Source Of Public Health Concern Research Articles

Distribution of Natural Trace Elements in the Drinking Water Sources of Hungary

Source water quality is a key determinant of drinking water quality. The recast European Union 2020/2184 Drinking Water Directive (DWD) introduced the obligation for comprehensive risk assessment in drinking water supplies, including hazard assessment of the water source. The DWD also requires further elements of natural origin to be monitored, including U, Ca, Mg and K. The current study is the first comprehensive assessment of 15 natural elements (B, Ba, Be, Ca, Co, K, Li, Mg, Mo, Na, Se, Sr, Ti, U and V) in 1155 (82%) Hungarian drinking water sources, including surface water, bank filtered and groundwater sources. Parameters posing a risk to health (Se, V and U) were typically below the limit of quantification (LOQ), but higher concentrations (max. 7.0, 17 and 41 µg/L, respectively) may occur in confined locations. U exceeded the DWD parametric value in one water supply. Mg and Ca in the majority of the water supplies and Li in a small geographic area reached the concentration range assumed to be protective to health. Water sources were grouped in six clusters based on their elemental distribution, some of them also showing clear geographical patterns. Surface and groundwater sources were not differentiated by composition, with the exception of karstic waters (dominated by Ca and Mg). None of the investigated parameters are expected to be a source of public health concern on a national level, but local occurrences of U and Se should be investigated and managed on a case-by-case basis.

Prevalence and Factors Associated with Cesarean Section at UTH Women and Newborn Hospital Lusaka, Zambia

Background: Increase in cesarean section (CS) has been a source of public health concern globally. There is scanty updated information about cesarean section and associated factors in developing countries like Zambia. The aim of this study was to determine the prevalence of CS and associated factors at The University Teaching Hospital women and New-born in Lusaka Zambia. Methodology: The study design was cross sectional. It involved retrospective collection of data from birth registers of women who gave birth at the University Teaching Hospital-Women and Newborn from 1st January, 2018 to 31st December 2018. The total sample size was 6,965 women (15-49 years) after the inclusion and exclusion criteria were met. Statistical analysis was conducted using Binary Logistic Regression, level of significance was 0.05 and Confidence Interval of 95%. Goodness of fit was conducted using the likelihood ratio test. Data was analyzed using STATA version 14.2. Results: The Prevalence of Cesarean section was 44%. Factors significantly associated with Cesarean Section were maternal age (grouped), Birth weight (grouped), gestational age (grouped) and still birth (AOR=0.47 P<0.0001). There was an increased odds of having Cesarean Section among multipara (AOR= 1.10 P=0.73) and Multigravida (AOR=1.04, P=0.73). Common maternal indicators identified were repeat caesarean section (18%), obstructed labor (11%) and failure to progress (10%). The common fetal indicators identified were fetal distress (18%), big baby (10%) and mal presentation (7%). Conclusion: Prevalence is higher than the recommended WHO limit. There is need to reinforce health education, reinforce fetal monitoring and promote vaginal birth after caesarean. Keywords: Cesarean Section, Prevalence, Factors, Women and newborn, Zambia.

Quality of medicines and public health in Latin America and the Caribbean (LAC): a review

PurposeIncreased outsourcing and importation of drugs from different parts of the world to the Latin America and the Caribbean (LAC) region result in the proliferation of substandard and fake medicines, posing a threat to public health. The presence of substandard and fake medications in LAC regions is a source of public health concern and causes an economic burden to the governments in these regions. Whereas testing and detecting medication quality can easily be achieved in developed countries, the situation is different in developing countries such as LAC. This paper aims to examine the public health challenges faced by LAC regarding substandard, fake and counterfeit medicines and how the region can tackle these challenges.Design/methodology/approachDatabases such as Scopus, PubMed, ScienceDirect, Embase, HINARI, EBSCOhost, Google Scholar, unpublished data, conference abstracts and papers from World Health Organization, Pan-American Health Organization and electronic newspapers were searched concerning medicine quality and in LAC.FindingsDrug treatment improves the quality of life while decreasing morbidity and mortality among diseased populations. Absence of or inadequate testing laboratories, old and ineffective legislature, lack of enforcement or willpower and lack of effective surveillance are challenges in LAC for the proliferation of substandard and falsified medicines (SFMs).Research limitations/implicationsThe most significant limitation of this study was the need for the reviewers to have used articles written in other languages besides English. The LAC region has a large population in non-English-speaking countries, and many articles are written using local languages. Hence, excluding those articles is a limitation worthy of note in this review. The articles accessed needed to provide adequate information on SFM markets and illegal pharmacies or hospitals but did not. Future reviews may focus on providing illegal substandard and falsified medicines markets in the region and how they can be minimized or eliminated.Originality/valueThis review highlights the challenges faced by LAC countries regarding substandard, fake and counterfeit medicines. The sources, prevalence and consequences of substandard and falsified drugs were identified to suggest the measures needed to curb the infiltration of low-quality medicines in LAC.

CRISPR-Cas-Based Antimicrobials: Design, Challenges, and Bacterial Mechanisms of Resistance.

The emergence of antibiotic-resistant bacterial strains is a source of public health concern across the globe. As the discovery of new conventional antibiotics has stalled significantly over the past decade, there is an urgency to develop novel approaches to address drug resistance in infectious diseases. The use of a CRISPR-Cas-based system for the precise elimination of targeted bacterial populations holds promise as an innovative approach for new antimicrobial agent design. The CRISPR-Cas targeting system is celebrated for its high versatility and specificity, offering an excellent opportunity to fight antibiotic resistance in pathogens by selectively inactivating genes involved in antibiotic resistance, biofilm formation, pathogenicity, virulence, or bacterial viability. The CRISPR-Cas strategy can enact antimicrobial effects by two approaches: inactivation of chromosomal genes or curing of plasmids encoding antibiotic resistance. In this Review, we provide an overview of the main CRISPR-Cas systems utilized for the creation of these antimicrobials, as well as highlighting promising studies in the field. We also offer a detailed discussion about the most commonly used mechanisms for CRISPR-Cas delivery: bacteriophages, nanoparticles, and conjugative plasmids. Lastly, we address possible mechanisms of interference that should be considered during the intelligent design of these novel approaches.

Twitter-Based Sentiment Analysis and Topic Modeling of Social Media Posts using Natural Language Processing, to Understand People’s Perspectives Regarding COVID-19 Omicron Subvariants XBB.1.5 and BF.7

Concerns about an increase in cases during the COVID-19 pandemic have been heightened by the emergence of a new Omicron subvariant XBB.1.5 that joined the previously reported BF.7 as a source of public health concern. COVID-19 cases have been on the rise intermittently throughout the ongoing pandemic, likely because of the continuous introduction of SARS-CoV-2 subtypes. The present study analyzed the Indian citizen’s perceptions of the latest covid variants XBB.1.5 and BF.7 using the natural language processing technique, especially topic modeling and sentiment analysis. The tweets posted by Indian citizens regarding this issue were analyzed and used for this study. Government authorities, policymakers, and healthcare officials will be better able to implement the necessary policy effectively to tackle the XBB 1.5 and BF.7 crises if they are aware of the people’s sentiments and concerns about the crisis. A total of 8,54,312 tweets have been used for this study. Our sentiment analysis study has revealed that out of those 8,54,312 tweets, the highest number of tweets (n = 3,19,512 tweets (37.3%)) about COVID variants XBB.1.5 and BF.7 had neutral sentiments, 3,16,951 tweets (37.1%) showed positive sentiments and 2,17,849 tweets (25.4%) had negative sentiments. Fear of the future and concerns about the immunity of the vaccines are of prime concerns to tackle the ongoing pandemic.

Occurrence and Resistance Pattern of Gram-Negative Bacteremia and Sepsis in A Tertiary Care Hospital - A Four-Year Study

The rise in antibiotic resistance has been a major source of public health concern. As a result, mortality and morbidity rates have risen significantly. This study was done to identify gram-negative organisms causing bacteremia/sepsis, study their prevalence rates, and antimicrobial resistance patterns, as evidence-based knowledge of gram-negative organisms causing sepsis and their resistance profiles is essential for effective hospital control and better management of infections caused by resistant bacteria. A retrospective study, conducted from January 2016 to December 2019, blood samples were collected using aseptic guidelines and cultured using automated blood culture methods. Biochemical tests were done according to microbiology standard procedures, while antimicrobial testing was done according to CLSI guidelines. A total of 13,808 blood samples were received within the study period of four years. Of the total, 2079 showed significant growth, with 765 being GNB isolates. The most common isolates were Escherichia coli (35.42%), Klebsiella pneumonia (19.74%), Acinetobacter species (9.67%), and other non-fermenting gram-negative bacilli (11.76%). Escherichia coli showed yearly resistance to aminoglycosides, cephalosporins, penicillin, fluoroquinolones, and B-lactam combination agents. Routine surveillance and awareness of the prevalence, etiological agents, and antibiotic resistance of gram-negative bacteria causing bacteremia/sepsis is critical for individual therapy, hospital control, and the effectiveness of preventive interventions.

Disposition Kinetics of Amitraz in Lactating Does.

Amitraz, a member of the formamidine pesticide family, commonly used for ectoparasite control, is applied as a dip or low-pressure hand spray to cattle and swine, and the neck collar on dogs. Data on amitraz were generated mainly on laboratory animals, hens, dogs, and baboons. The data on the toxicity and disposition of amitraz in animals and its residues in the milk are inadequate. Therefore, the present study was intended to analyze the disposition kinetics of amitraz and its pattern of elimination in the milk of lactating does after a single dermal application at a concentration of 0.25%. Blood at predetermined time intervals and milk twice daily were collected for eight days post application. The drug concentration was assayed by high-performance liquid chromatography (HPLC). Amitraz was detected in whole blood as early as 0.5 h, which attained a peak concentration at 12 ± 5 h, followed by a steady decline; however, detection persisted until 168 h. Amitraz was present in the blood at its 50% Cmax even after 48 h, and was still detectable after 7 days. The disposition after a single dermal application was best described non-compartmentally. The mean terminal half-life (t1/2), mean residence time (MRT), and area under the curve (AUC0–t) were 111 ± 31 h, 168 ± 39 h, and 539 ± 211 µg/mL/h, respectively. The apparent volume of distribution (Vdarea) was 92 ± 36 mL/g with an observed clearance (Cl) of 0.57 ± 0.33 mL/kg/h. Thus, the drug was well absorbed, widely distributed and slowly eliminated from the animal body. Amitraz achieved milk concentration approximating 0.2 per cent of the total dose after a single exposure and the steady-state elimination of amitraz in milk above the recommended maximum residue limit (MRL) of 0.01 mg/kg can act as a source of public health concern when applied on lactating animals.

Environmentally induced ribosomal DNA (rDNA) instability in human cells and populations exposed to hexavalent chromium [Cr (VI)

Hexavalent Chromium [Cr (VI)] is an established toxicant, carcinogen, and a significant source of public health concern. The multicopy ribosomal DNA (rDNA) array is mechanistically linked to aging and cancer, is the most evolutionarily conserved segment of the human genome, and gives origin to nucleolus, a nuclear organelle where ribosomes are assembled. Here we show that exposure to Cr (VI) induces instability in the rDNA, triggering cycles of rapid, specific, and transient amplification and contraction of the array in human cells. The dynamic of environmentally responsive rDNA copy number (CN) amplification and contraction occurs at doses to which millions of individuals are regularly exposed. Finally, analyses of human populations occupationally exposed to Cr (VI) indicate that environmental exposure history and drinking habits but not age shape extensive naturally occurring rDNA copy number variation. Our observations identify a novel pathway of response to hexavalent chromium exposure and raise the prospect that a suite of environmental determinants of rDNA copy number remain to be discovered.

Emergence of Bat-Related Betacoronaviruses: Hazard and Risks.

The current Coronavirus Disease 2019 (COVID-19) pandemic, with more than 111 million reported cases and 2,500,000 deaths worldwide (mortality rate currently estimated at 2.2%), is a stark reminder that coronaviruses (CoV)-induced diseases remain a major threat to humanity. COVID-19 is only the latest case of betacoronavirus (β-CoV) epidemics/pandemics. In the last 20 years, two deadly CoV epidemics, Severe Acute Respiratory Syndrome (SARS; fatality rate 9.6%) and Middle East Respiratory Syndrome (MERS; fatality rate 34.7%), plus the emergence of HCoV-HKU1 which causes the winter common cold (fatality rate 0.5%), were already a source of public health concern. Betacoronaviruses can also be a threat for livestock, as evidenced by the Swine Acute Diarrhea Syndrome (SADS) epizootic in pigs. These repeated outbreaks of β-CoV-induced diseases raise the question of the dynamic of propagation of this group of viruses in wildlife and human ecosystems. SARS-CoV, SARS-CoV-2, and HCoV-HKU1 emerged in Asia, strongly suggesting the existence of a regional hot spot for emergence. However, there might be other regional hot spots, as seen with MERS-CoV, which emerged in the Arabian Peninsula. β-CoVs responsible for human respiratory infections are closely related to bat-borne viruses. Bats are present worldwide and their level of infection with CoVs is very high on all continents. However, there is as yet no evidence of direct bat-to-human coronavirus infection. Transmission of β-CoV to humans is considered to occur accidentally through contact with susceptible intermediate animal species. This zoonotic emergence is a complex process involving not only bats, wildlife and natural ecosystems, but also many anthropogenic and societal aspects. Here, we try to understand why only few hot spots of β-CoV emergence have been identified despite worldwide bats and bat-borne β-CoV distribution. In this work, we analyze and compare the natural and anthropogenic environments associated with the emergence of β-CoV and outline conserved features likely to create favorable conditions for a new epidemic. We suggest monitoring South and East Africa as well as South America as these regions bring together many of the conditions that could make them future hot spots.

Nigeria, a high burden state of obstetric fistula: a contextual analysis of key drivers.

Obstetric fistula (OF) remain a source of public health concern and one of the most devastating maternal morbidities afflicting about two million women, mostly in developing countries. It is still prevalent in Nigeria due to the existence of socio-cultural beliefs/practices, socio-economic state and poor health facilities. The country's estimated annual 40,000 pregnancy-related deaths account for about 14% of the global maternal mortality, placing it among the top 10 most dangerous countries in the world for a woman to give birth. However, maternal morbidities including OF account for 20 to 30 times the number of maternal mortalities. This review substantiates why OF is yet to be eliminated in Nigeria as one of the countries with the largest burden of obstetric fistula. There is need for coordinated response to prevent and eliminate this morbidity via political commitment, implementation of evidence-based policy and execution of prevention programs.

Microbiological Quality of Traditionally Fermented Fresh Cow Milk (Nono) Retailed in Selected Local Government Areas of Kano State, Nigeria

Nono is an African fermented beverage commonly prepared by the Fulani cattle herdsmen and sold by their maids to both rural and urban people.This study was conducted to assess the microbiologicalquality of traditionally fermented fresh cow milk (Nono) retailed in selected local government areas of Kano State, Nigeria using standard protocol.The physico-chemical parameters (pH, titratable acidity and viscosity) were determined according to standard methods. The microbiological analyses carried out were based on the enumeration of aerobic mesophilic bacteria, lactic acid bacteria, Streptococcus sp.,fungi, Shigellasp. as well as the isolation and identification of Salmonella sp., Staphylococcus aureus and Clostridium botulinum using the method of International Dairy Federation. The results of the analyses showed that the pH ranged from 3.59 - 5.36, titratable acidity (0.73 - 2.17%), viscosity (10.14 – 550 cp). The aerobic mesophilic count ranged between 0.0 – 2.8 x 106cfu/ml. Lactic acid bacteria ranged from 4.0 x 103 – 6.0 x 106 cfu/ml. Streptococcus sp. ranged from 0.0 – 4.8 x 105cfu/ml.Fungal count ranged from 0.0 – 8.8 x 106cfu/mlwhile Shigella sp. ranged between 0.0 –9.3 x 104 cfu/ml. Staphylococcus aureus was not detected in any of the samples analyzed. The incidence of Salmonella sp. obtained in this study was 3.5% while Clostridium botulinum was 1.75%. The presence of these pathogens in nono milk is a source of public health concern.

Extinction of Zika Virus and Usutu Virus by Lethal Mutagenesis Reveals Different Patterns of Sensitivity to Three Mutagenic Drugs

Flaviviruses constitute an increasing source of public health concern, with growing numbers of pathogens causing disease and geographic spread to temperate climates. Despite a large body of evidence supporting mutagenesis as a conceivable antiviral strategy, there are currently no data on the sensitivity to increased mutagenesis for Zika virus (ZIKV) and Usutu virus (USUV), two emerging flaviviral threats. In this study, we demonstrate that both viruses are sensitive to three ribonucleosides, favipiravir, ribavirin, and 5-fluorouracil, that have shown mutagenic activity against other RNA viruses while remaining unaffected by a mutagenic deoxyribonucleoside. Serial cell culture passages of ZIKV in the presence of these compounds resulted in the rapid extinction of infectivity, suggesting elevated sensitivity to mutagenesis. USUV extinction was achieved when a 10-fold dilution was applied between every passage, but not in experiments involving undiluted virus, indicating an overall lower susceptibility than ZIKV. Although the two viruses are inhibited by the same three drugs, ZIKV is relatively more susceptive to serial passage in the presence of purine analogues (favipiravir and ribavirin), while USUV replication is suppressed more efficiently by 5-fluorouracil. These differences in sensitivity typically correlate with the increases in the mutation frequencies observed in each nucleoside treatment. These results are relevant to the development of efficient therapies based on lethal mutagenesis and support the rational selection of different mutagenic nucleosides for each pathogen. We will discuss the implications of these results to the fidelity of flavivirus replication and the design of antiviral therapies based on lethal mutagenesis.

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review.

Nonalcoholic fatty liver disease (NAFLD) has been increasingly diagnosed worldwide and is now recognized as a source of public health concern. It comprises a wide spectrum of histological features that range from simple steatosis to severe forms of fibrosis, steatohepatitis and even cirrhosis. The impact of bariatric surgery on the course of NAFLD in individuals with obesity has been extensively studied. Narrative review; public university hospital. A comprehensive review was conducted based on an online search on the electronic databases MEDLINE and LILACS using the MeSH terms "fatty liver" and "bariatric surgery". The exact mechanisms that lead to improvement in NAFLD following bariatric surgery are not completely understood. Since Roux-en-Y gastric bypass (RYGB) is the bariatric surgical procedure most performed worldwide, it is also the one from which the effects on NAFLD have been most studied, although there is also consistent evidence regarding the effects from gastric banding, sleeve gastrectomy and biliopancreatic diversions. According to the currently available evidence, bariatric surgery leads to significant improvement in NAFLD. Further research, especially by means of randomized controlled trials enrolling larger cohorts of individuals, is needed to determine the optimal procedure for this group of subjects.

Percutaneous penetration of anticancer agents: Past, present and future.

Cancer occurs as a result of alterations in oncogenes, tumor-suppressor genes, and microRNA genes. Over the past few decades, efforts have been made to understand the dominant oncogenes and tumor suppressor genes whose respective activation/upregulation or loss of function serve to impart aberrant properties on normal cells. Cancer continues to be a source of public health concern due to widespread prevalence, morbidity and mortality. The most common types include but are not limited to lung, prostate, colorectal, breast, ovarian and skin cancers. In 2012, there were more than 8 million deaths worldwide related to cancer from 14 million new cases. Cancer chemotherapy frequently requires long periods of multiple intravenous infusions which may compel patients to abandon treatment. One approach to overcome this challenge is through the use of transdermal drug delivery systems. The major obstacle with transdermal drug delivery is that the stratum corneum, which is the outermost layer of the skin, hinders the penetration of therapeutic agents. An avalanche of techniques is available to enhance the penetration of anticancer agents across the skin including iontophoresis, sonophoresis, microneedles, prodrugs, microemulsions and elastic liposomes. In this review, attention is focused on the numerous techniques used to overcome the skin barrier and enhance the percutaneous penetration of anticancer agents.

Shiga-toxin producing Escherichia coli (STEC) and other enterobacteriaceae associated with ready-to-eat salad

Ready-to-eat (RTE) salads sold in Nigeria are poorly delineated sources of human exposure to pathogenic microorganisms. In this study, we investigated the current situation in Benin City, Edo state, Nigeria. Twenty-four samples of RTE salad were obtained from different open markets, and the presence of Shiga toxin-producing Escherichia coli (STEC) and other enterobacteriaceae were determined by established methods using both selective and chromogenic agars. All RTE salad samples were found to habour Escherichia coli while 16.7% were further confirmed for the presence of STEC. Other Enterobacteriaceae present included Klebsiella spp, Proteus spp, Enterobacter spp, Serratia spp and Salmonella spp. The antibiogramic profile revealed that all bacterial isolates obtained were resistant to augmentin and amoxicillin while only 11.1% were resistant to ciprofloxacin and ofloxacin. The percentage resistance for the Shiga-toxin producing strains of E. coli was 60% while Serratia showed resistance to all the antibiotics used. The results of this study showed that RTE salad sold in Benin City, Edo State, Nigeria could be a source of public health concern, and effort should be made to avert possible outbreak.

Improving infection prevention practice in traditional birth attendants in Chongwe District, Zambia

Background: Traditional birth attendants' (TBAs') practice is a source of public health concern due to high rates of infection among women and babies. This study was undertaken in Chongwe district, prompted by an earlier study that revealed poor infection prevention practices among community-based TBAs in Lusaka province. Aims: The study aimed to assess the impact of a modified Ministry of Health TBA training curriculum on the infection-prevention knowledge, practice and attitude of TBAs in Chongwe district. Methods: A six-phased quasi-experimental study design using a structured interview schedule was administered to 238 participants aged between 22–81 years during the needs assessment, and 207 during the intervention stage. Findings: Infection-prevention knowledge levels were generally low during the needs assessment compared to the post-course phase, which showed a statistically significant impact resulting in lower infant and maternal morbidity rates (P = 0.001). Conclusions: The study had three outputs: the training of 207 TBAs, the production of a modified TBA training curriculum, and the creation of a monitoring and evaluation tool with performance indicators to be used in documenting the impact of the varied role of TBAs. Further research is recommended in the form of a randomised controlled trial.

Governing indigenous recreation at a distance: a critical analysis of an after school active health intervention

ABSTRACTWithin the Canadian context, the physical activity levels of children and youth in the after school time period has become a source of public health concern. We argue that this concern is informed by broader public health crises, in particular the ‘global obesity epidemic’ and the closely related ‘global pandemic of physical inactivity', and that these so-called ‘crises’ operate as part of a discursive regime that serves to justify after school interventions aimed at increasing the physical activity practices of children and youth. Although the objectives of such interventions are seemingly well intentioned, we suggest that such interventions nonetheless harbor difficult to discern, but potentially pernicious consequences, for the communities in which they are implemented. We focus our attention on the place-specific effects of one Public Health Agency of Canada-funded after school physical activity intervention – After the School Bell Rings (ASBR) – that was implemented in the mostly Indigenous, northern community of Placid, Manitoba. Based on a critical analysis of the ASBR program itself, along with interviews and focus groups with children, parents and recreation providers (n = 10) from the community of Placid, we contend that the ASBR serves to govern Indigenous recreation at a distance. We argue that when implemented in the place-specific context of Placid, the ASBR functions as part of a broader governmental assemblage composed of loosely connected discourses, institutions, socio-structural conditions and individuals that, when assembled, ultimately serve to govern geographically and culturally distinct communities. We conclude by suggesting that the objectives of broad-based health interventions, such as the goal of increasing after school physical activity levels, should not be universally implemented across diverse locales, but need to account for the diverse, place-specific priorities and needs of the communities into which they are implemented.

Study of the Injured Persons and the Injury Pattern in Road Traffic Accident in Sana’a City, Yemen

Background. Fatal road traffic accidents constitute a significant public health problem. Aim. The aim of the study was to analyze road traffic accidents in Sana’a city, Yemen, during 2013–2015. Methods. The required information and data of accidents were collected, respectively, from police reported road accident statistics, Sana’a city. 11684 cases of road traffic accidents during period 2013–2015 were studied. Results. 840 people were killed and 9760 people were injured in RTAs during 2013–2015 in Sana’a city. The accident rates per 100000 of the population were 234.8 in 2013, 180.3 in 2014, and 92.2 in 2015. Mortality rates per 100000 of the population were 15.17 in 2013, 12.2 in 2014, and 8.9 in 2015. High speed was the single most important factor responsible for accidents, deaths, and injuries accounting for 38.1% of RTAs followed by drivers’ fault accounting for 18.9% of the total RTAs. The most common age group involved was ≥18 years. Males accounted for 83.1% of killed and injured persons. Most frequent victims of road traffic accidents were vehicles motor (48.9%) followed by pedestrians (38.1%). More than half of RTAs occurred on the straight road. Conclusion. RTAs are a major source of public health concern in Sana’a city, Yemen. Preventive measures to reduce the burden of mortality and morbidity due to road accidents should be introduced.

Antibiogram of <i>Escherichia coli</i> and <i>Pseudomonas</i> Strains Isolated from Wastewater Generated by an Abattoir as It Journeys into a Receiving River

Untreated wastewater from abattoir operations contains nutrients and other components that aid the growth of microorganisms especially bacteria. They also serve as a habitat for potentially pathogenic bacteria which might be a source of public health concern. The study was carried out to determine the antibiotics susceptibility profile of Gram-negative bacteria (Pseudomonas and Escherichia coli) to selected antibiotics. Wastewater samples were collected from ten different sampling points and cultured on Eosin Methylene Blue (EMB) and King’s B medium. The bacterial strains obtained from the wastewater samples were subjected to antibiotics susceptibility tests, using the disc diffusion technique. A total of 60 Pseudomonas and 100 Escherichia coli were isolated out of which none of the Pseudomonas strains showed resistance to imipenem, colistin sulphate, meropenem and aztreonam, while 100% resistance was observed to ceftazidime and piperacillin. All the Escherichia coli strains were resistant to oxacillin and ceftazidime, while the percentage resistance to aztreonam, ertapenem, cefoxitin and tetracyline was 6%, 11%, 43% and 58% respectively. Eighty-five percent (85%) of the total Escherichia coli showed resistance to more than two antibiotics, while 14% showed resistance to ceftazidime and oxacillin, with only one isolate showing resistance to ceftazidime and cefoxitin. There is the need for an effective treatment of wastewater generated from abattoir operations to prevent the potential spread and transmission of antibiotic resistant bacteria to the human population who depends heavily on some of the water bodies, receiving input from abattoir wastes.

'Winter mortality, temperature and influenza' Revisiting Curwen and Devis after a quarter of a century

Objectives: to update the still quoted 25-year-old finding that a drop in winter temperature by 1 oC below its mean is associated with 8,000 excess winter deaths in England and Wales. Methods: time-series regression of excess winter deaths between 1950/1 and 2011/12 on mean outside temperature, influenza and pneumonia deaths and a secular trend. Results: we find that a 1 oC decrease in winter temperature below its mean is associated with 5,100 excess winter deaths. Excess winter mortality has been falling on average by approximately 580 deaths per year. Conclusions: Our revised estimates should supersede Curwen and Devis’s in academic and official publications. Notwithstanding there has been some mitigation in the effects of winter temperature on mortality over the last 60 years, excess winter mortality - given its magnitude- should still be a major source of public health concern in England and Wales. Jose IPARRAGUIRRE, Chief Economist, Age UK, London, United Kingdom, and Universidad de Moron, Buenos Aires, Argentina. London, United Kingdom. E-mail: jose.iparraguirre@ageuk.org.uk . James GOODWIN, Head of Research Department in Age UK, London, United Kingdom.