recommendations6. In contrast it is still battling to fully establish and function in emerging nations like Pakistan. The health system in Pakistan comprises primary, secondary and tertiary health centres. The latter are found in a few urban cities and are run by both the public and private sectors. Private bodies include profit as well as welfare-based organizations.2,3 According to the WHO, on average, there are 6.3 hospital beds per 10,000 population in Pakistan, which is below its recommendation and much less compared to other developing nations.2 Majority of the population reside in rural areas and thus their option in various illnesses is primary or secondary health unit.3 The major drawback in such centres is lack of attendance by doctors and paramedical staff, lack of competent clinician or general practitioner along with absence of equipment, state-of-the-art laboratory and latest treatment options, all contributing to delays in diagnosis and management.4,5 There is also a lack of patient registry, long-term follow-ups, appropriate and timely referrals to higher health care centre and disease discussion between clinicians.3 Due to such weakened basic units, many patients directly visit an urbanized tertiary health center, which is a major cause of overcrowding of our hospitals. Some break-through policies which could address this dilemma is giving incentives to the assigned staff, providing commute in case of long travels, improving the infrastructure and facilities within the centers, installation of biometrics and having regular audit of attendance, number of patients treated and medications provided. Conducting education seminars regarding work ethics would also contribute towards a professional working environment leading to better patient outcomes.3,4 Creating awareness regarding the responsibility and crucial role of general practitioners in primary and secondary health units along with recognition of their importance, would also help in diverting medical community towards opting for such roles.6 ---Continue

Temporal Trends and Spectrum of Pediatric Surgical Conditions Operated In A Tertiary Care Teaching Hospital In Pakistan

Introduction: Knowing the temporal trends as to when and how many pediatric surgery patients present and are operated on in a newly developed unit is crucial in the allocation of resources and policy making in health care center. Aims &amp; Objectives: The aim of this study is to describe the spectrum and pattern of operated pediatric surgery patients in a newly developed pediatric surgical unit of Pakistan. Place and Duration of Study: This study was conducted at Pardiatric Surgery Unit of Holy Family hospital, Rawalpindi between January 2020 and September 2021. Material &amp; Methods: This was a retrospective descriptive study conducted on all patients that were operated under Pediatric surgery unit over a period of 20-months. Data regarding age, sex, diagnosis, and procedure performed were obtained. Diagnoses were categorized based on organ system. SPSS version 22 was used to perform the data analysis., a p-value of ?0.05 was considered significant. Results:898 procedures were performed in total with a male to female ratio of 2.03:1. Most of the patients fell under 2-8 years of age. Digestive system disorders (164, 18.3%) and genitourinary (377, 42%) made most of the cases observed, with inguinal hernias making up to 15.0% of all cases. Oddsratio was calculated for different variables which showed that male patients , patients with gastrointestinal problems had greater odds of being operated. Conclusion: The expected number of operated cases in a newly developed unit is comparable to other units that have been established for a long time.More focus research needs to be done on different aspects of pediatric surgery in our region and to try for integration of pediatric surgery into public health programs including primary and secondary health centers to meet the increasing demand of pediatric surgical patients presented to tertiary care.

A Facility-Based Study of the Impact of COVID-19 on Supply Chain Performance of HIV/AIDS Commodities in Anambra State, Nigeria

The COVID-19 pandemic and its induced lockdown resulted in huge disruptions that affected access to and availability of healthcare commodities at different levels of the supply chain system. An understanding of the pandemic impact in different areas will help in designing strategies to mitigate future disruptions. This study was designed to evaluate the supply chain performance of HIV/AIDS commodities through the review of key performance indicators in health facilities in Anambra State, Nigeria, during the COVID-19 pandemic lockdown. A facility-based cross- sectional study was conducted across 27 selected health facilities in the state. Facilities were selected using a stratified random sampling technique. Data was collected using a combination of a semi-structured questionnaire and observational checklists adapted from a previous study and the Logistics Indicators Assessment Tool (LIAT). Data obtained were analyzed using SPSS software (version 23). A total number of 44 focal personnel managing the HIV/AIDS supply chain in 17 secondary health centres (SHCs) and 10 primary health centres (PHCs) participated in the study. Tenofovir/Lamivudine/Dolutegravir (300/300/50mg) and Nevirapine 10mg/ml oral suspension were the two most available drugs at 85.19% and 78% respectively whereas Determine and Uni-Gold were the most available non- drug commodities at 92.59%, and 81.48% respectively during the lockdown period. The Stat-Pak test kit was stocked out in 30% of the facilities during the lockdown with emergency orders of at least one HIV commodity recorded in 37% of the facilities during this period. Expired products were recorded in 48% of the health facilities and this amounted to a loss of USD 4,027.25. The COVID-19 crisis exposed vulnerabilities in Anambra State's HIV/AIDS commodity supply chain. Instances of emergency orders, stock-outs, and wastage highlight the need for a more resilient system. Investing in an agile supply chain is crucial for ensuring uninterrupted access to essential healthcare commodities during disruptions.

Knowledge and Practice of Pelvic Floor Muscle Exercises Among Antenatal and Postnatal Women Attending a Secondary Health Facility in Southeast, Nigeria

BACKGROUND:Pelvic floor exercise is beneficial to every antenatal and postnatal woman as it helps to strengthen the pelvic floor muscle and prevent pelvic floor complications. Although the knowledge, practice, and benefits of pelvic floor muscle exercises (PFMEs) are fairly known among health care professionals, there seems to be a deficit in knowledge and practice of PFMEs among antenatal and postnatal women in the study location.OBJECTIVES:This study assessed the knowledge and practice of PFMEs among women attending antenatal and postnatal clinics in a secondary health center, in Southeast, Nigeria.METHODS:Using a descriptive cross-sectional design, a convenience sampling technique was used to select 143 pregnant and postpartum women at a secondary health center. A researcher-designed questionnaire was used to collect information on their demographics, knowledge, and the practice of pelvic floor exercises. Data were analyzed using descriptive and inferential statistics in Statistical Package for the Social Sciences version 25 at 5% alpha level.RESULTS:The findings showed that a small proportion (28.5%) had good knowledge; however, 54 (54.7%) practiced PFMEs. There was a significant relationship between knowledge and practice of pelvic floor exercises (p&lt; .001).CONCLUSION:Limited knowledge and practice of PFMEs exist among the study population; therefore, good clinical practice guidelines should be developed to train and guide health providers on the best way to utilize antenatal classes to inform and train the antenatal and postnatal women properly on PFMEs.

The Convergence of Percapita Income in Central Sulawesi Province

This research aims at analyzing the influence of economic growth and human development index on the poverty rate of 13 regencies/cities in Central Sulawesi Province. The data were analyzed using panel data which employed Eviews version 11 software. The result of fixed effect model regression shows that economic growth and mean years of schooling negatively and significantly affect poverty rate, life expectancy and per capita expenditure positively and significantly affect poverty rate, and expected years of schooling does not affect poverty rate in regencies/cities of Central Sulawesi Province. To mitigate the poverty rate constant reference to pro-poor, pro-job, and pro-growth policies should be maintained and job vacancy need to be expanded and regency/city government could increase the realization of school and teacher facility spending budget allocation, administer nonformal education which can increase workers’ productivity, provide hospital, public health center, secondary public health center and health personnel facilities, public infrastructure and education assistance such as providing training on creativity in cooperatives and micro-, small-, and medium-enterprises (MSMEs).

The Role of Token Economy Therapy in Reducing the Psychological Burden of Formal Caregivers

Background: The responsibilities of providing care and support for individuals suffering from any form of illness sometimes impose psychological burdens of the care providers. Objective: The major concern of this study was to examine whether token economy therapy (TET) can effectively reduce the psychological burden of formal caregivers in Ibadan, Nigeria. Methods: A quasi-experimental design was adopted. Two secondary health centres in Ibadan were purposively selected, while paid caregivers were randomized into intervention (15) and control (15) groups. Two hypotheses were formulated and tested at a 0.05 significance level using Analysis of Covariance as a statistical analysis. Results: Findings revealed that the main effect of treatment was significant on the psychological burden (F (1, 29) = 725.492, partial; ῆ2 = 0.962). Furthermore, participants in the TET group had a post-treatment mean score of (χ=70.410) and those in the control group had (χ=31.335). Conclusion: The study concludes that TET was effective in reducing the psychological burden among health caregivers in state hospitals in Ibadan and was recommended as a treatment modality to reduce psychological burden.

Effect of an Educational Program on Nurses' Knowledge and Practice of Oxygen Therapy.

Past studies have shown that healthcare professionals may lack awareness and knowledge regarding oxygen therapy, and its implementation often has several obstacles. This study was carried out to investigate the effect of an educational program about oxygen therapy on nurses' knowledge and practices. This cross-sectional, quasi-experimental study was conducted in 2022 at the pediatric department of Nishtar Hospital, Multan, where 160 nurses from primary and secondary health centers attended an educational program delivered in the pediatric department. The pre-test-post-test approach was used to evaluate the effectiveness of the structured educational program. The independent variable was the educational program, and the dependent variable was the nurses' knowledge and practice about oxygen toxicity. Data analysis was performed using SPSS version 23 (IBM Corp., New York, USA). The data were tabulated as means and standard deviations for numerical values and frequency percentages for categorical values. The student's t-test and the chi-squaretest were applied to investigate any associations among variables. The average test scores before and after the implementation of the educational program were 10.75±2.65 and 17.52±2.04, respectively. The average post-test score was greater than that of the pre-test, and the difference was statistically significant (p<0.001). The study found that after the implementation of the educational program, the knowledge and practices of nurses regarding oxygen therapy improved significantly, with the majority showing a positive attitude toward the program.

The effect of the healthcare system's structure on COVID‐19 dynamics in Ecuador

AbstractTo manage the COVID‐19 pandemic, governments established certain stringency measures, such as lockdowns and traffic light systems. However, the response to the pandemic depended on the regions' preexisting capacities and underlying conditions. This study aims to determine the relationship between the COVID‐19 pandemic dynamics and the underlying regional healthcare system's structure in Ecuador, using three dependent variables—the number of COVID‐19 cases, the COVID‐19 prevalence rate at the cantonal level, and the daily deaths resulting from COVID‐19 at the provincial level—for three phases: isolation, social distancing, and contingency. Using daily COVID‐19 data and cantonal (provincial) level variables, a negative binomial model and a tobit model were estimated to analyze the determinants of the number of COVID‐19 cases and the prevalence rate, respectively. The results show a positive relationship between primary and secondary health centers and the number of infected people, implying that it is possible to make more diagnoses when the health infrastructure is more developed. As for COVID‐19 deaths, primary health centers are associated with a low number of daily deaths whereas secondary health centers are associated with a higher number of daily deaths, implying the transfer of severe COVID‐19 cases to cantons with secondary health centers. More affluent cantons had more COVID‐19 cases and deaths. Stringency measures, such as the traffic light system, were effective in managing the pandemic. The geographical proximity between cantons and the nature of economic activities (essential versus non‐essential) also impacted the spread of the virus.

Performance of Xpert MTB/RIF and sputum microscopy compared to sputum culture for diagnosis of tuberculosis in seven hospitals in Indonesia.

Tuberculosis (TB) is a major public health concern in Indonesia, where the incidence was 301 cases per 100,000 inhabitants in 2020 and the prevalence of multi-drug resistant (MDR) TB is increasing. Diagnostic testing approaches vary across Indonesia due to resource limitations. Acid-fast bacilli (AFB) smear is widely used, though Xpert MTB/RIF has been the preferred assay for detecting TB and rifampicin resistance since 2012 due to higher sensitivity and ability to rapidly identify rifampicin resistance. However, <1,000 Xpert instruments were available in Indonesia as of 2020 and the Xpert supply chain has suffered interruptions. We compared the performance of Xpert MTB/RIF and AFB smear to facilitate optimization of TB case identification. We analyzed baseline data from a cohort study of adults with pulmonary TB conducted at seven hospitals across Indonesia. We evaluated sensitivity and specificity of AFB smear and Xpert MTB/RIF using Mycobacterium tuberculosis (Mtb) culture as the gold standard, factors associated with assay results, and consistency of Xpert MTB/RIF with drug susceptibility test (DST) in detecting rifampicin resistance. Sensitivity of AFB smear was significantly lower than Xpert MTB/RIF (86.2 vs. 97.4%, p-value <0.001), but specificity was significantly better (86.7 vs. 73.3%, p-value <0.001). Performance varied by hospital. Positivity rate for AFB smear and Mtb culture was higher in subjects with pulmonary cavities and in morning sputum samples. Consistency of Xpert MTB/RIF with DST was lower in those with rifampicin- sensitive TB by DST. Additional evaluation using sputa from primary and secondary Indonesian health centers will increase the generalizability of the assessment of AFB smear and Xpert MTB/RIF performance, and better inform health policy. [https://clinicaltrials.gov/], identifier [NCT027 58236].

Histopathological spectrum of non-neoplastic skin lesions seen in a dermatology clinic in a secondary health centre in Benin city

Histopathological spectrum of non-neoplastic skin lesions seen in a dermatology clinic in a secondary health centre in Benin city

Ocular Manifestations in Severe Acute Malnutrition in Children under 60 Months in a Secondary Health Center

Ocular Manifestations in Severe Acute Malnutrition in Children under 60 Months in a Secondary Health Center

Beta-lactamase production and conjugative ability of multidrug resistant Salmonella Typhi in Southern Benue, Nigeria

Objective: To examine multidrug resistant (MDR) Salmonella (S.) Typhi isolates obtained from the stool samples of patients attending secondary health centers in Southern Benue, Nigeria, for extended spectrum beta-lactamase (ESBL) production and conjugative ability. Methods: The double disc synergy test was used to screen for ESBL production in MDR isolates. The ability of S. Typhi to transfer resistance gene was determined by conjugation experiments using standard protocols, with slight modifications. Escherichia (E.) coli ATCC 25922 was used as the recipient organism. Result: The donor S. Typhi isolates showed resistance to all the classes of antibiotics except aminoglycosides and carbapenems. All isolates except TKP 106, APA 55, APA 78 and OGB 106 were positive for ESBL production. Reduction in the zones of inhibition of E. coli after incubation with S. Typhi showed evidence of conjugation and transfer of antibiotic resistance from S. Typhi to E. coli. Conclusions: The presence of ESBL-producing S. Typhi capable of conjugation poses a significant risk to the treatment and management of typhoid fever, which highlights the need for the regulation of antibiotic use through relevant policies and strategies that aim at halting the spread of MDR and ESBL-producing S. Typhi in such rural settings.